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Kanthi A, Singh D, Manjunath NK, Nagarathna R. Changes in Electrical Activities of the Brain Associated with Cognitive Functions in Type 2 Diabetes Mellitus: A Systematic Review. Clin EEG Neurosci 2024; 55:130-142. [PMID: 35343277 DOI: 10.1177/15500594221089106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Electroencephalogram (EEG) has the potentials to decipher the neural underpinnings of cognitive processes in clinical and healthy populations. Objective: The current systematic review is intended to examine the functional brain changes underlying cognitive dysfunctions in T2DM patients. Methods: The review was conducted on studies published in the PubMed, WebofScience, Cochrane, PsycInfo database till June 2021. The keywords used were electroencephalogram, T2DM, cognitive impairment/dysfunction. We considered studies using resting-state EEG and ERP. The preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines were followed to compile the studies. Results: The search yielded a total of 2384 studies. Finally, 16 independent studies were included. There was a pattern of a shift in EEG power observed from higher to lower frequencies in T2DM patients, though to a lesser degree than Alzheimer's disease patients. P300 latency was increased in T2DM patients mainly over frontal, parietal, and posterior regions. P300 and N100 amplitudes were decreased in T2DM patients than in healthy controls. Conclusion: The results indicate that T2DM has consequences for cognitive functions, and it finds a place in the continuum of healthy cognition to dementia.
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Affiliation(s)
- Amit Kanthi
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
| | - Deepeshwar Singh
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
| | - N K Manjunath
- Department of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
| | - Raghuram Nagarathna
- Arogyadhama, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India
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2
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Wang Z, Zhao H, Zhou Q. Analysis of Risk Factors of Coronary Heart Disease and Its Correlation with Inflammatory Factors in Patients with Type 2 Diabetes Mellitus. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6818888. [PMID: 35782064 PMCID: PMC9249516 DOI: 10.1155/2022/6818888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/16/2022] [Accepted: 05/10/2022] [Indexed: 12/18/2022]
Abstract
In this paper, we propose a new method to analyze the risk factors of coronary heart disease (CHD) and their correlation with inflammatory factors in patients with type 2 diabetes mellitus (T2DM). To verify and implement this idea, we have selected a total of 165 patients with T2DM treated in our hospital from March 2019 to October 2021 that were divided into CHD group (n = 72) and non-CHD group (n = 93) according to the results of coronary angiography. Patients with CHD were divided into three groups according to SYNTAX score: low-risk group, medium-risk group, and high-risk group. The clinical data of all patients were collected. Univariate and multivariate analyses were used to screen the risk factors of CHD in patients with T2DM. The related inflammatory factors such as C-reactive protein (CRP), interleukin-6 (IL-6), and water-soluble CD40 ligand (sCD40L) were detected in all patients. Pearson's linear correlation analysis was used to analyze the correlation between the expression levels of CRP, IL-6, and sCD40L and CHD in patients with T2DM. The receiver working curve (ROC) was used to evaluate the efficacy of IL-6, CRP, and sCD40L in predicting high risk of CHD in patients with T2DM. Multivariate analysis showed that age and course of T2DM, FFA, UA, and Hcy were risk factors for CHD in patients with T2DM. The serum levels of IL-6, CRP, and sCD40L in patients with CHD were significantly higher than those in patients without CHD. According to SYNTAX score, 72 patients with CHD were divided into low-risk group (n = 36), medium-risk group (n = 26), and high-risk group (n = 10). Compared with the low-risk group, the expression levels of serum IL-6 CRP and sCD40L in the middle-risk group and high-risk group were significantly higher than those in the low-risk group. The expression levels of IL-6 CRP and sCD40L in the high-risk group were also significantly higher than those in the medium-risk group. There is a positive correlation between syntactic score and IL-6 expression in patients with T2DM complicated with coronary heart disease (r = 0.778, P < 0.001), with the expression of CRP (r = 0.756, P < 0.001) and with the expression of sCD40L (r = 0.748, P < 0.001). Advanced age, long course of T2DM, elevated levels of FFA, UA, and Hcy are all risk factors of CHD in patients with type 2 diabetes. T2DM patients with the above risk factors should be vigilant and pay attention to monitoring the related indexes of coronary heart disease to avoid the occurrence of serious cardiovascular disease. CRP, IL-6, and sCD40L are involved in the progression of CHD in patients with T2DM. The more severe CHD is, the higher the expression of IL-6, CRP, and sCD40L in serum.
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Affiliation(s)
- Zhigang Wang
- Department of Geriatrics, Wuhan No.1 Hospital, Wuhan, Hubei Province, China 430022
| | - Hui Zhao
- Department of Geriatrics, Wuhan No.1 Hospital, Wuhan, Hubei Province, China 430022
| | - Qian Zhou
- Department of Geriatrics, Huangshi Central Hospital, Huangshi, Hubei Province, China 435000
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Celik H, Dursun AD, Tatar Y, Omercioglu G, Bastug M. Irisin pathways in hearts of Type 1 diabetic adult male rats following 6 weeks of moderate and high-volume aerobic exercise on a treadmill. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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4
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Basnet R, Bahadur T, Basnet BB, Khadka S. Overview on thioredoxin-interacting protein (TXNIP): a potential target for diabetes intervention. Curr Drug Targets 2022; 23:761-767. [PMID: 35240955 DOI: 10.2174/1389450123666220303092324] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/25/2021] [Accepted: 12/31/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is a common metabolic disorder characterized by a persistent increment of blood glucose. Type 2 DM is characterized by insulin resistance and β-cell dysfunction. Thioredoxin-interacting protein (TXNIP) is among the factors that control the production and loss of pancreatic β-cells. OBJECTIVE Recent studies have shown that high glucose can significantly up-regulate the expression of the TXNIP. Overexpression of TXNIP in β-cells not only induced apoptosis but also decreased the production of insulin. At the same time, TXNIP deficiency protected the apoptosis of β-cells, leading to increased insulin production. Therefore, finding small molecules that can modulate TXNIP expression and downstream signalling pathways is essential. Thus, the inhibition of TXNIP has beneficial effects on the cardiovascular system and other tissues such as the heart and the kidney in DM. Therefore, DM treatment must target small TXNIP activity, inhibit expression, and promote endogenous cell mass and insulin production. CONCLUSION This review briefly describes the effect mechanism, regulatory mechanism, and crystal structure of TXNIP. In addition, we highlight how TXNIP signalling networks contribute to diabetes and interact with drugs that inhibit the development often and its complexes. Finally, the current status and prospects of TXNIP targeted therapy are also discussed.
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Affiliation(s)
- Rajesh Basnet
- State Key Laboratory of Respiratory Disease, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China
| | - Til Bahadur
- Fujian Medical University, Fuzhou, Fujian, China
| | - Buddha Bahadur Basnet
- Faculty of Science, Nepal Academy of Science and Technology, Government of Nepal, Lalitpur, Nepal
| | - Sandhya Khadka
- Department of Pharmacy, Hope International College, Purbanchal University, Lalitpur, Nepal
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5
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Pinna V, Doneddu A, Roberto S, Magnani S, Ghiani G, Mulliri G, Sanna I, Serra S, Hosseini Kakhak SA, Milia R, Fadda D, Lecis R, Guicciardi M, Crisafulli A. Combined mental task and metaboreflex impair cerebral oxygenation in patients with type 2 diabetes mellitus. Am J Physiol Regul Integr Comp Physiol 2021; 320:R488-R499. [PMID: 33533319 DOI: 10.1152/ajpregu.00288.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiovascular regulation is altered by type 2 diabetes mellitus (DM2), producing an abnormal response to muscle metaboreflex. During physical exercise, cerebral blood flow is impaired in patients with DM2, and this phenomenon may reduce cerebral oxygenation (COX). We hypothesized that the simultaneous execution of a mental task (MT) and metaboreflex activation would reduce COX in patients with DM2. Thirteen individuals suffering from DM2 (6 women) and 13 normal age-matched controls (CTL, 6 women) participated in this study. They underwent five different tests, each lasting 12 min: postexercise muscle ischemia (PEMI) to activate the metaboreflex, control exercise recovery (CER), PEMI + MT, CER + MT, and MT alone. COX was evaluated using near-infrared spectroscopy with sensors applied to the forehead. Central hemodynamics was assessed using impedance cardiography. We found that when MT was superimposed on the PEMI-induced metaboreflex, patients with DM2 could not increase COX to the same extent reached by the CTL group (101.13% ± 1.08% vs. 104.23% ± 2.51%, P < 0.05). Moreover, patients with DM2 had higher mean blood pressure and systemic vascular resistance as well as lower stroke volume and cardiac output levels compared with the CTL group, throughout our experiments. It was concluded that patients with DM2 had reduced capacity to enhance COX when undertaking an MT during metaboreflex. Results also confirm that patients with DM2 had dysregulated hemodynamics during metaboreflex, with exaggerated blood pressure response and vasoconstriction. This may have implications for these patients' lack of inclination to exercise.
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Affiliation(s)
- Virginia Pinna
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Sardinia, Italy
| | - Azzurrra Doneddu
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy
| | - Silvana Roberto
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy
| | - Sara Magnani
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Sardinia, Italy
| | - Giovanna Ghiani
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy
| | - Gabriele Mulliri
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Sardinia, Italy
| | - Irene Sanna
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy
| | - Stefano Serra
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy
| | | | - Raffaele Milia
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy
| | - Daniela Fadda
- The Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Sardinia, Italy
| | - Romina Lecis
- The Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Sardinia, Italy
| | - Marco Guicciardi
- The Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Sardinia, Italy
| | - Antonio Crisafulli
- The Sports Physiology Laboratory, University of Cagliari, Sardinia, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Sardinia, Italy
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6
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Doneddu A, Roberto S, Pinna V, Magnani S, Ghiani G, Sainas G, Mulliri G, Serra S, Kakhak SAH, Milia R, Lecis R, Guicciardi M, Crisafulli A. Effect of Combined Mental Task and Metaboreflex Activation on Hemodynamics and Cerebral Oxygenation in Patients With Metabolic Syndrome. Front Physiol 2020; 11:397. [PMID: 32477157 PMCID: PMC7241117 DOI: 10.3389/fphys.2020.00397] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/02/2020] [Indexed: 01/26/2023] Open
Abstract
Objective: The hemodynamic response to muscle metaboreflex has been reported to be significantly altered by metabolic syndrome (MS), with exaggerated systemic vascular resistance (SVR) increments and reduced cardiac output (CO) in comparison to healthy controls (CTLs). Moreover, patients with metabolic disorders, such as type 2 diabetes, have proven to have impaired cerebral blood flow in response to exercise. Thus, we hypothesized that contemporary mental task (MT) and metaboreflex would result in reduced cerebral oxygenation (COX) in these patients. Methods: Thirteen MS patients (five women) and 14 normal age-matched CTLs (six women) were enrolled in this study. All the participants underwent five different tests, each lasting 12 min: post-exercise muscle ischemia (PEMI) to activate the metaboreflex, control exercise recovery (CER), PEMI + MT, CER + MT, and MT alone. Cerebral oxygenation was evaluated using near-infrared spectroscopy with sensors applied to the forehead. Hemodynamics were measured using impedance cardiography. Results: The main results show that MS patients had higher SVR and lower CO levels compared to the CTL group during metaboreflex activation. Stroke volume and ventricular filling and emptying rates were also significantly reduced. Moreover, when MT was added to PEMI, COX was significantly increased in the CTL group with respect to the baseline (103.46 ± 3.14%), whereas this capacity was reduced in MS patients (102.37 ± 2.46%). Conclusion: It was concluded that (1) patients with MS showed hemodynamic dysregulation during the metaboreflex, with exaggerated vasoconstriction and that (2) as compared to CTL, MS patients had reduced capacity to enhance COX when an MT superimposed the metaboreflex.
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Affiliation(s)
- Azzurrra Doneddu
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Silvana Roberto
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Virginia Pinna
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Sara Magnani
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
| | - Giovanna Ghiani
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Gianmarco Sainas
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Gabriele Mulliri
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Stefano Serra
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | | | - Raffaele Milia
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy
| | - Romina Lecis
- Department of Pedagogy, Psychology, and Philosophy, University of Cagliari, Cagliari, Italy
| | - Marco Guicciardi
- Department of Pedagogy, Psychology, and Philosophy, University of Cagliari, Cagliari, Italy
| | - Antonio Crisafulli
- Sports Physiology Laboratory, University of Cagliari, Cagliari, Italy.,International PhD in Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
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7
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Diabetic Cardiomyopathy and Ischemic Heart Disease: Prevention and Therapy by Exercise and Conditioning. Int J Mol Sci 2020; 21:ijms21082896. [PMID: 32326182 PMCID: PMC7215312 DOI: 10.3390/ijms21082896] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 02/06/2023] Open
Abstract
Metabolic syndrome, diabetes, and ischemic heart disease are among the leading causes of death and disability in Western countries. Diabetic cardiomyopathy is responsible for the most severe signs and symptoms. An important strategy for reducing the incidence of cardiovascular disease is regular exercise. Remote ischemic conditioning has some similarity with exercise and can be induced by short periods of ischemia and reperfusion of a limb, and it can be performed in people who cannot exercise. There is abundant evidence that exercise is beneficial in diabetes and ischemic heart disease, but there is a need to elucidate the specific cardiovascular effects of emerging and unconventional forms of exercise in people with diabetes. In addition, remote ischemic conditioning may be considered among the options to induce beneficial effects in these patients. The characteristics and interactions of diabetes and ischemic heart disease, and the known effects of exercise and remote ischemic conditioning in the presence of metabolic syndrome and diabetes, are analyzed in this brief review.
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8
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Chronic Neovascular Central Serous Chorioretinopathy: A Stress/Rest Optical Coherence Tomography Angiography Study. Am J Ophthalmol 2020; 211:63-75. [PMID: 31715159 DOI: 10.1016/j.ajo.2019.10.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/29/2019] [Accepted: 10/24/2019] [Indexed: 11/22/2022]
Abstract
PURPOSE To compare optical coherence tomography-angiography (OCT-A) performed during physical exercise (stress OCT-A) to the basal examination (rest OCT-A) in the imaging of choroidal neovascularization (CNV) in patients with chronic central serous chorioretinopathy (CSCR). DESIGN Prospective, cohort study. METHODS This multicenter study included 29 consecutive patients with chronic CSCR and flat irregular pigment epithelium detachments (FIPEDs). All patients underwent rest and stress OCT-A (i.e., hand-grip test [HGT]). Systemic hemodynamic data were recorded during the examinations. Rest and stress OCT-A in the en-face and cross-sectional views were qualitatively compared to establish the degree of evidence of flow signals due to CNVs. The en-face angiograms underwent additional automated quantitative analysis to assess the rate of change in neovascular parameters during the stress condition. RESULTS Blood pressure significantly increased during the HGT (P = 0.001). Considering both the en-face and the cross-sectional images, CNV was identified in 13 eyes with the rest OCT-A and in 22 eyes with the stress OCT-A (P = 0.001). Cross-sectional imaging was more sensitive than en-face imaging in detecting neovascular blood flow signals under both rest (P = 0.125) and stress (P = 0.001) conditions. The quantitative analysis showed a significantly greater neovascular area and fractal dimension on the stress OCT-A (P = 0.002). CONCLUSIONS Performing OCT-A during HGT enhances the sensitivity of the examination in detecting CNV in chronic CSCR. The increased neovascular perfusion following the induced increase of blood pressure is consistent with choroidal blood flow dysregulation in patients with CSCR and indicates new areas of discussion about CNV in this disease.
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9
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Affiliation(s)
- Antonio Crisafulli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Pasquale Pagliaro
- Department of Clinical and Biological Science, University of Torino, Torino, Italy
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10
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Sprick JD, Morison DL, Fonkoue IT, Li Y, DaCosta D, Rapista D, Choi H, Park J. Metabolic acidosis augments exercise pressor responses in chronic kidney disease. Am J Physiol Regul Integr Comp Physiol 2019; 317:R312-R318. [PMID: 31141417 DOI: 10.1152/ajpregu.00076.2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Chronic kidney disease (CKD) patients experience augmented blood pressure (BP) reactivity during exercise that is associated with an increased risk of cardiovascular mortality. Exaggerated exercise pressor responses in CKD are in part mediated by augmented sympathetic nerve activation due to heightened muscle mechanoreflex. One mechanism that may lead to sensitization of the muscle mechanoreflex in CKD is metabolic acidosis. We hypothesized that CKD patients with low serum [bicarbonate] would exhibit exaggerated increases in arterial BP, greater reductions in muscle interstitial pH, and fatigue earlier during exercise compared with CKD patients with normal serum bicarbonate concentration ([bicarbonate]). Eighteen CKD participants with normal serum [bicarbonate] (≥24 mmol/l, normal-bicarb) and 9 CKD participants with mild metabolic acidosis ([bicarbonate] range 20-22 mmol/l, low-bicarb) performed rhythmic handgrip (RHG) exercise to volitional fatigue at 40% of maximal voluntary contraction. BP, heart rate, and muscle interstitial pH using near infrared spectroscopy were measured continuously. While mean arterial pressure (MAP) increased with exercise in both groups (P ≤ 0.002), CKD with low-bicarb had an exaggerated MAP response compared with CKD with normal-bicarb (+5.9 ± 1.3 mmHg/30 s vs. +2.6 ± 0.5 mmHg/30 s, P = 0.01). The low-bicarb group reached exhaustion earlier than the normal-bicarb group (179 ± 21 vs. 279 ± 19 s, P = 0.003). There were no differences in the change in muscle interstitial pH during exercise between groups (P = 0.31). CKD patients with metabolic acidosis have augmented exercise-induced increases in BP and poorer exercise tolerance. There was no difference in change in muscle interstitial pH between groups, however, suggesting that augmented exercise BP responses in metabolic acidosis are not due to impaired muscle-buffering capacity.
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Affiliation(s)
- Justin D Sprick
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.,Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Doree Lynn Morison
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.,Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Ida T Fonkoue
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.,Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Yunxiao Li
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Dana DaCosta
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.,Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - Derick Rapista
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.,Department of Veterans Affairs Health Care System, Decatur, Georgia
| | - HyunKyu Choi
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jeanie Park
- Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.,Department of Veterans Affairs Health Care System, Decatur, Georgia
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11
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Nabi R, Alvi SS, Saeed M, Ahmad S, Khan MS. Glycation and HMG-CoA Reductase Inhibitors: Implication in Diabetes and Associated Complications. Curr Diabetes Rev 2019; 15:213-223. [PMID: 30246643 DOI: 10.2174/1573399814666180924113442] [Citation(s) in RCA: 20] [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: 01/22/2018] [Revised: 07/17/2018] [Accepted: 09/19/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Diabetes Mellitus (DM) acts as an absolute mediator of cardiovascular risk, prompting the prolonged occurrence, size and intricacy of atherosclerotic plaques via enhanced Advanced Glycation Endproducts (AGEs) formation. Moreover, hyperglycemia is associated with enhanced glyco-oxidized and oxidized Low-Density Lipoprotein (LDL) possessing greater atherogenicity and decreased the ability to regulate HMG-CoA reductase (HMG-R). Although aminoguanidine (AG) prevents the AGE-induced protein cross-linking due to its anti-glycation potential, it exerts several unusual pharmaco-toxicological effects thus restraining its desirable therapeutic effects. HMG-R inhibitors/ statins exhibit a variety of beneficial impacts in addition to the cholesterol-lowering effects. OBJECTIVE Inhibition of AGEs interaction with receptor for AGEs (RAGE) and glyco-oxidized-LDL by HMG-R inhibitors could decrease LDL uptake by LDL-receptor (LDL-R), regulate cholesterol synthesis via HMG-R, decrease oxidative and inflammatory stress to improve the diabetes-associated complications. CONCLUSION Current article appraises the pathological AGE-RAGE concerns in diabetes and its associated complications, mainly focusing on the phenomenon of both circulatory AGEs and those accumulating in tissues in diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy, discussing the potential protective role of HMG-R inhibitors against diabetic complications.
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Affiliation(s)
- Rabia Nabi
- Clinical Biochemistry & Natural Product Research Lab, Department of Biosciences, Integral University, Lucknow, 226026, U.P, India
| | - Sahir Sultan Alvi
- Clinical Biochemistry & Natural Product Research Lab, Department of Biosciences, Integral University, Lucknow, 226026, U.P, India
| | - Mohammad Saeed
- Department of Clinical Lab. Sciences, College of Applied Medical Sciences, University of Hail, Hail, Saudi Arabia
| | - Saheem Ahmad
- Laboratory of Glycation Biology and Metabolic Disorders, Department of Biosciences, Integral University Lucknow, 226026, U.P, India
| | - Mohammad Salman Khan
- Clinical Biochemistry & Natural Product Research Lab, Department of Biosciences, Integral University, Lucknow, 226026, U.P, India
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12
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Roberto S, Milia R, Doneddu A, Pinna V, Palazzolo G, Serra S, Orrù A, Hosseini Kakhak SA, Ghiani G, Mulliri G, Pagliaro P, Crisafulli A. Hemodynamic abnormalities during muscle metaboreflex activation in patients with type 2 diabetes mellitus. J Appl Physiol (1985) 2018; 126:444-453. [PMID: 30543497 DOI: 10.1152/japplphysiol.00794.2018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Metaboreflex is a reflex triggered during exercise or postexercise muscle ischemia (PEMI) by metaboreceptor stimulation. Typical features of metaboreflex are increased cardiac output (CO) and blood pressure. Patients suffering from metabolic syndrome display hemodynamic abnormalities, with an exaggerated systemic vascular resistance (SVR) and reduced CO response during PEMI-induced metaboreflex. Whether patients with type 2 diabetes mellitus (DM2) have similar hemodynamic abnormalities is unknown. Here we contrast the hemodynamic response to PEMI in 14 patients suffering from DM2 (age 62.7 ± 8.3 yr) and in 15 age-matched controls (CTLs). All participants underwent a control exercise recovery reference test and a PEMI test to obtain the metaboreflex response. Central hemodynamics were evaluated by unbiased operator-independent impedance cardiography. Although the blood pressure response to PEMI was not significantly different between the groups, we found that the SVR and CO responses were reversed in patients with DM2 as compared with the CTLs (SVR: 392.5 ± 549.6 and -14.8 ± 258.9 dyn·s-1·cm-5; CO: -0.25 ± 0.63 and 0.46 ± 0.50 l/m, respectively, in DM2 and in CTL groups, respectively; P < 0.05 for both). Of note, stroke volume (SV) increased during PEMI in the CTL group only. Failure to increase SV and CO was the consequence of reduced venous return, impaired cardiac performance, and augmented afterload in patients with DM2. We conclude that patients with DM2 have an exaggerated vasoconstriction in response to metaboreflex activation not accompanied by a concomitant increase in heart performance. Therefore, in these patients, blood pressure response to the metaboreflex relies more on SVR increases rather than on increases in SV and CO. NEW & NOTEWORTHY The main new finding of the present investigation is that subjects with type 2 diabetes mellitus have an exaggerated vasoconstriction in response to metaboreflex activation. In these patients, blood pressure response to the metaboreflex relies more on systemic vascular resistance than on cardiac output increments.
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Affiliation(s)
- Silvana Roberto
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Raffaele Milia
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Azzurra Doneddu
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Virginia Pinna
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Girolamo Palazzolo
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Stefano Serra
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Andrea Orrù
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | | | - Giovanna Ghiani
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Gabriele Mulliri
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
| | - Pasquale Pagliaro
- Cardiovascular Physiology Laboratory, Department of Clinical and Biological Science, University of Torino , Turin , Italy
| | - Antonio Crisafulli
- Sports Physiology Laboratory, Department of Medical Sciences and Public Health, University of Cagliari , Cagliari , Italy
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