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Dias PB, Messias-Reason I, Hokazono K, Nisihara R. The role of mannose-binding lectin (MBL) in diabetic retinopathy: A scoping review. Immunol Lett 2024; 267:106863. [PMID: 38705482 DOI: 10.1016/j.imlet.2024.106863] [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: 03/18/2024] [Revised: 04/24/2024] [Accepted: 04/30/2024] [Indexed: 05/07/2024]
Abstract
Diabetes mellitus (DM) is a chronic systemic disease characterized by a multifactorial nature, which may lead to several macro and microvascular complications. Diabetic retinopathy (DR) is one of the most severe microvascular complications of DM, which can result in permanent blindness. The mechanisms involved in the pathogenesis of DR are multiple and still poorly understood. Factors such as dysregulation of vascular regeneration, oxidative and hyperosmolar stress in addition to inflammatory processes have been associated with the pathogenesis of DR. Furthermore, compelling evidence shows that components of the immune system, including the complement system, play a relevant role in the development of the disease. Studies suggest that high concentrations of mannose-binding lectin (MBL), an essential component of the complement lectin pathway, may contribute to the development of DR in patients with DM. This review provides an update on the possible role of the complement system, specifically the lectin pathway, in the pathogenesis of DR and discusses the potential of MBL as a non-invasive biomarker for both, the presence and severity of DR, in addition to its potential as a therapeutic target for intervention strategies.
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Affiliation(s)
- Paula Basso Dias
- Clinical Hospital, Federal University of Paraná, Curitiba, Brazil; Department of Ophthalmology, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil
| | | | - Kenzo Hokazono
- Department of Ophthalmology, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil
| | - Renato Nisihara
- Clinical Hospital, Federal University of Paraná, Curitiba, Brazil; Department of Medicine, Positivo University, Curitiba, Brazil.
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Pan X, Tan X, McDonald J, Kaminga AC, Chen Y, Dai F, Qiu J, Zhao K, Peng Y. Chemokines in diabetic eye disease. Diabetol Metab Syndr 2024; 16:115. [PMID: 38790059 PMCID: PMC11127334 DOI: 10.1186/s13098-024-01297-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 02/20/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Diabetic eye disease is a common micro-vascular complication of diabetes and a leading cause of decreased vision and blindness in people of working age worldwide.Although previous studies have shown that chemokines system may be a player in pathogenesis of diabetic eye disease, it is unclear which chemokines play the most important role.To date, there is no meta-analysis which has investigated the role of chemokines in diabetic eye disease.We hope this study will contribute to a better understanding of both the signaling pathways of the chemokines in the pathophysiological process, and more reliable therapeutic targets for diabetic eye disease. METHODS Embase, PubMed, Web of Science and Cochrane Library systematically searched for relevant studies from inception to Sep 1, 2023. A random-effect model was used and standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated to summarize the associated measure between chemokines concentrations and diabetic eye disease. Network meta-analysis to rank chemokines-effect values according to ranked probabilities. RESULTS A total of 33 different chemokines involving 11,465 subjects (6559 cases and 4906 controls) were included in the meta-analysis. Results of the meta-analysis showed that concentrations of CC and CXC chemokines in the diabetic eye disease patients were significantly higher than those in the controls. Moreover, network meta-analysis showed that the effect of CCL8, CCL2, CXCL8 and CXCL10 were ranked highest in terms of probabilities. Concentrations of CCL8, CCL2, CXCL8 and CXCL10 may be associated with diabetic eye disease, especially in diabetic retinopathy and diabetic macular edema. CONCLUSION Our study suggests that CCL2 and CXCL8 may play key roles in pathogenesis of diabetic eye disease. Future research should explore putative mechanisms underlying these links, with the commitment to develop novel prophylactic and therapeutic for diabetic eye disease.
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Affiliation(s)
- Xiongfeng Pan
- Pediatrics Research Institute of Hunan Province, Hunan Children's Hospital, 86 Ziyuan Rd, Changsha, Hunan, People's Republic of China, 410007.
- The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
| | - Xinrui Tan
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Judy McDonald
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada
| | | | - Yuyao Chen
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feizhao Dai
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jun Qiu
- Pediatrics Research Institute of Hunan Province, Hunan Children's Hospital, 86 Ziyuan Rd, Changsha, Hunan, People's Republic of China, 410007
| | - Kunyan Zhao
- School of Public Health, University of South China, Hengyang, China
| | - Yunlong Peng
- Department of Epidemiology and Health Statistics, Medical College of Soochow University, Suzhou, China
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Chen S, Xiao Y, Cui L, Qin X, An Q, Yuan T, Wu Y, Lin Q, Qian Y, Yang C, Zou H. Three-Year Follow-Up Study Investigating Changes in Retinal Vascular Morphology and the Relationship with Diabetic Retinopathy in Children with Type 1 Diabetes Mellitus. Ophthalmic Res 2024; 67:330-339. [PMID: 38679002 DOI: 10.1159/000538797] [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: 10/09/2023] [Accepted: 04/01/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION This study aimed to investigate changes in retinal microvascular morphology and associated factors, and their relationship with diabetic retinopathy (DR) in children with type 1 diabetes mellitus (T1DM). METHODS Thirty-eight children enrolled in this 3-year follow-up study underwent complete ophthalmic examinations including fundus photography. Retinal vascular parameters were measured automatically and compared between baseline and follow-up. Multiple linear regression was used to investigate factors affecting changes in vascular parameters. Binary logistic regression was used to analyze the relationship between retinal microvascular morphology and DR. RESULTS The caliber of all retinal vessels (within 1-1.5 papillary diameter [PD] from the center of the optic disc, p = 0.030; 1.5-2 PD, p = 0.003), arterioles, and venules (1.5-2 PD, p = 0.001) was narrower in nearly all regions in the follow-up group compared with the baseline group. Vascular tortuosity increased in the central part of the retina and decreased in the periphery. The density (1-1.5 PD, p = 0.030) and fractal dimension (p = 0.037) of retinal vessels were increased at the end of the follow-up compared with baseline. Retinal vascular caliber was independently correlated with DR (odds ratio 0.793 [95% confidence interval 0.633-0.993]; p = 0.044). CONCLUSION Retinal microvascular morphology in children with T1DM varied with the disease course. Narrower retinal vessels may be an independent risk factor for DR. Results of this study emphasized the importance of regular follow-up of fundus vascular morphology for the detection of early DR in children with T1DM.
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Affiliation(s)
- Shuli Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,
| | - Ying Xiao
- Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China
| | - Lipu Cui
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinran Qin
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qingyu An
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tianyi Yuan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiwei Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiurong Lin
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yu Qian
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenhao Yang
- Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China
| | - Haidong Zou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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Identification of novel differentially expressed genes in type 1 diabetes mellitus complications using transcriptomic profiling of UAE patients: a multicenter study. Sci Rep 2022; 12:16316. [PMID: 36175575 PMCID: PMC9523055 DOI: 10.1038/s41598-022-18997-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 08/23/2022] [Indexed: 12/01/2022] Open
Abstract
Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder that mainly affects children and young adults. It is associated with debilitating and long-life complications. Therefore, understanding the factors that lead to the onset and development of these complications is crucial. To our knowledge this is the first study that attempts to identify the common differentially expressed genes (DEGs) in T1DM complications using whole transcriptomic profiling in United Arab Emirates (UAE) patients. The present multicenter study was conducted in different hospitals in UAE including University Hospital Sharjah, Dubai Hospital and Rashid Hospital. A total of fifty-eight Emirati participants aged above 18 years and with a BMI < 25 kg/m2 were recruited and forty-five of these participants had a confirmed diagnosis of T1DM. Five groups of complications associated with the latter were identified including hyperlipidemia, neuropathy, ketoacidosis, hypothyroidism and polycystic ovary syndrome (PCOS). A comprehensive whole transcriptomic analysis using NGS was conducted. The outcomes of the study revealed the common DEGs between T1DM without complications and T1DM with different complications. The results revealed seven common candidate DEGs, SPINK9, TRDN, PVRL4, MYO3A, PDLIM1, KIAA1614 and GRP were upregulated in T1DM complications with significant increase in expression of SPINK9 (Fold change: 5.28, 3.79, 5.20, 3.79, 5.20) and MYO3A (Fold change: 4.14, 6.11, 2.60, 4.33, 4.49) in hyperlipidemia, neuropathy, ketoacidosis, hypothyroidism and PCOS, respectively. In addition, functional pathways of ion transport, mineral absorption and cytosolic calcium concentration were involved in regulation of candidate upregulated genes related to neuropathy, ketoacidosis and PCOS, respectively. The findings of this study represent a novel reference warranting further studies to shed light on the causative genetic factors that are involved in the onset and development of T1DM complications.
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Bek T. The risk for developing vision threatening diabetic retinopathy is influenced by heredity to diabetes. Curr Eye Res 2022; 47:1322-1328. [PMID: 35435085 DOI: 10.1080/02713683.2022.2067564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: Clustering of vision threatening diabetic retinopathy within specific families can be the result of similarities in life style but may also be due to a common genetic background. An evaluation of the role of heredity for the development of diabetic retinopathy may help adjusting control intervals in screening programmes to each patient's individual risk profile.Methods: Survival analysis was used to study whether family history of diabetes among men and women with type 1 or type 2 diabetes together with the degree of heredity could be added as risk factors to improve the prediction of the risk for developing proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME). The study was conducted on data from 12,281 patients followed in the Aarhus area, Denmark, from January 1. 2003 to July 1. 2019.Results: The risk for developing PDR was significantly reduced 2-11 years after known onset of diabetes in the presence of female family members with type 1 diabetes, and the risk for developing DME significantly increased 4-24 years after onset of diabetes in the presence of family members with type 2 diabetes of any sex. These hereditary factors were independent of other studied risk factors such as previous cataract surgery, age of onset of diabetes, metabolic regulation and blood pressure.Conclusions: The presence of family members with diabetes affects the risk for developing vision threatening diabetic retinopathy and affects the risk for developing PDR and DME differently. This evidence may help individualizing the control intervals in screening programmes for diabetic retinopathy.
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Affiliation(s)
- Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, DK-8200 Aarhus N, DENMARK
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Jung M, Ahn YS, Chang SJ, Kim CB, Jeong KS, Koh SB, Gim JA. Variation in Genotype and DNA Methylation Patterns Based on Alcohol Use and CVD in the Korean Genome and Epidemiology Study (KoGES). Genes (Basel) 2022; 13:genes13020172. [PMID: 35205218 PMCID: PMC8871634 DOI: 10.3390/genes13020172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/09/2022] [Accepted: 01/14/2022] [Indexed: 12/14/2022] Open
Abstract
Alcohol consumption can increase the risk of chronic diseases, such as myocardial infarction, coronary artery disease, hyperlipidemia, and hypertension. We aimed to assess the association between genotype, DNA methylation patterns, alcohol consumption, and chronic diseases in Korean population. We analyzed 8840 subjects for genotypes and 446 for DNA methylation among the 9351 subjects from the Korean Genome and Epidemiology Study (KoGES). We further divided both groups into two sub-groups according to the presence/absence of chronic diseases. We selected genes whose methylation varied significantly with alcohol consumption, and visualized genotype and DNA methylation patterns specific to each group. Genome-wide association study (GWAS) revealed single nucleotide polymorphisms (SNPs) rs2074356 and rs11066280 in HECT domain E3 ubiquitin protein ligase 4 (HECTD4) to be significantly associated with alcohol consumption in both the presence. The rs12229654 genotype also displayed significantly different patterns with alcohol consumption. Furthermore, we retrieved differentially methylated regions (DMRs) from four groups based on sex and chronic diseases and compared them by drinking status. In genotype analysis, cardiovascular diseases (CVDs) showed a higher proportion in drinker than in non-drinker, but not in DMR analysis. Additionally, we analyzed the enriched Gene Ontology terms and Kyoto Gene and Genome Encyclopedia (KEGG) pathways and visualized the network, heatmap, and upset plot. We show that the pattern of DNA methylation associated with CVD is strongly influenced by alcoholism. Overall, this study identified genetic and epigenetic variants influenced by alcohol consumption and chronic diseases.
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Affiliation(s)
- Myoungjee Jung
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea; (M.J.); (S.-J.C.); (C.-B.K.)
| | - Yeon-Soon Ahn
- Department of Preventive Medicine and Genomic Cohort Institute, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea;
| | - Sei-Jin Chang
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea; (M.J.); (S.-J.C.); (C.-B.K.)
| | - Chun-Bae Kim
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea; (M.J.); (S.-J.C.); (C.-B.K.)
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea;
| | - Sang-Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea; (M.J.); (S.-J.C.); (C.-B.K.)
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea
- Correspondence: (S.-B.K.); (J.-A.G.); Tel.: +82-33-741-0345 (S.-B.K.); +82-2-2626-2362 (J.-A.G.)
| | - Jeong-An Gim
- Medical Science Research Center, College of Medicine, Korea University, 8 Gamasan-ro 20-gil, Guro-gu, Seoul 08308, Korea
- Correspondence: (S.-B.K.); (J.-A.G.); Tel.: +82-33-741-0345 (S.-B.K.); +82-2-2626-2362 (J.-A.G.)
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Sex-specific associations between diabetes mellitus and hearing loss in the middle-aged and elderly: a national cohort study of Chinese adults. Endocr Pract 2022; 28:357-363. [PMID: 35033657 DOI: 10.1016/j.eprac.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/22/2021] [Accepted: 01/03/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To examine the association between diabetes and hearing loss and whether the association varied by sex. METHODS This cohort study based on nationally representative data from the China Health and Retirement Longitudinal Study included 16140 Chinese adults aged over 45 years between 2011 and 2018. Diabetes was identified by blood glucose, HbA1c, and a self-reported diagnosis at baseline. The main outcome is self-reported incident hearing loss. Cox proportional hazards regression models were performed to estimate the risk of hearing loss. RESULTS We documented 2388 cases of hearing loss during a median 6.9 years of follow-up. The incidence rate was 29.64 (95% CI 28.07-31.29) per 1000 person-years in women and 25.23 (95% CI 23.77-26.78) per 1000 person-years in men. After adjustment, the HR of hearing loss associated with diabetes was 1.20 (95% CI 1.01-1.42) for women and 0.97 (95% CI 0.78-1.19) for men. Compared with poor control of blood sugar, the OR for hearing loss for women with good glycemic control was reduced from 5.08 (95%CI 1.31-19.66) to 1.26 (95%CI 0.69-2.28), and the corresponding OR for men was 1.65 (95% CI 0.61-4.44) to 0.50 (95%CI 0.18-1.38). CONCLUSIONS In conclusion, we identified a differential effect of sex on hearing loss risk with more pronounced effects for women. Our data suggest that good blood glucose control is helpful to prevent hearing loss.
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Brodnicki TC. A Role for lncRNAs in Regulating Inflammatory and Autoimmune Responses Underlying Type 1 Diabetes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1363:97-118. [DOI: 10.1007/978-3-030-92034-0_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lin CH, Lo FS, Huang YY, Sun JH, Chen ST, Kuo CF, Hsieh MY, Hsieh SH. Evaluation of Disease Complications Among Adults With Type 1 Diabetes and a Family History of Type 2 Diabetes in Taiwan. JAMA Netw Open 2021; 4:e2138775. [PMID: 34905004 PMCID: PMC8672229 DOI: 10.1001/jamanetworkopen.2021.38775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IMPORTANCE Patients with type 1 diabetes (T1D) and a family history of type 2 diabetes (T2D) appear to be at a high risk of diabetes complications and other cardiovascular diseases. However, estimates of individual risks in patients in Taiwan are largely unavailable or unreliable. OBJECTIVE To evaluate the risk of diabetes complications and major adverse cardiovascular events (MACEs) in patients with T1D with a family history of T2D. DESIGN, SETTING, AND PARTICIPANTS A population-based cohort study used the Taiwan National Health Insurance Research Database. Participants included all individuals registered in that database on December 31, 2017, and followed up since March 1, 1995. The data were analyzed from December 6, 2018, to December 5, 2019. EXPOSURE Patients with T1D and a family history of T2D were evaluated. MAIN OUTCOMES AND MEASURES The prevalence and hazard ratios (HRs) of diabetes complications and other cardiovascular diseases in patients with T1D were analyzed. The MACEs were identified by diagnostic or procedural codes and heritability was formulated by the registry data of beneficiaries. RESULTS Of 27 370 965 individuals included in the database, 11 237 (mean [SD] age, 22.7 [14.4] years; 54% were female) had T1D. The crude prevalence of T1D was 0.04%, with a female to male ratio of 1.22: 1. The adjusted HRs in individuals who had a first-degree relative with T2D were 2.61 (95% CI, 1.32-5.16) for MACEs at an age at diagnosis of less than 20 years. Adjusted HRs were 1.44 (95% CI, 1.27-1.64) for diabetic neuropathy, 1.28 (95% CI, 1.12-1.47) for retinopathy, and 1.24 (95% CI, 1.06-1.47) for neuropathy at all ages of diagnosis. CONCLUSIONS AND RELEVANCE In this study of patients in Taiwan with T1D, having relatives with T2D was associated with an increase in the individual risks of developing diabetes complications. Patients with T1D and a family history of T2D might have more complications and require close management.
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Affiliation(s)
- Chia-Hung Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Fu-Sung Lo
- Division of Pediatric Endocrinology and Genetics, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Yao Huang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jui-Hung Sun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Szu-Tah Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chang-Fu Kuo
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Mei-Yun Hsieh
- Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Sheng-Hwu Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
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Abdissa D, Sorsa R, Gerbi A, Hamba N, Banjaw Z. Magnitude and associated factors of peripheral neuropathy among diabetes patients attending Jimma University Medical Center, Southwest Ethiopia. Heliyon 2021; 7:e08460. [PMID: 34877431 PMCID: PMC8628037 DOI: 10.1016/j.heliyon.2021.e08460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/03/2021] [Accepted: 11/18/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Chronic complications of diabetes (DM) are a major cause of mortality and morbidity. Of these, diabetic peripheral neuropathy (DPN) is the most common. Screening using validated tools for DPN is crucial to prevent consequent complications. One of the useful tools for DPN screening in clinical practice is the Michigan Neuropathy Screening Instrument (MNSI). However, there is limited information on DPN in the study area. Hence, the aim of this study was to assess the prevalence of DPN and its determinants among patients with type one DM (T1DM) attending Jimma University Medical Center (JUMC) from January 2 to March 31, 2020. METHODS An institution based cross-sectional study was conducted and DPN was assessed using MNSI. Data were collected using pretested structured questionnaire and entered into EPI data version 3.1 and exported to SPSS version 20 for analysis. A variable having a p-value of <0.25 in the bivariable logistic regression analysis were subjected to multivariable logistic regression analysis to avoid confounding variable's effect. Adjusted odds ratios (AOR) were calculated at 95% confidence interval (CI) and considered significant with a p-value of ≤0.05 in the final model. RESULTS A total of 217 study participants with T1DM who met inclusion criteria were recruited consecutively during the study period. Their mean age was 43 ± 15.5 years and the overall prevalence of DPN was 37.3% among study participants. The independent predictors of DPN identified by multivariable logistic regression analysis were increasing age [age of 40-49 years (AOR = 3.80; 95% CI: 1.30, 10.60), age of ≥50 years (AOR = 6.50; 95% CI: 2.50, 16.50)], smoking habit [current smoker (AOR = 3.40, 95% CI: 1.20, 9.50; former smoker (AOR = 2.70; 95% CI: 1.60, 6.80)] and comorbid hypertension (AOR = 2.40; 95% CI: 1, 5.40). CONCLUSION The magnitude of DPN among DM patients at JUMC was high. Early detection and appropriate management is vital particularly for these with increasing age, comorbid hypertension and smoking habit.
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Affiliation(s)
- Daba Abdissa
- Department of Biomedical Sciences, College of Medical Sciences, Institute of Health Science, Jimma University, Oromia, Ethiopia
| | - Rebuma Sorsa
- Department of Biomedical Sciences, College of Medical Sciences, Institute of Health Science, Jimma University, Oromia, Ethiopia
| | - Asfaw Gerbi
- Department of Biomedical Sciences, College of Medical Sciences, Institute of Health Science, Jimma University, Oromia, Ethiopia
| | - Nigusse Hamba
- Department of Biomedical Sciences, College of Medical Sciences, Institute of Health Science, Jimma University, Oromia, Ethiopia
| | - Zelalem Banjaw
- Department of Biomedical Sciences, College of Medical Sciences, Institute of Health Science, Jimma University, Oromia, Ethiopia
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Oxidative Stress Genes in Diabetes Mellitus Type 2: Association with Diabetic Kidney Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:2531062. [PMID: 34545296 PMCID: PMC8448992 DOI: 10.1155/2021/2531062] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/21/2021] [Indexed: 12/25/2022]
Abstract
Diabetic type 2 patients compared to nondiabetic patients exhibit an increased risk of developing diabetic kidney disease (DKD), the leading cause of end-stage renal disease. Hyperglycemia, hypertension, oxidative stress (OS), and genetic background are some of the mechanisms and pathways implicated in DKD pathogenesis. However, data on OS pathway susceptibility genes show limited success and conflicting or inconclusive results. Our study is aimed at exploring OS pathway genes and variants which could be associated with DKD. We recruited 121 diabetes mellitus type 2 (DM2) patients with DKD (cases) and 220 DM2, non-DKD patients (control) of Greek origin and performed a case-control association study using genome-wide association data. PLINK and EIGENSOFT were used to analyze the data. Our results indicate 43 single nucleotide polymorphisms with their 21 corresponding genes on the OS pathway possibly contributing or protecting from DKD: SPP1, TPO, TTN, SGO2, NOS3, PDLIM1, CLU, CCS, GPX4, TXNRD2, EPHX2, MTL5, EPX, GPX3, ALOX12, IPCEF1, GSTA, OXR1, GPX6, AOX1, and PRNP. Therefore, a genetic OS background might underlie the complex pathogenesis of DKD in DM2 patients.
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Giandalia A, Giuffrida AE, Gembillo G, Cucinotta D, Squadrito G, Santoro D, Russo GT. Gender Differences in Diabetic Kidney Disease: Focus on Hormonal, Genetic and Clinical Factors. Int J Mol Sci 2021; 22:5808. [PMID: 34071671 PMCID: PMC8198374 DOI: 10.3390/ijms22115808] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 02/07/2023] Open
Abstract
Diabetic kidney disease (DKD) is one of the most serious complications of both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Current guidelines recommend a personalized approach in order to reduce the burden of DM and its complications. Recognizing sex and gender- differences in medicine is considered one of the first steps toward personalized medicine, but the gender issue in DM has been scarcely explored so far. Gender differences have been reported in the incidence and the prevalence of DKD, in its phenotypes and clinical manifestations, as well as in several risk factors, with a different impact in the two genders. Hormonal factors, especially estrogen loss, play a significant role in explaining these differences. Additionally, the impact of sex chromosomes as well as the influence of gene-sex interactions with several susceptibility genes for DKD have been investigated. In spite of the increasing evidence that sex and gender should be included in the evaluation of DKD, several open issues remain uncovered, including the potentially different effects of newly recommended drugs, such as SGLT2i and GLP1Ras. This narrative review explored current evidence on sex/gender differences in DKD, taking into account hormonal, genetic and clinical factors.
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Affiliation(s)
- Annalisa Giandalia
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Alfio Edoardo Giuffrida
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Guido Gembillo
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98125 Messina, Italy
| | - Domenico Cucinotta
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Domenico Santoro
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
| | - Giuseppina T Russo
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
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13
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Piani F, Melena I, Tommerdahl KL, Nokoff N, Nelson RG, Pavkov ME, van Raalte DH, Cherney DZ, Johnson RJ, Nadeau KJ, Bjornstad P. Sex-related differences in diabetic kidney disease: A review on the mechanisms and potential therapeutic implications. J Diabetes Complications 2021; 35:107841. [PMID: 33423908 PMCID: PMC8007279 DOI: 10.1016/j.jdiacomp.2020.107841] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 02/08/2023]
Abstract
Sexual dimorphism may play a key role in the pathogenesis of diabetic kidney disease (DKD) and explain differences observed in disease phenotypes, responses to interventions, and disease progression between men and women with diabetes. Therefore, omitting the consideration of sex as a biological factor may result in delayed diagnoses and suboptimal therapies. This review will summarize the effects of sexual dimorphism on putative metabolic and molecular mechanisms underlying DKD, and the potential implications of these differences on therapeutic interventions. To successfully implement precision medicine, we require a better understanding of sexual dimorphism in the pathophysiologic progression of DKD. Such insights can unveil sex-specific therapeutic targets that have the potential to maximize efficacy while minimizing adverse events.
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Affiliation(s)
- Federica Piani
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Medicine and Surgery Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Isabella Melena
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kalie L Tommerdahl
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Natalie Nokoff
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert G Nelson
- Chronic Kidney Disease Section, Phoenix Epidemiology and Clinical Research Branch, NIDDK, Phoenix, AZ, USA
| | - Meda E Pavkov
- Division of Diabetes Translation, Center for Disease Control and Prevention, Atlanta, GA, USA
| | - Daniël H van Raalte
- Diabetes Center, Department of Internal Medicine, Amsterdam University Medical Center, location VUmc, Amsterdam, the Netherlands
| | - David Z Cherney
- Department of Medicine, Division of Nephrology, University of Toronto School of Medicine, Toronto, Ontario, Canada
| | - Richard J Johnson
- Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Kristen J Nadeau
- Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Petter Bjornstad
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Medicine, Division of Nephrology, University of Colorado School of Medicine, Aurora, CO, USA.
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14
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Martin Martins J, de Pina Jorge M, Martins Maia C, Roque J, Lemos C, Nunes D, Reis D, Mota C. Primary and Secondary Hypogonadism in Male Persons with Diabetes Mellitus. Int J Endocrinol 2021; 2021:8799537. [PMID: 34149839 PMCID: PMC8197670 DOI: 10.1155/2021/8799537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/13/2021] [Accepted: 05/28/2021] [Indexed: 11/17/2022] Open
Abstract
AIMS To characterize hypogonadism in male persons with diabetes mellitus. Patients and Methods. 184 consecutive male persons with diabetes were studied. Besides the usual care, total testosterone (TT), estradiol (E2), FSH, and LH were measured in the last appointment and in 40 patients, also in the next two appointments. Statistical analysis compared groups and explored factors for TT and LH levels. RESULTS TT levels were stable and highly correlated (r > 0.750, p < 0.001) over a 6-12-month period. 20% of the patients presented secondary hypogonadism (SH) and 18% presented primary hypogonadism (PH). SH was inversely related to HbA1 (partial r (rp) = 0.229, p < 0.005), while PH was directly related to age (r = 0.356, p < 0.001). TT levels were reduced independently by metformin (364 ± 160 vs. 431 ± 242 ng/dL, t = 2.241, p < 0.05) and statins (359 ± 156 vs. 424 ± 230 ng/dl, t = 2.224, p < 0.05). TT levels were inversely related to microvascular disease (rp = -0.169, p < 0.05). Discussion. TT levels were stable over time and hypogonadism was common. SH, generally clinically, is related to the diabetic state, while PH, generally subclinically, is an age-dependent process unrelated to diabetes. Low TT levels were related to older age, poor metabolic control, metformin and statins use, and microvascular disease.
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Affiliation(s)
- João Martin Martins
- Endocrine Department, Santa Maria Hospital, Lisbon, Portugal
- Endocrine University Clinic, Lisbon Medical School, Lisbon, Portugal
| | | | - Catarina Martins Maia
- Internal Medicine Department, Jacobi Medical Center and Albert Einstein College of Medicine, New York, NY, USA
| | - João Roque
- Endocrine Department, Santa Maria Hospital, Lisbon, Portugal
| | - Carlos Lemos
- Clinical Pathology Department, Santa Maria Hospital, Lisbon, Portugal
| | - Daniel Nunes
- Clinical Pathology Department, Santa Maria Hospital, Lisbon, Portugal
| | - Dinis Reis
- Endocrine Department, Santa Maria Hospital, Lisbon, Portugal
- Endocrine University Clinic, Lisbon Medical School, Lisbon, Portugal
| | - Catarina Mota
- Internal Medicine Department, Santa Maria Hospital, Lisbon, Portugal
- Internal Medicine University Clinic, Lisbon Medical School, Lisbon, Portugal
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15
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Cole JB, Florez JC. Genetics of diabetes mellitus and diabetes complications. Nat Rev Nephrol 2020; 16:377-390. [PMID: 32398868 DOI: 10.1038/s41581-020-0278-5] [Citation(s) in RCA: 581] [Impact Index Per Article: 145.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2020] [Indexed: 12/12/2022]
Abstract
Diabetes is one of the fastest growing diseases worldwide, projected to affect 693 million adults by 2045. Devastating macrovascular complications (cardiovascular disease) and microvascular complications (such as diabetic kidney disease, diabetic retinopathy and neuropathy) lead to increased mortality, blindness, kidney failure and an overall decreased quality of life in individuals with diabetes. Clinical risk factors and glycaemic control alone cannot predict the development of vascular complications; numerous genetic studies have demonstrated a clear genetic component to both diabetes and its complications. Early research aimed at identifying genetic determinants of diabetes complications relied on familial linkage analysis suited to strong-effect loci, candidate gene studies prone to false positives, and underpowered genome-wide association studies limited by sample size. The explosion of new genomic datasets, both in terms of biobanks and aggregation of worldwide cohorts, has more than doubled the number of genetic discoveries for both diabetes and diabetes complications. We focus herein on genetic discoveries for diabetes and diabetes complications, empowered primarily through genome-wide association studies, and emphasize the gaps in research for taking genomic discovery to the next level.
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Affiliation(s)
- Joanne B Cole
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA.,Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Division of Endocrinology and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, MA, USA
| | - Jose C Florez
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA. .,Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA. .,Department of Medicine, Harvard Medical School, Boston, MA, USA.
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16
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Vujosevic S, Aldington SJ, Silva P, Hernández C, Scanlon P, Peto T, Simó R. Screening for diabetic retinopathy: new perspectives and challenges. Lancet Diabetes Endocrinol 2020; 8:337-347. [PMID: 32113513 DOI: 10.1016/s2213-8587(19)30411-5] [Citation(s) in RCA: 237] [Impact Index Per Article: 59.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 12/15/2022]
Abstract
Although the prevalence of all stages of diabetic retinopathy has been declining since 1980 in populations with improved diabetes control, the crude prevalence of visual impairment and blindness caused by diabetic retinopathy worldwide increased between 1990 and 2015, largely because of the increasing prevalence of type 2 diabetes, particularly in low-income and middle-income countries. Screening for diabetic retinopathy is essential to detect referable cases that need timely full ophthalmic examination and treatment to avoid permanent visual loss. In the past few years, personalised screening intervals that take into account several risk factors have been proposed, with good cost-effectiveness ratios. However, resources for nationwide screening programmes are scarce in many countries. New technologies, such as scanning confocal ophthalmology with ultrawide field imaging and handheld mobile devices, teleophthalmology for remote grading, and artificial intelligence for automated detection and classification of diabetic retinopathy, are changing screening strategies and improving cost-effectiveness. Additionally, emerging evidence suggests that retinal imaging could be useful for identifying individuals at risk of cardiovascular disease or cognitive impairment, which could expand the role of diabetic retinopathy screening beyond the prevention of sight-threatening disease.
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Affiliation(s)
- Stela Vujosevic
- Eye Unit, University Hospital Maggiore della Carità, Novara, Italy
| | - Stephen J Aldington
- Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Paolo Silva
- Beetham Eye Institute, Joslin Diabetes Centre, Harvard Medical School, Boston, MA, USA; Philippine Eye Research Institute, University of the Philippines, Manila, Philippines
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain; Department of Medicine and Endocrinology, Autonomous University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Peter Scanlon
- Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Tunde Peto
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Rafael Simó
- Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Barcelona, Spain; Department of Medicine and Endocrinology, Autonomous University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain.
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17
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Maric-Bilkan C. Sex Differences in Diabetic Kidney Disease. Mayo Clin Proc 2020; 95:587-599. [PMID: 32138885 DOI: 10.1016/j.mayocp.2019.08.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 08/21/2019] [Accepted: 08/30/2019] [Indexed: 12/14/2022]
Abstract
While the global prevalence of both type 1 and type 2 diabetes mellitus is similar in men and women, the consequences of diabetes on associated end-organ complications, including diabetic kidney disease appear to be more sex-specific. Particularly, women with diabetes have higher mortality rates for diabetes-related deaths, and higher prevalence of diabetic kidney disease risk factors such as hypertension, hyperglycemia, obesity, and dyslipidemia. However, the evidence for the impact of sex on diabetic kidney disease prevalence and disease progression is limited and inconsistent. Although most studies agree that the protective effect of the female sex against the development of kidney disease is diminished in the setting of diabetes, the reasons for this observation are unclear. Whether or not sex differences exist in the risk of diabetic kidney disease is also unclear, with studies reporting either higher risk in men, women, or no sex differences. Despite the remaining controversies, some of the factors that associate with sex differences in the risk of diabetic kidney disease are age at onset, and type and duration of diabetes. There is growing appreciation of the importance of sex hormones in the regulation of renal function, with estrogens generally considered to be renoprotective. Although some progress has been made towards better understanding of the mechanisms by which sex hormones play a role in the pathophysiology of diabetic kidney disease, the translational potential of this knowledge is still underappreciated. A better understanding of sex differences in diabetic kidney disease may provide basis for personalized and sex-specific treatment of diabetic kidney disease.
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Affiliation(s)
- Christine Maric-Bilkan
- Division of Kidney, Urology and Hematology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
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18
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Aulich J, Cho YH, Januszewski AS, Craig ME, Selvadurai H, Wiegand S, Jenkins AJ, Donaghue KC. Associations between circulating inflammatory markers, diabetes type and complications in youth. Pediatr Diabetes 2019; 20:1118-1127. [PMID: 31464058 DOI: 10.1111/pedi.12913] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/26/2019] [Accepted: 08/08/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Inflammation is implicated in the pathogenesis of diabetes and its complications in adults. Little is known about the relative contribution of inflammation in common types of diabetes in youth: type 1 diabetes (T1D), type 2 diabetes (T2D), and cystic fibrosis-related diabetes (CFRD). This study investigates inflammatory markers by diabetes type and complication status, and assesses indicators of inflammation and complications. METHODS A cross-sectional study of 134 T1D, 32 T2D, 32 CFRD and 48 subjects without diabetes (including 11 with CF and normal glucose tolerance) was undertaken. Inflammation was assessed by sE-selectin by ELISA, hsCRP by turbidimetry, WCC and ESR. Nephropathy was defined by albuminuria, autonomic neuropathy by heart rate variability, and peripheral neuropathy by vibration and thermal threshold testing and retinopathy by seven-field stereoscopic fundus photography. Descriptive statistics, parametric and non-parametric ANOVA and regression analyses were performed, with significance at P < .05. RESULTS Of 198 diabetic participants; 49% female, mean (SD) age, median diabetes duration and median HbA1c were 16 (2.5) and 6 (3-9) years, and 8.1 (6.9-9.3)%, respectively. All inflammatory markers were lower in T1D than in other diabetes groups (P < .05) but higher than in non-diabetic controls. T2D (n = 32) and CFRD (n = 32) subjects had comparable elevated levels of inflammation. Body mass index (BMI) was a strong independent explanatory variable of inflammation. In multivariate analysis, hsCRP and ESR were associated with complications in addition to HbA1c, BMI, and diastolic BP. CONCLUSIONS Circulating inflammatory markers are elevated in adolescents with diabetes, being higher and comparable in T2D and CFRD than in T1D. Inflammation is independently associated with diabetes complications, consistent with inflammation driving vascular pathology in diabetes.
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Affiliation(s)
- Juliane Aulich
- Department of Paediatrics, Charité Universitätsmedizin Berlin, Berlin, Germany.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Yoon Hi Cho
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | | | - Maria E Craig
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | - Hiran Selvadurai
- The University of Sydney, Sydney, New South Wales, Australia.,Department of Respiratory Medicine, The Children Hospital at Westmead, Sydney, New South Wales, Australia
| | - Susanna Wiegand
- Department of Paediatrics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Alicia J Jenkins
- NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Kim C Donaghue
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
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19
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Liu E, Kaidonis G, McComish BJ, Gillies MC, Abhary S, Essex RW, Chang JH, Pal B, Daniell M, Lake S, Petrovsky N, Hewitt AW, Jenkins A, Lamoureux EL, Gleadle JM, Craig JE, Burdon KP. MicroRNA-Related Genetic Variants Are Associated With Diabetic Retinopathy in Type 1 Diabetes Mellitus. ACTA ACUST UNITED AC 2019; 60:3937-3942. [DOI: 10.1167/iovs.18-25570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Ebony Liu
- Department of Ophthalmology, Flinders University, College of Medicine and Public Health, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Georgia Kaidonis
- Department of Ophthalmology, Flinders University, College of Medicine and Public Health, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Bennet J. McComish
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Mark C. Gillies
- Save Sight Institute, Clinical Ophthalmology and Eye Health, the University of Sydney, Sydney, New South Wales, Australia
| | - Sotoodeh Abhary
- Department of Ophthalmology, Flinders University, College of Medicine and Public Health, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Rohan W. Essex
- Academic Unit of Ophthalmology, Australian National University, Canberra, Australia
| | - John H. Chang
- School of Medical Sciences, University of NSW, Sydney, New South Wales, Australia
- Medical Retina Service, Moorfields Eye Hospital, London, United Kingdom
| | - Bishwanath Pal
- Medical Retina Service, Moorfields Eye Hospital, London, United Kingdom
| | - Mark Daniell
- Department of Ophthalmology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Stewart Lake
- Department of Ophthalmology, Flinders University, College of Medicine and Public Health, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Nikolai Petrovsky
- Department of Endocrinology, Flinders University, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Alex W. Hewitt
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
| | - Alicia Jenkins
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
- St. Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Ecosse L. Lamoureux
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
- Singapore Eye Research Institute, Singapore
- Duke-NUS Medical School, Singapore
| | - Jonathan M. Gleadle
- Renal Medicine, College of Medicine and Public Health, Flinders University, Flinders Medical Centre, Adelaide, South Australia
| | - Jamie E. Craig
- Department of Ophthalmology, Flinders University, College of Medicine and Public Health, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - Kathryn P. Burdon
- Department of Ophthalmology, Flinders University, College of Medicine and Public Health, Flinders Medical Centre, Adelaide, South Australia, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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20
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Simó-Servat O, Hernández C, Simó R. Diabetic Retinopathy in the Context of Patients with Diabetes. Ophthalmic Res 2019; 62:211-217. [DOI: 10.1159/000499541] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/09/2019] [Indexed: 01/05/2023]
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21
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Meng W, Shah KP, Pollack S, Toppila I, Hebert HL, McCarthy MI, Groop L, Ahlqvist E, Lyssenko V, Agardh E, Daniell M, Kaidonis G, Craig JE, Mitchell P, Liew G, Kifley A, Wang JJ, Christiansen MW, Jensen RA, Penman A, Hancock HA, Chen CJ, Correa A, Kuo JZ, Li X, Chen YDI, Rotter JI, Klein R, Klein B, Wong TY, Morris AD, Doney AS, Colhoun HM, Price AL, Burdon KP, Groop PH, Sandholm N, Grassi MA, Sobrin L, Palmer CN. A genome-wide association study suggests new evidence for an association of the NADPH Oxidase 4 (NOX4) gene with severe diabetic retinopathy in type 2 diabetes. Acta Ophthalmol 2018; 96:e811-e819. [PMID: 30178632 PMCID: PMC6263819 DOI: 10.1111/aos.13769] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 03/01/2018] [Indexed: 12/29/2022]
Abstract
Purpose Diabetic retinopathy is the most common eye complication in patients with diabetes. The purpose of this study is to identify genetic factors contributing to severe diabetic retinopathy. Methods A genome‐wide association approach was applied. In the Genetics of Diabetes Audit and Research in Tayside Scotland (GoDARTS) datasets, cases of severe diabetic retinopathy were defined as type 2 diabetic patients who were ever graded as having severe background retinopathy (Level R3) or proliferative retinopathy (Level R4) in at least one eye according to the Scottish Diabetic Retinopathy Grading Scheme or who were once treated by laser photocoagulation. Controls were diabetic individuals whose longitudinal retinopathy screening records were either normal (Level R0) or only with mild background retinopathy (Level R1) in both eyes. Significant Single Nucleotide Polymorphisms (SNPs) were taken forward for meta‐analysis using multiple Caucasian cohorts. Results Five hundred and sixty cases of type 2 diabetes with severe diabetic retinopathy and 4,106 controls were identified in the GoDARTS cohort. We revealed that rs3913535 in the NADPH Oxidase 4 (NOX4) gene reached a p value of 4.05 × 10−9. Two nearby SNPs, rs10765219 and rs11018670 also showed promising p values (p values = 7.41 × 10−8 and 1.23 × 10−8, respectively). In the meta‐analysis using multiple Caucasian cohorts (excluding GoDARTS), rs10765219 and rs11018670 showed associations for diabetic retinopathy (p = 0.003 and 0.007, respectively), while the p value of rs3913535 was not significant (p = 0.429). Conclusion This genome‐wide association study of severe diabetic retinopathy suggests new evidence for the involvement of the NOX4 gene.
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22
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Nomogram for prediction of non-proliferative diabetic retinopathy in juvenile-onset type 1 diabetes: a cohort study in an Asian population. Sci Rep 2018; 8:12164. [PMID: 30111889 PMCID: PMC6093915 DOI: 10.1038/s41598-018-30521-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/01/2018] [Indexed: 12/18/2022] Open
Abstract
The need for screening for retinopathy in patients with type 1 diabetes mellitus (T1DM) has been emphasised, but diagnostic delays were reported when screening was done at fixed intervals. To establish an individualised risk-prediction model to assist screening non-proliferative diabetic retinopathy (NPDR) in T1DM, we performed a retrospective cohort study enrolling participants in the Chang Gung Juvenile Diabetes Eye Study. There were 413 patients with 12 381 records analysed from 2005 to 2015. A time-dependent Cox proportional hazard analysis was used to evaluate the risks of NPDR development and a nomogram with risk-stratification indicators was established based on the results. During 97 months of follow-up, 43 of 413 patients (10.4%) developed NPDR. Male sex (HR: 0.4, 95% CI: 0.19–0.85), age 5–14 years at onset of T1DM (6.38, 2.41–16.87), duration of diabetes (1.57, 1.41–1.75), and hemoglobin A1c level (1.56, 1.35–1.80) were independently associated with NPDR. Using the nomogram offers a quick method in the clinical setting to interpret the risk of NPDR development. Based on its weighting, each of the independent factors is allocated a score, and the total points indicate the probabilities of NPDR occurring within 6 months, 1 year, and 3 years.
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23
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Cardinez N, Lovblom LE, Bai JW, Lewis E, Abraham A, Scarr D, Lovshin JA, Lytvyn Y, Boulet G, Farooqi MA, Orszag A, Weisman A, Keenan HA, Brent MH, Paul N, Bril V, Cherney DZ, Perkins BA. Sex differences in neuropathic pain in longstanding diabetes: Results from the Canadian Study of Longevity in Type 1 Diabetes. J Diabetes Complications 2018; 32:660-664. [PMID: 29929836 DOI: 10.1016/j.jdiacomp.2018.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/28/2018] [Accepted: 05/01/2018] [Indexed: 10/17/2022]
Abstract
AIM Neuropathy and neuropathic pain are common complications of type 1 diabetes (T1D). We aimed to determine if sex-specific differences in neuropathic pain are present in adults with longstanding T1D. METHODS Canadians with ≥50 years of T1D (n = 361) completed health history questionnaires that included assessment of neuropathy (defined by Michigan Neuropathy Screening Instrument questionnaire components ≥3; NEUROPATHYMNSI-Q) and neuropathic pain. Multivariable logistic regression was used to determine sex-differences in neuropathic pain controlling for neuropathy. RESULTS Participants had mean age 66 ± 9 years, median diabetes duration 53[51,58] years, mean HbA1c 7.5 ± 1.0%, and 207(57%) were female. Neuropathic pain was present in 128(36%) of all participants, more prevalent among those with NEUROPATHYMNSI-Q compared to those without [96(63%) vs. 31(15%), p < 0.001], and more prevalent in females compared to males [87(42%) vs. 41(27%), p = 0.003]. Independent of the presence of NEUROPATHYMNSI-Q and other factors, female sex was associated with the presence of neuropathic pain [OR 2.68 (95% CI 1.4-5.0), p = 0.002]. CONCLUSIONS We demonstrated a novel sex-specific difference in neuropathic pain in females compared to males with longstanding T1D, independent of the presence of neuropathy. Further research using more objective measures of neuropathy than the MNSI is justified to further understand this sex-specific difference.
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Affiliation(s)
- Nancy Cardinez
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Leif E Lovblom
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Johnny-Wei Bai
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Evan Lewis
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alon Abraham
- Neuromuscular Diseases Unit of the Department of Neurology, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Scarr
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Julie A Lovshin
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Yuliya Lytvyn
- Division of Nephrology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Genevieve Boulet
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mohammed A Farooqi
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Andrej Orszag
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alanna Weisman
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Hillary A Keenan
- Research Division, Joslin Diabetes Center, Boston, MA, USA; Genzyme Corporation, Cambridge, MA, USA
| | - Michael H Brent
- Department of Ophthalmology and Vision Sciences, Department of Medicine, University of Toronto, Ontario, Canada
| | - Narinder Paul
- Joint Department of Medical Imaging, Division of Cardiothoracic Radiology, University Health Network, Toronto, Ontario, Canada
| | - Vera Bril
- Neuromuscular Diseases Unit of the Department of Neurology, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Z Cherney
- Division of Nephrology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Bruce A Perkins
- Division of Endocrinology and Metabolism, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
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Affiliation(s)
- Anil Kapur
- World Diabetes Foundation, Gentofte, Denmark
| | - Veeraswamy Seshiah
- Distinguished Professor, The Tamil Nadu Dr. M.G.R. Medical University; Diabetes in Pregnancy Study Group; Executive Board International Association of Diabetes & Pregnancy Study Group; Dr. Seshiah & Dr. Balaji Diabetes Care & Research Institute, Chennai 600 029, Tamil Nadu, India
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25
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Sandholm N, Groop PH. Genetic basis of diabetic kidney disease and other diabetic complications. Curr Opin Genet Dev 2018; 50:17-24. [PMID: 29453109 DOI: 10.1016/j.gde.2018.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 01/19/2018] [Accepted: 01/24/2018] [Indexed: 12/21/2022]
Abstract
Diabetic kidney disease and other long-term complications are common in diabetes, and comprise the main cause of co-morbidity and premature mortality in individuals with diabetes. While familial clustering and heritability have been reported for all diabetic complications, the genetic background and the molecular mechanisms remain poorly understood. In recent years, genome-wide association studies have identified a few susceptibility loci for the renal complications as well as for diabetic retinopathy, diabetic cardiovascular disease and mortality. As for many complex diseases, the genetic factors increase the risk of complications in concert with the environment, and certain associations seem specific for particular conditions, for example, SP3-CDCA7 associated with end-stage renal disease only in women, or MGMT and variants on chromosome 5q13 associated with cardiovascular mortality only under tight glycaemic control. The characterization of the phenotypes is one of the main challenges for genetic research on diabetic complications, in addition to an urgent need to increase the number of individuals with diabetes with high quality phenotypic data to be included in future genetic studies.
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Affiliation(s)
- Niina Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, 00290 Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; Research Programs Unit, Diabetes and Obesity, University of Helsinki, 00290 Helsinki, Finland.
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, 00290 Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, 00290 Helsinki, Finland; Research Programs Unit, Diabetes and Obesity, University of Helsinki, 00290 Helsinki, Finland; Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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26
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Mukhopadhyay N, Noble JA, Govil M, Marazita ML, Greenberg DA. Identifying genetic risk loci for diabetic complications and showing evidence for heterogeneity of type 1 diabetes based on complications risk. PLoS One 2018; 13:e0192696. [PMID: 29444168 PMCID: PMC5812614 DOI: 10.1371/journal.pone.0192696] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/29/2018] [Indexed: 12/13/2022] Open
Abstract
There is a growing body of evidence suggesting that type 1 diabetes (T1D) is a genetically heterogeneous disease. However, the extent of this heterogeneity, and what observations may distinguish different forms, is unclear. One indicator may be T1D-related microvascular complications (MVCs), which are familial, but occur in some families, and not others. We tested the hypothesis that T1D plus MVC is genetically distinct from T1D without MCV. We studied 415 families (2,462 individuals, 896 with T1D) using genome-wide linkage analysis, comparing families with and without MVC. We also tested for interaction between identified loci and alleles at the HLA-DRB1 locus. We found significant linkage scores at 1p36.12, 1q32.1, 8q21.3, 12p11.21 and 22q11.21. In all regions except 1p36.12, linkage scores differed between MVC-based phenotype groups, suggesting that families with MVCs express different genetic influences than those without. Our linkage results also suggested gene-gene interaction between the above putative loci and the HLA region; HLA-based strata produced significantly increased linkage scores in some strata, but not others within a phenotype group. We conclude that families with type 1 diabetes plus MVCs are genetically different from those with diabetes alone.
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Affiliation(s)
- Nandita Mukhopadhyay
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- * E-mail:
| | - Janelle A. Noble
- Children’s Hospital Oakland Research Institute, Oakland, California, United States of America
| | - Manika Govil
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Mary L. Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - David A. Greenberg
- Battelle Center for Mathematical Medicine, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Department of Pediatrics, Wexner Medical Center, Ohio State University, Columbus, Ohio, United States of America
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27
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Barbieux P, György B, Gand E, Saulnier PJ, Ducrocq G, Halimi JM, Feigerlova E, Hulin-Delmotte C, Llaty P, Montaigne D, Rigalleau V, Roussel R, Sosner P, Zaoui P, Ragot S, Marre M, Tregouët DA, Hadjadj S. No prognostic role of a GWAS-derived genetic risk score in renal outcomes for patients from French cohorts with type 1 and type 2 diabetes. DIABETES & METABOLISM 2018. [PMID: 29540294 DOI: 10.1016/j.diabet.2018.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- P Barbieux
- Service d'endocrinologie, CHU de Poitiers, 86000 Poitiers, France
| | - B György
- Inserm UMR-S1166, Sorbonne universités, UPMC université Paris 06, 75013, Paris, France; ICAN Institute for Cardiometabolism and Nutrition, 75013 Paris, France
| | - E Gand
- CHU de Poitiers, pôle Dune, 86000 Poitiers, France
| | - P-J Saulnier
- UFR médecine pharmacie, centre d'investigation clinique, université de Poitiers, 86000 Poitiers, France; CHU de Poitiers, centre d'investigation clinique, 86000 Poitiers, France; Inserm, CIC 1402 & U1082, 86000 Poitiers, France
| | - G Ducrocq
- Inserm U698, 75018 Paris, France; Département de cardiologie, groupe hospitalier Bichat Claude-Bernard, Assistance publique-Hôpitaux de Paris (AP-HP), 75018 Paris, France
| | - J-M Halimi
- Service néphrologie, dialyse et transplantation, CHU de Tours, 37000 Tours, France; Inserm, centre d'investigation clinique 0202, 37000 Tours, France
| | - E Feigerlova
- Service d'endocrinologie, CHU de Poitiers, 86000 Poitiers, France; UFR médecine pharmacie, centre d'investigation clinique, université de Poitiers, 86000 Poitiers, France; CHU de Poitiers, centre d'investigation clinique, 86000 Poitiers, France; Inserm, CIC 1402 & U1082, 86000 Poitiers, France
| | | | - P Llaty
- Service de cardiologie, CHU de Poitiers, 86000 Poitiers, France
| | - D Montaigne
- Service d'explorations fonctionnelles cardiovasculaires, CHU de Lille, 59000 Lille, France; Université de Lille, 59000 Lille, France; Inserm, U1011, 59000 Lille, France; EGID, 59000 Lille, France; Institut Pasteur de Lille, 59019 Lille, France
| | - V Rigalleau
- Service endocrinologie, diabétologie maladies métaboliques et nutrition, CHU de Bordeaux, 33604 Pessac cedex, France; Université Victor-Segalen, faculté de médecine, 33000 Bordeaux, France
| | - R Roussel
- UMR_S 1138, centre de recherche des Cordeliers, Sorbonne Paris-Cité, université Paris-Diderot, 75006 Paris, France; Diabetologie endocrinologie nutrition, DHU FIRE, AP-HP, hôpital Bichat, 75018 Paris, France; Inserm UMR-S 1138, centre de recherche des Cordeliers, 75006 Paris, France
| | - P Sosner
- Service de cardiologie, CHU de Poitiers, 86000 Poitiers, France; Complexe médico-sportif Mon Stade, 75013 Paris, France; Laboratoire MOVE (EA 6314), université de Poitiers, 86000 Poitiers, France
| | - P Zaoui
- Service néphrologie, dialyse et transplantation, CHU de Grenoble, 38000 Grenoble, France; Faculté de médecine, université Grenoble Alpes, 38000 Grenoble, France
| | - S Ragot
- UFR médecine pharmacie, centre d'investigation clinique, université de Poitiers, 86000 Poitiers, France; CHU de Poitiers, centre d'investigation clinique, 86000 Poitiers, France; Inserm, CIC 1402 & U1082, 86000 Poitiers, France
| | - M Marre
- UMR_S 1138, centre de recherche des Cordeliers, Sorbonne Paris-Cité, université Paris-Diderot, 75006 Paris, France; Diabetologie endocrinologie nutrition, DHU FIRE, AP-HP, hôpital Bichat, 75018 Paris, France; Inserm UMR-S 1138, centre de recherche des Cordeliers, 75006 Paris, France
| | - D-A Tregouët
- Inserm UMR-S1166, Sorbonne universités, UPMC université Paris 06, 75013, Paris, France; ICAN Institute for Cardiometabolism and Nutrition, 75013 Paris, France
| | - S Hadjadj
- Service d'endocrinologie, CHU de Poitiers, 86000 Poitiers, France; UFR médecine pharmacie, centre d'investigation clinique, université de Poitiers, 86000 Poitiers, France; CHU de Poitiers, centre d'investigation clinique, 86000 Poitiers, France; Inserm, CIC 1402 & U1082, 86000 Poitiers, France; UFR médecine pharmacie, université de Poitiers, 86000 Poitiers, France.
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28
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Hamilton DJ, Gotto AM. Coronary Disease Survival with Diabetes. Cardiology 2017; 139:40-42. [PMID: 29224007 DOI: 10.1159/000484518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Dale J Hamilton
- Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
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29
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Velayutham V, Benitez-Aguirre PZ, Craig ME, Liew G, Wong TY, Jenkins AJ, Donaghue KC. Innovative technology shows impact of glycaemic control on peripheral retinal vessels in adolescents with type 1 diabetes. Diabetologia 2017; 60:2103-2110. [PMID: 28711971 DOI: 10.1007/s00125-017-4375-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/01/2017] [Indexed: 12/21/2022]
Abstract
AIMS/HYPOTHESIS Retinal imaging enables non-invasive microvasculature assessment; however, only central retinal vessels have been studied in type 1 diabetes. Peripheral smaller vessels have a major haemodynamic role and may differ from central vessels in their response to the diabetic milieu. We hypothesise that diabetes has a greater impact on peripheral retinal vessels vs central vessels. METHODS Retinal photographs from adolescents (n = 736; age 12-20 years) with type 1 diabetes were graded (Singapore I Vessel Assessment) with vessel calibres measured in the 'central zone' as central retinal arteriolar and venular equivalents (CRAE and CRVE, respectively) and the 'extended zone' as mean width of arterioles and venules (MWa and MWv, respectively). Multivariable linear regression was used to explore associations between vessel calibres and HbA1c, diabetes duration, sex and BP. RESULTS Mean ± SD age was 14.1 ± 1.5 years, HbA1c was 8.5 ± 1.3% (69.4 ± 14.1 mmol/mol) and median diabetes duration was 4.9 years (interquartile range 3.1-7.6 years). Wider MWa was associated with HbA1c (β 0.01 [95% CI 0.004, 0.03]), longer diabetes duration (0.07 [0.02, 0.13]) and higher systolic BP (0.04 [0.02, 0.05]). MWv was associated with HbA1c (0.02 [0.009, 0.03]) and higher systolic BP (0.04 [0.03, 0.06]). CRAE was associated with longer diabetes duration (0.93 [0.58, 1.28]) and higher systolic BP (-0.28 [-0.37, -0.19]). CRVE was associated with longer diabetes duration (0.91 [0.42, 1.41]) and higher systolic BP (-0.20 [-0.33, -0.07]). Girls had wider vessels (for all four calibre measurements). CONCLUSIONS/INTERPRETATION In adolescents with type 1 diabetes, higher HbA1c is associated with adverse changes to peripheral smaller retinal vessels but not central vessels. The predictive value of retinal vascular imaging should be evaluated using longitudinal data.
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Affiliation(s)
- Valli Velayutham
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Paul Z Benitez-Aguirre
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia
- Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Maria E Craig
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia
- Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
- School of Paediatrics, University of New South Wales, Sydney, NSW, Australia
| | - Gerald Liew
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia
- Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Tien Y Wong
- Department of Ophthalmology, University of Melbourne and Centre for Eye Research, East Melbourne, VIC, Australia
- Singapore Eye Research Institute, Singapore, Republic of Singapore
| | - Alicia J Jenkins
- Singapore Eye Research Institute, Singapore, Republic of Singapore
| | - Kim C Donaghue
- The Children's Hospital at Westmead, 212 Hawkesbury Road, Westmead, NSW, 2145, Australia.
- Singapore Eye Research Institute, Singapore, Republic of Singapore.
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Abstract
PURPOSE OF REVIEW Diabetic complications affecting the kidneys, retina, nerves, and the cardiovasculature are the major causes of morbidity and mortality in diabetes. This paper aims to review the current understanding of the genetic basis of these complications, based on recent findings especially from genome-wide association studies. RECENT FINDINGS Variants in or near AFF3, RGMA-MCTP2, SP3-CDCA7, GLRA3, CNKSR3, and UMOD have reached genome-wide significance (p value <5 × 10-8) for association with diabetic kidney disease, and recently, GRB2 was reported to be associated at genome-wide significance with diabetic retinopathy. While some loci affecting cardiovascular disease in the general population have been replicated in diabetes, GLUL affects the risk of cardiovascular disease specifically in diabetic subjects. Genetic findings are emerging for diabetic complications, although the studies remain relatively small compared to those for type 1 and type 2 diabetes. In addition to pinpointing specific loci, the studies also reveal biological information on correlated traits and pathways.
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Affiliation(s)
- Emma Dahlström
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Haartmaninkatu 8, 00290, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland
| | - Niina Sandholm
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Haartmaninkatu 8, 00290, Helsinki, Finland.
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland.
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31
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Ou HT, Lee TY, Li CY, Wu JS, Sun ZJ. Incidence of diabetes-related complications in Chinese patients with type 1 diabetes: a population-based longitudinal cohort study in Taiwan. BMJ Open 2017; 7:e015117. [PMID: 28637729 PMCID: PMC5791549 DOI: 10.1136/bmjopen-2016-015117] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To estimate the incidence densities and cumulative incidence of diabetes-related complications in patients with type 1 diabetes for a maximum of 15-year follow-up. The estimations were further stratified by gender and age at diagnosis (ie, early onset: 0-12 years, late onset:≥13 years). DESIGN A population-based retrospective longitudinal cohort study. SETTING Taiwan's National Health Insurance medical claims. PARTICIPANTS 4007 patients newly diagnosed with type 1 diabetes were identified during 1999-2012. OUTCOME MEASURES Acute complications included diabetic ketoacidosis (DKA) and hypoglycaemia. Chronic complications were cardiovascular diseases (CVD), retinopathy, neuropathy and nephropathy. RESULTS The incidence density of retinopathy was greatest (97.74 per 1000 person-years), followed by those of nephropathy (31.36), neuropathy (23.93) and CVD (4.39). Among acute complications, the incidence density of DKA was greatest (121.11 per 1000 person-years). The cumulative incidences of acute complications after 12 years following diagnosis were estimated to be 52.1%, 36.1% and 4.1% for DKA, outpatient hypoglycaemia and hospitalised hypoglycaemia, respectively. For chronic complications, the cumulative incidence of retinopathy after 12 years following diagnosis was greatest (65.2%), followed by those of nephropathy (30.2%), neuropathy (23.7%) and CVD (4.1%). Females with late-onset diabetes were greatly affected by advanced retinopathy (ie, sight-threatening diabetic retinopathy) and hospitalised hypoglycaemia, whereas those with early-onset diabetes were more vulnerable to DKA. Chronic complications were more commonly seen in late-onset diabetes, whereas early-onset diabetes were most affected by acute complications. CONCLUSIONS Ethnic Chinese patients with type 1 diabetes were greatly affected by DKA and retinopathy. The incidence of diabetes-related complications differed by age at diagnosis and sex.
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Affiliation(s)
- Huang-Tz Ou
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Tsung-Ying Lee
- Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Jin-Shang Wu
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Zih-Jie Sun
- School of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital, Dou-Liou Branch, Dou-Liou, Taiwan
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32
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Sex differences in micro- and macro-vascular complications of diabetes mellitus. Clin Sci (Lond) 2017; 131:833-846. [PMID: 28424377 DOI: 10.1042/cs20160998] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 12/14/2022]
Abstract
Vascular complications are a leading cause of morbidity and mortality in both men and women with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus, however the prevalence, progression and pathophysiology of both microvascular (nephropathy, neuropathy and retinopathy) and macrovascular [coronary heart disease (CHD), myocardial infarction, peripheral arterial disease (PAD) and stroke] disease are different in the two sexes. In general, men appear to be at a higher risk for diabetic microvascular complications, while the consequences of macrovascular complications may be greater in women. Interestingly, in the absence of diabetes, women have a far lower risk of either micro- or macro-vascular disease compared with men for much of their lifespan. Thus, the presence of diabetes confers greater risk for vascular complications in women compared with men and some of the potential reasons, including contribution of sex hormones and sex-specific risk factors are discussed in this review. There is a growing body of evidence that sex hormones play an important role in the regulation of cardiovascular function. While estrogens are generally considered to be cardioprotective and androgens detrimental to cardiovascular health, recent findings challenge these assumptions and demonstrate diversity and complexity of sex hormone action on target tissues, especially in the setting of diabetes. While some progress has been made toward understanding the underlying mechanisms of sex differences in the pathophysiology of diabetic vascular complications, many questions and controversies remain. Future research leading to understanding of these mechanisms may contribute to personalized- and sex-specific treatment for diabetic micro- and macro-vascular disease.
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Siokas V, Dardiotis E, Sokolakis T, Kotoula M, Tachmitzi SV, Chatzoulis DZ, Almpanidou P, Stefanidis I, Hadjigeorgiou GM, Tsironi EE. Plasminogen Activator Inhibitor Type-1 Tag Single-Nucleotide Polymorphisms in Patients with Diabetes Mellitus Type 2 and Diabetic Retinopathy. Curr Eye Res 2017. [DOI: 10.1080/02713683.2016.1276197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Thomas Sokolakis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Maria Kotoula
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Sophia V. Tachmitzi
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Dimitrios Z. Chatzoulis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Pavlina Almpanidou
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Ioannis Stefanidis
- Department of Nephrology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Georgios M. Hadjigeorgiou
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece
| | - Evangelia E. Tsironi
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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Shen Y, Cai R, Sun J, Dong X, Huang R, Tian S, Wang S. Diabetes mellitus as a risk factor for incident chronic kidney disease and end-stage renal disease in women compared with men: a systematic review and meta-analysis. Endocrine 2017; 55:66-76. [PMID: 27477292 DOI: 10.1007/s12020-016-1014-6] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/02/2016] [Indexed: 01/11/2023]
Abstract
Diabetes mellitus is a strong risk factor for chronic kidney disease and end-stage renal disease. Whether sex differences in chronic kidney disease and end-stage renal disease incidence exist among diabetic patients remains unclear. This systematic review and meta-analysis was conducted to evaluate the relative effect of diabetes on chronic kidney disease and end-stage renal disease risk in women compared with men. We systematically searched Embase, PubMed, and the Cochrane Library for both cohort and case-control studies until October 2015. Studies were selected if they reported a sex-specific relationship between diabetes mellitus and chronic kidney disease or end-stage renal disease. We generated pooled estimates across studies using random-effects meta-analysis after log transformation with inverse variance weighting. Ten studies with data from more than 5 million participants were included. The pooled adjusted risk ratio of chronic kidney disease associated with diabetes mellitus was 3.34 (95 % CI 2.27, 4.93) in women and 2.84 (95 % CI 1.73, 4.68) in men. The data showed no difference in diabetes-related chronic kidney disease risk between the sexes (pooled adjusted women-to-men relative risk ratio was 1.14 [95 % CI 0.97, 1.34]) except for end-stage renal disease-the pooled adjusted women-to men relative risk ratio was 1.38 (95 % CI 1.22, 1.55; p = 0.114, I² = 38.1 %). The study found no evidence of a sex difference in the association between diabetes mellitus and chronic kidney disease. However, the excess risk for end-stage renal disease was higher in women with diabetes than in men with the same condition, from which we assume that the female gender could accelerate the disease progression. Further studies are needed to support this notion and elucidate the underlying mechanisms.
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Affiliation(s)
- Yanjue Shen
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
- Medical School of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
| | - Rongrong Cai
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
- Medical School of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
| | - Jie Sun
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
- Medical School of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
| | - Xue Dong
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
- Medical School of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
| | - Rong Huang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
- Medical School of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
| | - Sai Tian
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
- Medical School of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China
| | - Shaohua Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87, DingJiaQiao Road, Nanjing, 210009, China.
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Zheng B, Chen L, Gonzalez FJ. ISN Forefronts Symposium 2015: Nuclear Receptors and Diabetic Nephropathy. Kidney Int Rep 2016; 1:177-188. [PMID: 28932823 PMCID: PMC5601313 DOI: 10.1016/j.ekir.2016.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 01/19/2023] Open
Abstract
Diabetic nephropathy (DN) is the major reason for end stage renal disease in the western world. Patients with DN developed more severe cardiovascular complications with worse prognosis. In spite of tight blood pressure and glucose control through applying angiotensin II receptor antagonism, angiotensin receptor inhibitors and even direct renin inhibitors, the progression and development of DN has continued to accelerate. Nuclear receptors are, with few exceptions, ligand-depended transcription factors some of which modulate genes involved in the transportation and metabolism of carbohydrate or lipid, and inflammation. Considering the diverse biological functions of nuclear receptors, efforts have been made to explore their contributions to the pathogenesis of DN and potential therapeutic strategies. This review is mainly focused on the association between various nuclear receptors and the pathogenesis of DN, the potential beneficial effects of targeting these receptors for preventing the progress of DN, and the important role that nuclear receptors may play in future therapeutic strategies for DN.
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Affiliation(s)
- Bo Zheng
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute, Second Military Medical University, Shanghai, China
- National Center for Liver Cancer, Shanghai, China
| | - Lei Chen
- International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Institute, Second Military Medical University, Shanghai, China
- National Center for Liver Cancer, Shanghai, China
- Laboratory of Metabolism, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Frank J. Gonzalez
- Laboratory of Metabolism, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Goldberg I, Krause I. The Role of Gender in Chronic Kidney Disease. EUROPEAN MEDICAL JOURNAL 2016. [DOI: 10.33590/emj/10312319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Chronic kidney disease (CKD) is a common disease worldwide and is associated with high rates of morbidity and mortality. This review discusses several aspects of the relationship between gender and CKD. While the prevalence of CKD tends to be higher in women, the disease is more severe in men, who also have a higher prevalence of end-stage renal disease. Most of the evidence in the current literature suggests a higher progression rate and mortality risk of CKD in men compared with women, except in post-menopausal women and diabetic patients. However, the decrease in glomerular filtration rate and the increase in the level of albuminuria are more prominent mortality risk factors among women. Sex hormones are thought to play a major role in the biological mechanisms associated with variability in CKD prevalence and characteristics between men and women. Animal studies have demonstrated the harmful influence of testosterone and protective influence of oestrogen on several biological processes that are involved in kidney injury. However, the role of sex hormones in explaining gender-related differences in CKD in humans has not yet been established. In summary, gender has an important influence on several aspects of CKD. Further research is needed to find additional gender-related characteristics in CKD and to identify the mechanisms of sexual dimorphism in CKD.
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Affiliation(s)
- Idan Goldberg
- Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - Ilan Krause
- Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
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Tsai WC, Wu HY, Peng YS, Ko MJ, Wu MS, Hung KY, Wu KD, Chu TS, Chien KL. Risk Factors for Development and Progression of Chronic Kidney Disease: A Systematic Review and Exploratory Meta-Analysis. Medicine (Baltimore) 2016; 95:e3013. [PMID: 26986114 PMCID: PMC4839895 DOI: 10.1097/md.0000000000003013] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The risk factors influencing the natural course of chronic kidney disease (CKD) are complex and heterogeneous, and few systematic reviews to date have focused on this issue. The aim of the study is to identify the risk factors for disease development and progression in each stage of CKD. We conducted electronic literature searches of PubMed, MEDLINE, Scopus, and the Cochrane Library up to October 15, 2012, for observational studies evaluating the risk factors on the development or progression of CKD. Eligible studies should have collected repeated information that could evaluate changes in renal function. Extracted information from all the included studies was synthesized narratively. Quality assessments were performed using the Newcastle-Ottawa Scale. An exploratory random-effects meta-analysis was performed where feasible to pool effect sizes across studies for a specific risk factor in a specific outcome. We identified 38 cohort studies and 2 case-control studies from 40 articles, with a total of 318,898 participants from 14 countries. The follow-up duration ranged from 1.5 to 16 years. The majority of the included studies were of high quality. The baseline CKD stages of the included studies ranged from normal to later stages, and only 19 studies could be classified into a specific range of CKD stages during follow-up. Three risk factors from studies of the same baseline and follow-up CKD stages were eligible for the exploratory meta-analysis, including male sex, substantial proteinuria, and diabetes. The hazard ratios for the progression from CKD stages 3-5 to end-stage renal disease (ESRD) were 1.37 (95% confidence interval 1.17-1.62), 1.64 (1.01-2.66), and 1.16 (0.98-1.38) for male sex, substantial proteinuria, and diabetes, respectively. In conclusion, our analyses comprehensively summarize the initiating and perpetuating factors for CKD. Male sex and substantial proteinuria are significant perpetuating factors for the progression from late stage CKD to ESRD, and diabetes may play a minor role for the outcome of ESRD among patients with later stages of CKD.
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Affiliation(s)
- Wan-Chuan Tsai
- From the Department of Internal Medicine (W-CT, H-YW, Y-SP), Far Eastern Memorial Hospital, New Taipei City; Institute of Epidemiology and Preventive Medicine (W-CT, H-YW, K-LC), College of Public Health, National Taiwan University; Department of Internal Medicine (H-YW, Y-SP, M-SW, K-YH, K-DW, T-SC, K-LC); Department of Dermatology (M-JK), National Taiwan University Hospital and College of Medicine; and Department of Dermatology (M-JK), Taipei City Hospital, Taipei, Taiwan
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Geloneck MM, Forbes BJ, Shaffer J, Ying GS, Binenbaum G. Ocular Complications in Children with Diabetes Mellitus. Ophthalmology 2015; 122:2457-64. [PMID: 26341461 PMCID: PMC4769865 DOI: 10.1016/j.ophtha.2015.07.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 07/07/2015] [Accepted: 07/07/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The effectiveness of annual eye examinations in diabetic children is unclear. We sought to determine the prevalence and onset of ocular pathology in children with diabetes mellitus (DM), identify risk factors for ocular disease, and recommend a screening regimen for asymptomatic children. DESIGN Retrospective, consecutive cohort study. PARTICIPANTS Children aged less than 18 years with type 1 or 2 DM examined over a 4-year period. METHODS All children underwent a complete eye examination, including dilated fundoscopy and cycloplegic refraction. A literature review was performed, identifying the youngest reported age and shortest reported duration of DM before the diagnosis of diabetic retinopathy (DR). MAIN OUTCOME MEASURES Prevalence of DR, cataract, high refractive error, and strabismus. RESULTS A total of 370 children (mean age, 11.2 years; range, 1-17.5 years) had 693 examinations, with a mean DM duration of 5.2 years (range, 0.1-16.2 years) and a mean hemoglobin A1c (HbA1c) of 8.6 (range, 5-≥14). No children had DR. A total of 12 children had cataract; 5 required extraction but were identified by decreased vision, not diabetic screening. A total of 19 children had strabismus; only 1 was microvascular paralytic strabismus. A total of 41 children had high refractive error. There were no associations between these conditions and duration or control of DM. In the literature, the youngest age at diagnosis of severe DR was 15 years, and the shortest duration of disease was 5 years. CONCLUSIONS Diabetic retinopathy is rare in children regardless of duration and control of DM. On the basis of our study and literature review, screening examinations for type 1 diabetes could begin at age 15 years or at 5 years after the diagnosis of DM, whichever occurs later, unless the child is judged by the endocrinologist as being at unusually high risk. Other ocular complications are identifiable through existing amblyopia screening methods.
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Affiliation(s)
- Megan M Geloneck
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Brian J Forbes
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - James Shaffer
- Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gui-shuang Ying
- Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gil Binenbaum
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
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Burdon KP, Fogarty RD, Shen W, Abhary S, Kaidonis G, Appukuttan B, Hewitt AW, Sharma S, Daniell M, Essex RW, Chang JH, Klebe S, Lake SR, Pal B, Jenkins A, Govindarjan G, Sundaresan P, Lamoureux EL, Ramasamy K, Pefkianaki M, Hykin PG, Petrovsky N, Brown MA, Gillies MC, Craig JE. Genome-wide association study for sight-threatening diabetic retinopathy reveals association with genetic variation near the GRB2 gene. Diabetologia 2015; 58:2288-97. [PMID: 26188370 DOI: 10.1007/s00125-015-3697-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
Abstract
AIMS/HYPOTHESIS Diabetic retinopathy is a serious complication of diabetes mellitus and can lead to blindness. A genetic component, in addition to traditional risk factors, has been well described although strong genetic factors have not yet been identified. Here, we aimed to identify novel genetic risk factors for sight-threatening diabetic retinopathy using a genome-wide association study. METHODS Retinopathy was assessed in white Australians with type 2 diabetes mellitus. Genome-wide association analysis was conducted for comparison of cases of sight-threatening diabetic retinopathy (n = 336) with diabetic controls with no retinopathy (n = 508). Top ranking single nucleotide polymorphisms were typed in a type 2 diabetes replication cohort, a type 1 diabetes cohort and an Indian type 2 cohort. A mouse model of proliferative retinopathy was used to assess differential expression of the nearby candidate gene GRB2 by immunohistochemistry and quantitative western blot. RESULTS The top ranked variant was rs3805931 with p = 2.66 × 10(-7), but no association was found in the replication cohort. Only rs9896052 (p = 6.55 × 10(-5)) was associated with sight-threatening diabetic retinopathy in both the type 2 (p = 0.035) and the type 1 (p = 0.041) replication cohorts, as well as in the Indian cohort (p = 0.016). The study-wide meta-analysis reached genome-wide significance (p = 4.15 × 10(-8)). The GRB2 gene is located downstream of this variant and a mouse model of retinopathy showed increased GRB2 expression in the retina. CONCLUSIONS/INTERPRETATION Genetic variation near GRB2 on chromosome 17q25.1 is associated with sight-threatening diabetic retinopathy. Several genes in this region are promising candidates and in particular GRB2 is upregulated during retinal stress and neovascularisation.
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Affiliation(s)
- Kathryn P Burdon
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
- Menzies Institute for Medical Research, University of Tasmania, Private bag 23, Hobart, TAS, 7000, Australia.
| | - Rhys D Fogarty
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Weiyong Shen
- Save Sight Institute, Clinical Ophthalmology and Eye Health, The University of Sydney, Sydney, NSW, Australia
| | - Sotoodeh Abhary
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Georgia Kaidonis
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Binoy Appukuttan
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, VIC, Australia
| | - Shiwani Sharma
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Mark Daniell
- Department of Ophthalmology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Rohan W Essex
- Academic Unit of Ophthalmology, Australian National University, Canberra, ACT, Australia
| | - John H Chang
- School of Medical Sciences, University of NSW, Sydney, NSW, Australia
- Medical Retina Service, Moorfields Eye Hospital, London, UK
| | - Sonja Klebe
- Department of Anatomical Pathology, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Stewart R Lake
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia
| | - Bishwanath Pal
- Medical Retina Service, Moorfields Eye Hospital, London, UK
| | | | - Gowthaman Govindarjan
- Department of Genetics, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
| | - Periasamy Sundaresan
- Department of Genetics, Aravind Medical Research Foundation, Madurai, Tamil Nadu, India
| | - Ecosse L Lamoureux
- Centre for Eye Research Australia, University of Melbourne, East Melbourne, VIC, Australia
- Department of Population Health, Singapore Eye Research Institute, Singapore, Singapore
| | - Kim Ramasamy
- Retina Clinic, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | | | - Philip G Hykin
- Medical Retina Service, Moorfields Eye Hospital, London, UK
| | - Nikolai Petrovsky
- Department of Endocrinology, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Matthew A Brown
- Diamantina Institute, The University of Queensland, Translational Research Institute Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Mark C Gillies
- Save Sight Institute, Clinical Ophthalmology and Eye Health, The University of Sydney, Sydney, NSW, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia.
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Simó R, Hernández C. Novel approaches for treating diabetic retinopathy based on recent pathogenic evidence. Prog Retin Eye Res 2015; 48:160-80. [PMID: 25936649 DOI: 10.1016/j.preteyeres.2015.04.003] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/13/2015] [Accepted: 04/21/2015] [Indexed: 12/15/2022]
Abstract
Diabetic retinopathy remains as a leading cause of blindness in developed countries. Current treatments target late stages of DR when vision has already been significantly affected. A better understanding of the pathogenesis of DR would permit the development of more efficient preventional/interventional strategies against early stages of DR. In this article a critical review of the state of the art of this issue is provided along with a discussion of problems which have yet to be overcome. Neuroprotection as a new approach for the treatment of the early stages of DR has been particularly emphasized. The development and progression of DR is not homogeneous and, apart from blood glucose levels and blood pressure, it depends on genetic factors which remain to be elucidated. In addition, the role of the pathogenic pathways is not the same in all patients. All these factors should be taken into account in the near future when an individualized oriented treatment for DR could become feasible. The new techniques in retinal imaging acquisition, the identification of useful circulating biomarkers and the individualized analysis of biological samples could facilitate the development of early and personalized therapy in the setting of DR. Finally, it should be noted that only a coordinated action among ophthalmologists, diabetologists, basic researchers, experts in pharmaco-economics and health care providers addressed to the design of rational strategies targeting prevention and the early stages of DR will be effective in reducing the burden and improving the clinical outcome of this devastating complication of diabetes.
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Affiliation(s)
- Rafael Simó
- CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas) and Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, 08035 Barcelona, Spain.
| | - Cristina Hernández
- CIBERDEM (CIBER de Diabetes y Enfermedades Metabólicas Asociadas) and Diabetes and Metabolism Research Unit, Vall Hebron Institut de Recerca (VHIR), Universitat Autónoma de Barcelona, 08035 Barcelona, Spain.
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Lipner EM, Tomer Y, Noble JA, Monti MC, Lonsdale JT, Corso B, Greenberg DA. Linkage Analysis of Genomic Regions Contributing to the Expression of Type 1 Diabetes Microvascular Complications and Interaction with HLA. J Diabetes Res 2015; 2015:694107. [PMID: 26539552 PMCID: PMC4619952 DOI: 10.1155/2015/694107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 01/29/2015] [Accepted: 02/08/2015] [Indexed: 01/14/2023] Open
Abstract
We conducted linkage analysis to follow up earlier work on microvascular complications of type 1 diabetes (T1D). We analyzed 415 families (2,008 individuals) previously genotyped for 402 SNP markers spanning chromosome 6. We did linkage analysis for the phenotypes of retinopathy and nephropathy. For retinopathy, two linkage peaks were mapped: one located at the HLA region and another novel locus telomeric to HLA. For nephropathy, a linkage peak centromeric to HLA was mapped, but the linkage peak telomeric to HLA seen in retinopathy was absent. Because of the strong association of T1D with DRB1*03:01 and DRB1*04:01, we stratified our analyses based on families whose probands were positive for DRB1*03:01 or DRB1*04:01. When analyzing the DRB1*03:01-positive retinopathy families, in addition to the novel telomeric locus, one centromeric to HLA was identified at the same location as the nephropathy peak. When we stratified on DRB1*04:01-positive families, the HLA telomeric peak strengthened but the centromeric peak disappeared. Our findings showed that HLA and non-HLA loci on chromosome 6 are involved in T1D complications' expression. While the HLA region is a major contributor to the expression of T1D, our results suggest an interaction between specific HLA alleles and other loci that influence complications' expression.
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Affiliation(s)
- Ettie M. Lipner
- Integrated Center for Genes, Environment and Health, National Jewish Health, Denver, CO 80206, USA
- Department of Pharmacology, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA
| | - Yaron Tomer
- Department of Medicine, Mount Sinai Medical Center, New York, NY 10013, USA
| | - Janelle A. Noble
- Children's Hospital Oakland Research Institute, Oakland, CA 94702, USA
| | - Maria C. Monti
- National Research Council, Neuroscience Institute, 35128 Padova, Italy
| | - John T. Lonsdale
- National Disease Research Interchange, Philadelphia, PA 19103, USA
| | - Barbara Corso
- National Research Council, Neuroscience Institute, 35128 Padova, Italy
| | - David A. Greenberg
- Battelle Center for Mathematical Medicine, Nationwide Children's Hospital, Columbus, OH 43215, USA
- Department of Pediatrics, Wexner Medical Center, Ohio State University, Columbus, OH 43205, USA
- *David A. Greenberg:
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Awata T, Yamashita H, Kurihara S, Morita-Ohkubo T, Miyashita Y, Katayama S, Mori K, Yoneya S, Kohda M, Okazaki Y, Maruyama T, Shimada A, Yasuda K, Nishida N, Tokunaga K, Koike A. A genome-wide association study for diabetic retinopathy in a Japanese population: potential association with a long intergenic non-coding RNA. PLoS One 2014; 9:e111715. [PMID: 25364816 PMCID: PMC4218806 DOI: 10.1371/journal.pone.0111715] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/30/2014] [Indexed: 12/31/2022] Open
Abstract
Elucidation of the genetic susceptibility factors for diabetic retinopathy (DR) is important to gain insight into the pathogenesis of DR, and may help to define genetic risk factors for this condition. In the present study, we conducted a three-stage genome-wide association study (GWAS) to identify DR susceptibility loci in Japanese patients, which comprised a total of 837 type 2 diabetes patients with DR (cases) and 1,149 without DR (controls). From the stage 1 genome-wide scan of 446 subjects (205 cases and 241 controls) on 614,216 SNPs, 249 SNPs were selected for the stage 2 replication in 623 subjects (335 cases and 288 controls). Eight SNPs were further followed up in a stage 3 study of 297 cases and 620 controls. The top signal from the present association analysis was rs9362054 in an intron of RP1-90L14.1 showing borderline genome-wide significance (Pmet = 1.4×10−7, meta-analysis of stage 1 and stage 2, allele model). RP1-90L14.1 is a long intergenic non-coding RNA (lincRNA) adjacent to KIAA1009/QN1/CEP162 gene; CEP162 plays a critical role in ciliary transition zone formation before ciliogenesis. The present study raises the possibility that the dysregulation of ciliary-associated genes plays a role in susceptibility to DR.
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Affiliation(s)
- Takuya Awata
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
- * E-mail:
| | - Hisakuni Yamashita
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Susumu Kurihara
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Tomoko Morita-Ohkubo
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yumi Miyashita
- Division of RI Laboratory, Biomedical Research Center, Saitama Medical University, Saitama, Japan
| | - Shigehiro Katayama
- Department of Endocrinology and Diabetes, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Keisuke Mori
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Faculty of Medicine, Saitama, Japan
| | - Shin Yoneya
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Faculty of Medicine, Saitama, Japan
| | - Masakazu Kohda
- Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Yasushi Okazaki
- Division of Translational Research, Research Center for Genomic Medicine, Saitama Medical University, Saitama, Japan
| | - Taro Maruyama
- Department of Internal Medicine, Saitama Social Insurance Hospital, Saitama, Japan
| | - Akira Shimada
- Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan
| | - Kazuki Yasuda
- Department of Metabolic Disorder, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nao Nishida
- Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsushi Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Asako Koike
- Central Research Laboratory, Hitachi Ltd, Tokyo, Japan
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Affiliation(s)
- Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai, China
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Wang H, Cheng JW, Zhu LS, Wei RL, Cai JP, Li Y, Ma XY. Meta-analysis of association between the -2578C/A polymorphism of the vascular endothelial growth factor and retinopathy in type 2 diabetes in Asians and Caucasians. Ophthalmic Res 2014; 52:1-8. [PMID: 24751925 DOI: 10.1159/000357110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 10/31/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Vascular endothelial growth factor (VEGF) has been shown to play an important role in the development and progress of diabetic retinopathy (DR). A number of case-control studies focused on the association between VEGF -2578C/A and risk for DR. But the results were not always consistent, so we performed a meta-analysis to evaluate the precise association between this variant and risk for DR. METHODS All publications on the association between VEGF -2578C/A polymorphism and DR were searched in the following electronic databases: PubMed, Embase, the Cochrane Library and Chinese Biomedical Literature Database, with the last report up to January 2013. This meta-analysis was assessed by Review Manager 5.1. RESULTS A total of 6 studies were involved in this meta-analysis, including 835 cases and 867 controls. Overall, we found a significant association between this polymorphism and DR (A vs. C: OR=1.49, 95% CI=1.26-1.77, p<0.00001; AA vs. CA+CC: OR=1.26, 95% CI=0.94-1.68, p=0.12; AA+CA vs. CC: OR=1.56, 95% CI=1.27-1.91, p<0.00001; AA vs. CC: OR=1.67, 95% CI=1.20-2.32, p=0.003; CA vs. CC: OR=1.51, 95% CI=1.21-1.87, p=0.0002), but we did not find any significant association in Caucasians in subgroup analysis. The results were not materially altered after the studies which did not fulfill the Hardy-Weinberg equilibrium were excluded. CONCLUSION Our meta-analysis supports the association between the VEGF -2578C/A polymorphism and DR, but not in the Caucasian population.
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Affiliation(s)
- Hao Wang
- Department of Ophthalmology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China
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Brell JM. Animal Models of Peripheral Neuropathy: Modeling What We Feel, Understanding What They Feel. ILAR J 2014; 54:253-8. [DOI: 10.1093/ilar/ilt056] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Kajiwara A, Miyagawa H, Saruwatari J, Kita A, Sakata M, Kawata Y, Oniki K, Yoshida A, Jinnouchi H, Nakagawa K. Gender differences in the incidence and progression of diabetic retinopathy among Japanese patients with type 2 diabetes mellitus: a clinic-based retrospective longitudinal study. Diabetes Res Clin Pract 2014; 103:e7-10. [PMID: 24503044 DOI: 10.1016/j.diabres.2013.12.043] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 12/28/2013] [Indexed: 12/21/2022]
Abstract
A clinic-based retrospective longitudinal study conducted for 5.8 ± 2.5 years, including 383 (M/F 245/138) Japanese patients with type 2 diabetes mellitus showed that females exhibit a significantly higher prevalence of proliferative diabetic retinopathy (DR) at baseline and that female gender is an independent risk factor for the development of DR.
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Affiliation(s)
- A Kajiwara
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - H Miyagawa
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - J Saruwatari
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - A Kita
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - M Sakata
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Kawata
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - K Oniki
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - A Yoshida
- Jinnouchi Clinic, Diabetes Care Center, Kumamoto, Japan
| | - H Jinnouchi
- Jinnouchi Clinic, Diabetes Care Center, Kumamoto, Japan
| | - K Nakagawa
- Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan; Center for Clinical Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
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48
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Simó-Servat O, Hernández C, Simó R. Genetics in diabetic retinopathy: current concepts and new insights. Curr Genomics 2014; 14:289-99. [PMID: 24403848 PMCID: PMC3763680 DOI: 10.2174/13892029113149990008] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 06/25/2013] [Accepted: 06/25/2013] [Indexed: 01/05/2023] Open
Abstract
There is emerging evidence which indicates the essential role of genetic factors in the development of diabetic retinopathy (DR). In this regard it should be highlighted that genetic factors account for 25-50% of the risk of developing DR. Therefore, the use of genetic analysis to identify those diabetic patients most prone to developing DR might be useful in designing a more individualized treatment. In this regard, there are three main research strategies: candidate gene studies, linkage studies and Genome-Wide Association Studies (GWAS). In the candidate gene approach, several genes encoding proteins closely related to DR development have been analyzed. The linkage studies analyze shared alleles among family members with DR under the assumption that these predispose to a more aggressive development of DR. Finally, Genome-Wide Association Studies (GWAS) are a new tool involving a massive evaluation of single nucleotide polymorphisms (SNP) in large samples. In this review the available information using these three methodologies is critically analyzed. A genetic approach in order to identify new candidates in the pathogenesis of DR would permit us to design more targeted therapeutic strategies in order to decrease this devastating complication of diabetes. Basic researchers, ophthalmologists, diabetologists and geneticists should work together in order to gain new insights into this issue.
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Affiliation(s)
- Olga Simó-Servat
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain; ; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Spain
| | - Rafael Simó
- Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain; ; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Spain
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49
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Schnell O, Cappuccio F, Genovese S, Standl E, Valensi P, Ceriello A. Type 1 diabetes and cardiovascular disease. Cardiovasc Diabetol 2013; 12:156. [PMID: 24165454 PMCID: PMC3816572 DOI: 10.1186/1475-2840-12-156] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 10/08/2013] [Indexed: 12/16/2022] Open
Abstract
The presence of cardiovascular disease (CVD) in Type 1 diabetes largely impairs life expectancy. Hyperglycemia leading to an increase in oxidative stress is considered to be the key pathophysiological factor of both micro- and macrovascular complications. In Type 1 diabetes, the presence of coronary calcifications is also related to coronary artery disease. Cardiac autonomic neuropathy, which significantly impairs myocardial function and blood flow, also enhances cardiac abnormalities. Also hypoglycemic episodes are considered to adversely influence cardiac performance. Intensive insulin therapy has been demonstrated to reduce the occurrence and progression of both micro- and macrovascular complications. This has been evidenced by the Diabetes Control and Complications Trial (DCCT) / Epidemiology of Diabetes Interventions and Complications (EDIC) study. The concept of a metabolic memory emerged based on the results of the study, which established that intensified insulin therapy is the standard of treatment of Type 1 diabetes. Future therapies may also include glucagon-like peptide (GLP)-based treatment therapies. Pilot studies with GLP-1-analogues have been shown to reduce insulin requirements.
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Affiliation(s)
- Oliver Schnell
- Forschergruppe Diabetes e.V., Helmholtz Center Munich, Ingolstaedter Landstrasse 1, 85764 Munich-Neuherberg, Germany
| | | | - Stefano Genovese
- Department of Cardiovascular and Metabolic Diseases, Gruppo Multimedica, Sesto San Giovanni, Milan, Italy
| | - Eberhard Standl
- Forschergruppe Diabetes e.V., Helmholtz Center Munich, Ingolstaedter Landstrasse 1, 85764 Munich-Neuherberg, Germany
| | - Paul Valensi
- Service d’Endocrinologie-Diabétologie-Nutrition, Hôpital Jean Verdier, Bondy Cedex, France
| | - Antonio Ceriello
- Insititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Hospital Clínic Barcelona, Barcelona, Spain
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50
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Lipner EM, Tomer Y, Noble JA, Monti MC, Lonsdale JT, Corso B, Stewart WCL, Greenberg DA. HLA class I and II alleles are associated with microvascular complications of type 1 diabetes. Hum Immunol 2013; 74:538-44. [PMID: 23376458 PMCID: PMC3686564 DOI: 10.1016/j.humimm.2013.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 12/13/2012] [Accepted: 01/14/2013] [Indexed: 12/25/2022]
Abstract
Although HLA alleles are associated with type 1 diabetes, association with microvascular complications remains controversial. We tested HLA association with complications in multiplex type 1 diabetes families. Probands from 425 type 1 diabetes families from the Human Biological Data Interchange (HBDI) collection were analyzed. The frequencies of specific HLA alleles in patients with complications were compared with the frequencies in complications-free patients. The complications we examined were: retinopathy, neuropathy, and nephropathy. We used logistic regression models with covariates to estimate odds ratios. We found that the DRB1*03:01 allele is a protective factor for complications (OR=0.58; p=0.03), as is the DQA1*05:01-DQB1*02:01 haplotype found in linkage disequilibrium with DRB1*03:01 (OR=0.59; p=0.031). The DRB1*04:01 allele showed no evidence of association (OR=1.13; p=0.624), although DRB1*04:01 showed suggestive evidence when the carriers of the protective DRB1*03:01 were removed from the analysis. The class II DQA1*03:01-DQB1*03:02 haplotype was not associated with complications, but the class I allele B*39:06 (OR=3.27; p=0.008) suggested a strong positive association with complications. Our results show that in type 1 diabetes patients, specific HLA alleles may be involved in susceptibility to, or protection from, microvascular complications.
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Affiliation(s)
- E M Lipner
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA
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