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Jaradat N, Hawash M, Sharifi-Rad M, Shakhshir A, Sobuh S, Hussein F, Issa L, Hamamrhe S, Al-Sheikh E, Ibrahim AN. Insights into free radicals scavenging, α-Amylase inhibition, cytotoxic and antifibrotic activities unveiled by Peganum harmala extracts. BMC Complement Med Ther 2024; 24:299. [PMID: 39135016 PMCID: PMC11320836 DOI: 10.1186/s12906-024-04602-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/30/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Peganum harmala L. is used in traditional medicine to treat several health ailments. Hence, the present work aimed to investigate the DPPH free radical scavenging, α-amylase, cytotoxic, and antifibrotic effects of the hydrophilic extract and fixed oil obtained from P. harmala seeds. METHODS The hydrophilic extract and fixed oil of P. harmala were assessed for their abilities to scavenge DPPH free radicals and inhibit α-amylase using reference bioassays. The cytotoxicity was assessed on several cancer and normal cell lines, including B16F1, Caco-2, COLO205, HeLa, Hep 3B and Hep G2, MCF-7, and HEK-293 T cells. The MTS assay was used to evaluate the antifibrotic capabilities utilizing the human hepatic stellate (LX-2) cell line. RESULTS P. harmala plant fixed oil has potent DPPH free radical scavenging activity with an IC50 dose of 79.43 ± 0.08 µg/ml. Besides, the hydrophilic extract has a poor anti-α-amylase effect compared with the antidiabetic drug Acarbose, with IC50 doses of 398 ± 0.59 and 25.11 ± 1.22 µg/ml, respectively. In addition, the growth of MCF-7, Hep3B, HepG2, HeLa, COLO205, CaCo2, B16F1, and HeK293t was inhibited by P. harmala hydrophilic extract with IC50 doses of 121.34 ± 1.71, 268.3 ± 0.75, 297.20 ± 1.00, 155.60 ± 1.14, 150.01 ± 0.51, 308.35 ± 0.53, 597.93 ± 1.36, and 5.38 ± 0.99 µg/ml, respectively. In addition, at 1000 µg/ml, 5-Fluorouracil reduced fibrosis cells by 0.089%, while the hydrophilic extract decreased the number of LX-2 cells by 5.81%. CONCLUSION P. harmala plant-fixed oil exhibits potential antioxidant properties. While the hydrophilic extract showed limited effectiveness as an anti-α-amylase agent and demonstrated notable cytotoxic effects against various tested cancer cell lines. Furthermore, this extract significantly reduces the number of LX-2 fibrotic cells. These findings emphasize the therapeutic potential of these products in managing various health disorders and warrant further investigation into their mechanisms of action and clinical applications.
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Affiliation(s)
- Nidal Jaradat
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine.
| | - Mohammed Hawash
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Majid Sharifi-Rad
- Department of Range and Watershed Management, Faculty of Water and Soil, University of Zabol, Zabol, 98613-35856, Iran.
| | - Ali Shakhshir
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Shorooq Sobuh
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Fatima Hussein
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Linda Issa
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Sondos Hamamrhe
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Eman Al-Sheikh
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Alaa Naser Ibrahim
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
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Trandafir AI, Ghemigian A, Ciobica ML, Nistor C, Gurzun MM, Nistor TVI, Petrova E, Carsote M. Diabetes Mellitus in Non-Functioning Adrenal Incidentalomas: Analysis of the Mild Autonomous Cortisol Secretion (MACS) Impact on Glucose Profile. Biomedicines 2024; 12:1606. [PMID: 39062179 PMCID: PMC11274780 DOI: 10.3390/biomedicines12071606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Non-functioning adrenal incidentalomas (NFAIs) have been placed in relationship with a higher risk of glucose profile anomalies, while the full-blown typical picture of Cushing's syndrome (CS) and associated secondary (glucocorticoid-induced) diabetes mellitus is not explicitly confirmed in this instance. Our objective was to highlight the most recent data concerning the glucose profile, particularly, type 2 diabetes mellitus (T2DM) in NFAIs with/without mild autonomous cortisol secretion (MACS). This was a comprehensive review of the literature; the search was conducted according to various combinations of key terms. We included English-published, original studies across a 5-year window of publication time (from January 2020 until 1 April 2024) on PubMed. We excluded case reports, reviews, studies on T1DM or secondary diabetes, and experimental data. We identified 37 studies of various designs (14 retrospective studies as well 13 cross-sectional, 4 cohorts, 3 prospective, and 2 case-control studies) that analysed 17,391 individuals, with a female-to-male ratio of 1.47 (aged between 14 and 96 years). T2DM prevalence in MACS (affecting 10 to 30% of NFAIs) ranged from 12% to 44%. The highest T2DM prevalence in NFAI was 45.2% in one study. MACS versus (non-MACS) NFAIs (n = 16) showed an increased risk of T2DM and even of prediabetes or higher fasting plasma glucose or HbA1c (no unanimous results). T2DM prevalence was analysed in NFAI (N = 1243, female-to-male ratio of 1.11, mean age of 60.42) versus (non-tumour) controls (N = 1548, female-to-male ratio of 0.91, average age of 60.22) amid four studies, and two of them were confirmatory with respect to a higher rate in NFAIs. Four studies included a sub-group of CS compared to NFAI/MACS, and two of them did not confirm an increased rate of glucose profile anomalies in CS versus NFAIs/ACS. The longest period of follow-up with concern to the glycaemic profile was 10.5 years, and one cohort showed a significant increase in the T2DM rate at 17.9% compared to the baseline value of 0.03%. Additionally, inconsistent data from six studies enrolling 1039 individuals that underwent adrenalectomy (N = 674) and conservative management (N = 365) pinpointed the impact of the surgery in NFAIs. The regulation of the glucose metabolism after adrenalectomy versus baseline versus conservative management (n = 3) was improved. To our knowledge, this comprehensive review included one of the largest recent analyses in the field of glucose profile amid the confirmation of MACS/NFAI. In light of the rising incidence of NFAI/AIs due to easier access to imagery scans and endocrine evaluation across the spectrum of modern medicine, it is critical to assess if these patients have an increased frequency of cardio-metabolic disorders that worsen their overall comorbidity and mortality profile, including via the confirmation of T2DM.
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Affiliation(s)
- Alexandra-Ioana Trandafir
- PhD Doctoral School of “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Clinical Endocrinology V, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.G.); (E.P.); (M.C.)
| | - Adina Ghemigian
- Department of Clinical Endocrinology V, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.G.); (E.P.); (M.C.)
- Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihai-Lucian Ciobica
- Department of Internal Medicine and Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Internal Medicine I and Rheumatology, “Dr. Carol Davila” Central Military University Emergency Hospital, 010825 Bucharest, Romania
| | - Claudiu Nistor
- Department 4-Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Thoracic Surgery Department, “Dr. Carol Davila” Central Military University Emergency Hospital, 010242 Bucharest, Romania
| | - Maria-Magdalena Gurzun
- Cardiology Discipline, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Laboratory of Non-Invasive Cardiovascular Exploration, “Dr. Carol Davila” Central Military University Emergency Hospital, 010242 Bucharest, Romania
| | - Tiberiu Vasile Ioan Nistor
- Medical Biochemistry Discipline, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Eugenia Petrova
- Department of Clinical Endocrinology V, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.G.); (E.P.); (M.C.)
- Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mara Carsote
- Department of Clinical Endocrinology V, “C.I. Parhon” National Institute of Endocrinology, 011863 Bucharest, Romania; (A.G.); (E.P.); (M.C.)
- Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Musa OAH, Syed A, Khatib MA, Hamdan A, Hub Allah A, Almahdi H, Onitilo AA, Sheehan MT, Beer SF, Bashir M, Abou-Samra AB, Doi SA. Time to Move Beyond a Binary Criterion for Gestational Diabetes? Reprod Sci 2024; 31:2073-2079. [PMID: 38485893 DOI: 10.1007/s43032-024-01514-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/01/2024] [Indexed: 07/03/2024]
Abstract
Over the years, several international guidelines have been developed by specialist organizations for the diagnosis of gestational diabetes mellitus (GDM). However, these guidelines vary and lack consensus on what level of glycemia defines GDM and worryingly, there is now evidence of over- or- under-diagnosis of women with GDM by current criteria. Towards this end, the National Priorities Research Program (NPRP) funded a program of research aimed at elucidating the problem with GDM diagnosis. It was determined, on completion of the project, that the solution required diagnosis of graded levels of dysglycemia in pregnancy and not just a diagnosis of presence or absence of GDM. A new diagnostic criterion (called the NPRP criterion) was created based on a single numerical summary of the three readings from the oral glucose tolerance test (GTT) that diagnosed women in pregnancy into four levels: normal, impaired, GDM and high risk GDM. This paper now examines existing GDM criteria vis-à-vis the NPRP criterion. It is noted that no significant change has happened over the years for existing criteria except for a gradual reduction in the threshold values of individual time-points or the number of time points, bringing us towards over-diagnosis of GDM in pregnancy. The new criterion unifies all readings from the GTT into one numerical value and, because it results in four levels of glycemia, represents a new way forwards for GDM diagnosis and can potentially reduce the rates of under diagnosis and over diagnosis of GDM.
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Affiliation(s)
- Omran A H Musa
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Asma Syed
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Malkan A Khatib
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ahmad Hamdan
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Amrou Hub Allah
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hamad Almahdi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Michael T Sheehan
- Department of Endocrinology, Marshfield Clinic Health System-Weston Center, Weston, WI, USA
| | - Stephen F Beer
- Division of Endocrinology and Qatar Metabolic Institute, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Bashir
- Division of Endocrinology and Qatar Metabolic Institute, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Abdul-Badi Abou-Samra
- Division of Endocrinology and Qatar Metabolic Institute, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Suhail A Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
- Department of Population Medicine, College of Medicine, Clinical Epidemiology and Clinical Endocrinology, Qatar University, Doha, Qatar.
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Ramírez-Cruz A, Rios-Lugo MJ, Soto-Sánchez J, Juárez-Pérez CA, Cabello-López A, Jiménez-Ramírez C, Chang-Rueda C, Cruz M, Hernández-Mendoza H, Vazquez-Moreno M. Overweight, Obesity, Hypertriglyceridemia, and Insulin Resistance Are Positively Associated with High Serum Copper Levels in Mexican Adults. Metabolites 2024; 14:282. [PMID: 38786759 PMCID: PMC11122773 DOI: 10.3390/metabo14050282] [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: 03/25/2024] [Revised: 04/27/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Recently, the role of trace elements in the pathophysiology of obesity, insulin resistance (IR), and metabolic diseases has been explored. In this cross-sectional study, we aimed to assess the association of overweight, obesity, and cardiometabolic traits with serum copper (Cu) levels in 346 Mexican adults. Serum Cu level was measured by inductively coupled plasma mass spectrometry (ICP-MS). Anthropometrical data were collected, and biochemical parameters were measured. The triglyceride-glucose (TyG) index was used as a surrogate marker to evaluate IR. Overweight and obesity status was positively associated with the serum Cu level (β = 19.434 ± 7.309, p = 0.008). Serum Cu level was observed to have a positive association with serum triglycerides level (β = 0.160 ± 0.045, p < 0.001) and TyG (β = 0.001 ± 0.001, p < 0.001). Additionally, high serum Cu level was positively associated with overweight and obesity status (odds ratio [OR] = 1.9, 95% confidence interval [95% CI] 1.1-3.4, p = 0.014), hypertriglyceridemia (OR = 3.0, 95% CI 1.7-5.3, p < 0.001), and IR (OR = 2.6, 95% CI 1.4-4.6, p = 0.001). In conclusion, our results suggest that overweight, obesity, hypertriglyceridemia, and IR are positively associated with serum Cu levels in Mexican adults.
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Affiliation(s)
- Armando Ramírez-Cruz
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (A.R.-C.)
- Posgrado en Biología Experimental, Universidad Autónoma Metropolitana, Unidad Iztapalapa, Ciudad de México 09340, Mexico
| | - María Judith Rios-Lugo
- Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78290, Mexico;
- Sección de Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, Mexico
| | - Jacqueline Soto-Sánchez
- Sección de Estudios de Posgrado e Investigación, Escuela Nacional de Medicina y Homeopatía, Instituto Politécnico Nacional, Ciudad de México 07320, Mexico
| | - Cuauhtémoc Arturo Juárez-Pérez
- Unidad de Investigación de Salud en el Trabajo, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Alejandro Cabello-López
- Unidad de Investigación de Salud en el Trabajo, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico
| | - Carmina Jiménez-Ramírez
- Unidades Médicas de Alta Especialidad, Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, Ciudad de México 07760, Mexico
| | - Consuelo Chang-Rueda
- Facultad de Ciencias Químicas, Campus IV, Universidad Autónoma de Chiapas, Tapachula 30792, Mexico
| | - Miguel Cruz
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (A.R.-C.)
| | - Héctor Hernández-Mendoza
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, San Luís Potosí 78377, Mexico
- Laboratorio del Agua y Monitoreo Ambiental, Universidad del Centro de México, San Luis Potosí 78250, Mexico
| | - Miguel Vazquez-Moreno
- Unidad de Investigación Médica en Bioquímica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México 06720, Mexico; (A.R.-C.)
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Duman I, Tanrıverdi G, Öztürk Özener H. Effects of vitamin K2 administration on guided bone regeneration in diabetic rats. J Periodontal Res 2024. [PMID: 38742688 DOI: 10.1111/jre.13287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024]
Abstract
AIM The present study aimed to investigate the histomorphometric and immunohistochemical impacts of vitamin K2 on guided bone regeneration (GBR) in calvarial critical-size defects (CSDs) in diabetic rats. METHODS A total of 30 rats were used in this study, comprising 12 non-diabetic (control) rats and 18 with streptozotocin-nicotinamide-induced experimental Diabetes mellitus (DM). In all rats, two calvarial CSDs were created: one defect was left empty (E), the other was treated with bovine-derived bone graft and collagen-based resorbable membrane (GM). Study groups were as follows: control rats administered saline (n = 6, C-E and C-GM groups) or vitamin K2 (n = 6, CK-E and CK-GM groups) and diabetic rats administered saline (n = 6, DM-E and DM-GM groups) or vitamin K2 (n = 6, DMK-E and DMK-GM groups). After 4 weeks of saline or vitamin K2 administration, the rats were euthanized. Bone defect healing and new bone formation were assessed histomorphometrically, and osteocalcin and osteopontin levels were examined immunohistochemically. RESULTS Percentage of new bone formation was greater in CK-GM vs. CK-E and in DMK-GM vs. DMK-E [d = 3.86 (95% CI = 16.38-28.61), d = 1.86, (95% CI = 10.74-38.58), respectively, p < .05]. Bone defect healing scores were higher in CK-GM vs. CK-E and in DMK-GM vs. DMK-E [d = 2.69 (95% CI = -2.12 to -0.87), d = 3.28 (95% CI = 0.98-1.91), respectively, p < .05]. Osteocalcin expression levels were elevated in CK-GM vs. CK-E, in DMK-GM vs. DMK-E [d = 1.19 (95% CI = 0.08-1.41), d = 1.10 (95% CI = 0.02-1.22), respectively p < .05]. Vitamin K2 enhanced osteocalcin expression levels in DMK-E vs. DM-E [d = 2.78, (95% CI = 0.56-1.53), p < .05] and in DMK-GM vs. DM-GM [d = 2.43, (95% CI = 0.65-2.10), p < .05]. Osteopontin expression was enhanced in defects treated with GM vs. E defects [C-GM vs. C-E, d = 1.56 (95% CI = 0.38-2.01); CK-GM vs. CK-E, d = 1.91 (95% CI = 0.49-1.72); DM-GM vs. DM-E, d = 2.34 (95% CI = -1.12 to -0.50); DMK-GM vs. DMK-E, d = 2.00 (95% CI = 0.58-1.91), p < .05]. CONCLUSION The research findings suggest that administering vitamin K2 in GBR for rats with DM favorably impacts bone healing in CSDs, presenting an adjunctive strategy for bone regeneration.
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Affiliation(s)
- Irmak Duman
- Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Turkey
| | - Gamze Tanrıverdi
- Department of Histology and Embryology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hafize Öztürk Özener
- Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
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Pitocco D, Popolla V, Rizzi A, Lancellotti S, Tartaglione L, Sacco M, Viti L, Mazzotta FA, Iezzi R, Santoliquido A, Caputo S, Flex A, Pontecorvi A, De Cristofaro R. Von Willebrand factor hyperactivity affects the outcome of lower limb revascularization in subjects with type 2 diabetes mellitus complicated by diabetic foot vasculopathy: An observational pilot study. J Diabetes Complications 2024; 38:108653. [PMID: 38039934 DOI: 10.1016/j.jdiacomp.2023.108653] [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] [Received: 01/23/2023] [Revised: 08/08/2023] [Accepted: 11/24/2023] [Indexed: 12/03/2023]
Abstract
Aim of this study is to evaluate any differences in VWF antigen, VWF activity and ADAMTS-13 activity before and after successful and non-successful Percutaneous Transluminal Angioplasty (PTA) in subjects with type 2 diabetes (T2DM) complicated by Chronic limb-threatening ischemia (CLTI) in diabetic foot vasculopathy. METHODS In this prospective observational pilot study, we enrolled 35 T2DM subjects who underwent lower limb PTA. Transcutaneous oximetry was performed in all patients before and 6 weeks after PTA. The change in oxygen partial pressure (TcpO2) before and after PTA was expressed as TcpO2-delta (ΔTcpO2). VWF antigen, VWF activity and ADAMTS-13 activity were measured before and 6 weeks after PTA; changes were expressed as delta and ratio from baseline. RESULTS Subjects with ∆TcpO2 < 15 mmHg presented higher ΔVWF activity (p = 0.050) and lower ADAMTS-13 activity ratio (p = 0.080). Subjects with ∆TcpO2 < 30 mmHg showed lower ADAMTS-13 activity Δ and ratio (p = 0.028). CONCLUSIONS VWF antigen levels and VWF activity may potentially affect PTA outcome. Higher levels of VWF could derive from VWF release as consequence of PTA-induced mechanical endothelial damage and/or oxidative stress-induced modifications of VWF structure with impairment of VWF-ADAMTS13 interactions.
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Affiliation(s)
- Dario Pitocco
- Diabetes Care Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy.
| | - Valentina Popolla
- Diabetes Care Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Alessandro Rizzi
- Diabetes Care Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Stefano Lancellotti
- Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Linda Tartaglione
- Diabetes Care Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Monica Sacco
- Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Luca Viti
- Diabetes Care Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Francesco Antonio Mazzotta
- Department of Endocrinology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Roberto Iezzi
- Diagnostic Radiology and General Interventional Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Angelo Santoliquido
- Department of cardiovascular sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Salvatore Caputo
- Diabetes Care Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Andrea Flex
- Department of Internal Medicine, Medical Clinic and Vascular Diseases, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Alfredo Pontecorvi
- Department of Endocrinology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
| | - Raimondo De Cristofaro
- Hemorrhagic and Thrombotic Diseases Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore Rome, Italy
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Zhang Z, Zhou Z, Li H. The role of lipid dysregulation in gestational diabetes mellitus: Early prediction and postpartum prognosis. J Diabetes Investig 2024; 15:15-25. [PMID: 38095269 PMCID: PMC10759727 DOI: 10.1111/jdi.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 01/03/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a pathological condition during pregnancy characterized by impaired glucose tolerance, and the failure of pancreatic beta-cells to respond appropriately to an increased insulin demand. However, while the majority of women with GDM will return to normoglycemia after delivery, they have up to a seven times higher risk of developing type 2 diabetes during midlife, compared with those with no history of GDM. Gestational diabetes mellitus also increases the risk of multiple metabolic disorders, including non-alcoholic fatty liver disease, obesity, and cardiovascular diseases. Lipid metabolism undergoes significant changes throughout the gestational period, and lipid dysregulation is strongly associated with GDM and the progression to future type 2 diabetes. In addition to common lipid variables, discovery-based omics techniques, such as metabolomics and lipidomics, have identified lipid biomarkers that correlate with GDM. These lipid species also show considerable potential in predicting the onset of GDM and subsequent type 2 diabetes post-delivery. This review aims to update the current knowledge of the role that lipids play in the onset of GDM, with a focus on potential lipid biomarkers or metabolic pathways. These biomarkers may be useful in establishing predictive models to accurately predict the future onset of GDM and type 2 diabetes, and early intervention may help to reduce the complications associated with GDM.
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Affiliation(s)
- Ziyi Zhang
- Department of Endocrinology, Sir Run Run Shaw HospitalZhejiang University, School of MedicineHangzhouChina
| | - Zheng Zhou
- Zhejiang University, School of MedicineHangzhouChina
| | - Hong Li
- Department of Endocrinology, Sir Run Run Shaw HospitalZhejiang University, School of MedicineHangzhouChina
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Nidhar M, Kumar V, Mahapatra A, Gupta P, Yadav BK, Singh RK, Tewari AK. Ligand-based designing of DPP-4 inhibitors via hybridization; synthesis, docking, and biological evaluation of pyridazine-acetohydrazides. Mol Divers 2023; 27:2729-2740. [PMID: 36534357 DOI: 10.1007/s11030-022-10577-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022]
Abstract
A series of novel pyridazine-acetohydrazide hybrids were designed, synthesized, and evaluated for their in vitro and in vivo antihyperglycemic activity. In this context, pyridazine-acetohydrazides (6a-6p) were synthesized by coupling substituted aldehyde with 2-(5-cyano-6-oxo-3,4-diphenylpyridazine-1-6H-yl) acetohydrazide, which was prepared via the reaction of pyridazine ester with hydrazine hydrate. The molecular docking study was carried out to examine the binding affinities and interaction of designed compounds against the DPP-4 enzyme. Compounds 6e, 6f, 6l, and 6n exhibited interaction with active residue. In silico ADMET properties, and toxicity studies corroborated that compounds were found to have good bioavailability and less toxic. The synthesized compounds were further estimated for in vitro DPP-4 activity. Compounds 6e and 6l were found as the most effective DPP-4 inhibitor in this series with IC50 values (6.48, 8.22 nM) when compared with sitagliptin (13.02 nM). According to the toxicity assay compound, 6l showed very less toxicity at a higher concentration so further selected for the in vivo antihyperglycemic activity.
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Affiliation(s)
- Manisha Nidhar
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Vipin Kumar
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Archisman Mahapatra
- Molecular Endocrinology and Toxicology Lab (MET Lab), Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Priya Gupta
- Molecular Endocrinology and Toxicology Lab (MET Lab), Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Brijesh Kumar Yadav
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India
| | - Rahul Kumar Singh
- Molecular Endocrinology and Toxicology Lab (MET Lab), Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India.
| | - Ashish Kumar Tewari
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India.
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9
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Kassab HS, Osman NA, Elrahmany SM. Assessment of Triglyceride-Glucose Index and Ratio in Patients with Type 2 Diabetes and Their Relation to Microvascular Complications. Endocr Res 2023; 48:94-100. [PMID: 37565769 DOI: 10.1080/07435800.2023.2245909] [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] [Received: 06/08/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Triglyceride-based indices have gained much attention over the past few years. Relation of triglyceride - glucose (TyG) index with insulin resistance and diabetic macrovascular complications was thoroughly studied; nevertheless its relation to microvascular complications is still unclear. This provoked us to carry out the present study. METHODS This cross-sectional study included 500 patients with type 2 diabetes (T2DM), who were enrolled from the outpatient clinic of the Diabetes and Metabolism Unit at Alexandria Main University Hospital. The equations utilized to calculate triglycerides-related indices were: TyG ratio = fasting triglycerides (mg/dL)/fasting glucose (mg/dL), and TyG index = logarithm of [fasting triglyceride (mg/dl) x fasting glucose (mg/dl)/2]. The diagnostic criteria set by the American Diabetes Association were followed to diagnose diabetic microvascular complications. RESULTS In patients with T2DM, TyG index was significantly higher in patients with diabetic retinopathy, diabetic kidney disease, and diabetic peripheral neuropathy compared to those without complications (p < 0.001). TyG index was significantly positively correlated to diabetes duration, as well as triglyceride/high density lipoprotein ratio in the total sample (p < 0.001). CONCLUSION TyG index is an easy, cheap, and available marker for detection of microvascular complications in patients with T2DM.
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Affiliation(s)
- Heba S Kassab
- Lecturer of Internal Medicine (Diabetes and Metabolism Unit), Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nermin A Osman
- Lecturer of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Shimaa M Elrahmany
- Lecturer of Internal Medicine (Diabetes and Metabolism Unit), Faculty of Medicine, Alexandria University, Alexandria, Egypt
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10
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Andrikopoulos P, Aron-Wisnewsky J, Chakaroun R, Myridakis A, Forslund SK, Nielsen T, Adriouch S, Holmes B, Chilloux J, Vieira-Silva S, Falony G, Salem JE, Andreelli F, Belda E, Kieswich J, Chechi K, Puig-Castellvi F, Chevalier M, Le Chatelier E, Olanipekun MT, Hoyles L, Alves R, Helft G, Isnard R, Køber L, Coelho LP, Rouault C, Gauguier D, Gøtze JP, Prifti E, Froguel P, Zucker JD, Bäckhed F, Vestergaard H, Hansen T, Oppert JM, Blüher M, Nielsen J, Raes J, Bork P, Yaqoob MM, Stumvoll M, Pedersen O, Ehrlich SD, Clément K, Dumas ME. Evidence of a causal and modifiable relationship between kidney function and circulating trimethylamine N-oxide. Nat Commun 2023; 14:5843. [PMID: 37730687 PMCID: PMC10511707 DOI: 10.1038/s41467-023-39824-4] [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: 11/02/2022] [Accepted: 06/30/2023] [Indexed: 09/22/2023] Open
Abstract
The host-microbiota co-metabolite trimethylamine N-oxide (TMAO) is linked to increased cardiovascular risk but how its circulating levels are regulated remains unclear. We applied "explainable" machine learning, univariate, multivariate and mediation analyses of fasting plasma TMAO concentration and a multitude of phenotypes in 1,741 adult Europeans of the MetaCardis study. Here we show that next to age, kidney function is the primary variable predicting circulating TMAO, with microbiota composition and diet playing minor, albeit significant, roles. Mediation analysis suggests a causal relationship between TMAO and kidney function that we corroborate in preclinical models where TMAO exposure increases kidney scarring. Consistent with our findings, patients receiving glucose-lowering drugs with reno-protective properties have significantly lower circulating TMAO when compared to propensity-score matched control individuals. Our analyses uncover a bidirectional relationship between kidney function and TMAO that can potentially be modified by reno-protective anti-diabetic drugs and suggest a clinically actionable intervention for decreasing TMAO-associated excess cardiovascular risk.
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Affiliation(s)
- Petros Andrikopoulos
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
- Section of Genomic & Environmental Medicine, National Heart & Lung Institute, Imperial College London, London, UK.
| | - Judith Aron-Wisnewsky
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Rima Chakaroun
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Antonis Myridakis
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Environmental Research Group, MRC Centre for Environment and Health, School of Public Health, Imperial College London, 86 Wood Lane, London, W12 0BZ, UK
| | - Sofia K Forslund
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany
- Experimental and Clinical Research Center, a cooperation of Charité-Universitätsmedizin and the Max-Delbrück Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
- Charité University Hospital, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Trine Nielsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Solia Adriouch
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
| | | | - Julien Chilloux
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Sara Vieira-Silva
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
- Institute of Medical Microbiology and Hygiene and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Gwen Falony
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
- Institute of Medical Microbiology and Hygiene and Research Center for Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | - Joe-Elie Salem
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Fabrizio Andreelli
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Eugeni Belda
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Sorbonne Université, IRD, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, F-93143, Bondy, France
| | - Julius Kieswich
- Diabetic Kidney Disease Centre, Renal Unit, Barts Health National Health Service Trust, The Royal London Hospital, London, UK
- Centre for Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kanta Chechi
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Section of Genomic & Environmental Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Francesc Puig-Castellvi
- European Genomics Institute for Diabetes, EGENODIA, INSERM U1283, CNRS UMR8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France
| | - Mickael Chevalier
- European Genomics Institute for Diabetes, EGENODIA, INSERM U1283, CNRS UMR8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France
| | | | - Michael T Olanipekun
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Lesley Hoyles
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Renato Alves
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Gerard Helft
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
- Institute of Cardiometabolism and Nutrition, ICAN, INSERM, 1166, Paris, France
| | - Richard Isnard
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Lars Køber
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Luis Pedro Coelho
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Christine Rouault
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
| | - Dominique Gauguier
- INSERM UMR 1124, Université de Paris, 45 rue des Saint-Pères, 75006, Paris, France
- McGill Genome Centre, McGill University, 740 Doctor Penfield Avenue, Montreal, QC, H3A 0G1, Canada
| | - Jens Peter Gøtze
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Edi Prifti
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Sorbonne Université, IRD, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, F-93143, Bondy, France
| | - Philippe Froguel
- European Genomics Institute for Diabetes, EGENODIA, INSERM U1283, CNRS UMR8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France
- Section of Genetics and Genomics, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, W12 0NN, UK
| | - Jean-Daniel Zucker
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France
- Sorbonne Université, IRD, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, F-93143, Bondy, France
| | - Fredrik Bäckhed
- The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Vestergaard
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Medicine, Bornholms Hospital, Rønne, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jean-Michel Oppert
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France
| | - Matthias Blüher
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Jeroen Raes
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- Center for Microbiology, VIB, Leuven, Belgium
| | - Peer Bork
- Structural and Computational Biology, European Molecular Biology Laboratory, Heidelberg, Germany
- Max Delbrück Center for Molecular Medicine (MDC), Berlin, Germany
- Department of Bioinformatics, Biocenter, University of Würzburg, Würzburg, Germany
- Yonsei Frontier Lab (YFL), Yonsei University, Seoul, 03722, South Korea
| | - Muhammad M Yaqoob
- Diabetic Kidney Disease Centre, Renal Unit, Barts Health National Health Service Trust, The Royal London Hospital, London, UK
- Centre for Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Michael Stumvoll
- Medical Department III-Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Metabolic Research, Gentofte University Hospital, Copenhagen, Denmark
| | - S Dusko Ehrlich
- Department of Clinical and Movement Neurosciences, University College London, London, NW3 2PF, UK
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and obesities; systemic approaches (NutriOmics), Paris, France.
- Assistance Publique Hôpitaux de Paris, Pitie-Salpêtrière Hospital, Paris, France.
| | - Marc-Emmanuel Dumas
- Section of Biomolecular Medicine, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
- Section of Genomic & Environmental Medicine, National Heart & Lung Institute, Imperial College London, London, UK.
- European Genomics Institute for Diabetes, EGENODIA, INSERM U1283, CNRS UMR8199, Institut Pasteur de Lille, Lille University Hospital, University of Lille, Lille, France.
- McGill Genome Centre, McGill University, 740 Doctor Penfield Avenue, Montreal, QC, H3A 0G1, Canada.
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11
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Şenel E, Salmanoğlu M, Solmazgül E, İnal BB. Acrochordons as a cutaneous sign of impaired carbohydrate metabolism, hyperlipidemia, liver enzyme abnormalities and hypertension: A case-control study. J Eur Acad Dermatol Venereol 2023; 37:1811-1814. [PMID: 37622223 DOI: 10.1111/jdv.4396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 11/23/2011] [Indexed: 08/26/2023]
Abstract
BACKGROUND Acrochordons are common and benign skin tumours. A few studies with contradictory results have been reported regarding the abnormalities of carbohydrate and/or lipid metabolisms in patients with acrochordons. OBJECTIVES We aimed to determine if the presence of acrochordons could be a marker of diabetes, hyperlipidemia, liver enzyme abnormalities and hypertension by comparing with a control group. METHODS A total of 110 patients having two or more acrochordons and age- and gender-matched 110 controls were included in the study. Localization, size and the total number of acrochordons were recorded in the patient group. Fasting plasma glucose (FPG), serum lipids and liver enzyme levels were tested in patient and controls. All participants underwent a standard 2-h oral glucose tolerance test with 75 g glucose. Diabetes mellitus and impaired glucose intolerance were diagnosed according to the American Diabetes Association criteria. Arterial blood pressures were measured in two groups. RESULTS A total of 56 patients and 10 controls were diagnosed with overt DM. Thirteen per cent of the patients and 9% of controls had an impaired glucose tolerance test. The difference was statistically significant for the diagnosis of DM and not significant for the impaired glucose tolerance. The mean levels of FPG, total cholesterol, LDL cholesterol, triglyceride, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase and alkaline phosphatase were significantly higher in patients than those in controls. Furthermore, serum levels of HDL were less in patients. Patients with acrochordons had higher systolic and diastolic blood pressures than controls. CONCLUSIONS The results of our study suggest that acrochordons may represent a cutaneous sign for impaired carbohydrate or lipid metabolism, liver enzyme abnormalities and hypertension.
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Affiliation(s)
- E Şenel
- Department of Dermatology, Merzifon Military Hospital, Amasya, Turkey
| | - M Salmanoğlu
- Department of Internal Medicine, Merzifon Military Hospital, Amasya, Turkey
| | - E Solmazgül
- Department of Internal Medicine, Merzifon Military Hospital, Amasya, Turkey
| | - B Berçik İnal
- Department of Biochemistry, Ministry of Health İstanbul Education and Research Hospital, İstanbul, Turkey
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12
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Moon JH, Kim Y, Oh TJ, Moon JH, Kwak SH, Park KS, Jang HC, Choi SH, Cho NH. Triglyceride-Glucose Index Predicts Future Atherosclerotic Cardiovascular Diseases: A 16-Year Follow-up in a Prospective, Community-Dwelling Cohort Study. Endocrinol Metab (Seoul) 2023; 38:406-417. [PMID: 37533176 PMCID: PMC10475965 DOI: 10.3803/enm.2023.1703] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGRUOUND While the triglyceride-glucose (TyG) index is a measure of insulin resistance, its association with cardiovascular disease (CVD) has not been well elucidated. We evaluated the TyG index for prediction of CVDs in a prospective large communitybased cohort. METHODS Individuals 40 to 70 years old were prospectively followed for a median 15.6 years. The TyG index was calculated as the Ln [fasting triglycerides (mg/dL)×fasting glucose (mg/dL)/2]. CVDs included any acute myocardial infarction, coronary artery disease or cerebrovascular disease. We used a Cox proportional hazards model to estimate CVD risks according to quartiles of the TyG index and plotted the receiver operating characteristics curve for the incident CVD. RESULTS Among 8,511 subjects (age 51.9±8.8 years; 47.5% males), 931 (10.9%) had incident CVDs during the follow-up. After adjustment for age, sex, body mass index, diabetes mellitus, hypertension, total cholesterol, smoking, alcohol, exercise, and C-reactive protein, subjects in the highest TyG quartile had 36% increased risk of incident CVD compared with the lowest TyG quartile (hazard ratio, 1.36; 95% confidence interval, 1.10 to 1.68). Carotid plaque, assessed by ultrasonography was more frequent in subjects in the higher quartile of TyG index (P for trend=0.049 in men and P for trend <0.001 in women). The TyG index had a higher predictive power for CVDs than the homeostasis model assessment of insulin resistance (HOMA-IR) (area under the curve, 0.578 for TyG and 0.543 for HOMA-IR). Adding TyG index on diabetes or hypertension alone gave sounder predictability for CVDs. CONCLUSION The TyG index is independently associated with future CVDs in 16 years of follow-up in large, prospective Korean cohort.
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Affiliation(s)
- Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yongkang Kim
- Institute for Behavioral Genetics, University of Colorado at Boulder, Boulder, CO, USA
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Soo Heon Kwak
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyong Soo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Nam H. Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
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13
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Goyal S, Rani J, Bhat MA, Vanita V. Genetics of diabetes. World J Diabetes 2023; 14:656-679. [PMID: 37383588 PMCID: PMC10294065 DOI: 10.4239/wjd.v14.i6.656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/13/2023] [Accepted: 04/17/2023] [Indexed: 06/14/2023] Open
Abstract
Diabetes mellitus is a complicated disease characterized by a complex interplay of genetic, epigenetic, and environmental variables. It is one of the world's fastest-growing diseases, with 783 million adults expected to be affected by 2045. Devastating macrovascular consequences (cerebrovascular disease, cardiovascular disease, and peripheral vascular disease) and microvascular complications (like retinopathy, nephropathy, and neuropathy) increase mortality, blindness, kidney failure, and overall quality of life in individuals with diabetes. Clinical risk factors and glycemic management alone cannot predict the development of vascular problems; multiple genetic investigations have revealed a clear hereditary component to both diabetes and its related complications. In the twenty-first century, technological advancements (genome-wide association studies, next-generation sequencing, and exome-sequencing) have led to the identification of genetic variants associated with diabetes, however, these variants can only explain a small proportion of the total heritability of the condition. In this review, we address some of the likely explanations for this "missing heritability", for diabetes such as the significance of uncommon variants, gene-environment interactions, and epigenetics. Current discoveries clinical value, management of diabetes, and future research directions are also discussed.
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Affiliation(s)
- Shiwali Goyal
- Department of Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Rockville, MD 20852, United States
| | - Jyoti Rani
- Department of Human Genetics, Guru Nanak Dev University, Amritsar 143005, Punjab, India
| | - Mohd Akbar Bhat
- Department of Ophthalmology, Georgetown University Medical Center, Washington DC, DC 20057, United States
| | - Vanita Vanita
- Department of Human Genetics, Guru Nanak Dev University, Amritsar 143005, Punjab, India
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14
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Adane T, Melku M, Worku YB, Fasil A, Aynalem M, Kelem A, Getawa S. The Association between Neutrophil-to-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Diabetes Res 2023; 2023:3117396. [PMID: 37305430 PMCID: PMC10257553 DOI: 10.1155/2023/3117396] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 04/18/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023] Open
Abstract
Background Glycated hemoglobin (HbA1c) is a commonly used clinical marker to monitor the control of type 2 diabetes mellitus patients (T2DM). However, it is unable to identify the ongoing inflammatory changes in the body. These factors could be easily identified and monitored by the neutrophil-to-lymphocyte ratio (NLR). Therefore, this study is aimed at investigating the relationship between NLR and glycemic control in T2DM. Method A comprehensive search of eligible studies was performed in various databases published until July 2021. A random effect model was used to estimate the standardized mean difference (SMD). A metaregression, subgroup, and sensitivity analysis were conducted to search for potential sources of heterogeneity. Result A total of 13 studies were included in this study. Accordingly, the SMD of the NLR values between the poor and good glycemic control groups was 0.79 (95% CI, 0.46-1.12). Our study also showed that high NLR was significantly associated with poor glycemic control in T2DM patients (OR = 1.50, 95% CI: 1.30-1.93). Conclusion The results of this study suggest an association between high NLR values and an elevated HbA1C in T2DM patients. Therefore, NLR should be considered a marker of glycemic control in addition to HbA1c in T2DM patients.
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Affiliation(s)
- Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yilkal Belete Worku
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Fasil
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melak Aynalem
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amanuel Kelem
- Department of Medical Laboratory Sciences, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Solomon Getawa
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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15
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Amini A, Ghasemi Moravej F, Mostafavinia A, Ahmadi H, Chien S, Bayat M. Photobiomodulation Therapy Improves Inflammatory Responses by Modifying Stereological Parameters, microRNA-21 and FGF2 Expression. J Lasers Med Sci 2023; 14:e16. [PMID: 37583493 PMCID: PMC10423949 DOI: 10.34172/jlms.2023.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/13/2023] [Indexed: 08/17/2023]
Abstract
Introduction: Photobiomodulation treatment (PBMT) is a relatively invasive method for treating wounds. An appropriate type of PBMT can produce desired and directed cellular and molecular processes. The aim of this study was to investigate the impacts of PBMT on stereological factors, bacterial count, and the expression of microRNA-21 and FGF2 in an infected, ischemic, and delayed wound healing model in rats with type one diabetes mellitus. Methods: A delayed, ischemic, and infected wound was produced on the back skin of all 24 DM1 rats. Then, they were put into 4 groups at random (n=6 per group): 1=Control group day4 (CGday4); 2=Control group day 8 (CGday8); 3=PBMT group day4 (PGday4), in which the rats were exposed to PBMT and killed on day 4; 4=PBMT group day8 (PGday8), in which the rats received PBMT and they were killed on day 8. The size of the wound, the number of microbial colonies, stereological parameters, and the expression of microRNA-21 and FGF2 were all assessed in this study throughout the inflammation (day 4) and proliferation (day 8) stages of wound healing. Results: On days 4 and 8, we discovered that the PGday4 and PGday8 groups significantly improved stereological parameters in comparison with the same CG groups. In terms of ulcer area size and microbiological counts, the PGday4 and PGday8 groups performed much better than the same CG groups. Simultaneously, the biomechanical findings in the PGday4 and PGday8 groups were much more extensive than those in the same CG groups. On days 4 and 8, the expression of FGF2 and microRNA-21 was more in all PG groups than in the CG groups (P<0.01). Conclusion: PBMT significantly speeds up the repair of ischemic and MARS-infected wounds in DM1 rats by lowering microbial counts and modifying stereological parameters, microRNA-21, and FGF2 expression.
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Affiliation(s)
- Abdollah Amini
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ghasemi Moravej
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atarodalsadat Mostafavinia
- Department of Anatomy, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hossein Ahmadi
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sufan Chien
- Price Institute of Surgical Research, University of Louisville, and Noveratech LLC, Louisville, Kentucky, USA
| | - Mohammad Bayat
- Department of Biology and Anatomical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Price Institute of Surgical Research, University of Louisville, and Noveratech LLC, Louisville, Kentucky, USA
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16
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Riahi SM, Yousefi A, Saeedi F, Martin SS. Associations of emotional social support, depressive symptoms, chronic stress, and anxiety with hard cardiovascular disease events in the United States: the multi-ethnic study of atherosclerosis (MESA). BMC Cardiovasc Disord 2023; 23:236. [PMID: 37142978 PMCID: PMC10161545 DOI: 10.1186/s12872-023-03195-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/21/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are a major cause of morbidity and mortality around the globe and psychosocial factors are not sufficiently understood. AIM In the current study, we aimed to evaluate the role of different psychosocial factors including depressive symptoms, chronic stress, anxiety, and emotional social support (ESS) on the incidence of hard CVD (HCVD). METHODS We examined the association of psychosocial factors and HCVD incidence amongst 6,779 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). Using physician reviewers' adjudication of CVD events incident, depressive symptoms, chronic stress, anxiety, emotional social support scores were measured by validated scales. We used Cox proportional Hazards (PH) models with psychosocial factors in several of the following approaches: (1) Continuous; (2) categorical; and (3) spline approach. No violation of the PH was found. The model with the lowest AIC value was chosen. RESULTS Over an 8.46-year median follow-up period, 370 participants experienced HCVD. There was not a statistically significant association between anxiety and HCVD (95%CI) for the highest versus the lowest category [HR = 1.51 (0.80-2.86)]. Each one point higher score for chronic stress (HR, 1.18; 95% CI, 1.08-1.29) and depressive symptoms (HR, 1.02; 95% CI, 1.01-1.03) was associated with a higher risk of HCVD in separate models. In contrary, emotional social support (HR, 0.98; 95% CI, 0.96-0.99) was linked with a lower risk of HCVD. CONCLUSIONS Higher levels of chronic stress is associated with greater risk of incident HCVD whereas ESS has a protective association.
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Affiliation(s)
- Seyed Mohammad Riahi
- Cardiovascular Diseases Research Center, Department of Epidemiology and Biostatistics, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran.
| | - Ahmad Yousefi
- PhD in Clinical Psychology, Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Saeedi
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Seth Shay Martin
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Shakya A, Dodson M, Artiola JF, Ramirez-Andreotta M, Root RA, Ding X, Chorover J, Maier RM. Arsenic in Drinking Water and Diabetes. WATER 2023; 15:1751. [PMID: 37886432 PMCID: PMC10601382 DOI: 10.3390/w15091751] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
Arsenic is ubiquitous in soil and water environments and is consistently at the top of the Agency for Toxic Substances Disease Registry (ATSDR) substance priority list. It has been shown to induce toxicity even at low levels of exposure. One of the major routes of exposure to arsenic is through drinking water. This review presents current information related to the distribution of arsenic in the environment, the resultant impacts on human health, especially related to diabetes, which is one of the most prevalent chronic diseases, regulation of arsenic in drinking water, and approaches for treatment of arsenic in drinking water for both public utilities and private wells. Taken together, this information points out the existing challenges to understanding both the complex health impacts of arsenic and to implementing the treatment strategies needed to effectively reduce arsenic exposure at different scales.
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Affiliation(s)
- Aryatara Shakya
- Department Pharmacology & Toxicology, University of Arizona, Tucson, AZ 85721, USA
| | - Matthew Dodson
- Department Pharmacology & Toxicology, University of Arizona, Tucson, AZ 85721, USA
| | - Janick F. Artiola
- Department Environmental Science, University of Arizona, Tucson, AZ 85721, USA
| | | | - Robert A. Root
- Department Environmental Science, University of Arizona, Tucson, AZ 85721, USA
| | - Xinxin Ding
- Department Pharmacology & Toxicology, University of Arizona, Tucson, AZ 85721, USA
| | - Jon Chorover
- Department Environmental Science, University of Arizona, Tucson, AZ 85721, USA
| | - Raina M. Maier
- Department Environmental Science, University of Arizona, Tucson, AZ 85721, USA
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Keaskin L, Egan SM, Almirall-Sanchez A, Tewatia V, Jorba R, Ferreres J, Memba R, Ridgway PF, O'Connor DB, Duggan SN, Conlon KC. Development of a clinical score to estimate pancreatitis-related hospital admissions in patients with a new diagnosis of chronic pancreatitis: the trinity score. HPB (Oxford) 2023:S1365-182X(23)00131-4. [PMID: 37183126 DOI: 10.1016/j.hpb.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/20/2023] [Accepted: 04/27/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND The clinical course of chronic pancreatitis is unpredictable and there is no globally accepted score to predict the disease course. We developed a clinical score to estimate pancreatitis-related hospitalisation in patients with newly diagnosed chronic pancreatitis. METHODS We conducted a retrospective cohort study using two clinical chronic pancreatitis databases held in tertiary referral centres in Dublin, Ireland, and in Tarragona, Spain. Individuals diagnosed with chronic pancreatitis between 2007 and 2014 were eligible for inclusion. Candidate predictors included aetiology, body mass index, exocrine dysfunction, smoking and alcohol history. We used multivariable logistic regression to develop the model. RESULTS We analysed data from 154 patients with newly diagnosed chronic pancreatitis. Of these, 105 patients (68%) had at least one hospital admission for pancreatitis-related reasons in the 6 years following diagnosis. Aetiology of chronic pancreatitis, body mass index, use of pain medications and gender were found to be predictive of more pancreatic-related hospital admissions. These predictors were used to develop a clinical score which showed acceptable discrimination (area under the ROC curve = 0.70). DISCUSSION We developed a clinical score based on easily accessible clinical parameters to predict pancreatitis-related hospitalisation in patients with newly diagnosed chronic pancreatitis.
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Affiliation(s)
- Laura Keaskin
- Department of Surgery, School of Medicine, Trinity College, Dublin, Ireland
| | - Suzanne M Egan
- Centre for Pancreatico-Biliary Diseases, Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland
| | | | - Vikram Tewatia
- Department of Surgery, School of Medicine, Trinity College, Dublin, Ireland; Centre for Pancreatico-Biliary Diseases, Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland
| | - Rosa Jorba
- Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Joan Ferreres
- Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Robert Memba
- Hepato-Pancreato-Biliary Unit, University Hospital of Tarragona Joan XXIII, Tarragona, Spain
| | - Paul F Ridgway
- Department of Surgery, School of Medicine, Trinity College, Dublin, Ireland; Centre for Pancreatico-Biliary Diseases, Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland
| | - Donal B O'Connor
- Department of Surgery, School of Medicine, Trinity College, Dublin, Ireland
| | - Sinead N Duggan
- Department of Surgery, School of Medicine, Trinity College, Dublin, Ireland.
| | - Kevin C Conlon
- Department of Surgery, School of Medicine, Trinity College, Dublin, Ireland; Centre for Pancreatico-Biliary Diseases, Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland
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Koca S, Vural E, Sırakaya E, Kılıc D. Evaluation of the lamina cribrosa in different stages of diabetic retinopathy. Jpn J Ophthalmol 2023; 67:280-286. [PMID: 37039947 DOI: 10.1007/s10384-023-00987-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/24/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE To evaluate the relationship of the peripapillary retina nerve fiber layer (RNFL) and lamina cribrosa (LC) with diabetic retinopathy (DR) in type 2 diabetes mellitus (DM) cases. STUDY DESIGN Prospective comparative study. METHODS This study included 50 non-DR (Group 1), 55 non-proliferative diabetic retinopathy (NPDR) (Group 2), 28 DM cases with proliferative diabetic retinopathy (PDR) (Group 3) and 45 healthy volunteers (Group 4). All participants were evaluated with visual acuity, intraocular pressure (IOP) with Goldman applanation tonometry, anterior segment biomicroscopy, 24 - 2 visual field testing, and dilated fundus examination. Retinal nerve fiber layer (RNFL) thickness, lamina cribrosa thickness (LCT) and anterior lamina cribrosa depth (ALCD) were examined by spectral-domain optical coherence tomography (OCT). RESULTS There was no difference between the groups in terms of age and gender. Visual acuity (p < 0.001) was significantly different between the groups, while IOP (p = 0.068) was similar. Mean (p = 0.010), superior-temporal (p = 0.024), and superior-nasal (p = 0.011) RNFL thickness decreased significantly in correlation with the stage of DR. LCT decreased significantly as the stage of DR progressed in both vertical and horizontal radial OCT scans (p < 0.001). ALCD was not different between groups (p = 0.954 for horizontal scan, p = 0.867 for vertical scan). CONCLUSION Peripapillary RNFL and LCT significantly decreases as the DR stage progresses. The biomechanical effects of the LC may also be responsible for diabetes-induced neurodegeneration.
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Affiliation(s)
- Semra Koca
- Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey.
| | - Esra Vural
- Department of Ophthalmology, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Ender Sırakaya
- Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey
| | - Deniz Kılıc
- Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey
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Carulli E, Pompilio G, Vinci MC. Human Hematopoietic Stem/Progenitor Cells in Type One Diabetes Mellitus Treatment: Is There an Ideal Candidate? Cells 2023; 12:cells12071054. [PMID: 37048127 PMCID: PMC10093723 DOI: 10.3390/cells12071054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Type 1 diabetes mellitus (T1DM) is a highly prevalent autoimmune disease causing the destruction of pancreatic islet β-cells. The resulting insulin production deficiency leads to a lifelong need for insulin re-placement therapy, systemic complications, and reduced life quality and expectancy. Cell therapy has been extensively attempted to restore insulin independence (IID), and autologous nonmyeloablative hematopoietic stem cell transplantation (AHST) has appeared to give the most promising results, but with a highly variable quote of patients achieving IID across the studies. We performed a comprehensive review of the trials involving stem cells, and in particular AHST, for the treatment of T1DM. We then pooled the patients enrolled in the different trials and looked for the patient characteristics that could be associated with the achievement of IID. We found a significantly higher probability of achieving IID in older patients (OR 1.17, 95%CI 1.06–1.33, p = 0.002) and a significantly lower probability in patients with a history of ketoacidosis (OR 0.23, 95%CI 0.06–0.78, p = 0.023). This suggests that there could be a population of patients more likely to benefit from AHST, but further data would be required to depict the profile of the ideal candidate.
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Affiliation(s)
- Ermes Carulli
- Doctoral Programme in Translational Medicine, Università di Milano, 20122 Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, 20122 Milan, Italy
- National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK
- Correspondence:
| | - Giulio Pompilio
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (G.P.); (M.C.V.)
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università di Milano, 20122 Milan, Italy
| | - Maria Cristina Vinci
- Unit of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (G.P.); (M.C.V.)
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Yang Y, Yan S, Yao N, Guo Y, Wang H, Sun M, Hu W, Li X, Wang L, Li B. Effects of vitamin D supplementation on the regulation of blood lipid levels in prediabetic subjects: A meta-analysis. Front Nutr 2023; 10:983515. [PMID: 36969817 PMCID: PMC10033891 DOI: 10.3389/fnut.2023.983515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/06/2023] [Indexed: 03/11/2023] Open
Abstract
This meta-analysis aimed to systematically investigate whether vitamin D supplementation reduces blood lipid—total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and triglyceride (TG)—levels in prediabetic individuals. Pubmed, Web of Science, Cochrane Library, Embase, CNKI, and WANFANG databases were searched for studies published before 13 February 2022 (including 13 February 2022). Five articles were included. The results showed that vitamin D intervention led to a significant reduction in TG compared with control or placebo treatment (−0.42 [−0.59, −0.25], P < 0.001). Subgroup analyses showed that this effect was particularly significant among the studies that included obese subjects (−0.46 [−0.65, −0.28], P < 0.001), the studies that also included men (not only women) (−0.56 [−0.78, −0.34], P < 0.001), and the studies with intervention durations longer than 1 year (−0.46 [−0.65, −0.28], P < 0.001). Both relatively low doses of 2,857 IU/day (−0.65 [−0.92, −0.38], P < 0.001) and relatively high doses of 8,571 IU/day (−0.28 [−0.54, −0.02] P = 0.04) of vitamin D supplementation reduced TG levels, and the effect was observed both in Northern Europe (−0.65 [−0.92, −0.38], P < 0.001) and Asian (−0.25 [−0.48, −0.03], P = 0.03) country subgroups. No significant effects on TC, HDL-C, and LDL-C were shown. In conclusion, vitamin D supplementation might beneficially affect TG levels in individuals with prediabetes. Particularly longer durations of treatment, more than 1 year, with doses that correct vitamin deficiency/insufficiency, can have a beneficial effect. This meta-analysis was registered at www.crd.york.ac.uk/prospero (CRD42020160780).
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Affiliation(s)
- Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Shoumeng Yan
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Han Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Wenyu Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiaotong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
- *Correspondence: Bo Li
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Abhilasha A, Mitra P, Suri S, Saxena I, Shukla R, Shukla KK, Sharma P. Increased expression of serum IL-18 and IL-18R in newly diagnosed type 2 diabetes mellitus. Minerva Endocrinol (Torino) 2023; 48:35-41. [PMID: 33103874 DOI: 10.23736/s2724-6507.20.03271-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder in which genetic, sedentary lifestyle, obesity, and environmental factors come together to produce insulin resistance in target tissues, leading to hyperglycemia. Evidence reveals that inflammation may play an essential role in the pathogenesis of T2DM. Interleukin-18 (IL-18), a proinflammatory cytokine, plays a crucial role in the acute and chronic inflammatory process. The association of IL-18 levels with IL-18R expression in T2DM has not been investigated so far. The aim of this study was to compare the peripheral changes in serum IL-18 levels and its receptor (IL18R) expression in newly diagnosed T2DM and healthy controls. METHODS A total of 35 newly diagnosed type 2 diabetic cases and 35 non-diabetic controls were enrolled after obtaining informed consent. Venous whole blood was taken under aseptic conditions. Biochemical parameters were estimated in an auto-analyzer. Serum IL-18 levels were calculated using ELISA, whereas IL-18R expression was determined via RT-PCR. GAPDH was used as an internal control. RESULTS When compared to non-diabetic controls, the serum IL-18 levels were significantly higher in T2DM patients (P=0.010) along with a significant upregulation of IL18R (P=0.0018). Serum IL-18 levels in T2DM and non-diabetic controls were 669.5 (445) and 498.3 (404.9) pg/mL respectively, and IL-18R showed a fold change of 10.33. CONCLUSIONS Both serum IL-18 and its receptor IL-18R is significantly higher in newly diagnosed T2DM patients.
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Affiliation(s)
- Abhilasha Abhilasha
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Prasenjit Mitra
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Smriti Suri
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Indu Saxena
- Department of Biochemistry, All India Institute of Medical Sciences, Gorakhpur, India
| | - Ravindra Shukla
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Jodhpur, India
| | - Kamla Kant Shukla
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India -
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Nidhar M, Kumar V, Mahapatra A, Gupta P, Yadav P, Sonker P, Kumar A, Mishra S, Singh RK, Tewari AK. Lead modification via computational studies: Synthesis of pyrazole-containing β-amino carbonyls for the treatment of type 2 diabetes. Chem Biol Drug Des 2023; 101:638-649. [PMID: 36271321 DOI: 10.1111/cbdd.14157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/27/2022] [Accepted: 10/16/2022] [Indexed: 11/28/2022]
Abstract
This article describes studies on the design, synthesis, and biological evaluation of pyrazole-containing β-amino carbonyl compounds (5a-5q) as DPP-4 inhibitors and anti-diabetic agents. In contrast, mannich reactions went smoothly with bismuth nitrate (Bi (NO3 )3 ) catalyst in the presence of ethanol and produced pyrazole-containing β-amino carbonyl compounds in good yield. Molecular docking studies of designed derivatives with DPP-4 enzyme (PDB: 2OLE), compounds 5d, 5h, 5j, and 5k showed excellent interaction. 3D QSAR and pharmacophoric model studies were also carried out. ADMET parameters, pharmacokinetic properties, and in vivo toxicity studies further confirmed that all the designed compounds were found to have good bioavailability and were less toxic. Further, these compounds were evaluated as enzyme-based in vitro DPP-4 inhibitory activity, and 5d, 5h, 5i, 5j, and 5k exhibited IC50 toward DPP-4 enzyme of 10.52, 10.41, 5.55, 4.16, and 7.5 nM, respectively. The most potent compound, 5j, was further selected for in vivo anti-diabetic activity using an STZ-induced diabetic mice model, and 5j showed a significant diabetic control effect.
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Affiliation(s)
- Manisha Nidhar
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Vipin Kumar
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Archisman Mahapatra
- Department of Zoology, Molecular Endocrinology and Toxicology Lab (MET Lab), Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Priya Gupta
- Department of Zoology, Molecular Endocrinology and Toxicology Lab (MET Lab), Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Priyanka Yadav
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Priyanka Sonker
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Akhilesh Kumar
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shweta Mishra
- School of Pharmacy, Devi Ahilya Vishwavidyalaya, Indore, Madhya Pradesh, India
| | - Rahul Kumar Singh
- Department of Zoology, Molecular Endocrinology and Toxicology Lab (MET Lab), Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ashish Kumar Tewari
- Department of Chemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Shitomi-Jones LM, Akam L, Hunter D, Singh P, Mastana S. Genetic Risk Scores for the Determination of Type 2 Diabetes Mellitus (T2DM) in North India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3729. [PMID: 36834424 PMCID: PMC9959290 DOI: 10.3390/ijerph20043729] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Globally, type 2 diabetes mellitus (T2DM) is one of the fastest-growing noncommunicable multifactorial and polygenic diseases, which leads to many health complications and significant morbidity and mortality. South Asians have a high genetic predisposition to T2DM, with India being home to one in six diabetics. This study investigates the association of selected genetic polymorphisms with T2DM risk and develops a polygenic risk score (PRS). METHODS A case-control study recruited fully consented participants from a population of Jat Sikhs in north India. DNA samples were genotyped for a range of polymorphisms and odds ratios were calculated under several genetic association models. Receiver operating characteristic (ROC) curves were produced for combinations of the PRS and clinical parameters. RESULTS The GSTT1(rs17856199), GSTM1(rs366631), GSTP1(rs1695), KCNQ1(rs2237892), ACE(rs4646994), and TCF7L2(rs12255372; rs7903146; rs7901695) polymorphisms were associated with increased T2DM risk (p ≤ 0.05). No association was observed with IGF2BP2(rs4402960) or PPARG2(rs1801282). The weighted PRS was found to be significantly higher in patients (mean = 15.4, SD = 3.24) than controls (mean = 11.9, SD = 3.06), and t(454) = -12.2 (p < 0.001). The ROC curve analysis found the weighted PRS in combination with clinical variables to be the most effective predictor of T2DM (area under the curve = 0.844, 95%CI = 0.0.808-0.879). CONCLUSIONS Several polymorphisms were associated with T2DM risk. PRS based on even a limited number of loci improves the prediction of the disease. This may provide a useful method for determining T2DM susceptibility for clinical and public health applications.
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Affiliation(s)
- Lisa Mitsuko Shitomi-Jones
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK
| | - Liz Akam
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK
| | - David Hunter
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK
| | - Puneetpal Singh
- Department of Human Genetics, Punjabi University, Patiala 147002, India
| | - Sarabjit Mastana
- School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Leicestershire, Loughborough LE11 3TU, UK
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Jayant SS, Gupta R, Rastogi A, Sachdeva N, Ram S, Dutta P, Bhansali A, Bhadada SK. Incidence and predictors of metabolic syndrome in Asian-Indians: a 10-year population-based prospective cohort study. Int J Diabetes Dev Ctries 2023:1-7. [PMID: 36777473 PMCID: PMC9903260 DOI: 10.1007/s13410-023-01169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 01/05/2023] [Indexed: 02/10/2023] Open
Abstract
Background Metabolic syndrome represents aggregation of risk factors associated with an increased risk of developing type 2 diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD). Assessing its incidence is an effective way for estimating the future burden of DM and ASCVD and understanding their secular trends and effect of public health measures on halting the evolution of risk factors. The present study aimed to estimate the incidence of metabolic syndrome and its predictors using a population-based cohort. Methods A subset of Chandigarh Urban Diabetes Study cohort (n = 1023) without diabetes or metabolic syndrome was prospectively evaluated after a mean of 10.7 years. Metabolic syndrome was defined as per International Diabetes Federation criteria and diabetes as per American Diabetes Association standards. The incidence was calculated in 1000 person years, and multivariate logistic regression was used to estimate the strength of association between incident metabolic syndrome and risk factors. Results In the followed-up individuals (n = 303), incidence of metabolic syndrome was 32.1 per 1000 person years (95% CI 26.3-38.7 per 1000 person years). Amongst those developing metabolic syndrome, ≥4 components were present in 52% individuals, with low HDL-C being the most common abnormality. Those with metabolic syndrome had a five-time higher risk of diabetes (OR: 4.94; 95% CI: 2.27-9.96; p < 0.001) and a threefold higher risk of hypertension (OR: 2.67; 95% CI: 1.30-5.48; p = 0.006). Conclusion Asian-Indians have a high incidence rate of metabolic syndrome, which is associated with sedentary lifestyle and consequent central obesity.
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Affiliation(s)
- Satyam Singh Jayant
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Rahul Gupta
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Ashu Rastogi
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Naresh Sachdeva
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Sant Ram
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pinaki Dutta
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Anil Bhansali
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
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Buyinza R, Nsamba J, Muyingo A, Matovu N, Nabirye G, Kantengwa A, Akandunda S, Sseguya W, Mathews E. Body composition of type 2 diabetes patients in Uganda: A case-control study. J Public Health Afr 2023; 14:2249. [PMID: 36798845 PMCID: PMC9926559 DOI: 10.4081/jphia.2023.2249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction The prevalence of obesity among people diagnosed with Type 2 Diabetes Mellitus (T2DM) has been widely documented. However, the specific composition of this bodyweight remains largely unknown. The study aimed to understand the body composition of T2DM patients using the bioelectric impedance analysis technique, comparing findings to sex and agematched controls. Materials and Methods A comparative case-control study was carried out among 139 known cases of Type 2 diabetes aged 18 to 78 years randomly sampled from the diabetic clinic of Mbarara Regional Referral Hospital. We matched them to 139 hospital controls who were healthy non-diabetic attendants. Body composition parameters were computed and summarized as medians and interquartile ranges. Differences in the medians of body composition parameters were further assessed using the Mann- Whitney U test. Fat-free and fat mass indices were derived to offer a precise estimation of body composition parameters adjusted for height differences among study participants. Results Cases had significantly higher median systolic blood pressure, pulse rate, weight, Body Mass Index (BMI), Waist-Hip Ratio (WHR), total fat percentage, fat mass amount, Fat Mass Index, visceral fat, and metabolic age than their counterparts, whereas controls had significantly higher median total body water percentage versus cases. The highest significant differences occurred in fat percentage composition (Cases: β: 6.9 (95% C.I: 4.4, 9.4); Controls: Ref) followed by visceral fat (Cases: β: 3.5 (95% C.I: 2.5, 4.4); controls: Ref) and Fat Mass Index (Cases: 95% C.I: 2.6 (95% C.I: 1.6, 3.7). Cases had significantly higher Fat Mass Index, visceral fat and fat percentage (all p<0.05) than controls. Conclusions Routine assessment of body composition of T2DM patients needs to be done to assess the amount, type and pattern of weight gain to prevent increases in adiposity.
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Affiliation(s)
- Ronald Buyinza
- Pharmacy Department, Mbarara Regional Referral Hospital, Mbarara, Uganda,Pharmacy Department, Mbarara Regional Referral Hospital, Mbarara, Uganda.
| | - Jonathan Nsamba
- Department of Clinical Research, Jeuticals Research and Consulting (U) Ltd., Kampala, Uganda,Department of Public Health and Community Medicine, Central University of Kerala, Periya, India
| | - Anthony Muyingo
- Diabetes Clinic, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Nicholas Matovu
- Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kampala, Uganda,Centre for Public Health, Queens University Belfast, Belfast, United Kingdom
| | - Gloria Nabirye
- Department of Nursing, Faculty of Health Sciences, Busitema University, Busitema, Uganda
| | - Adellah Kantengwa
- Diabetes Clinic, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Sandra Akandunda
- Diabetes Clinic, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | | | - Elezebeth Mathews
- Department of Public Health and Community Medicine, Central University of Kerala, Periya, India
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Jung Y, Kim JH, Shin AR, Song KB, Amano A, Choi YH. Association of Adiposity with Periodontitis and Metabolic Syndrome: From the Third National Health and Nutrition Examination Survey of United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032533. [PMID: 36767897 PMCID: PMC9916149 DOI: 10.3390/ijerph20032533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 05/31/2023]
Abstract
This study explored the epidemiological role of central adiposity and body mass index (BMI) in terms of clinical attachment loss (CAL)/pocket depth (PD) and metabolic syndrome components. This study included data from the National Health and Nutrition Examination Survey III of America on 12,254 adults aged 20 years of age or older with a blood sample, anthropometric measurements, and a periodontal examination. Clinical periodontitis measurements, including CAL and PD, were classified into quintiles or quartiles and compared. CAL was positively associated with central adiposity, hypertension, and hyperglycemia; the relationship between CAL and diabetes was stronger when central adiposity was absent (odds ratio [OR] and 95% confidence interval: 6.33, 2.14-18.72 vs. 3.14, 1.78-5.56). The relationship between CAL and impaired fasting glucose (IFG) differed slightly with BMI. The IFG ORs for normal, overweight, and obese patients were 1.63 (1.08-2.45), 1.76 (1.05-2.97), and 1.43 (0.88-2.30), respectively. CAL was positively correlated with all metabolic syndrome components except hypertriglyceridemia. Associations between CAL, diabetes, and IFG significantly varied with BMI. Periodontitis in individuals without central obesity or with normal bodyweight may independently indicate diabetes and IFG. Therefore, preventive measures against periodontitis without obesity are necessary to improve general and oral health.
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Affiliation(s)
- YunSook Jung
- Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju 37224, Republic of Korea
| | - Ji-Hye Kim
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Ah-Ra Shin
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
| | - Keun-Bae Song
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
- Craniofacial Nerve-Bone Network Research Center, Kyungpook National University School of Dentistry, Daegu 41940, Republic of Korea
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Osaka 565-0871, Japan
| | - Youn-Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu 41940, Republic of Korea
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Farahmand MA, Daneshzad E, Fung TT, Zahidi F, Muhammadi M, Bellissimo N, Azadbakht L. What is the impact of vitamin D supplementation on glycemic control in people with type-2 diabetes: a systematic review and meta-analysis of randomized controlled trails. BMC Endocr Disord 2023; 23:15. [PMID: 36647067 PMCID: PMC9841647 DOI: 10.1186/s12902-022-01209-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 11/10/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND There is conflicting evidence on the effect of vitamin D on glycemic control. Therefore, in the current meta-analyses, we aimed to assess the effect of vitamin D supplementation on the glycemic control of type 2 diabetes (T2D) patients. METHODS We conducted a comprehensive search in electronic databases including; PubMed/Medline, Web of Science, Scopus, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and NIH's Clinical Trials Registry, from the inception of each database up to January first, 2021. RESULTS A total of 46 randomized controlled trials (RCTs) consisting of 2164 intervention subjects and 2149 placebo controls were included in this meta-analysis. Pooled analyses for HbA1c showed a significant change between the intervention and placebo group, the weighted mean difference (WMD)(95% confidence interval(CI)) was -0.20%(-0.29, -0.11) with P < 0.001. Analyses for assessing changes in FPG found a significant reduction in the intervention group after vitamin D supplementation, the WMD (95%CI) was -5.02 mg/dl (-6.75,-3.28) with P < 0.001. The result of pooled analyses for HOMA-IR revealed a significant change between the intervention and control group, the WMD (95%CI) was -0.42(-0.76, -0.07) with P = 0.019. The subgroup analyses showed the most efficacy in a higher dose and short intervention period and in subjects with deficient vitamin D status. CONCLUSION Vitamin D supplementation might be beneficial for the reduction of FPG, HbA1c, and HOMA-IR in type 2 diabetes patients with deficient vitamin D status. This effect was especially prominent when vitamin D was given in large doses and for a short period of time albeit with substantial heterogeneity between studies and a probability of publication bias.
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Affiliation(s)
- Mohammad Ashraf Farahmand
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran
- Public Health Faculty, Kabul University of Medical Science (KUMS), Kabul, Afghanistan
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Teresa T Fung
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
- Department of Nutrition, Simmons University, Boston, MA, USA
| | - Fawzia Zahidi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran
| | - Maryam Muhammadi
- Critical Nursing Care Department, Kabul University of Medical Science (KUMS), Kabul, Afghanistan
| | - Nick Bellissimo
- School of Nutrition, Toronto Metropolitan University, Toronto, ON, Canada
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), PO BOX: 1416643931, Tehran, Iran.
- Diabetes Research Centre, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Chihaoui M, Oueslati I, Khessairi N, Chaker F, Cherni S, Hammami B, Feki M, Yazidi M. Metabolic disorders during endogenous Cushing's syndrome: prevalence, associated factors, and outcome after remission. Endocr Regul 2023; 57:138-143. [PMID: 37561832 DOI: 10.2478/enr-2023-0017] [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: 08/12/2023] Open
Abstract
Objective. The prognosis of Cushing's syndrome (CS) is related to a higher cardiovascular morbidity and mortality. This study aimed to determine the prevalence of metabolic disorders in patients with CS, the associated factors, and the rate of remission of these disorders after the remission from CS. Methods. It is a retrospective study including 75 cases of CS followed up at the university hospital La Rabta of Tunis from 1987 to 2018. Clinical and paraclinical data were collected from medical files. Results. The mean age of the patients was 44.1±18.9 years and the sex ratio was 0.39. At CS diagnosis, the frequencies of obesity, hypertension, diabetes, dyslipidemia, and metabolic syndrome were 52, 75, 43, 83, and 73%, respectively. The age, gender, body mass index, waist circumference, and baseline serum cortisol level were not associated with the presence of diabetes, hypertension or dyslipidemia. Forty-eight patients were operated on. At one year, 38 patients were in remission from CS. The remission rates of hypertension, diabetes, and dyslipidemia were respectively 58% (p<0.001), 76% (p<0.001), and 17% (NS). Conclusion. Metabolic disorders were frequent during CS and their frequencies decreased after the remission from the syndrome.
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Affiliation(s)
- Melika Chihaoui
- 1Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ibtissem Oueslati
- 1Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nadia Khessairi
- 1Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Fatma Chaker
- 1Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Skander Cherni
- 1Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Bessam Hammami
- 2Department of Biochemistry, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Moncef Feki
- 2Department of Biochemistry, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Meriem Yazidi
- 1Department of Endocrinology, University Hospital La Rabta, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Yusufoğlu E, Güngör Kobat S, Keser S. Evaluation of central corneal epithelial thickness with anterior segment OCT in patients with type 2 diabetes mellitus. Int Ophthalmol 2023; 43:27-33. [PMID: 35781596 DOI: 10.1007/s10792-022-02384-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 06/14/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study aimed to evaluate the central corneal thickness (CCT) and central corneal epithelial thickness (CCET) in patients with Type 2 diabetes mellitus (DM), and the effect of the duration of diabetes, the degree of diabetic retinopathy (DR), and HbA1c level. METHODS CCT and CCET values of 72 patients diagnosed with type 2 DM and 72 healthy individuals were measured by anterior segment optical coherence tomography. The eye tear function was evaluated with the Tear Break-up Time test (TBUT) and the Schirmer test. From the results of fundus examination, the diabetic patients were grouped as those without DR, non-proliferative DR, and proliferative DR. The disease duration and the HbA1c levels were recorded. RESULTS In the diabetic patients, the mean CCT was determined to be thicker (p = 0.025), the CCET was thinner (p = 0.003), and the TBUT and Schirmer values were lower (p <0.001, p <0.001, respectively). The duration of diabetes and the HbA1c level was not found to have any statistically significant effect on these parameters (p >0.05). The presence of retinopathy had no significant effect on CCT, TBUT, and Schirmer values. The CCET was determined to be thinner in patients with retinopathy (p <0.001). CONCLUSIONS As the corneal epithelial thickness is reduced in patients with advanced diabetic retinopathy, corneal epithelial pathologies can be seen more often. Therefore, early and effective treatment can be started by taking into consideration the complications which may develop associated with the corneal epithelium following surgical procedures, especially those applied to the cornea.
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Affiliation(s)
- Elif Yusufoğlu
- Department of Ophthalmology, Elazığ Fethi Sekin City Hospital, Elâzığ, Turkey.
| | | | - Sinem Keser
- Department of Ophthalmology, Elazığ Fethi Sekin City Hospital, Elâzığ, Turkey
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Widodo W, Kusumaningrum HRP, Wihadmadyatami H, Wicaksana AL. Milk Fermented with Pediococcus acidilactici Strain BE Improves High Blood Glucose Levels and Pancreatic Beta-Cell Function in Diabetic Rats. Food Sci Anim Resour 2023; 43:170-183. [PMID: 36789203 PMCID: PMC9890364 DOI: 10.5851/kosfa.2022.e69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/01/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022] Open
Abstract
This study evaluated the effects of milk fermented with Pediococcus acidilactici strain BE and Pediococcus pentosaceus strain M103 on diabetes in rats (Rattus norvegicus). The bacteria were separately used as starter cultures for milk fermentation, and the products were then fed to diabetic rats for 15 days. Blood glucose levels, immunohistochemical and histological indicators, lipid profiles, and total lactic acid bacterium counts were evaluated before and after treatment. The administration of milk fermented with P. acidilactici strain BE reduced blood glucose levels from 410.27±51.60 to 304.07±9.88 mg/dL (p<0.05), similar to the effects of metformin (from 382.30±13.39 mg/dL to 253.33±40.66 mg/dL, p<0.05). Increased insulin production was observed in diabetic rats fed milk fermented with P. acidilactici strain BE concomitant with an increased number and percentage area of immunoreactive beta-cells. The structure of insulin-producing beta-cells was improved in diabetic rats fed milk fermented with P. acidilactici strain BE or metformin (insulin receptor substrate scores of 5.33±0.94 and 3.5±0.5, respectively). This suggests that the administration of milk fermented with P. acidilactici BE potentially reduces blood glucose levels and improves pancreatic beta-cell function in diabetic rats.
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Affiliation(s)
- Widodo Widodo
- Faculty of Animal Science, Universitas
Gadjah Mada, Yogyakarta 55281, Indonesia,Corresponding author: Widodo
Widodo, Faculty of Animal Science, Universitas Gadjah Mada, Yogyakarta 55281,
Indonesia, Tel: +62-274-6491963, E-mail:
| | | | - Hevi Wihadmadyatami
- Faculty of Veterinary Medicine,
Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Anggi Lukman Wicaksana
- Faculty of Medicine, Public Health, and
Nursing, Universitas Gadjah Mada, Yogyakarta 55281,
Indonesia,School of Nursing, College of Nursing,
Taipei Medical University, Taipei 11031, Taiwan
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Hernández-Mendoza H, Álvarez-Loredo HE, Romero-Guzmán ET, Gaytán-Hernández D, Chang-Rueda C, Martínez-Navarro I, Juárez-Flores BI, Rios-Lugo MJ. Relationship Between Serum Levels of Arsenic, Cadmium, and Mercury and Body Mass Index and Fasting Plasma Glucose in a Mexican Adult Population. Biol Trace Elem Res 2022; 200:4916-4923. [PMID: 35098445 PMCID: PMC8801291 DOI: 10.1007/s12011-021-03081-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/20/2021] [Indexed: 01/22/2023]
Abstract
In Mexico, few studies have analyzed the associations between toxic elements and metabolic diseases. In the present study, we analyzed the associations between serum arsenic (As), cadmium (Cd), and mercury (Hg) levels and body mass index (BMI) and fasting plasma glucose (FPG) in a Mexican adult population. Anthropometric data corresponding to 86 Mexican healthy adults (59 females and 27 men) were analyzed. FPG was analyzed by an enzymatic colorimetric method, and serum As, Cd, and Hg levels were analyzed by inductively coupled plasma-mass spectrometry (ICP-MS). The data show that the median serum As, Cd, and Hg levels were relatively higher in females (As = 1.78 ng mL-1, Cd = 1.00 ng mL-1, Hg = 0.96 ng mL-1) than those in males (As = 1.22 ng mL-1, Cd = 0.91 ng mL-1, Hg = 0.95 ng mL-1). However, these differences were not statistically significant (p ≥ 0.097). We also found that the median level of As significantly increased with an increase in the body weight categories (normal weight = 1.08; overweight = 1.50; obesity = 2.75; p < 0.001). In addition, a positive association between serum As levels and FPG before and after adjustment for BMI was demonstrated (RhoUnadjusted = 0.012; (RhoAdjusted = 0.243, p = 0.032). Serum As levels are positively associated with BMI and FPG in the adult population of Mexico. Nevertheless, these results need to be replicated and confirmed with a larger sample size.
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Affiliation(s)
- Héctor Hernández-Mendoza
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, C.P: 78377, San Luis Potosí, S.L.P., México.
- Universidad del Centro de México, Capitán Caldera 75, C.P: 78250, San Luis Potosí, S.L.P., México.
| | - Héctor Edmundo Álvarez-Loredo
- Centro de Investigación en Ciencias de Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, C.P: 78210, San Luis Potosí, S.L.P., México
| | - Elizabeth Teresita Romero-Guzmán
- Departamento de Química, Gerencia de Ciencias Básicas, Dirección de Investigación Científica, Carretera México-Toluca S/N, C.P: 52750, La Marquesa Ocoyoacác, México
| | - Darío Gaytán-Hernández
- Facultad de Enfermería Y Nutrición, Unidad de Posgrado, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, C.P: 78210, San Luis Potosí, S.L.P., México
| | - Consuelo Chang-Rueda
- Facultad de Ciencias Químicas, Universidad Autónoma de Chiapas, Campus IV Carretera a Puerto Madero Km 1.5, C.P: 30580, Tapachula, Chiapas, México
| | - Israel Martínez-Navarro
- Centro de Investigación en Ciencias de Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, C.P: 78210, San Luis Potosí, S.L.P., México
| | - Bertha Irene Juárez-Flores
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, C.P: 78377, San Luis Potosí, S.L.P., México
| | - María Judith Rios-Lugo
- Centro de Investigación en Ciencias de Salud y Biomedicina, Sección de Medicina Molecular y Traslacional, Universidad Autónoma de San Luis Potosí, Avda Sierra Leona 550, C.P: 78210, San Luis Potosí, S.L.P., México.
- Facultad de Enfermería Y Nutrición, Unidad de Posgrado, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, C.P: 78210, San Luis Potosí, S.L.P., México.
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Muacevic A, Adler JR, Bukhamsin SA, Alkhars FS, Al-Hussaini H. Diabetic Neuropathy: Prevalence and Impact on Quality of Life in Al-Ahsa, Saudi Arabia. Cureus 2022; 14:e33176. [PMID: 36601164 PMCID: PMC9805359 DOI: 10.7759/cureus.33176] [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] [Accepted: 12/31/2022] [Indexed: 01/02/2023] Open
Abstract
Objective This study aims to measure the prevalence of diabetic neuropathy (DN) in patients with type 1 and type 2 diabetes mellitus (DM) and to explore the impact of DN on quality of life (QoL) in type 1 and type 2 DM patients in Al-Ahsa, Saudi Arabia. Methods This cross-sectional study targeted type 1 and type 2 DM patients who live in Al-Ahsa, Saudi Arabia. Self-reported online questionnaires distributed randomly on social media were used. The survey included three parts: sociodemographic data, the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire, and the modified Arabic Diabetes Quality of Life (DQoL) questionnaire. The data have been collected from April 2022 to May 2022. Results The study included participants (n = 329) of both type 1 and type 2 DM. Patients' age ranged from 18 to 82 years with a mean age of 45.9 ± 15.2 years. A total of 166 (50.5%) patients were males and 319 (97%) were Saudi nationals. The prevalence of DN in the study population was 44.1%. Of the patients with DN, 73.1% have low QoL, which means DN increased the risk of low QoL by about four times (OR = 3.9; 95% CI: 2.5-6.3). Conclusion In conclusion, the study showed that the prevalence of DN in Al-Ahsa, Saudi Arabia was 44.1%. The presence of DN was associated with reduced QoL. Type 2 DM, low educational level, and the presence of other comorbidities were significantly associated with low QoL.
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Martin-Ridaura C, Ochoa-Esteban D, Berlinches-Zapero C, Ruiz-Fernández D, Sanz-Martín V, Gavira-Izquierdo R, March S, López-Toribio M, Ceinos-Arcones M, Pino-Vega S, Melero-Rubio JM, Bordel-Nieto F, Caballero-Jauregui M, Corella-Monzon I, Pino-Días R, Cutanda-Rodriguez C, Sánchez-Muñoz S, Fernández-Garrido JM, Morales-López C, Majarrez-Arias MJ, Sancho S, Fernández NC, Martínez-Cortes M, García-Crespo P, León-Dominguez CM, Pascual M, Herrera R. Evaluation under real-life conditions of a lifestyle intervention for diabetes prevention developed by the municipal health services of Madrid, Spain. Sci Rep 2022; 12:19700. [PMID: 36385106 PMCID: PMC9669021 DOI: 10.1038/s41598-022-21531-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
The Diet, Physical Activity and Health (Alimentación, Actividad física y Salud, ALAS) program is an intervention implemented by the municipal health services of Madrid with the objective of reducing weight and preventing diabetes in high-risk population by improving diet and physical activity. The ALAS program combines individual visits with a 10-session group workshop that takes place over a 6-month period. This study evaluated the effectiveness of the ALAS intervention implemented under real-life conditions between 2016 and 2019. The intervention was evaluated with a pre- and post-intervention study with follow-up performed 6 and 12 months from the start of the program. The analyzed outcomes were a 5-10% reduction in the initial weight, body mass index (BMI), waist circumference and a change in glycemic status in prediabetic participants. Statistical models were adjusted by sociodemographic variables. The participants were recruited from municipal community health centers or referred by municipal occupational health services. Between 2016 and 2019, 1629 people participated in the program. At 6 months, 85% of the participants had lost weight; 43% had lost 5% or more of their initial weight, and 12% had lost 10% or more. Regarding BMI, 22.3% of participants who were initially obese were no longer obese, and 15.2% of the overweight participants achieved normal weight. A total of 35.1% of the prediabetic participants reverted to normoglycemic status. The intervention was found to be more effective for men, for those who completed the intervention and those who accessed the program through the occupational health route. Among the participants who accessed the intervention via the community, the intervention was more effective in those with a high educational level. The evaluation demonstrated the effectiveness of the ALAS program for reducing weight and the risk of developing Type 2 diabetes when applied under real-life conditions. The effectiveness of the intervention differed according to gender, access route and educational level of the participants.
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Affiliation(s)
| | - Darío Ochoa-Esteban
- Madrid Salud, Madrid City Council, 62 Mediterraneo Avenue, Floor 6, Madrid, Spain
| | | | | | - Vanessa Sanz-Martín
- Madrid Salud, Madrid City Council, 62 Mediterraneo Avenue, Floor 6, Madrid, Spain
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Ahmad MZ, Alasiri AS, Ahmad J, Alqahtani AA, Abdullah MM, Abdel-Wahab BA, Pathak K, Saikia R, Das A, Sarma H, Alzahrani SA. Green Synthesis of Titanium Dioxide Nanoparticles Using Ocimum sanctum Leaf Extract: In Vitro Characterization and Its Healing Efficacy in Diabetic Wounds. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27227712. [PMID: 36431808 PMCID: PMC9699599 DOI: 10.3390/molecules27227712] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/05/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
Diabetes mellitus is one of the most prevalent metabolic disorders characterized by hyperglycemia due to impaired glucose metabolism. Overproduction of free radicals due to chronic hyperglycemia may cause oxidative stress, which delays wound healing in diabetic conditions. For people with diabetes, this impeded wound healing is one of the predominant reasons for mortality and morbidity. The study aimed to develop an Ocimum sanctum leaf extract-mediated green synthesis of titanium dioxide (TiO2) nanoparticles (NPs) and further incorporate them into 2% chitosan (CS) gel for diabetic wound healing. UV-visible spectrum analysis recorded the sharp peak at 235 and 320 nm, and this was the preliminary sign for the biosynthesis of TiO2 NPs. The FTIR analysis was used to perform a qualitative validation of the biosynthesized TiO2 nanoparticles. XRD analysis indicated the crystallinity of TiO2 NPs in anatase form. Microscopic investigation revealed that TiO2 NPs were spherical and polygonal in shape, with sizes ranging from 75 to 123 nm. The EDX analysis of green synthesized NPs showed the presence of TiO2 NPs, demonstrating the peak of titanium ion and oxygen. The hydrodynamic diameter and polydispersity index (PDI) of the TiO2 NPs were found to be 130.3 nm and 0.237, respectively. The developed TiO2 NPs containing CS gel exhibited the desired thixotropic properties with pseudoplastic behavior. In vivo wound healing studies and histopathological investigations of healed wounds demonstrated the excellent wound-healing efficacy of TiO2 NPs containing CS gel in diabetic rats.
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Affiliation(s)
- Mohammad Zaki Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Kingdom of Saudi Arabia
| | - Ali S. Alasiri
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Kingdom of Saudi Arabia
- Correspondence:
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Kingdom of Saudi Arabia
| | - Abdulsalam A. Alqahtani
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Kingdom of Saudi Arabia
| | - Md Margub Abdullah
- Advanced Materials and Nano-Research Centre, Department of Physics, Faculty of Science and Arts, Najran University, Najran 11001, Kingdom of Saudi Arabia
| | - Basel A. Abdel-Wahab
- Department of Pharmacology, College of Pharmacy, Najran University, Najran 11001, Kingdom of Saudi Arabia
- Department of Pharmacology, College of Medicine, Assiut University, Assiut 7111, Egypt
| | - Kalyani Pathak
- Department of Pharmaceutical Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India
| | - Riya Saikia
- Department of Pharmaceutical Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India
| | - Aparoop Das
- Department of Pharmaceutical Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India
| | - Himangshu Sarma
- Sophisticated Analytical Instrument Facility (SAIF), Girijananda Chowdhury Institute of Pharmaceutical Science (GIPS), Guwahati 781017, Assam, India
| | - Seham Abdullah Alzahrani
- Pharmacy Department, Khamis Mushait General Hosptial, King Khalid Rd, Al Shifa, Khamis Mushait 62433, Kingdom of Saudi Arabia
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Muacevic A, Adler JR, Algarni AS, Alashqan ZM, Aljarallah FAM, AlIbrahim A, Alshehri TK, Al-Asmari ZS, Alshahrani A, Alsalem A, Alfaifi AH, Hammad AM. Effect of Uncomplicated Diabetes Mellitus on Acute Respiratory Distress Syndrome Among COVID-19 Patients in Aseer Region, Saudi Arabia. Cureus 2022; 14:e31793. [PMID: 36569667 PMCID: PMC9779536 DOI: 10.7759/cureus.31793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; an ssRNA virus), which mainly affects the respiratory system but can also cause damage to other body systems. Acute respiratory distress syndrome (ARDS) is a serious complication of COVID-19 that requires early recognition and comprehensive management. ARDS is a diffuse inflammatory process that causes diffuse alveolar damage in the lung. Aim: The study aimed to assess the effect of uncomplicated diabetes mellitus on ARDS among COVID-19 patients in the Aseer region. METHODOLOGY A retrospective cohort study was conducted in Aseer Central Hospital between July 10, 2021 to Jan 15, 2022 where confirmed inpatient COVID-19 cases in the Aseer region were classified into two groups. The first group was diabetic patients without any diabetes-related complications and confirmed for COVID-19 infection (diabetes group). The second group was confirmed COVID-19 patients free from any chronic disease. Extracted data included patients' diabetes status, medical history, socio-demographic data, COVID-19 infection data and vaccination, experienced signs and symptoms, tachypnea, use of accessory muscles of respiration, nasal flaring, grunting, cyanosis, need for hospitalization, need for mechanical ventilation and ICU admission. Results: The study included 144 patients with uncomplicated diabetes and 323 healthy patients with COVID-19 infection. The mean age of the diabetic group was 65.4 ± 12.9 years old compared to 40.2 ± 11.9 years old for the healthy group. Only one case of the diabetic group was vaccinated against COVID-19 at the study period versus two cases of the healthy group (P=.925). Also, 14 (9.7%) of the diabetic group were contacted with confirmed COVID-19 cases in comparison to 44 (13.6%) healthy cases (P=.238). A total of five (3.5%) diabetic cases needed mechanical ventilation during hospitalization compared to 23 (7.1%) healthy cases with no statistical significance (P=.125). Also, 12 (8.3%) diabetic cases admitted to ICU versus 42 (13%) of healthy cases (P=.145). Conclusions: In conclusion, there is a great controversy regarding the effect of diabetes on the progression of COVID-19 infection to ARDS. The current study showed that there was no significant difference between diabetic and healthy COVID-19 infected cases regarding ARDS related clinical factors mainly need of ICU admission and mechanical ventilation.
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The clinical and translational prospects of microneedle devices, with a focus on insulin therapy for diabetes mellitus as a case study. Int J Pharm 2022; 628:122234. [PMID: 36191817 DOI: 10.1016/j.ijpharm.2022.122234] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 09/01/2022] [Accepted: 09/21/2022] [Indexed: 11/20/2022]
Abstract
Microneedles have the clinical advantage of being able to deliver complex drugs across the skin in a convenient and comfortable manner yet haven't successfully transitioned to medical practice. Diabetes mellitus is a complicated disease, which is commonly treated with multiple daily insulin injections, contributing to poor treatment adherence. Firstly, this review determines the clinical prospect of microneedles, alongside considerations that ought to be addressed before microneedle technology can be translated from bench to bedside. Thereafter, we use diabetes as a case study to consider how microneedle-based-technology may be successfully harnessed. Here, publications referring to insulin microneedles were evaluated to understand whether insertion efficiency, angle of insertion, successful dose delivery, dose adjustability, material biocompatibility and therapeutic stability are being addressed in early stage research. Moreover, over 3,000 patents from 1970-2019 were reviewed with the search term '"microneedle" AND "insulin"' to understand the current status of the field. In conclusion, the reporting of early stage microneedle research demonstrated a lack of consistency relating to the translational factors addressed. Additionally, a more rational design, based on a patient-centred approach is required before microneedle-based delivery systems can be used to revolutionise the lives of people living with diabetes following regulatory approval.
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Orumiyehei A, Khoramipour K, Rezaei MH, Madadizadeh E, Meymandi MS, Mohammadi F, Chamanara M, Bashiri H, Suzuki K. High-Intensity Interval Training-Induced Hippocampal Molecular Changes Associated with Improvement in Anxiety-like Behavior but Not Cognitive Function in Rats with Type 2 Diabetes. Brain Sci 2022; 12:1280. [PMID: 36291214 PMCID: PMC9599079 DOI: 10.3390/brainsci12101280] [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: 08/03/2022] [Revised: 09/01/2022] [Accepted: 09/16/2022] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Exercise exerts many neuroprotective effects in diabetes-induced brain disorders. In this study, we investigated the effect of high-intensity interval training (HIIT) on brain molecular changes and cognitive and anxiety-like behaviors in rats with type 2 diabetes. (2) Methods: Twenty-eight adult male rats were divided into four groups (n = 7): control (C), exercise + control (C+EX), diabetes (DM), and diabetes + exercise (DM+EX). Diabetes was induced using a two-month high-fat diet and a single dose of streptozotocin (35 mg/kg) in the DM and DM+EX groups. After, the C+EX and DM+EX groups performed HIIT for eight weeks (five sessions per week, running at 80-100% of VMax, 4-10 intervals) on a motorized treadmill. Then, the elevated plus maze (EPM) and open field test (OFT) were performed to evaluate anxiety-like behaviors. The Morris water maze (MWM) and shuttle box were used to assess cognitive function. The hippocampal levels of beta-amyloid and tau protein were also assessed using Western blot. (3) Results: The hippocampal levels of beta-amyloid and tau protein were increased in the DM group, but HIIT restored these changes. While diabetes led to a significant decrease in open arm time percentage (%OAT) and open arm enters percentage (%OAE) in the EPM, indicating anxiety-like behavior, HIIT restored them. In the OFT, grooming was decreased in diabetic rats, which was restored by HIIT. No significant difference between groups was seen in the latency time in the shuttle box or for learning and memory in the MWM. (4) Conclusions: HIIT-induced hippocampal molecular changes were associated with anxiety-like behavior improvement but not cognitive function in rats with type 2 diabetes.
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Affiliation(s)
- Amin Orumiyehei
- Toxicology Research Center, Aja University of Medical Sciences, Tehran 1411718541, Iran
| | - Kayvan Khoramipour
- Neuroscience Research Center, Institute of Neuropharmacology, Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman 7616914115, Iran
| | - Maryam Hossein Rezaei
- Department of Exercise Physiology, Faculty of Sport Sciences, Shahid Bahonar University, Kerman 7616913439, Iran
| | - Elham Madadizadeh
- Department of Exercise Physiology, Faculty of Sport Sciences, Shahid Bahonar University, Kerman 7616913439, Iran
| | - Manzumeh Shamsi Meymandi
- Neuroscience Research Center, Institute of Neuropharmacology, Department of Physiology and Pharmacology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman 7616914115, Iran
| | | | - Mohsen Chamanara
- Toxicology Research Center, Aja University of Medical Sciences, Tehran 1411718541, Iran
- Department of Pharmacology, School of Medicine, Aja University of Medical Sciences, Tehran 1411718541, Iran
| | - Hamideh Bashiri
- Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Department of Physiology and Pharmacology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman 7616914115, Iran
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Institute of Sports Nutrition, Waseda University, Saitama 359-1192, Japan
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Kidawara Y, Kadoya M, Morimoto A, Daimon T, Kakutani-Hatayama M, Kosaka-Hamamoto K, Miyoshi A, Konishi K, Kusunoki Y, Shoji T, Goda A, Asakura M, Ishihara M, Koyama H. Sleep Apnea and Physical Movement During Sleep, But Not Sleep Duration, Are Independently Associated With Progression of Left Ventricular Diastolic Dysfunction: Prospective Hyogo Sleep Cardio-Autonomic Atherosclerosis Cohort Study. J Am Heart Assoc 2022; 11:e024948. [PMID: 36129028 PMCID: PMC9673706 DOI: 10.1161/jaha.121.024948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Although co‐occurrence of sleep disorder with heart failure is known, it is not clear whether that condition is a cause or consequence of heart failure. The present study was conducted as a longitudinal examination of the predictive value of sleep parameters on progression of left ventricular diastolic dysfunction. Methods and Results Four‐hundred fifty‐two subjects were followed for a mean of 34.7 months. An outcome of diastolic dysfunction was defined as increase in early inflow velocity/early diastolic tissue velocity >14. Sleep apnea‐hypopnea index, minimal oxygen saturation, sleep duration, and activity index (physical movement during sleep time, a potential parameter of poor sleep quality) were determined using apnomonitor and actigraphy findings, while heart rate variability was measured with a 24‐hour active tracer device. Sixty‐six of the patients developed diastolic dysfunction during the follow‐up period, with a median time of 25 months. Kaplan–Meier analysis results revealed that those with sleep apnea classified as moderate (apnea‐hypopnea index 15 to <30, P<0.01 versus none) or severe (apnea‐hypopnea index ≥30, P<0.01 versus none), and with a high activity index (Q3 or Q4, P<0.01 versus Q1), but not short sleep duration (P=0.27) had a significantly greater risk for a diastolic dysfunction event. Results of multivariable Cox proportional hazards regression analysis indicated that moderate to severe sleep apnea after a follow‐up period of 3 years (hazard ratio [HR], 9.26 [95% CI, 1.89–45.26], P<0.01) and high activity index (HR, 1.85 [95% CI, 1.01–3.39], P=0.04) were significantly and independently associated with future diastolic dysfunction. Moreover, significant association of high activity index with the outcome was not confounded by either minimal oxygen saturation or heart rate variability. Conclusions Sleep apnea and physical movement during sleep, but not sleep duration and autonomic nervous dysfunction, are independent important predictors for progression of left ventricular diastolic dysfunction.
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Affiliation(s)
- Yonekazu Kidawara
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Manabu Kadoya
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Akiko Morimoto
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Takashi Daimon
- Department of Biostatistics, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Miki Kakutani-Hatayama
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Kae Kosaka-Hamamoto
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Akio Miyoshi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Kosuke Konishi
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Yoshiki Kusunoki
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Takuhito Shoji
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Akiko Goda
- Department of Cardiovascular and Renal Medicine, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Masanori Asakura
- Department of Cardiovascular and Renal Medicine, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Masaharu Ishihara
- Department of Cardiovascular and Renal Medicine, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical Immunology, School of Medicine Hyogo Medical University Nishinomiya Hyogo Japan
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Dietary habits are associated with the prevalence of type 2 diabetes: a study among a middle eastern population. J Nutr Sci 2022; 11:e78. [PMID: 36304825 PMCID: PMC9554423 DOI: 10.1017/jns.2022.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/17/2022] [Indexed: 12/14/2022] Open
Abstract
Worldwide type 2 diabetes (T2D) prevalence is increasing dramatically. The present study aimed to evaluate the association between dietary habits and T2D in an Iranian adult population using a cross-sectional analysis of the Shahedieh cohort study. Participants were adults aged 35-70 years (n 9261) from Zarch and Shahedieh, Yazd, Iran, who attended the baseline phase of the Shahedieh cohort study. Dietary habits including meal frequency, fried-food consumption, adding salt to prepared meals and grilled-food consumption were assessed by a standard questionnaire. T2D was defined as fasting plasma glucose (FPG) ≥126 mg/dl according to the American Diabetes Association. Multiple logistic regression assessed the association between dietary habits and T2D. Individuals who consumed a meal more than six times per day compared to three times per day had greater odds for T2D (OR 2⋅503, 95 % CI 1⋅651, 3⋅793). These associations remained significant in a fully adjusted model. There was a significant association between greater intakes of fried foods and prevalence of T2D (OR 1⋅294, 95 % CI 1⋅004, 1⋅668) in the adjusted model. No significant associations were observed between other dietary habits (adding salt to prepared meals and grilled-food consumption) and odds of T2D in all crude and adjusted models. In conclusion, we have highlighted the association between meal and fried-food consumption frequencies with risk of T2D. Large longitudinal studies in different ethnicities are needed to confirm these associations.
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Qiu Z, Yu X, Zhang J, Xu C, Gao M, Cheng Y, Zhu M. Fibrous aggregates: Amplifying aggregation-induced emission to boost health protection. Biomaterials 2022; 287:121666. [PMID: 35835002 PMCID: PMC9250848 DOI: 10.1016/j.biomaterials.2022.121666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022]
Abstract
Environmental monitoring and personal protection are critical for preventing and for protecting human health during all infectious disease outbreaks (including COVID-19). Fluorescent probes combining sensing, imaging and therapy functions, could not only afford direct visualizing existence of biotargets and monitoring their dynamic information, but also provide therapeutic functions for killing various bacteria or viruses. Luminogens with aggregation-induced emission (AIE) could be well suited for above requirements because of their typical photophysical properties and therapeutic functions. Integration of these molecules with fibers or textiles is of great interest for developing flexible devices and wearable systems. In this review, we mainly focus on how fibers and AIEgens to be combined for health protection based on the latest advances in biosensing and bioprotection. We first discuss the construction of fibrous sensors for visualization of biomolecules. Next recent advances in therapeutic fabrics for individual protection are introduced. Finally, the current challenges and future opportunities for "AIE + Fiber" in sensing and therapeutic applications are presented.
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Affiliation(s)
- Zhenduo Qiu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University. Shanghai, 201620, China
| | - Xiaoxiao Yu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University. Shanghai, 201620, China
| | - Junyan Zhang
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University. Shanghai, 201620, China
| | - Chengjian Xu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University. Shanghai, 201620, China
| | - Mengyue Gao
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University. Shanghai, 201620, China
| | - Yanhua Cheng
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University. Shanghai, 201620, China.
| | - Meifang Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University. Shanghai, 201620, China
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Zahedifar R, Keymasi Khalaji A. Control of blood glucose induced by meals for type-1 diabetics using an adaptive backstepping algorithm. Sci Rep 2022; 12:12228. [PMID: 35851835 PMCID: PMC9293929 DOI: 10.1038/s41598-022-16535-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
In this study, an adaptive backstepping method is proposed to regulate the blood glucose induced by meals for type-1 diabetic patients. The backstepping controller is used to control the blood glucose level and an adaptive algorithm is utilized to compensate for the blood glucose induced by meals. Moreover, the effectiveness of the proposed method is evaluated by comparing results in two different case studies: in the presence of actuator faults and the loss of control input for a short while during treatment. Effects of unannounced meals three times a day are investigated for a nominal patient in every case. It is argued that adaptive backstepping is the preferred control method in either case. The Lyapunov theory is used to prove the stability of the proposed method. Obtained results, indicated that the adaptive backstepping controller is stable, and the desired level of glucose concentration is being tracked efficiently.
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Affiliation(s)
- Rasoul Zahedifar
- Department of Mechanical Engineering, Faculty of Engineering, Kharazmi University, Tehran, P.O.B. 15719-14911, Iran
| | - Ali Keymasi Khalaji
- Department of Mechanical Engineering, Faculty of Engineering, Kharazmi University, Tehran, P.O.B. 15719-14911, Iran.
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Hernández-Mendoza H, Rios-Lugo MJ, Álvarez-Loredo HE, Romero-Guzmán ET, Gaytán-Hernández D, Martínez-Navarro I, Juárez-Flores BI, Chang-Rueda C. Serum lead levels and its association with overweight and obesity. J Trace Elem Med Biol 2022; 72:126984. [PMID: 35427954 DOI: 10.1016/j.jtemb.2022.126984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 02/16/2022] [Accepted: 04/07/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Lead (Pb) exposure has been associated with cardiovascular diseases and metabolic syndrome, nevertheless its association with obesity, type 2 diabetes, and dyslipidemia markers has been little explored in Mexico. Therefore, we evaluated the association of serum Pb levels (Pb-S), with body mass index (BMI), fasting plasma glucose (FPG), total cholesterol (TC), and triglycerides (TG). METHODS A cross-sectional study was performed on 85 Mexican adults (57 women and 28 men). BMI was calculated, while FPG, TC, and TG were measured by the enzymatic colorimetric method. Total Pb-S levels were measured using inductively coupled plasma mass spectrometry (ICP-MS). RESULTS The study population was 20.3 ± 1.9 years old, showed an average of Pb-S of 0.0982 ± 0.068 μg dL-1, and presented a frequency of overweight (OW) and obesity (OB) of 50.5% and 18.8%, respectively. Men had higher average FPG than women (Women= 83.930 ± 5.662 vs Men= 84.953 ± 6.495; p = 0.037). When we analyzed anthropometric and clinical variables, Pb-S and frequency of OW and OB were observed to increase within the categories of Pb-S tertiles (<0.001). The averages of Pb-S were 0.051 ± 0.035 µg dL-1, 0.107 ± 0.067 µg dL-1, and 0.151 ± 0.063 µg dL-1 for individuals with normal weight (NW), OW, and OB, respectively. In addition, an analysis adjusted for age and sex shows Pb-S is positively associated with BMI (β = 2.76 ± 0.498, p = <0.001). CONCLUSION Our results evidence a significant association between Pb-S and the increase of BMI in Mexican adults and highlight the important health impact that may represent environmental Pb exposure.
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Affiliation(s)
- Héctor Hernández-Mendoza
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, C.P, 78377 San Luis Potosí, SLP, Mexico; Universidad del Centro de México, Capitán Caldera 75, C.P., 78250 San Luis Potosí, SLP, Mexico
| | - María Judith Rios-Lugo
- Unidad de Posgrado, Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, C.P., 78210 San Luis Potosí, SLP, Mexico; Sección de Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Avda, Sierra Leona 550, C.P., 78210 San Luis Potosí, SLP, Mexico.
| | - Héctor Edmundo Álvarez-Loredo
- Sección de Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Avda, Sierra Leona 550, C.P., 78210 San Luis Potosí, SLP, Mexico
| | - Elizabeth Teresita Romero-Guzmán
- Departamento de Química, Instituto Nacional de Investigaciones Nucleares, Carretera México-Toluca s/n, C.P., La Marquesa, 52750 Ocoyoacác, Mexico
| | - Darío Gaytán-Hernández
- Unidad de Posgrado, Facultad de Enfermería y Nutrición, Universidad Autónoma de San Luis Potosí, Avda. Niño Artillero 130, C.P., 78210 San Luis Potosí, SLP, Mexico
| | - Israel Martínez-Navarro
- Sección de Medicina Molecular y Traslacional, Centro de Investigación en Ciencias de Salud y Biomedicina, Universidad Autónoma de San Luis Potosí, Avda, Sierra Leona 550, C.P., 78210 San Luis Potosí, SLP, Mexico
| | - Bertha Irene Juárez-Flores
- Instituto de Investigación de Zonas Desérticas, Universidad Autónoma de San Luis Potosí, Altair 200, C.P, 78377 San Luis Potosí, SLP, Mexico
| | - Consuelo Chang-Rueda
- Facultad de Ciencias Químicas, Campus IV. Universidad Autónoma de Chiapas, Carretera a Puerto Madero Km 1.5, C.P., 30580, Tapachula, Chiapas, Mexico
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Aynalem M, Getu F, Adane T. Peripheral Cytopenia and Its Associated Factors in Type 2 Diabetes Mellitus Patients, Northwest Ethiopia. J Blood Med 2022; 13:373-383. [PMID: 35814281 PMCID: PMC9268223 DOI: 10.2147/jbm.s369583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/29/2022] [Indexed: 01/08/2023] Open
Abstract
Background Hematological abnormalities are linked with diabetes mellitus (DM) and play a major role in diabetes-related micro- and macro-vascular complications. Therefore, this study aimed to investigate the magnitude of peripheral cytopenia and associated factors in type 2 diabetes (T2DM) patients. Methods A cross-sectional study was conducted from March to May 2021 at the University of Gondar Comprehensive Specialized Hospital. A total of 357 T2DM participants were selected using a simple random sampling technique. A total of 3 mL of venous blood samples were collected using the vacutainer method for the complete blood count (CBC). A univariate and multivariate regression analysis were used to investigate the association between dependent and independent variables. P-value ˂0.05 was considered statistically significant. Results The magnitude of cytopenia, bicytopenia, and pancytopenia were 21% (95% CI: 17.1, 25.53), 1.1% (95% CI: 0.44, 2.85), and 0.56% (95% CI: 0.01, 1.12), respectively. Furthermore, the magnitudes of anemia, leucopenia, and thrombocytopenia were 8.7% (95% CI: 6.18, 12.06), 10.9% (95% CI: 8.09, 14.59), and 5.3% (95% CI: 3.43, 8.16), respectively. Being male (AOR: 3.23; 95% CI: 1.43, 7.56), lack of exercise (AOR: 2.70; 95% CI: 1.137, 6.43), and never married (AOR: 3.90; 95% CI: 1.248, 12.18) were all associated with anemia. Conclusion This study showed that T2DM causes disturbances in the hematological parameters and leads to a mild level of cytopenia. It is, therefore, suggested that hematological abnormalities, especially cytopenia, should be monitored and controlled on a regular basis in T2DM patients for better prognosis and quality of life.
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Affiliation(s)
- Melak Aynalem
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- Correspondence: Melak Aynalem, Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, Tel +251912692619, Email
| | - Fasil Getu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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George S, Jean-Baptiste W, Yusuf Ali A, Inyang B, Koshy FS, George K, Poudel P, Chalasani R, Goonathilake MR, Waqar S, Mohammed L. The Role of Type 2 Diabetes in Pancreatic Cancer. Cureus 2022; 14:e26288. [PMID: 35898377 PMCID: PMC9308974 DOI: 10.7759/cureus.26288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022] Open
Abstract
The incidence of type 2 diabetes mellitus (T2DM) and its potential complications, such as cancers, are increasing worldwide at an astounding rate. There are many factors such as obesity, diabetes, alcohol consumption, and the adoption of sedentary lifestyles that are driving pancreatic cancer (PC) to become one of the leading causes of cancer mortality in the United States. PC is notorious for its generic symptoms and late-stage presentation with rapid metastasis. The connection between T2DM and the risk of PC development is multifaceted and complex. Some of the proposed theories reveal that chronic inflammation, insulin resistance, hyperinsulinemia, hyperglycemia, and abnormalities in the insulin and insulin-like growth factor axis (IGF) contribute to the disease association between these two conditions. This literature review aims to highlight relevant studies and explore the molecular mechanisms involved in the etiology of diabetes and its impact on PC development, as well as the role of anti-diabetic agents on PC. Despite extensive studies, the exact interaction between T2DM and PC remains obscure and will need further investigation. According to current knowledge, there is a substantial link between diabetes, obesity, and dietary patterns in the development and progression of PC. Consequently, focusing our efforts on preventive measures by reducing modifiable risk factors remains the most effective strategy to reduce the risk of PC at this time. Antidiabetic drugs can have various effects on the occurrence and prognosis of PC with metformin offering a clear benefit of inhibiting PC and insulin increasing the risk of PC. The development of future novel therapies will require a deeper knowledge of the triggering mechanisms and interplay between these two disease states.
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Todero JE, Koch-Laskowski K, Shi Q, Kanke M, Hung YH, Beck R, Styblo M, Sethupathy P. Candidate master microRNA regulator of arsenic-induced pancreatic beta cell impairment revealed by multi-omics analysis. Arch Toxicol 2022; 96:1685-1699. [PMID: 35314868 PMCID: PMC9095563 DOI: 10.1007/s00204-022-03263-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2022] [Indexed: 02/05/2023]
Abstract
Arsenic is a pervasive environmental toxin that is listed as the top priority for investigation by the Agency for Toxic Substance and Disease Registry. While chronic exposure to arsenic is associated with type 2 diabetes (T2D), the underlying mechanisms are largely unknown. We have recently demonstrated that arsenic treatment of INS-1 832/13 pancreatic beta cells impairs glucose-stimulated insulin secretion (GSIS), a T2D hallmark. We have also shown that arsenic alters the microRNA profile of beta cells. MicroRNAs have a well-established post-transcriptional regulatory role in both normal beta cell function and T2D pathogenesis. We hypothesized that there are microRNA master regulators that shape beta cell gene expression in pathways pertinent to GSIS after exposure to arsenicals. To test this hypothesis, we first treated INS-1 832/13 beta cells with either inorganic arsenic (iAsIII) or monomethylarsenite (MAsIII) and confirmed GSIS impairment. We then performed multi-omic analysis using chromatin run-on sequencing, RNA-sequencing, and small RNA-sequencing to define profiles of transcription, gene expression, and microRNAs, respectively. Integrating across these data sets, we first showed that genes downregulated by iAsIII treatment are enriched in insulin secretion and T2D pathways, whereas genes downregulated by MAsIII treatment are enriched in cell cycle and critical beta cell maintenance factors. We also defined the genes that are subject primarily to post-transcriptional control in response to arsenicals and demonstrated that miR-29a is the top candidate master regulator of these genes. Our results highlight the importance of microRNAs in arsenical-induced beta cell dysfunction and reveal both shared and unique mechanisms between iAsIII and MAsIII.
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Affiliation(s)
- Jenna E Todero
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Kieran Koch-Laskowski
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Qing Shi
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matt Kanke
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Yu-Han Hung
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Rowan Beck
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Miroslav Styblo
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Praveen Sethupathy
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
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In Vitro Alpha-Amylase Enzyme Assay of Hydroalcoholic Polyherbal Extract: Proof of Concept for the Development of Polyherbal Teabag Formulation for the Treatment of Diabetes. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1577957. [PMID: 35600963 PMCID: PMC9119791 DOI: 10.1155/2022/1577957] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 04/16/2022] [Indexed: 12/13/2022]
Abstract
For the treatment and maintenance of postprandial blood glucose increases (i.e., diabetes mellitus), alpha (α)-amylase is a well-known therapeutic target. In this paper, we report an initial exploration of the work, i.e., in vitro alpha-amylase activity of the hydroalcoholic polyherbal extract of the selected plants. After drying, the plant material is ground individually, and at least 100 gm of the crude powder is prepared from each plant. 100 gm of each plant was combined, and a total of 500 gm of the crude powder (Ichnocarpus frutescens (100 gm) + Ficus dalhousie (100 gm) + Crateva magna (100 gm) + Alpinia galangal (100 gm) + Swertia chirata (100 gm)) was prepared to carry out the extraction. This obtained extract was subjected to preliminary phytochemical screening and in vitro alpha-amylase activity. At 16 mg/mL, acarbose displayed 78.40 ± 0.36% inhibition, whereas the extract exhibited 72.96 ± 0.70% inhibition, which is significantly comparable. The IC50 value of acarbose was 12.9 ± 1.12, whereas the extract exhibited 13.31 ± 1.12 mg/mL. The extract possesses numerous classes of chemicals such as alkaloids, glycosides, tannins, polyphenols, and terpenoids, which can contribute to the antidiabetic activity through alpha-amylase inhibition. This was an initial exploration of the work as a proof of concept for the development of polyherbal tea bag formulation for the treatment of diabetes. In the future, we are aiming to investigate the effectiveness of polyherbal tea bags in the treatment of diabetes using more in vitro and in vivo models. From the present investigation, we have concluded that this extract can be used for the treatment of diabetes.
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Kurajoh M, Mori K, Miyabe M, Matsufuji S, Ichii M, Morioka T, Kizu A, Tsujimoto Y, Emoto M. Nutritional Status Association With Sarcopenia in Patients Undergoing Maintenance Hemodialysis Assessed by Nutritional Risk Index. Front Nutr 2022; 9:896427. [PMID: 35634393 PMCID: PMC9137182 DOI: 10.3389/fnut.2022.896427] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/26/2022] [Indexed: 01/07/2023] Open
Abstract
Background Malnutrition and sarcopenia are frequently observed in patients undergoing maintenance hemodialysis (MHD). To elucidate whether malnutrition is associated with sarcopenia in those cases, the relationship of nutritional status with sarcopenia was investigated. Methods Nutritional status was assessed using a nutritional risk index (NRI) developed for patients undergoing MHD. This retrospective cross-sectional study included 315 MHD patients (199 males, 116 females), who were divided into low-risk (score 0–7) and medium-/high-risk (score 8–13) groups. Sarcopenia and severe sarcopenia, along with low muscle mass, low muscle strength, and low physical performance were defined using the Asian Working Group for Sarcopenia 2019 criteria. Results The median NRI score was 5.0, while the prevalence of medium-/high-risk cases among the patients was 31.1%. Additionally, the rates of those with low muscle mass, low muscle strength, and low physical performance were 55.9, 60.6, and 31.4%, respectively, while those of sarcopenia and severe sarcopenia were 44.1 and 20.0%, respectively. Multivariable logistic regression analyses revealed a significant (P < 0.001) association of NRI score with sarcopenia [odds ratio (OR) 1.255, 95% confidence interval (CI) 1.143–1.377] and severe sarcopenia (OR 1.257, 95% CI 1.122–1.407), as well as low muscle mass (OR 1.260, 95% CI 1.157–1.374), low muscle strength (OR 1.310, 95% CI 1.178–1.457), and low physical performance (OR 1.216, 95% CI 1.104–1.339). Furthermore, medium-/high-risk status showed a significant (P < 0.05) association with sarcopenia (OR 2.960, 95% CI 1.623–5.401) and severe sarcopenia (OR 2.241, 95% CI 1.151–4.362), as well as low muscle mass (OR 2.141, 95% CI 1.219–3.760), low muscle strength (OR 7.665, 95% CI 3.438–17.091), and low physical performance (OR 2.570, 95% CI 1.401–4.716). Conclusions These results suggest that malnutrition contributes to sarcopenia/severe sarcopenia in MHD patients by reducing muscle mass and strength, and physical performance.
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Affiliation(s)
- Masafumi Kurajoh
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- *Correspondence: Masafumi Kurajoh
| | - Katsuhito Mori
- Department of Nephrology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Mizuki Miyabe
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Osaka, Japan
| | | | - Mitsuru Ichii
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Osaka, Japan
| | - Tomoaki Morioka
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Akane Kizu
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Osaka, Japan
| | - Yoshihiro Tsujimoto
- Division of Internal Medicine, Dialysis Center, Inoue Hospital, Osaka, Japan
| | - Masanori Emoto
- Department of Metabolism, Endocrinology, and Molecular Medicine, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Department of Nephrology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Gupta R, Jain N, Bhansali A, Bhadada SK, Walia R. Demystifying the Relevance of Size Amongst Macro- and Micro-Corticotropinoma: Experience in 206 Patients. Indian J Endocrinol Metab 2022; 26:275-281. [PMID: 36248045 PMCID: PMC9555381 DOI: 10.4103/ijem.ijem_134_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/16/2022] [Accepted: 05/29/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE In individuals with adrenocorticotrophic hormone (ACTH)-dependent Cushing's syndrome (CS), to estimate the differences between micro-corticotropinoma (size ≤6 mm and 6-10 mm), macro-corticotropinoma (>10 mm) and ectopic Cushing's syndrome (ECS), in relation to their epidemiological, clinical and biochemical parameters. METHODS In individuals with CS, the clinical and hormonal parameters, and magnetic resonance imaging of sella were collected from 1984 to 2019. A total of 138 cases of micro-corticotropinoma, 47 cases of macro-corticotropinoma and 21 cases of ECS were compared. RESULTS Except for size, there were no differences in biochemical and hormonal parameters of macro- and micro-corticotropinoma, irrespective of their size (≤6 mm, 6-10 mm and >10 mm). In comparison to Cushing's disease (CD), individuals with ECS had a male predominance (F:M ratio of 2.4:1 vs. 0.5:1), shorter duration from onset of symptoms to diagnosis (24 vs. 12 months). They also had a higher ACTH (139 vs. 65.8 pg/ml), 0800h cortisol (1200 vs. 880 nmol/l), 2300h cortisol (1100 vs. 700 nmol/l) and cortisol levels after high dose dexamethasone suppression test (1050 vs. 244.5 nmol/l). CONCLUSION The biochemical phenotype of macro-corticotropinoma resembles that of micro-corticotropinoma despite their larger tumour size, suggesting that the former is relatively less functional. Micro-corticotropinoma ≤6 mm and 6-10 mm have a similar clinical and biochemical profile. As compare to CD, ECS is characterised by a higher disease burden as reflected in their higher cortisol, more autonomicity and loss of rhythmicity.
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Affiliation(s)
- Rahul Gupta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nimisha Jain
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay K. Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rama Walia
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Alcantara M, Ngo M, de la Cruz J, Menon D, Barnett-Tapia C, Katzberg H, Bril V. Temporal Dispersion and Duration of the Distal Compound Muscle Action Potential Do Not Distinguish Diabetic Sensorimotor Polyneuropathy From Chronic Inflammatory Demyelinating Polyneuropathy. Front Neurol 2022; 13:872762. [PMID: 35557614 PMCID: PMC9087194 DOI: 10.3389/fneur.2022.872762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo investigate the contribution of duration and temporal dispersion (TD) of the distal compound muscle action potential (CMAP) in discriminating chronic inflammatory demyelinating polyneuropathy (CIDP) from diabetic sensorimotor polyneuropathy (DSP) and from CIDP+DSP.MethodsWe performed a retrospective review of patients diagnosed with CIDP, DSP and CIDP+DSP (responsive to immunotherapy) and examined differences in CMAP duration and TD at baseline.ResultsWe included 59 subjects: 17 CIDP, 21 DSP and 21 CIDP+DSP. Of these, 16 (94.1%) CIDP, 18 (85.7%) CIDP+DSP and 1 (4.7%) DSP fulfilled the 2010 EFNS/PNS criteria for definite CIDP. There was no difference in CMAP duration or TD in all nerves (compound outcome) or in individual motor nerves. Patients with CIDP/CIDP+DSP had more conduction blocks, slower conduction velocities and more prolonged F wave latencies than those with DSP.ConclusionMeasures of CMAP duration and TD were not helpful in distinguishing CIDP, DSP or CIDP+DSP patients; however, parameters such as F-wave latencies, conduction blocks or the number of demyelinating parameters were useful in this separation.SignificanceThere are no definite nerve conduction criteria to distinguish patients with CIDP+DSP from DSP alone. Further studies focusing on measures of demyelination may provide stronger evidence to guide treatment decisions in CIDP + DSP patients.
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Affiliation(s)
- Monica Alcantara
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital, University Health Network (UHN), Toronto, ON, Canada
| | - Mylan Ngo
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital, University Health Network (UHN), Toronto, ON, Canada
| | - James de la Cruz
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital, University Health Network (UHN), Toronto, ON, Canada
| | - Deepak Menon
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Carolina Barnett-Tapia
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital, University Health Network (UHN), Toronto, ON, Canada
| | - Hans Katzberg
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital, University Health Network (UHN), Toronto, ON, Canada
| | - Vera Bril
- Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Toronto General Hospital, University Health Network (UHN), Toronto, ON, Canada
- *Correspondence: Vera Bril
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