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Zhang S, Wang J, Chen S, Zhang Y, He R, Wang X, Ding F, Hu W, Dai Y, Lu L, Zhang R, Ni J, Chen Q. Serum levels of lipoprotein-associated phospholipase A2 are associated with coronary atherosclerotic plaque progression in diabetic and non-diabetic patients. BMC Cardiovasc Disord 2024; 24:251. [PMID: 38745157 PMCID: PMC11092249 DOI: 10.1186/s12872-024-03931-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Lp-PLA2 is linked to cardiovascular diseases and poor outcomes, especially in diabetes, as it functions as a pro-inflammatory and oxidative mediator. OBJECTIVES This research aimed to explore if there is a connection between the serum levels of Lp-PLA2 and the progression of coronary plaques (PP) in individuals with type 2 diabetes mellitus (T2DM) and those without the condition. MATERIALS AND METHODS Serum Lp-PLA2 levels were measured in 137 T2DM patients with PP and 137 T2DM patients with no PP, and in 205 non-diabetic patients with PP and 205 non-diabetic patients with no PP. These individuals met the criteria for eligibility and underwent quantitative coronary angiography at the outset and again after about one year of follow-up. The attributes and parameters of the participants at the outset were recorded. RESULTS Increased serum levels of Lp-PLA2 were closely associated with coronary artery PP, and also significantly correlated with change of MLD, change of diameter stenosis and change of cumulative coronary obstruction in both diabetic and non-diabetic groups, with higher correlation coefficients in diabetic patients as compared with non-diabetic patients. Moreover, multivariate logistic regression analysis showed that serum Lp-PLA2 level was an independent determinant of PP in both groups, with OR values more significant in diabetic patients than in non-diabetic patients. CONCLUSIONS Levels of serum Lp-PLA2 show a significant association with the progression of coronary atherosclerotic plaque in patients with T2DM and those without, especially among individuals with diabetes.
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Affiliation(s)
- Shudong Zhang
- Department of Cardiovascular Medicine, Wuxi branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Wuxi, China
| | - Jiangang Wang
- Health Management Medicine Center, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Shuai Chen
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Zhang
- Department of Cardiovascular Medicine, Wuxi branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Wuxi, China
| | - Ruming He
- Department of Cardiovascular Medicine, Wuxi branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Wuxi, China
| | - Xiaoqun Wang
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fenghua Ding
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenbo Hu
- Eachy biopharma, Zhangjiagang, Jiangsu Province, China
| | - Yang Dai
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Lu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruiyan Zhang
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, China
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingwei Ni
- Department of Cardiovascular Medicine, Wuxi branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Wuxi, China.
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, China.
| | - Qiujing Chen
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025, China.
- Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Tylutka A, Walas Ł, Zembron-Lacny A. Level of IL-6, TNF, and IL-1β and age-related diseases: a systematic review and meta-analysis. Front Immunol 2024; 15:1330386. [PMID: 38495887 PMCID: PMC10943692 DOI: 10.3389/fimmu.2024.1330386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Chronic low-grade inflammation is an important aspect of morbidity and mortality in older adults. The level of circulating pro-inflammatory cytokines (interleukin (IL)-6, tumor necrosis factor (TNF) or IL-1β) is a risk factor in cardiovascular and neurodegenerative diseases and is also associated with sarcopenia and frailties. The objective of this study was to assess each cytokine: IL-6, TNF, and IL-1β separately in the elderly with comorbidities against controls without diseases according to the data published in the available literature. Methods The electronic bibliographic PubMed database was systematically searched to select all the relevant studies published up to July 2023. The total number of the subjects involved in the meta-analysis included patients with diseases (n=8154) and controls (n=33967). Results The overall concentration of IL-6 was found to be higher in patients with diseases compared to controls and the difference was statistically significant, with a p-value of <0.001 (SMD, 0.16; 95% CI, 0.12-0.19). The heterogeneity was considerable with Q = 109.97 (P <0.0001) and I2 = 79.2%. The potential diagnostic usefulness of IL-6 was confirmed by odds ratio (OR) analysis (OR: 1.03, 95% CI (1.01; 1.05), p=0.0029). The concentration of both TNF and IL-1β was elevated in the control group compared to patients and amounted to SMD -0.03; 95% CI, -0.09-0.02, p-value 0.533 and SMD-0.29; 95% CI, -0.47- -0.12; p = 0.001, respectively. For TNF, however, the difference was statistically insignificant. Discussion IL-6, unlike TNF and IL-1β, could be a useful and convenient marker of peripheral inflammation in older adults with various comorbidities.
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Affiliation(s)
- Anna Tylutka
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, Zielona Gora, Poland
| | - Łukasz Walas
- Institute of Dendrology, Polish Academy of Sciences, Kórnik, Poland
| | - Agnieszka Zembron-Lacny
- Department of Applied and Clinical Physiology, Collegium Medicum University of Zielona Gora, Zielona Gora, Poland
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Mulyani DE, Maksum IP. Detection of Biomarker Using Aptasensors to Determine the Type of Diabetes. Diagnostics (Basel) 2023; 13:2035. [PMID: 37370930 DOI: 10.3390/diagnostics13122035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Diabetes mellitus (DM) is a metabolic disorder characterized by elevated blood glucose levels. This disease is so serious that many experts refer to it as the "silent killer". The early detection of diabetes mellitus, whether type 1, type 2 or mitochondrial, is crucial because it can improve the success of treatment and the quality of life for patients. Aptamer-based biosensor diagnosis methods have been widely developed because they have high sensitivity and selectivity in detecting biomarkers of various diseases. Aptamers are short sequences of oligonucleotides or proteins that recognize specific ligands and bind to various target molecules, ranging from small ions to large proteins. They are promising diagnostic molecules due to their high sensitivity and selectivity, ease of modification, low toxicity, and high stability. This article aims to summarize the progress of detection methods, including detection principles, sensitivity, selectivity, and the performance of detection devices, to distinguish between types of diabetes mellitus using electrochemical aptasensors with biomarkers such as glucose, insulin, HbA1c, GHSA, and ATP.
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Affiliation(s)
- Dinda Exelsa Mulyani
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang 45363, Indonesia
| | - Iman Permana Maksum
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang 45363, Indonesia
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Jin F, Chang X, Wang X, Xiong H, Wang L, Zhang B, Wang P, Zhao L. Relationship between red blood cell-related indices and coronary artery calcification. Postgrad Med J 2023; 99:4-10. [PMID: 36947423 DOI: 10.1093/postmj/qgac003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 09/18/2022] [Accepted: 09/25/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Red blood cell (RBC) indices such as RBC count and RBC distribution width (RDW) are associated with heart failure and coronary artery disease, but the relationship between RBC indices and coronary artery calcification (CAC) is unclear. This study aimed to investigate RBC indices' correlation with, and predictive value for, the presence and severity of CAC. METHODS In this study, 1257 hospitalized patients who received a coronary computed tomography angiography examination were finally selected. Patients were classified into a control group (without CAC, n = 655) and a calcification group (with CAC, n = 602) according to their CAC score. The calcification group was further divided into a low calcification group, medium calcification group, and high calcification group. RESULTS In the calcification group, the RBC count was lower, and the RDW-standard deviation (SD) and RDW-coefficient of variation (CV) were higher, than those in the control group (P < .05). In the high calcification group, the RBC count was significantly lower, and the RDW-SD and RDW-CV were significantly higher, than those in the low calcification group (P < .05). Multivariate logistic regression analysis showed that RBC count, RDW-SD, and RDW-CV were independent predictors of CAC presence. Furthermore, multivariate logistic regression analysis also showed that RBC count and RDW-SD were independent predictors of severe CAC. CONCLUSIONS RBC indices were significantly associated with the presence and severity of CAC, indicating that these RBC indices have the potential to be predictors of CAC.
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Affiliation(s)
- Fulu Jin
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Xiansong Chang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Xiaozhong Wang
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Hui Xiong
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Li Wang
- Emergency Department of Xuguan District, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Bo Zhang
- Radiology Department, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004 China
| | - Peiyu Wang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
| | - Liangping Zhao
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou City, 215004, China
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Chen Q, Chen S, Dai Y, Wang X, Ding F, Zhang R, Shen W, Hu W, Lu L, Pan W. Serum MPO levels and activities are associated with angiographic coronary atherosclerotic plaque progression in type 2 diabetic patients. BMC Cardiovasc Disord 2022; 22:496. [PMID: 36404308 PMCID: PMC9677674 DOI: 10.1186/s12872-022-02953-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The uncontrolled production of MPO promotes inflammation, oxidative stress and atherosclerosis. Serum MPO levels are increased in patients with diabetes compared with patients without diabetes. OBJECTIVES This study aimed to investigate whether the serum levels and activities of MPO are related to coronary plaque progression in patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS Serum MPO levels and activities were measured in 161 patients with diabetes with plaque progression (plaque progression group) and 87 patients with diabetes with no plaque progression (no plaque progression group). These patients were eligible based on the inclusion criteria and received quantitative coronary angiography at baseline and after approximately 1 year of follow-up. The characteristics and parameters of the participants at baseline were documented. RESULTS Serum MPO levels and activities were significantly higher in plaque progression group than in no plaque progression group (P < 0.001). We categorized these patients with diabetes into MPO level or activity tertile subgroups. Significant differences in the plaque progression ratio and prominent changes in the minimal lumen diameter, stenosis diameter and coronary artery stenosis score were observed across the tertile subgroups of MPO levels and activities (all P < 0.01). Moreover, serum MPO levels and activities correlated significantly with these indices of coronary artery disease severity after adjustment for other risk factors. Multivariable regression analyses revealed that serum MPO levels and activities remained independently associated with plaque progression, in addition to smoking, hypertension and CRP levels (all P < 0.05). CONCLUSIONS Serum MPO levels and activities are significantly associated with coronary atherosclerotic plaque progression in patients with type 2 diabetes.
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Affiliation(s)
- Qiujing Chen
- grid.16821.3c0000 0004 0368 8293Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuai Chen
- grid.16821.3c0000 0004 0368 8293Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Dai
- grid.16821.3c0000 0004 0368 8293Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoqun Wang
- grid.16821.3c0000 0004 0368 8293Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fenghua Ding
- grid.16821.3c0000 0004 0368 8293Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruiyan Zhang
- grid.16821.3c0000 0004 0368 8293Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weifeng Shen
- grid.16821.3c0000 0004 0368 8293Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenbo Hu
- Eachy Biopharma, Zhangjiagang, Jiangsu Province China
| | - Lin Lu
- grid.16821.3c0000 0004 0368 8293Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293Institute of Cardiovascular Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenqi Pan
- grid.16821.3c0000 0004 0368 8293Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Road II, Shanghai, 200025 China
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Lin XL, Li QY, Zhao DH, Liu JH, Fan Q. Serum glycated albumin is associated with in-stent restenosis in patients with acute coronary syndrome after percutaneous coronary intervention with drug-eluting stents: An observational study. Front Cardiovasc Med 2022; 9:943185. [PMID: 36237913 PMCID: PMC9551162 DOI: 10.3389/fcvm.2022.943185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/22/2022] [Indexed: 11/24/2022] Open
Abstract
Background Previous studies have confirmed the predicted value of serum glycated albumin (GA) in atherosclerotic cardiovascular disease. However, the relationship between GA and the development of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation has not been verified in patients with acute coronary syndrome (ACS). Materials and methods In this study, 797 patients diagnosed with ACS who underwent re-coronary angiography more than 6 months after the first successful DES-based percutaneous coronary intervention (PCI) were eventually included. Patients were categorized into two groups based on the median GA levels of 14.94%. Moreover, multivariate logistic regression analysis models and the net reclassification improvement and integrated differentiation improvement risk models were constructed to assess the relationship between the GA and DES-ISR in patients with ACS. Results The GA was significantly associated with an increased risk of DES-ISR, upon adjusting for confounding factors (as nominal variate: OR 1.868, 95% CI 1.191-2.932, P = 0.007; as continuous variate: OR 1.109, 95% CI 1.040-1.183, P = 0.002). The addition of GA to a baseline risk model had an incremental effect on the predictive value for DES-ISR (AUC: GA vs. baseline model, 0.714 vs. 0.692, comparison P = 0.017; category-free net reclassification improvement (NRI) 0.080, P = 0.035; integrated discrimination improvement (IDI) 0.023, P < 0.001). Conclusion GA level was significantly associated with a high risk of DES-ISR in patients with ACS treated with PCI. Moreover, the addition of the GA to a baseline risk model has an incremental effect on the predictive potential for DES-ISR.
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Affiliation(s)
| | | | | | | | - Qian Fan
- Center for Coronary Artery Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, and Blood Vessel Diseases, Beijing, China
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Zhang J, Du Y, Hu C, Liu Y, Liu J, Gao A, Zhao Y, Zhou Y. Elevated Glycated Albumin in Serum Is Associated with Adverse Cardiac Outcomes in Patients with Acute Coronary Syndrome Who Underwent Revascularization Therapy. J Atheroscler Thromb 2022; 29:482-491. [PMID: 33642440 PMCID: PMC9090483 DOI: 10.5551/jat.61358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/20/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS The associations between increased glycated albumin (GA) in the serum and diabetic complications and mortality have been revealed in the general population. However, less is known regarding the prognostic value of GA in patients diagnosed with acute coronary syndrome (ACS). METHODS In this study, all patients admitted for ACS who underwent a successful percutaneous coronary intervention (PCI) at our center from January 2018 to February 2019 were retrospectively examined. Clinical characteristics, laboratory results (e.g., serum GA levels), and procedural details were collected. The primary outcome included a composite of major adverse cardio-cerebral events (MACCE), such as death, myocardial infarction, stroke, and unplanned revascularization. The association between serum GA levels and clinical outcomes was tested in three multivariable models using Cox proportional hazard analysis. Subgroup analysis was performed in patients who were diagnosed with diabetes versus patients without diabetes. RESULTS A total of 1,806 ACS patients (mean age of 59.4 years; 77.8% were men; 44.9% were diagnosed with diabetes) were enrolled in this study, where the majority exhibited unstable angina (81.6%) and showed preserved left ventricular systolic function. Patients in the high GA level group were commonly female and were more likely to have metabolic disorders and to exhibit severe CAD (all p<0.05). MACCE occurred in 126 patients (7.0%) during a mean follow-up time of 17.2 months. The cumulative risk of MACCE at the 18-month follow-up visit significantly increased in a stepwise fashion along with increased GA levels (log-rank p=0.018) in the serum. The association between serum GA levels and MACCE was further determined after adjusting traditional risk factors and hemoglobin A1c (HbA1c) (GA, per 1% increase: hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.06-1.13; GA, higher vs. lower tertial: HR 1.92, 95% CI 1.01-3.67). In a subgroup analysis, the prognostic role of serum GA only existed in diabetic patients, even when adjusting for traditional risk factors and HbA1c levels. CONCLUSIONS Elevated GA levels in the serum were associated with poor intermediate-term outcomes in low-risk ACS patients who underwent PCI, especially in patients with preexisting diabetes.
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Affiliation(s)
- Jianwei Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Yu Du
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Chengping Hu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Yan Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Jinxing Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Ang Gao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Yingxin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel
Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical center for coronary heart
disease, Capital Medical University, Beijing, China
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Ortiz-Martínez M, González-González M, Martagón AJ, Hlavinka V, Willson RC, Rito-Palomares M. Recent Developments in Biomarkers for Diagnosis and Screening of Type 2 Diabetes Mellitus. Curr Diab Rep 2022; 22:95-115. [PMID: 35267140 PMCID: PMC8907395 DOI: 10.1007/s11892-022-01453-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Diabetes mellitus is a complex, chronic illness characterized by elevated blood glucose levels that occurs when there is cellular resistance to insulin action, pancreatic β-cells do not produce sufficient insulin, or both. Diabetes prevalence has greatly increased in recent decades; consequently, it is considered one of the fastest-growing public health emergencies globally. Poor blood glucose control can result in long-term micro- and macrovascular complications such as nephropathy, retinopathy, neuropathy, and cardiovascular disease. Individuals with diabetes require continuous medical care, including pharmacological intervention as well as lifestyle and dietary changes. RECENT FINDINGS The most common form of diabetes mellitus, type 2 diabetes (T2DM), represents approximately 90% of all cases worldwide. T2DM occurs more often in middle-aged and elderly adults, and its cause is multifactorial. However, its incidence has increased in children and young adults due to obesity, sedentary lifestyle, and inadequate nutrition. This high incidence is also accompanied by an estimated underdiagnosis prevalence of more than 50% worldwide. Implementing successful and cost-effective strategies for systematic screening of diabetes mellitus is imperative to ensure early detection, lowering patients' risk of developing life-threatening disease complications. Therefore, identifying new biomarkers and assay methods for diabetes mellitus to develop robust, non-invasive, painless, highly-sensitive, and precise screening techniques is essential. This review focuses on the recent development of new clinically validated and novel biomarkers as well as the methods for their determination that represent cost-effective alternatives for screening and early diagnosis of T2DM.
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Affiliation(s)
- Margarita Ortiz-Martínez
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
| | - Mirna González-González
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México.
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Nuevo León, México.
| | - Alexandro J Martagón
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Nuevo León, México
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | - Victoria Hlavinka
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Richard C Willson
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
- Department of Chemical and Biomolecular Engineering, University of Houston, Houston, TX, USA
| | - Marco Rito-Palomares
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Nuevo León, México
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Liu C, Zhao Q, Ma X, Cheng Y, Sun Y, Zhang D, Liu X, Zhou Y. Prognostic implication of serum glycated albumin for patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. Cardiovasc Diabetol 2022; 21:11. [PMID: 35045846 PMCID: PMC8772172 DOI: 10.1186/s12933-022-01446-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 12/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It has been demonstrated that glycated albumin (GA) is significantly associated with diabetes complications and mortality. However, among patients diagnosed with non-ST-elevation acute coronary syndrome (NSTE-ACS) administered percutaneous coronary intervention (PCI), the predictive value of GA for poor prognosis is unclear. METHODS This study eventually included 2247 NSTE-ACS patients in Beijing Anzhen Hospital, Capital Medical University in January-December 2015 who received PCI. All patients were followed up until death or for 48 months post-discharge. The primary endpoint was major adverse cardio-cerebral events (MACCEs), including all-cause death, non-fatal myocardial infarction, ischemia-induced revascularization and non-fatal ischemic stroke. RESULTS In total, 547 (24.3%) MACCEs were recorded during the follow-up period. Upon adjusting for potential confounders, GA remained an important risk predictor of MACCEs (As nominal variate: hazard ratio [HR] 1.527, 95% confidence interval [CI] 1.236-1.886, P < 0.001; As continuous variate: HR 1.053, 95% CI 1.027-1.079, P < 0.001). GA addition significantly enhanced the predictive ability of the traditional risk model (Harrell's C-index, GA vs. Baseline model, 0.694 vs. 0.684, comparison P = 0.002; continuous net reclassification improvement (continuous-NRI) 0.085, P = 0.053; integrated discrimination improvement (IDI) 0.007, P = 0.020). CONCLUSION GA is highly correlated with poor prognosis in NSTE-ACS patients undergoing PCI, suggesting that it may be a major predictive factor of adverse events among these individuals.
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Affiliation(s)
- Chi Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Qi Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Xiaoteng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Yujing Cheng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Yan Sun
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Dai Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China
| | - Xiaoli Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China.
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, 100029, China.
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10
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Giglio RV, Stoian AP, Haluzik M, Pafili K, Patti AM, Rizvi AA, Ciaccio M, Papanas N, Rizzo M. Novel molecular markers of cardiovascular disease risk in type 2 diabetes mellitus. Biochim Biophys Acta Mol Basis Dis 2021; 1867:166148. [PMID: 33892081 DOI: 10.1016/j.bbadis.2021.166148] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/15/2021] [Accepted: 04/13/2021] [Indexed: 02/07/2023]
Abstract
Diabetes represents the leading risk factor for the development of cardiovascular disease (CVD). Chronic hyperglycemia and/or acute post-prandial changes in blood glucose determine an increase in reactive oxygen species (ROS), which play a fundamental role in endothelial dysfunction and in the nuclear transport of pro-atherogenic transcription factors that activate the "inflammasome". In addition, the glycemic alteration favors the formation and stabilization of atherosclerotic plaque through the mechanism of non-enzymatic glycation of different molecules, with the establishment of the so-called "advanced glycosylation end products" (AGE). Laboratory information provided by the level of biomarkers could make a quantitative and qualitative contribution to the clinical process of screening, prediction, prevention, diagnosis, prognosis and monitoring of cardiovascular (CV) risk linked to diabetes. This review describes the importance of specific biomarkers, with particular focus on novel ones, for stratifying and management of diabetes CV risk.
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Affiliation(s)
- Rosaria Vincenza Giglio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Laboratory Medicine, University of Palermo, Palermo, Italy
| | - Anca Pantea Stoian
- Faculty of General Medicine, Diabetes, Nutrition and Metabolic Diseases Department, Carol Davila University, Bucharest, Romania
| | - Martin Haluzik
- Centre for Experimental Medicine and Department of Diabetes, Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Kalliopi Pafili
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Angelo Maria Patti
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
| | - Ali Abbas Rizvi
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University, Atlanta, Georgia, USA; Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine Columbia, South Carolina, USA
| | - Marcello Ciaccio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Laboratory Medicine, University of Palermo, Palermo, Italy; Department of Laboratory Medicine, University-Hospital, Palermo, Italy
| | - Nikolaos Papanas
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Manfredi Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine Columbia, South Carolina, USA
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11
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Recent Updates and Advances in the Use of Glycated Albumin for the Diagnosis and Monitoring of Diabetes and Renal, Cerebro- and Cardio-Metabolic Diseases. J Clin Med 2020; 9:jcm9113634. [PMID: 33187372 PMCID: PMC7697299 DOI: 10.3390/jcm9113634] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022] Open
Abstract
Diabetes mellitus is a heterogeneous and dysmetabolic chronic disease in which the laboratory plays a fundamental role, from diagnosis to monitoring therapy and studying complications. Early diagnosis and good glycemic control should start as early as possible to delay and prevent metabolic and cardio-vascular complications secondary to this disease. Glycated hemoglobin is currently used as the reference parameter. The accuracy of the glycated hemoglobin dosage may be compromised in subjects suffering from chronic renal failure and terminal nephropathy, affected by the reduction in the survival of erythrocytes, with consequent decrease in the time available for glucose to attach to the hemoglobin. In the presence of these renal comorbidities as well as hemoglobinopathies and pregnancy, glycated hemoglobin is not reliable. In such conditions, dosage of glycated albumin can help. Glycated albumin is not only useful for short-term diagnosis and monitoring but predicts the risk of diabetes, even in the presence of euglycemia. This protein is modified in subjects who do not yet have a glycemic alteration but, as a predictive factor, heralds the risk of diabetic disease. This review summarizes the importance of glycated albumin as a biomarker for predicting and stratifying the cardiovascular risk linked to multiorgan metabolic alterations.
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12
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Investigating the relationship between myocardial infarction and the ratio of glycated albumin to glycated hemoglobin in patients admitted to cardiac ward. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00883-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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13
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Mihara A, Ohara T, Hata J, Honda T, Chen S, Sakata S, Oishi E, Hirakawa Y, Nakao T, Kitazono T, Ninomiya T. Association between serum glycated albumin and risk of cardiovascular disease in a Japanese community: The Hisayama Study. Atherosclerosis 2020; 311:52-59. [DOI: 10.1016/j.atherosclerosis.2020.08.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/14/2020] [Accepted: 08/27/2020] [Indexed: 01/28/2023]
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14
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Kohata Y, Ohara M, Nagaike H, Fujikawa T, Osaka N, Goto S, Fukase A, Kushima H, Hiromura M, Terasaki M, Mori Y, Fukui T, Ouchi M, Suzuki T, Hirano T, Yamagishi SI. Association of Hemoglobin A1c, 1,5-Anhydro-D-Glucitol and Glycated Albumin with Oxidative Stress in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study. Diabetes Ther 2020; 11:655-665. [PMID: 31997224 PMCID: PMC7048877 DOI: 10.1007/s13300-020-00772-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Oxidative stress plays a central role in the development and progression of vascular complications in patients with type 2 diabetes mellitus (T2DM). We have previously shown that markers of glucose variability evaluated by continuous glucose monitoring (CGM) are positively associated with oxidative stress in patients with T2DM. However, the evaluation of the glycemic variability by CGM remains a time- and money-consuming procedure. Therefore, this study investigated the independent correlates of oxidative stress among various other clinical markers routinely measured in primary care. METHODS This was a retrospective cross-sectional study with 234 T2DM patients to examine which clinical variables, including 1,5-anhydro-D-glucitol (1,5-AG) and glycated albumin (GA), were independently associated with oxidative stress. Oxidative stress was measured using the diacron-reactive oxygen metabolites (d-ROMs) test. The relationships between d-ROMs and clinical factors, such as blood glucose, glycated hemoglobin (HbA1c), 1,5-AG, GA, lipid parameters, and blood pressure, were examined. RESULTS Multiple stepwise regression analysis revealed that 1,5-AG (inversely), GA, triglycerides, use of metformin and being female were independently associated with d-ROMs. When patients with T2DM were stratified into two groups with HbA1c < 8.0% and HbA1c ≥ 8.0%, 1,5-AG (inversely), HbA1c, use of metformin and being female were independently associated with d-ROMs in diabetes patients with HbA1c < 8.0%, whereas GA, fasting plasma glucose and being female were independently associated with d-ROMs in patients with HbA1c ≥ 8.0%. CONCLUSION Our present study suggests that 1,5-AG and GA are the strongest correlates of oxidative stress in patients with well and poorly controlled T2DM, respectively.
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Affiliation(s)
- Yo Kohata
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Makoto Ohara
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan.
| | - Hiroe Nagaike
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoki Fujikawa
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Naoya Osaka
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Satoshi Goto
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Ayako Fukase
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Hideki Kushima
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Munenori Hiromura
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Michishige Terasaki
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Yusaku Mori
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Tomoyasu Fukui
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | - Motoshi Ouchi
- Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Tatsuya Suzuki
- Division of Geriatric Medicine, Nippon Medical School, Tokyo, Japan
| | - Tsutomu Hirano
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
- Diabetes Center, Ebina General Hospital, Ebina, Japan
| | - Sho-Ichi Yamagishi
- Department of Medicine, Division of Diabetes, Metabolism, and Endocrinology, Showa University School of Medicine, Tokyo, Japan
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15
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The Modern Western Diet Rich in Advanced Glycation End-Products (AGEs): An Overview of Its Impact on Obesity and Early Progression of Renal Pathology. Nutrients 2019; 11:nu11081748. [PMID: 31366015 PMCID: PMC6724323 DOI: 10.3390/nu11081748] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/15/2019] [Accepted: 07/25/2019] [Indexed: 01/12/2023] Open
Abstract
Advanced glycation end-products (AGEs) are an assorted group of molecules formed through covalent bonds between a reduced sugar and a free amino group of proteins, lipids, and nucleic acids. Glycation alters their structure and function, leading to impaired cell function. They can be originated by physiological processes, when not counterbalanced by detoxification mechanisms, or derive from exogenous sources such as food, cigarette smoke, and air pollution. Their accumulation increases inflammation and oxidative stress through the activation of various mechanisms mainly triggered by binding to their receptors (RAGE). So far, the pathogenic role of AGEs has been evidenced in inflammatory and chronic diseases such as chronic kidney disease, cardiovascular disease, and diabetic nephropathy. This review focuses on the AGE-induced kidney damage, by describing the molecular players involved and investigating its link to the excess of body weight and visceral fat, hallmarks of obesity. Research regarding interventions to reduce AGE accumulation has been of great interest and a nutraceutical approach that would help fighting chronic diseases could be a very useful tool for patients’ everyday lives.
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16
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Ul-Haque I, Ud Deen Z, Shafique S, Ur Rehman SI, Zaman M, Basalat ST, Munaf M, Wahidi Y. The Role of Glycated Hemoglobin A1c in Determining the Severity of Coronary Artery Disease in Diabetic and Non-Diabetic Subjects in Karachi. Cureus 2019; 11:e4982. [PMID: 31467816 PMCID: PMC6706255 DOI: 10.7759/cureus.4982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/24/2019] [Indexed: 12/16/2022] Open
Abstract
Introduction Coronary artery disease is the leading cause of death worldwide by incidence. Over the years, many studies have been conducted to find predictors of coronary artery disease; however, in the last few decades, the level of HbA1c in diabetics has been investigated as a potential predictor. Our study offers additional insight by investigating similar relationships in non-diabetic patients and by investigating potential predictors more comprehensively, making it the first of its kind study. The aim of our study is to indicate that rising HbA1c levels suggest that there's a greater risk of coronary artery disease, which can further be confirmed by the SYNTAX score, degree of stenosis, and numbers of vessels involved. Methods Data from 177 diabetic and 378 non-diabetic patients, all of whom were above 18 years of age, were included in the research. HbA1c levels (>5.6%), SYNTAX score, hypertension, number of vessels involved, and other demographic elements, such as age, smoking, and body measurements, were calculated and compared for diabetics and non-diabetics. Results HbA1c was higher in comparison to non-diabetic subjects (p <0.001). Age >53 was found to be a predictor for SYNTAX score ≥23 in diabetic patients (p <0.05). Male gender and smoking were found to be independent predictors for three-vessel disease in the non-diabetic population (p-value<0.05). There was no significant relationship between the SYNTAX score and HbA1c levels in non-diabetics (p=0.885) and diabetics. In conclusion, there is no correlation between elevated HbA1c levels and SYNTAX score ≥23.
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Affiliation(s)
- Ibtehaj Ul-Haque
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi , PAK
| | - Zia Ud Deen
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Shiza Shafique
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Syed Inam Ur Rehman
- Internal Medicine, Civil Hospital Karachi, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Maryam Zaman
- Miscellaneous, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Syeda T Basalat
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Misbah Munaf
- Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, PAK
| | - Yusra Wahidi
- Internal Medicine: Critical Care, Dow University of Health Sciences (DUHS), Karachi, PAK
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17
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Adela R, Reddy PNC, Ghosh TS, Aggarwal S, Yadav AK, Das B, Banerjee SK. Serum protein signature of coronary artery disease in type 2 diabetes mellitus. J Transl Med 2019; 17:17. [PMID: 30674322 PMCID: PMC6345069 DOI: 10.1186/s12967-018-1755-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/21/2018] [Indexed: 12/11/2022] Open
Abstract
Background Coronary artery disease (CAD) is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). The purpose of the present study was to discriminate the Indian CAD patients with or without T2DM by using multiple pathophysiological biomarkers. Methods Using sensitive multiplex protein assays, we assessed 46 protein markers including cytokines/chemokines, metabolic hormones, adipokines and apolipoproteins for evaluating different pathophysiological conditions of control, T2DM, CAD and T2DM with CAD patients (T2DM_CAD). Network analysis was performed to create protein-protein interaction networks by using significantly (p < 0.05) altered protein markers in each disease using STRING 10.5 database. We used two supervised analysis methods i.e., between class analysis (BCA) and principal component analysis (PCA) to reveals distinct biomarkers profiles. Further, random forest classification (RF) was used to classify the diseases by the panel of markers. Results Our two supervised analysis methods BCA and PCA revealed a distinct biomarker profiles and high degree of variability in the marker profiles for T2DM_CAD and CAD. Thereafter, the present study identified multiple potential biomarkers to differentiate T2DM, CAD, and T2DM_CAD patients based on their relative abundance in serum. RF classified T2DM based on the abundance patterns of nine markers i.e., IL-1β, GM-CSF, glucagon, PAI-I, rantes, IP-10, resistin, GIP and Apo-B; CAD by 14 markers i.e., resistin, PDGF-BB, PAI-1, lipocalin-2, leptin, IL-13, eotaxin, GM-CSF, Apo-E, ghrelin, adipsin, GIP, Apo-CII and IP-10; and T2DM _CAD by 12 markers i.e., insulin, resistin, PAI-1, adiponectin, lipocalin-2, GM-CSF, adipsin, leptin, Apo-AII, rantes, IL-6 and ghrelin with respect to the control subjects. Using network analysis, we have identified several cellular network proteins like PTPN1, AKT1, INSR, LEPR, IRS1, IRS2, IL1R2, IL6R, PCSK9 and MYD88, which are responsible for regulating inflammation, insulin resistance, and atherosclerosis. Conclusion We have identified three distinct sets of serum markers for diabetes, CAD and diabetes associated with CAD in Indian patients using nonparametric-based machine learning approach. These multiple marker classifiers may be useful for monitoring progression from a healthy person to T2DM and T2DM to T2DM_CAD. However, these findings need to be further confirmed in the future studies with large number of samples. Electronic supplementary material The online version of this article (10.1186/s12967-018-1755-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ramu Adela
- Drug Discovery Research Center, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India.,Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, NIPER, Guwahati, Assam, India
| | | | - Tarini Shankar Ghosh
- Centre for Human Microbial Ecology, Translational Health Science and Technology Institute, Faridabad, 121001, India
| | - Suruchi Aggarwal
- Drug Discovery Research Center, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India
| | - Amit Kumar Yadav
- Drug Discovery Research Center, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India
| | - Bhabatosh Das
- Centre for Human Microbial Ecology, Translational Health Science and Technology Institute, Faridabad, 121001, India
| | - Sanjay K Banerjee
- Drug Discovery Research Center, Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, 121001, India.
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18
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Gan T, Liu X, Xu G. Glycated Albumin Versus HbA1c in the Evaluation of Glycemic Control in Patients With Diabetes and CKD. Kidney Int Rep 2018; 3:542-554. [PMID: 29854962 PMCID: PMC5976809 DOI: 10.1016/j.ekir.2017.11.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/02/2017] [Accepted: 11/13/2017] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION It is inaccurate to assess blood glucose with glycated hemoglobin (HbA1c) in patients with diabetes and chronic kidney disease (CKD), and whether glycated albumin (GA) is better than HbA1c in these patients remains unclear. METHODS We searched PubMed, Embase, Web of Science, Scopus, the Cochrane Library, and MEDLINE to July 2017 for studies that investigated the correlation between GA or HbA1c and the average glucose levels (AG) relevant to this theme. Statistical analysis was performed using RevMan5.3 and Stata12.0. The outcome was the correlation coefficient between GA or HbA1c and AG. For the first time, we made a comparison of GA and HbA1c in different CKD stages. RESULTS A total of 24 studies with 3928 patients were included. Early stages of CKD refer to CKD stage 1 to 3. Advanced CKD refer to CKD stage 4 and 5 including patients receiving dialysis. The meta-analysis suggested that in early stages of CKD, the pooled R between GA and AG was 0.61 (95% CI = 0.49-0.73) and 0.71 (95% CI = 0.55-0.87) for HbA1c (P > 0.05). In advanced CKD patients, the pooled R between GA and AG was 0.57 (95% CI = 0.52-0.62), and 0.49 (95% CI = 0.45-0.52) for HbA1c (P = 0.0001). CONCLUSION GA is superior to HbA1c in assessing blood glucose control in diabetes patients with advanced CKD.
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Affiliation(s)
- Ting Gan
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
- Grade 2014, the First Clinical Medical College of Nanchang University, Nanchang, China
| | - Xin Liu
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Gaosi Xu
- Department of Nephrology, the Second Affiliated Hospital of Nanchang University, Nanchang, China
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19
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Glycated albumin (GA) and inflammation: role of GA as a potential marker of inflammation. Inflamm Res 2017; 67:21-30. [PMID: 29022053 DOI: 10.1007/s00011-017-1089-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 08/22/2017] [Accepted: 08/27/2017] [Indexed: 12/12/2022] Open
Abstract
AIMS Abnormal levels of glycated albumin (GA) are associated with the onset of both diabetes and inflammation. Although inflammation has long been associated with diabetes, this article aims to explore the underlying mechanisms of this relationship as it pertains to the role of GA. METHODS We have reviewed 52 research articles since the year 2000. Common search terms used were "(inflammatory mediator) and GA" or "inflammation and GA". The findings have been organized according to diabetic complications with respect to the interactions of GA and inflammatory mediators. Glycated albumin and specific inflammatory mediators have been reported to play various roles in the pathogenesis of insulin resistance, atherosclerosis, coronary artery disease, retinopathy, and nephropathy. In the case of nephropathy and recently retinopathy, there is considerable evidence for GA in concert with inflammation playing a direct role in organ pathology. There is copious literature detailing GA's involvement in stimulating inflammatory markers and certain pro-inflammatory cytokines. A recent clinical study has shown GA to be a marker for inflammation in non-diabetic rheumatoid arthritis patients with the significance of standard inflammatory markers. CONCLUSIONS The clinical utility of GA measurement may likely reside in its versatility as both a mediator of inflammation as well as a marker to track hyperglycemia and other diabetes complications. Further understanding of the role GA plays in glycemic and inflammatory diseases could lead to its acceptance as an independent bio-inflammatory marker.
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Jun JE, Lee SE, Lee YB, Ahn JY, Kim G, Jin SM, Hur KY, Lee MK, Kim JH. Glycated albumin and its variability as an indicator of cardiovascular autonomic neuropathy development in type 2 diabetic patients. Cardiovasc Diabetol 2017; 16:127. [PMID: 29017498 PMCID: PMC5635541 DOI: 10.1186/s12933-017-0619-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 10/06/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We investigated whether glycated albumin (GA) and its variability are associated with cardiovascular autonomic neuropathy (CAN) and further compared their associations with glycated hemoglobin (HbA1c). METHODS This retrospective longitudinal study included 498 type 2 diabetic patients without CAN. CAN was defined as at least two abnormal results in parasympathetic tests or presence of orthostatic hypotension. The mean, standard deviation (SD), and coefficient of variance (CV) were calculated from consecutively measured GA (median 7 times) and HbA1c levels (median 8 times) over 2 years. Logistic regression analysis was used to compare the associations between CAN and GA- or HbA1c-related parameters. Receiver operating characteristic (ROC) curve analysis was used to compare the predictive power for CAN between GA- and HbA1c-related parameters. RESULTS A total of 53 subjects (10.6%) developed CAN over 2 years. The mean, SD, and CV of GA or HbA1c were significantly higher in subjects with CAN. Higher mean GA and GA variability were associated with the risk of developing CAN, independent of conventional risk factors and HbA1c. In ROC curve analysis, the SD and CV of GA showed higher predictive value for CAN compared to the SD and CV of HbA1c, whereas the predictive value of mean GA did not differ from that of mean HbA1c. The mean, SD, and CV of GA showed additive predictive power to detect CAN development along with mean HbA1c. CONCLUSIONS Higher serum GA and its variability are significantly associated with the risk of developing CAN. Serum GA might be a useful indicator for diabetic complications and can enhance HbA1c's modest clinical prediction for CAN.
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Affiliation(s)
- Ji Eun Jun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Seung-Eun Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Ji Yeon Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Moon-Kyu Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. .,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul, Republic of Korea.
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Choi N, Lee JY, Sunwoo JS, Roh H, Ahn MY, Park ST, Lee KB. Recently Uncontrolled Glycemia in Diabetic Patients Is Associated with the Severity of Intracranial Atherosclerosis. J Stroke Cerebrovasc Dis 2017; 26:2615-2621. [PMID: 28784278 DOI: 10.1016/j.jstrokecerebrovasdis.2017.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 05/22/2017] [Accepted: 06/17/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Diabetes mellitus is a specific risk factor for intracranial atherosclerosis (ICAS) regardless of race. However, it is largely unknown whether poor glycemic control is associated with the severity of ICAS in diabetic patients. METHODS We selected diabetic patients with acute ischemic stroke who were prospectively registered between March 2005 and December 2015. The patients who had a high-risk source of cardiogenic embolism were excluded. ICAS was graded from 0 to 3 by the number of significant (≥50%) stenoses on intracranial magnetic resonance angiography, and was divided into 4 types: unilateral anterior, bilateral anterior, posterior, and anterior plus posterior. Ordinal and multinomial regression tests were applied for the factors influencing the number and types of ICAS. RESULTS A total of 774 patients with noncardioembolic acute ischemic stroke with diabetes were enrolled. The multiplicity of ICAS was independently associated with age (odds ratio [OR], 1.035 per 1 year, 1.018-1.052; P < .001), hypertension (OR, 1.992, 1.336-2.965; P = .001), and glycated hemoglobin (HbA1c; OR, 1.207 per 1%, 1.089-1.338; P < .001) in the ordinal regression model. In multinomial regression, bilateral anterior stenosis tended to be correlated with age (OR, 1.042, 1.008-1.077; P = .016) and HbA1c (OR, 1.201 per 1%, .991-1.520; P = .057). Both anterior and posterior stenoses were significantly associated with age (OR, 1.056, 1.029-1.084; P < .001), hypertension (OR, 2.584, 1.404-4.762; P = .002), and HbA1c (OR, 1.272, 1.070-1.511; P = .006). CONCLUSIONS Age, concomitant hypertension, and HbA1c were factors associated with multiple intracranial stenoses. Further study is warranted to elucidate whether poor glycemic control facilitates ICAS in diabetic patients.
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Affiliation(s)
- Nari Choi
- Departments of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
| | - Jeong-Yoon Lee
- Departments of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
| | - Jun-Sang Sunwoo
- Departments of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
| | - Hakjae Roh
- Departments of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
| | - Moo-Young Ahn
- Departments of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
| | - Sung-Tae Park
- Departments of Radiology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea
| | - Kyung Bok Lee
- Departments of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea.
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22
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Association of glycated albumin to HbA1c ratio with diabetic retinopathy but not diabetic nephropathy in patients with type 2 diabetes. Clin Biochem 2017; 50:270-273. [DOI: 10.1016/j.clinbiochem.2016.11.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 11/26/2016] [Accepted: 11/28/2016] [Indexed: 11/20/2022]
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23
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Nichols TC, Merricks EP, Bellinger DA, Raymer RA, Yu J, Lam D, Koch GG, Busby WH, Clemmons DR. Oxidized LDL and Fructosamine Associated with Severity of Coronary Artery Atherosclerosis in Insulin Resistant Pigs Fed a High Fat/High NaCl Diet. PLoS One 2015; 10:e0132302. [PMID: 26147990 PMCID: PMC4492503 DOI: 10.1371/journal.pone.0132302] [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] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 06/11/2015] [Indexed: 12/22/2022] Open
Abstract
Background Insulin-resistant subjects develop more severe and diffuse coronary artery atherosclerosis than insulin-sensitive controls but the mechanisms that mediate this atherosclerosis phenotype are unknown. Research Objective To determine the metabolic parameters that associate with the severity of coronary atherosclerosis in insulin resistant pigs fed a high fat/high NaCl diet. Key Methods The primary endpoint was severity of coronary atherosclerosis in adult pigs (Sus scrofa, n = 37) fed a high fat diet that also contained high NaCl (56% above recommended levels) for 1 year. Principal Findings Twenty pigs developed severe and diffuse distal coronary artery atherosclerosis (i.e., severe = intimal area as a percent medial area > 200% in at least 2 coronary artery cross sections and diffuse distal = intimal area as a percent medial area ≥ 150% over 3 sections separated by 2 cm in the distal half of the coronary artery). The other 17 pigs had substantially less coronary artery atherosclerosis. All 37 pigs had blood pressure in a range that would be considered hypertensive in humans and developed elevations in total and LDL and HDL cholesterol, weight gain, increased backfat, and increased insulin resistance (Bergman Si) without overt diabetes. Insulin resistance was not associated with atherosclerosis severity. Five additional pigs fed regular pig chow also developed increased insulin resistance but essentially no change in the other variables and little to no detectible coronary atherosclerosis. Most importantly, the 20 high fat/high NaCl diet -fed pigs with severe and diffuse distal coronary artery atherosclerosis had substantially greater increases (p< 0.05) in oxidized LDL (oxLDL) and fructosamine consistent with increased protein glycation. Conclusion In pigs fed a high fat/high NaCl diet, glycated proteins are induced in the absence of overt diabetes and this degree of increase is associated with the development of severe and diffuse distal coronary artery atherosclerosis.
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Affiliation(s)
- Timothy C. Nichols
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Elizabeth P. Merricks
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Dwight A. Bellinger
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Robin A. Raymer
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jing Yu
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Diana Lam
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Gary G. Koch
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Walker H. Busby
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - David R. Clemmons
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Mukai N, Ninomiya T, Hata J, Hirakawa Y, Ikeda F, Fukuhara M, Hotta T, Koga M, Nakamura U, Kang D, Kitazono T, Kiyohara Y. Association of hemoglobin A1c and glycated albumin with carotid atherosclerosis in community-dwelling Japanese subjects: the Hisayama Study. Cardiovasc Diabetol 2015; 14:84. [PMID: 26099223 PMCID: PMC4482030 DOI: 10.1186/s12933-015-0247-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/16/2015] [Indexed: 12/11/2022] Open
Abstract
Background It is not clear which glucose measure is more useful in the assessment of atherosclerosis. We investigated the associations of hemoglobin A1c (HbA1c), glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), fasting plasma glucose (FPG), and 2-hour postload glucose (PG) with carotid intima-media thickness (IMT) in community-dwelling Japanese subjects. Methods A total of 2702 subjects aged 40–79 years underwent a 75-g oral glucose tolerance test and measurements of HbA1c, GA, 1,5-AG, and carotid IMT by ultrasonography in 2007–2008. Carotid wall thickening was defined as a maximum IMT of >1.0 mm. The crude and multivariable-adjusted linear and logistic regression models were used to analyze cross-sectional associations between levels of glycemic measures and carotid IMT. Results The crude average of the maximum IMT increased significantly with rising quartiles of HbA1c, GA, FPG, and 2-hour PG levels in subjects with and without glucose intolerance (GI), while no clear association was observed for 1,5-AG. After adjustment for other confounding factors, positive trends for HbA1c, GA, and FPG (all p for trend < 0.05), but not 2-hour PG (p = 0.07) remained robust in subjects with GI, but no such associations were found in those without GI. When estimating multivariable-adjusted β values for the associations of 1 SD change in glycemic measures with the maximum IMT in subjects with GI, the magnitude of the influence of HbA1c (β = 0.021), GA (β = 0.024), and FPG (β = 0.024) was larger than that of 2-hour PG (β = 0.014) and 1,5-AG (β = 0.003). The multivariable-adjusted odds ratios for the presence of carotid wall thickening increased significantly with elevating HbA1c, GA, and FPG levels only in subjects with GI (all p for trend < 0.001). Among subjects with GI, the area under the receiver operating characteristic curve significantly increased by adding HbA1c (p = 0.04) or GA (p = 0.04), but not 1,5-AG, FPG, or 2-hour PG, to the model including other cardiovascular risk factors. Conclusions In community-dwelling Japanese subjects with GI, elevated HbA1c, GA, and FPG levels were significantly associated with increased carotid IMT, and HbA1c and GA provided superior discrimination for carotid wall thickening compared to 1,5-AG, FPG, and 2-hour PG, suggesting that HbA1c and GA are useful for assessing carotid atherosclerosis. Electronic supplementary material The online version of this article (doi:10.1186/s12933-015-0247-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Naoko Mukai
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. .,Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Toshiharu Ninomiya
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. .,Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Jun Hata
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. .,Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yoichiro Hirakawa
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Fumie Ikeda
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. .,Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Masayo Fukuhara
- Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Taeko Hotta
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan.
| | - Masafumi Koga
- Department of Internal Medicine, Kawanishi City Hospital, Hyogo, Japan.
| | - Udai Nakamura
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Dongchon Kang
- Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, Fukuoka, Japan.
| | - Takanari Kitazono
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. .,Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Yutaka Kiyohara
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. .,Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Ma X, Shen Y, Hu X, Hao Y, Luo Y, Tang J, Zhou J, Bao Y, Jia W. Associations of glycated haemoglobin A1c and glycated albumin with subclinical atherosclerosis in middle-aged and elderly Chinese population with impaired glucose regulation. Clin Exp Pharmacol Physiol 2015; 42:582-7. [DOI: 10.1111/1440-1681.12394] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 01/19/2015] [Accepted: 02/01/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Xiaojing Ma
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
| | - Yun Shen
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
| | - Xiang Hu
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
| | - Yaping Hao
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
| | - Yuqi Luo
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
| | - Junling Tang
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
| | - Jian Zhou
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
| | - Weiping Jia
- Department of Endocrinology and Metabolism; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Jiao Tong University Affiliated Sixth People's Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai China
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Norimatsu K, Miura SI, Suematsu Y, Shiga Y, Miyase Y, Nakamura A, Yamada M, Matsunaga A, Saku K. Associations between glycated albumin or hemoglobin A1c and the presence of coronary artery disease. J Cardiol 2015; 65:487-93. [DOI: 10.1016/j.jjcc.2014.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 06/06/2014] [Accepted: 07/08/2014] [Indexed: 11/29/2022]
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Ikezaki H, Furusyo N, Ihara T, Hayashi T, Ura K, Hiramine S, Mitsumoto F, Takayama K, Murata M, Kohzuma T, Ai M, Schaefer EJ, Hayashi J. Glycated albumin as a diagnostic tool for diabetes in a general Japanese population. Metabolism 2015; 64:698-705. [PMID: 25817605 DOI: 10.1016/j.metabol.2015.03.003] [Citation(s) in RCA: 36] [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: 12/24/2014] [Revised: 02/19/2015] [Accepted: 03/07/2015] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Diabetes mellitus is a major cause of cardiovascular, kidney, neurologic, and eye diseases, and may be preventable in some cases by lifestyle modification. Screening tests for diabetes mellitus include fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Our objective was to evaluate the utility of plasma glycated albumin (GA) in the diagnosis of diabetes mellitus. DESIGN AND METHODS A cross-sectional, community-based population study of 908 non-diabetic Japanese residents was conducted. Of these subjects, 176 with FPG value between 5.5 and 6.9mmol/l, and an HbA1c level of <6.5% received an oral glucose tolerance test (OGTT). RESULTS The OGTT results were used for the diagnosis of diabetes mellitus using World Health Organization criteria. Receiver operating characteristic (ROC) analyses demonstrated that optimal threshold values for the diagnosis of diabetes in this population were 15.2% for GA and 5.9% for HbA1c, respectively. Using these cutoff levels, the sensitivity of GA at 62.1% for detecting diabetes was the same as that of HbA1c. However the specificity for GA for detecting diabetes was 61.9%, while for HbA1c it was higher at 66.7%. CONCLUSIONS Our results indicate that the measurement of glycated albumin may serve as a useful screening test for diabetes in a general Japanese population.
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Affiliation(s)
- Hiroaki Ikezaki
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan; Cardiovascular Nutrition Laboratory, Jean Mayor USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan.
| | - Takeshi Ihara
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
| | - Takeo Hayashi
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
| | - Kazuya Ura
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
| | - Satoshi Hiramine
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
| | - Fujiko Mitsumoto
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
| | - Koji Takayama
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
| | - Masayuki Murata
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan
| | - Takuji Kohzuma
- Diagnostic Department, Asahi-Kasei Pharma, Tokyo 1018101, Japan
| | - Masumi Ai
- Department of Insured Medical Care Management, Tokyo Medical and Dental University Hospital, Tokyo 1138510, Japan
| | - Ernst J Schaefer
- Cardiovascular Nutrition Laboratory, Jean Mayor USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA
| | - Jun Hayashi
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 8128582, Japan; Kyushu General Internal Medicine Center, Hara-Doi Hospital, Fukuoka 8138588, Japan
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Danese E, Montagnana M, Nouvenne A, Lippi G. Advantages and pitfalls of fructosamine and glycated albumin in the diagnosis and treatment of diabetes. J Diabetes Sci Technol 2015; 9:169-76. [PMID: 25591856 PMCID: PMC4604592 DOI: 10.1177/1932296814567227] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The efficient diagnosis and accurate monitoring of diabetic patients are cornerstones for reducing the risk of diabetic complications. The current diagnostic and prognostic strategies in diabetes are mainly based on two tests, plasma (or capillary) glucose and glycated hemoglobin (HbA1c). Nevertheless, these measures are not foolproof, and their clinical usefulness is biased by a number of clinical and analytical factors. The introduction of other indices of glucose homeostasis in clinical practice such as fructosamine and glycated albumin (GA) may be regarded as an attractive alternative, especially in patients in whom the measurement of HbA1c may be biased or even unreliable. These include patients with rapid changes of glucose homeostasis and larger glycemic excursions, and patients with red blood cell disorders and renal disease. According to available evidence, the overall diagnostic efficiency of GA seems superior to that of fructosamine throughout a broad range of clinical settings. The current method for measuring GA is also better standardized and less vulnerable to preanalytical variables than those used for assessing fructosamine. Additional advantages of GA over HbA1c are represented by lower reagent cost and being able to automate the GA analysis on many conventional laboratory instruments. Although further studies are needed to definitely establish that GA can complement or even replace conventional measures of glycemic control such as HbA1c, GA may help the clinical management of patients with diabetes in whom HbA1c values might be unreliable.
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Affiliation(s)
- Elisa Danese
- Department of Life and Reproduction Sciences, Laboratory of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Martina Montagnana
- Department of Life and Reproduction Sciences, Laboratory of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Antonio Nouvenne
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Giuseppe Lippi
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy
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29
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Ma X, Hu X, Zhou J, Hao Y, Luo Y, Lu Z, Bao Y, Jia W. Glycated albumin is more closely correlated with coronary artery disease than 1,5-anhydroglucitol and glycated hemoglobin A1c. Cardiovasc Diabetol 2015; 14:16. [PMID: 25851542 PMCID: PMC4334610 DOI: 10.1186/s12933-014-0166-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/27/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the associations of two nontraditional glycemic markers, glycated albumin (GA) and 1,5-anhydroglucitol (1,5-AG), as well as glycated hemoglobin A1c (HbA1c) with coronary artery disease (CAD). METHODS In total, 272 subjects (178 men and 94 postmenopausal women) were enrolled in this study. All of them underwent coronary angiography which was used to diagnose CAD. The severity of coronary artery stenosis was assessed by the coronary stenosis index (CSI). GA and 1,5-AG were assayed using the enzymatic method, and HbA1c was detected by high-pressure liquid chromatography. RESULTS The HbA1c and GA levels were significantly higher in CAD group than those in non-CAD group (both P < 0.01). While the 1,5-AG level was significantly lower in CAD group than that in non-CAD group (P < 0.05). After adjustment for traditional risk factors of CAD, HbA1c, 1,5-AG, and GA, multivariate logistic regression analysis showed that GA was an independent risk factor for CAD (odds ratio = 1.143, 95% confidence interval: 1.048-1.247, P = 0.002). With CSI as a dependent variable, multiple stepwise regression analysis demonstrated an independent positive correlation between GA and CSI (standardized β = 0.184, P = 0.003), beyond gender, age, and lipid-lowering therapy, after adjustment for traditional risk factors of CAD, HbA1c, 1,5-AG, and GA. CONCLUSIONS GA was more closely correlated with CAD than HbA1c and 1,5-AG in a Chinese population with high risk of CAD.
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Abstract
The main purpose of treating diabetes is to prevent the onset and the progression of diabetic chronic complications. Since the mechanism of onset of chronic complications is still not well understood, the main strategy to achieve this purpose is to bring the plasma glucose level in diabetic patients as close as possible to that in healthy subjects and try to maintain good glycemic control over the long term. Glycated hemoglobin (HbA1c), glycated albumin (GA), fructosamine, and 1,5-anhydroglucitol (1,5 AG) are used for evaluating glycemic control. At present, HbA1c is widely used as a gold standard index for glycemic control in clinical practice. While HbA1c reflects the long-term glycemic control state (for the past 1-2 months), it does not accurately reflect glycemic control in the clinical state in which glycemic control improves or deteriorates in the short-term. It is also known that HbA1c in patients with hematological disorders such as anemia and variant hemoglobin shows an abnormal value. In addition, HbA1c mainly reflects the mean plasma glucose but does not reflect the postprandial plasma glucose. On the other hand, GA and 1,5-AG reflect intermediate- or short-term glycemic control and are not influenced by hemoglobin metabolism. While 1,5-AG is known to reflect the postprandial plasma glucose, it was shown recently that GA also reflects the postprandial plasma glucose. This chapter summarizes the measurement methods, usage methods, evidence, and problems concerning such indices for glycemic control.
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Bhat S, Mary S, Banarjee R, Giri AP, Kulkarni MJ. Immune response to chemically modified proteome. Proteomics Clin Appl 2014; 8:19-34. [PMID: 24375944 DOI: 10.1002/prca.201300068] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 12/06/2013] [Accepted: 12/09/2013] [Indexed: 11/10/2022]
Abstract
Both enzymatic and nonenzymatic PTMs of proteins involve chemical modifications. Some of these modifications are prerequisite for the normal functioning of cell, while other chemical modifications render the proteins as "neo-self" antigens, which are recognized as "non-self" leading to aberrant cellular and humoral immune responses. However, these modifications could be a secondary effect of autoimmune diseases, as in the case of type I diabetes, hyperglycemia leads to protein glycation. The enigma of chemical modifications and immune response is akin to the "chick-and-egg" paradox. Nevertheless, chemical modifications regulate immune response. In some of the well-known autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis, chemically modified proteins act as autoantigens forming immune complexes. In some instances, chemical modifications are also involved in regulating immune response during pathogen infection. Further, the usefulness of proteomic analysis of immune complexes is briefly discussed.
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Affiliation(s)
- Shweta Bhat
- Proteomics Facility, Division of Biochemical Sciences, CSIR-National Chemical Laboratory, Pune, India
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Indurthi VS, Leclerc E, Vetter SW. Calorimetric investigation of diclofenac drug binding to a panel of moderately glycated serum albumins. Eur J Pharm Sci 2014; 59:58-68. [DOI: 10.1016/j.ejps.2014.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 04/01/2014] [Accepted: 04/02/2014] [Indexed: 01/27/2023]
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Koga M. Glycated albumin; clinical usefulness. Clin Chim Acta 2014; 433:96-104. [PMID: 24631132 DOI: 10.1016/j.cca.2014.03.001] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 02/28/2014] [Accepted: 03/02/2014] [Indexed: 12/13/2022]
Abstract
The main purpose of treating diabetes is to prevent the onset and progression of diabetic chronic complications. Since the mechanism of onset of chronic complications is still not well understood, the main strategy to achieve this purpose is to bring plasma glucose levels as close as possible to those in healthy subjects and maintain good glycemic control over the long term. Since glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects, glycated protein can be used as a glycemic control indicator. Currently, among these glycated proteins, HbA1c is used as the gold standard of glycemic control indicators. However, HbA1c does not accurately reflect the actual status of glycemic control in some conditions with rapid changes in glycemic control and in patients with anemia (hemolytic anemia, iron deficiency anemia, etc.) and variant hemoglobin. In comparison, glycated albumin (GA) more accurately reflects changes in plasma glucose during the short term and postprandial plasma glucose. GA also reflects glycemic control in patients with hematologic disorders whereas GA does not reflect glycemic control in patients with disorder of albumin metabolism. GA is a glycemic control indicator which overcomes most of the disadvantages of HbA1c, and could be therefore expected to replace HbA1c as the standard glycemic control indicator in the near future. However, it is necessary to accumulate more evidences from large research studies on the effective directions for measuring GA.
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Affiliation(s)
- Masafumi Koga
- Department of Internal Medicine, Kawanishi City Hospital, Hyogo, Japan.
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Glycated albumin and diabetes mellitus. Biochim Biophys Acta Gen Subj 2013; 1830:5509-14. [DOI: 10.1016/j.bbagen.2013.05.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Revised: 05/02/2013] [Accepted: 05/06/2013] [Indexed: 12/21/2022]
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Sato Y, Nagao M, Asai A, Nakajima Y, Takaya M, Takeichi N, Takemitsu S, Sudo M, Kano‐Wakakuri T, Ishizaki A, Harada T, Tanimura‐Inagaki K, Okajima F, Tamura H, Sugihara H, Oikawa S. Association of glycated albumin with the presence of carotid plaque in patients with type 2 diabetes. J Diabetes Investig 2013; 4:634-9. [PMID: 24843719 PMCID: PMC4020260 DOI: 10.1111/jdi.12085] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 01/29/2013] [Accepted: 03/01/2013] [Indexed: 12/16/2022] Open
Abstract
AIMS/INTRODUCTION Postprandial hyperglycemia is a potent risk factor for cardiovascular disease. Serum glycated albumin (GA) has been reported to reflect postprandial blood glucose fluctuations. In the present study, we assessed the possible correlation of GA with the presence of carotid plaque to evaluate the potential clinical usefulness of GA for predicting atherosclerotic cardiovascular complications in patients with type 2 diabetes. MATERIALS AND METHODS Patients with type 2 diabetes (n = 236) admitted to Nippon Medical School Hospital (Tokyo, Japan) for glycemic control (aged 19-86 years, 81 females and 155 males) were examined. Clinical measurements were taken on admission. The presence of carotid plaque was assessed by ultrasonography. RESULTS In patients with carotid plaque (n = 154), GA (P = 0.023) was higher than those without carotid plaque (n = 82). In contrast, neither fasting plasma glucose (P = 0.48) nor glycated hemoglobin (P = 0.41) was significantly different between the groups. The results of logistic regression analysis showed that GA (age- and sex-adjusted odds ratio [95% confidence interval], 1.05 [1.01-1.09]; P = 0.017) and glycated hemoglobin (1.17 [1.01-1.37]; P = 0.036) were significantly associated with the presence of carotid plaque. CONCLUSIONS The positive correlation of serum GA with the presence of carotid plaque in type 2 diabetes suggests that GA will serve as a useful clinical marker for predicting diabetic cardiovascular complications.
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Affiliation(s)
- Yuki Sato
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Mototsugu Nagao
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Akira Asai
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Yasushi Nakajima
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Makiyo Takaya
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Naomi Takeichi
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Shuji Takemitsu
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Mariko Sudo
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Toshiko Kano‐Wakakuri
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Akira Ishizaki
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Taro Harada
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Kyoko Tanimura‐Inagaki
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Fumitaka Okajima
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Hideki Tamura
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Hitoshi Sugihara
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
| | - Shinichi Oikawa
- Division of Endocrinology and MetabolismDepartment of MedicineNippon Medical SchoolTokyoJapan
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Cohen MP. Clinical, pathophysiological and structure/function consequences of modification of albumin by Amadori-glucose adducts. Biochim Biophys Acta Gen Subj 2013; 1830:5480-5. [PMID: 23624335 DOI: 10.1016/j.bbagen.2013.04.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 04/16/2013] [Accepted: 04/17/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND The nonenzymatic condensation of glucose with albumin results in the formation of albumin modified by Amadori glucose adducts, the principal form in which glycated albumin exists in vivo. SCOPE OF REVIEW This review focuses on (a) the utility of measurement of Amadori-modified glycated albumin (AGA) as a biomarker in diabetes, where elevated levels attend the hyperglycemic state; (b) the role of AGA as a causal factor in the pathogenesis of complications of diabetes; (c) effects on transport properties; and (d) structural and functional consequences of the modification of albumin by Amadori glucose adducts. It does not discuss counterparts with respect to Advanced Glycation Endproducts (AGE), which may be found in other publications. MAJOR CONCLUSIONS Nonenzymatic glycation of albumin, which is increased in diabetes, has clinical relevance and pathophysiologic importance, with ramifications for the management of this disease, the development of its complications, and the transport of endogenous and exogenous ligands. GENERAL SIGNIFICANCE Appreciation of the manifold consequences of AGA has afforded new avenues for assessing clinical management of diabetes, awareness of the impact of nonenzymatic glycation on albumin biology, insights into the pathogenesis of vascular complications of diabetes, and avenues of investigation of and intervention strategies for these complications. This article is part of a Special Issue on albumin. This article is part of a Special Issue entitled Serum Albumin.
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Affiliation(s)
- Margo P Cohen
- Glycadia, Inc., 1880 JFK Boulevard, Suite 200, Philadelphia, PA 19103, United States.
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Evaluation of biological variation of glycated albumin (GA) and fructosamine in healthy subjects. Clin Chim Acta 2013; 423:1-4. [PMID: 23588063 DOI: 10.1016/j.cca.2013.04.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/03/2013] [Accepted: 04/03/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Glycated albumin (GA) and fructosamine are nonenzymatically glycated proteins still frequently utilized for monitoring glycemic control in diabetics. To investigate the analytical variation and the degree of individuality of these glycemic markers, we have performed an experimental study under a well designed and standardized protocol. METHODS We collected five specimens from each of 18 apparently healthy subjects (9 men and 9 women, ages 26-52 years), on the same day, every two weeks for two months. Samples were stored at -80°C until analysis and assayed in duplicate in a single analytical run. GA and fructosamine were measured using enzymatic (Lucica®GA-L, Asahi Kasei Pharma, AKP, Tokyo, Japan) and colorimetric assays, respectively, on a Modular P Roche system (Roche Diagnostics GmbH, Mannheim, Germany). Data were analyzed by ANOVA. RESULTS Analytical coefficient of variation (CVA) was 1.7%, 2.3% and 2.8% for GA, albumin and fructosamine, respectively. Within-subject (CVW) and between-subject (CVG) coefficients of variation were 2.1% and 10.6% for GA, 2.3% and 2.9% for albumin, and 2.3% and 6.3% for fructosamine. The estimated critical difference (CD) was 7.5% for GA, 9% for albumin and 10% for fructosamine. CONCLUSIONS The good quality achieved by the analytical method for GA assessment and the reduced within-subject biological variation would allow to recommend this test in clinical practice for evaluation of glycemic control along with measurement of glycated hemoglobin.
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Machado-Lima A, Iborra RT, Pinto RS, Sartori CH, Oliveira ER, Nakandakare ER, Stefano JT, Giannella-Neto D, Corrêa-Giannella MLC, Passarelli M. Advanced glycated albumin isolated from poorly controlled type 1 diabetes mellitus patients alters macrophage gene expression impairing ABCA-1-mediated reverse cholesterol transport. Diabetes Metab Res Rev 2013; 29:66-76. [PMID: 23015358 DOI: 10.1002/dmrr.2362] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 08/31/2012] [Accepted: 09/02/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND We evaluated the effects of albumin isolated from control individuals and from patients with poorly controlled type 1 diabetes mellitus on macrophage gene expression and on reverse cholesterol transport. METHODS Serum albumin was purified from control subjects (n = 12) and from patients with poorly controlled type 1 diabetes mellitus (n = 13). (14)C-cholesterol-labelled J774 macrophages treated with albumin were employed to measure cholesterol efflux mediated by apo A-I, HDL(3) or HDL(2), the intracellular lipid accumulation and the cellular ABCA-1 protein content. Agilent arrays (44000 probes) were used to analyse gene expression. Several differentially expressed genes were validated by real-time reverse transcription-PCR using TaqMan Two Step RT-PCR. RESULTS Levels of glycation-modified and (carboxymethyl)lysine-modified albumin were higher in diabetic patients than in control subjects. Apo A-I-mediated and HDL(2)-mediated cellular cholesterol efflux were impaired in macrophages treated with albumin from diabetic patients in comparison with control albumin-treated cells, which was attributed to the reduction in ABCA-1 protein content. Even in the presence of cholesterol acceptors, a higher level of intracellular lipid was observed in macrophages exposed to albumin from diabetic individuals in comparison with the control. The reduction in ABCA-1 content was associated with enhanced expression of stearoyl CoA desaturase 1 and decreased expression of janus kinase 2, which were induced by albumin from patients with type 1 diabetes mellitus. CONCLUSIONS (Carboxymethyl)lysine-modified albumin isolated from poorly controlled type 1 diabetic patients impairs ABCA-1-mediated reverse cholesterol transport and elicits intracellular lipid accumulation, possibly contributing to atherosclerosis.
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Affiliation(s)
- Adriana Machado-Lima
- Lipids Laboratory (LIM 10), Faculty of Medical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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Shen Y, Pu LJ, Lu L, Zhang Q, Zhang RY, Shen WF. Serum advanced glycation end-products and receptors as prognostic biomarkers in diabetics undergoing coronary artery stent implantation. Can J Cardiol 2012; 28:737-43. [PMID: 23073352 DOI: 10.1016/j.cjca.2012.08.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Revised: 08/15/2012] [Accepted: 08/15/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study investigated the impact of elevated glycated albumin (GA) and reduced soluble receptor for advanced glycation end-products (sRAGE) and endogenous secretory receptor for advanced glycation end-products (esRAGE) levels in serum on the severity of albuminuria, occurrence of contrast-induced acute kidney injury (CI-AKI) and 1-year clinical outcome in type 2 diabetic patients undergoing sirolimus-eluting stent-based percutaneous coronary intervention. METHODS We compared serum levels of GA, sRAGE, esRAGE, and glycosylated hemoglobin (HbA1c), occurrence of CI-AKI, and major adverse cardiac events at 1-year clinical follow-up in 3 groups of type 2 diabetes based on 24-hour urinary albumin excretion: I = normoalbuminuria (< 30 mg; n = 190); II = microalbuminuria (30-300 mg; n = 102); and III = macroalbuminuria (≥ 300 mg; n = 86). RESULTS Serum levels of GA and HbA1c increased step-wise from group I to III, and serum levels of sRAGE and esRAGE were decreased in the groups with albuminuria, with the lowest values in those with microalbuminuria. GA (Pearson's r = 0.264; P < 0.001), sRAGE (Pearson's r = -0.210; P < 0.001), esRAGE (Pearson's r = -0.145; P = 0.04), and HbA1c (Pearson's r = 0.214; P < 0.001) correlated significantly with urinary albumin excretion. After adjusting for confounding factors, GA, sRAGE, esRAGE, and albuminuria status remained independently associated with both CI-AKI and 1-year major adverse cardiac events. CONCLUSIONS Elevated GA and reduced sRAGE and esRAGE levels in serum are associated with severity of albuminuria and postprocedural CI-AKI, and exert a negative impact on 1-year clinical outcome in patients with type 2 diabetes undergoing percutaneous coronary intervention with sirolimus-eluting stent implantation.
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Affiliation(s)
- Ying Shen
- Department of Cardiology, Rui Jin Hospital, Medical School of Jiaotong University, RuiJin Hospital, 197 Rui Jin Road II, Shanghai, People's Republic of China
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Alvarez E. Two reflections about Amadori products: biomarkers or therapeutic targets for coronary artery disease? Cardiology 2012; 123:81-3. [PMID: 23018587 DOI: 10.1159/000342807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Indexed: 11/19/2022]
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Zheng CM, Ma WY, Wu CC, Lu KC. Glycated albumin in diabetic patients with chronic kidney disease. Clin Chim Acta 2012; 413:1555-61. [PMID: 22579765 DOI: 10.1016/j.cca.2012.04.025] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 04/23/2012] [Accepted: 04/23/2012] [Indexed: 02/08/2023]
Abstract
Chronic hyperglycemia results in a non-enzymatic glycation of proteins, and produces Amadori products, such as glycated albumin (GA), glycosylated hemoglobin (HbA1c), and fructosamine. In current clinical practice, long-term glycemic control is assessed by quarterly measurements of HbA1c. Since the degree of hemoglobin glycosylation depends not only on the level of glycemic control, but also on the lifespan of red blood cells, patients with hemoglobin disorders or anemia of any cause may have erroneous HbA1c levels, and consequently receive insufficient treatment. Patients with chronic kidney disease (CKD) often suffer from various types of anemia, and consequently, they are frequently treated with iron and/or erythropoietin therapy or frequent blood transfusion. Thus, serum GA is a potentially useful glycemic index in diabetic patients with CKD, since it is not influenced by anemia and associated treatments. GA may also reflect the status of blood glucose more rapidly (2-3 weeks) than HbA1c (2-3 months), and is beneficial in those with wide variations in blood glucose or at higher risk for hypoglycemia. If clinical investigations support its utility, it may be applicable as a screening tool for all patients with diabetes during routine health examinations. Serum GA levels are also associated with AGE-related fluorescence and the number of glycation sites, and it may influence the structural and functional changes inalbumin. Since end-stage renal disease is an extreme microvascular complication of diabetic nephropathy, CKD patients with diabetes should be carefully managed to prevent disease progression. In this review, the clinical aspects of GA were discussed, including a comparison of GA with other glycated proteins, the utility and limitations of GA as a glycemic index, its influence on the therapeutic effects of hypoglycemic agents, its correlations with vascular complications, and its potential role in pathogenesis, specifically in diabetic patients with CKD.
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Affiliation(s)
- Cai-Mei Zheng
- Division of Nephrology, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan
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Barman I, Dingari NC, Kang JW, Horowitz GL, Dasari RR, Feld MS. Raman spectroscopy-based sensitive and specific detection of glycated hemoglobin. Anal Chem 2012; 84:2474-82. [PMID: 22324826 PMCID: PMC3296902 DOI: 10.1021/ac203266a] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In recent years, glycated hemoglobin (HbA1c) has been increasingly accepted as a functional metric of mean blood glucose in the treatment of diabetic patients. Importantly, HbA1c provides an alternate measure of total glycemic exposure due to the representation of blood glucose throughout the day, including post-prandially. In this article, we propose and demonstrate the potential of Raman spectroscopy as a novel analytical method for quantitative detection of HbA1c, without using external dyes or reagents. Using the drop coating deposition Raman (DCDR) technique, we observe that the nonenzymatic glycosylation (glycation) of the hemoglobin molecule results in subtle but discernible and highly reproducible changes in the acquired spectra, which enable the accurate determination of glycated and nonglycated hemoglobin using standard chemometric methods. The acquired Raman spectra display excellent reproducibility of spectral characteristics at different locations in the drop and show a linear dependence of the spectral intensity on the analyte concentration. Furthermore, in hemolysate models, the developed multivariate calibration models for HbA1c show a high degree of prediction accuracy and precision--with a limit of detection that is a factor of ~15 smaller than the lowest physiological concentrations encountered in clinical practice. The excellent accuracy and reproducibility achieved in this proof-of-concept study opens substantive avenues for characterization and quantification of the glycosylation status of (therapeutic) proteins, which are widely used for biopharmaceutical development. We also envision that the proposed approach can provide a powerful tool for high-throughput HbA1c sensing in multicomponent mixtures and potentially in hemolysate and whole blood lysate samples.
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Affiliation(s)
- Ishan Barman
- Laser Biomedical Research Center, G. R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA.
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Katsiki N, Yovos JG, Gotzamani-Psarrakou A, Karamitsos DT. Adipokines and vascular risk in type 2 diabetes mellitus. Angiology 2012; 62:601-4. [PMID: 21990548 DOI: 10.1177/0003319711409201] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Niki Katsiki
- First Propedeutic Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Kim WJ, Park CY. Review of the Potential Glycemic Markers Glycated Albumin and 1,5-anhydroglucitol. ACTA ACUST UNITED AC 2012. [DOI: 10.4093/jkd.2012.13.1.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Won Jun Kim
- Department of Endocrinology and Metabolism, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Cheol-Young Park
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lu L, Peng WH, Wang W, Wang LJ, Chen QJ, Shen WF. Effects of atorvastatin on progression of diabetic nephropathy and local RAGE and soluble RAGE expressions in rats. J Zhejiang Univ Sci B 2011; 12:652-9. [PMID: 21796806 DOI: 10.1631/jzus.b1101004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Advanced glycation end-products (AGEs) exert inflammatory and oxidative stress insults to produce diabetic nephropathy mainly through the receptor for AGEs (RAGE). This study aimed to assess the effect of atorvastatin on diabetic nephropathy via soluble RAGE (sRAGE) and RAGE expressions in the rat kidney. METHODS Thirty-two male Sprague-Dawley rats were divided into four groups based on the presence or absence of streptozotocin-induced diabetes with or without atorvastatin treatment (10 mg/kg for 24 weeks). Serum sRAGE and glycated albumin (GA) levels were measured with enzyme-linked immunosorbent assay (ELISA) and improved bromocresol purple methods. Renal AGEs, RAGE, endogenous secretory RAGE (esRAGE), and sRAGE were determined with reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. RESULTS Mesangial expansion and microalbuminuria were aggravated in diabetic rats, and improved with atorvastatin treatment. Serum sRAGE levels were lower in diabetic than in normal rats. After atorvastatin treatment, serum and renal sRAGE levels were up-regulated, while renal RAGE expression was decreased in diabetic rats, associated with a reduction in accumulation of AGEs, though renal esRAGE mRNA expression was not significantly increased. CONCLUSIONS Atorvastatin exerted a beneficial effect on diabetic nephropathy with reduced AGE accumulation, down-regulating RAGE expression and up-regulating sRAGE in the kidney.
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Affiliation(s)
- Lin Lu
- Department of Cardiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
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Foo JP, Mantzoros CS. The quest for the perfect biomarker of long-term glycemia: new studies, new trials and tribulations. Metabolism 2011; 60:1651-4. [PMID: 21820137 DOI: 10.1016/j.metabol.2011.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 06/22/2011] [Indexed: 10/17/2022]
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Vos FE, Schollum JB, Walker RJ. Glycated albumin is the preferred marker for assessing glycaemic control in advanced chronic kidney disease. NDT Plus 2011; 4:368-75. [PMID: 25984197 PMCID: PMC4421676 DOI: 10.1093/ndtplus/sfr140] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 09/05/2011] [Indexed: 12/14/2022] Open
Abstract
Diabetic nephropathy is the most common aetiology of end-stage kidney disease (ESKD). Strict glycaemic control reduces the development and progression of diabetes-related complications, and there is evidence that improved metabolic control improves outcomes in diabetic subjects with advanced chronic kidney disease (CKD). Glycaemic control in people with kidney disease is complex. Changes in glucose and insulin homeostasis may occur as a consequence of loss of kidney function and dialysis. The reliability of measures of long-term glycaemic control is affected by CKD and the accuracy of glycated haemoglobin (HbA1c) in the setting of CKD and ESKD is questioned. Despite the altered character of diabetes in CKD, current guidelines for diabetes management are not specifically adjusted to this patient group. The validity of indicators of longer term glycaemic control has been the focus of increased recent research. This review discusses the current understanding of commonly used indicators of metabolic control (HbA1c, fructosamine, glycated albumin) in the setting of advanced CKD (Stages 4 and 5, glomerular filtration rate <30 mL/min/1.73m(2)).
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Affiliation(s)
- Frederiek E Vos
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - John B Schollum
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Robert J Walker
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Ibrahim AS, El-Remessy AB, Matragoon S, Zhang W, Patel Y, Khan S, Al-Gayyar MM, El-Shishtawy MM, Liou GI. Retinal microglial activation and inflammation induced by amadori-glycated albumin in a rat model of diabetes. Diabetes 2011; 60:1122-33. [PMID: 21317295 PMCID: PMC3064086 DOI: 10.2337/db10-1160] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE During diabetes, retinal microglial cells are activated to release inflammatory cytokines that initiate neuronal loss and blood-retinal barrier breakdown seen in diabetic retinopathy (DR). The mechanism by which diabetes activates microglia to release those inflammatory mediators is unclear and was therefore elucidated. RESEARCH DESIGN AND METHODS Microglia activation was characterized in streptozocin-injected rats and in isolated microglial cells using immunofluorescence, enzyme-linked immunosorbent assay, RT-PCR, and Western blot analyses. RESULTS In 8-week diabetic retina, phospho-extracellular signal-related kinase (ERK) and P38 mitogen-activated protein kinases were localized in microglia, but not in Mueller cells or astrocytes. At the same time, Amadori-glycated albumin (AGA)-like epitopes were featured in the regions of microglia distribution, implicating a pathogenic effect on microglial activation. To test this, diabetic rats were treated intravitreally with A717, a specific AGA-neutralizing antibody, or murine IgG. Relative to nondiabetic rats, diabetic rats (IgG-treated) manifested 3.9- and 7.9-fold increases in Iba-1 and tumor necrosis factor (TNF)-α mRNAs, respectively. Treatment of diabetic rats with A717 significantly attenuated overexpression of these mRNAs. Intravitreal injection of AGA per se in normal rats resulted in increases of Iba-1 expression and TNF-α release. Guided by these results, a cultured retinal microglia model was developed to study microglial response after AGA treatment and the mechanistic basis behind this response. The results showed that formation of reactive oxygen species and subsequent activation of ERK and P38, but not Jun NH2-terminal kinase, are molecular events underpinning retinal microglial TNF-α release during AGA treatment. CONCLUSIONS These results provide new insights in understanding the pathogenesis of early DR, showing that the accumulated AGA within the diabetic retina elicits the microglial activation and secretion of TNF-α. Thus, intervention trials with agents that neutralize AGA effects may emerge as a new therapeutic approach to modulate early pathologic pathways long before the occurrence of vision loss among patients with diabetes.
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Affiliation(s)
- Ahmed S. Ibrahim
- Department of Ophthalmology, Medical College of Georgia, Augusta, Georgia
- Vision Discovery Institute, Medical College of Georgia, Augusta, Georgia
- Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Azza B. El-Remessy
- Department of Ophthalmology, Medical College of Georgia, Augusta, Georgia
- Vision Discovery Institute, Medical College of Georgia, Augusta, Georgia
- Program in Clinical and Experimental Therapeutics, University of Georgia, Athens, Georgia
- VA Medical Center, Augusta, Georgia
| | - Suraporn Matragoon
- Program in Clinical and Experimental Therapeutics, University of Georgia, Athens, Georgia
- VA Medical Center, Augusta, Georgia
| | - Wenbo Zhang
- Vascular Biology Center, Medical College of Georgia, Augusta, Georgia
| | - Yogin Patel
- Department of Medicine, Medical College of Georgia, Augusta, Georgia
| | - Sohail Khan
- Department of Ophthalmology, Medical College of Georgia, Augusta, Georgia
| | - Mohammed M. Al-Gayyar
- Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
- Program in Clinical and Experimental Therapeutics, University of Georgia, Athens, Georgia
- VA Medical Center, Augusta, Georgia
| | | | - Gregory I. Liou
- Department of Ophthalmology, Medical College of Georgia, Augusta, Georgia
- Vision Discovery Institute, Medical College of Georgia, Augusta, Georgia
- Corresponding author: Gregory I. Liou,
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Wang XQ, Yang K, He YS, Lu L, Shen WF. Receptor Mediated Elevation in FABP4 Levels by Advanced Glycation End Products Induces Cholesterol and Triacylglycerol Accumulation in THP-1 Macrophages. Lipids 2011; 46:479-86. [DOI: 10.1007/s11745-011-3542-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 02/08/2011] [Indexed: 01/22/2023]
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50
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Ma WY, Wu CC, Pei D, Hung KC, Hsia TL, Su CC, Chu YM, Lu KC. Glycated albumin is independently associated with estimated glomerular filtration rate in nondiabetic patients with chronic kidney disease. Clin Chim Acta 2010; 412:583-6. [PMID: 21172335 DOI: 10.1016/j.cca.2010.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 12/07/2010] [Accepted: 12/07/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Glycated albumin (GA) may contribute to diabetic nephropathy, but the clinical significance of GA in patients with chronic kidney disease (CKD) is unknown. METHODS Patients were classified with the NKF/DOQI classification system as mild (stage I, II), moderate (stage III), or advanced CKD (stage IV). Those undergoing dialysis or with CKD stage V were excluded. GA was measured using the Lucica TM GA-L assay kit. The relationship between GA and renal dysfunction was analyzed in patients with or without diabetes. RESULTS A total of 187 subjects were enrolled. GA values in those with normal, mild, moderate and advanced CKD were 18.4 ± 1.4%, 18.4 ± 3.1%, 19.0 ± 3.8%, 20.4 ± 6.4%, respectively, in diabetic patients (N=67, p=0.5), and were 14.1 ± 1.9%, 14.2 ± 2.2%, 15.9 ± 1.9%, 15.0 ± 1.7%, respectively, in nondiabetic patients (N=120, p=0.004). GA value was negatively correlated to eGFR in nondiabetic patients (r=-0.35, p<0.001) but not in diabetic patients (r=-0.11, p=0.39). In the adjusted model, GA is independently correlated to eGFR only in nondiabetic subjects. CONCLUSIONS Increased GA concentrations are independently associated with renal dysfunction in nondiabetic patients with CKD.
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Affiliation(s)
- Wen-Ya Ma
- Department of Internal Medicine, Cardinal Tien Hospital, Medical School, Catholic Fu Jen University, Xindien City, Taipei County, Taiwan
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