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Lim J, Kim SE, Jo AJ, Kim JH, Han SK, Kim TH, Yim HJ, Jung YK, Song DS, Yoon EL, Kim HY, Kang SH, Chang Y, Yoo JJ, Lee SW, Park JG, Park JW, Jeong SW, Jin YJ, Kim HS, Suk KT, Kim MY, Kim SG, Kim W, Jang JY, Yang JM, Kim DJ. Effect of diabetes on mortality and liver transplantation in alcoholic liver cirrhotic patients with acute decompensation. Hepatol Int 2024:10.1007/s12072-024-10710-5. [PMID: 39020135 DOI: 10.1007/s12072-024-10710-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/14/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Previous studies have investigated the influence of diabetes on alcoholic liver cirrhosis patients, leaving its impact unclear. Thus, we conducted a study to reveal the association of diabetes and clinical outcomes of such patients. MATERIALS AND METHODS We prospectively collected data from multicenter pertaining to 965 patients diagnosed with alcoholic liver cirrhosis, all of whom were admitted due to acute decompensation between 2015 and 2019. Risk of major precipitating factors and incidences of death or liver transplantation in patients with and without diabetes was comparatively assessed. Propensity score (PS) matching was performed at a 1:2 ratio for accurate comparisons. RESULTS The mean age was 53.4 years, and 81.0% of the patients were male. Diabetes was prevalent in 23.6% of the cohort and was positively correlated with hepatic encephalopathy and upper gastrointestinal bleeding, although not statistically significant. During a median follow-up of 903.5 person-years (PYs), 64 patients with and 171 without diabetes died or underwent liver transplantation, with annual incidence of 33.6/100 PYs and 24.0/100 PYs, respectively. In the PS-matched cohort, the incidence of death or liver transplantation was 36.8/100 PYs and 18.6/100 PYs in the diabetes and matched control group, respectively. After adjusting for various factors, coexisting diabetes significantly heightened the risk of death or liver transplantation in the short and long term, in addition to prolonged prothrombin time, low serum albumin, elevated total bilirubin and creatinine, and decreased serum sodium levels. CONCLUSIONS Diabetes increases the risk of death or liver transplantation in patients with alcoholic liver cirrhosis.
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Affiliation(s)
- Jihye Lim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Eun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea.
| | - Ae Jeong Jo
- Department of Information Statistics, Andong National University, Andong-si, Republic of Korea
| | - Jung Hee Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea
| | - Seul Ki Han
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Ilsanro, Wonju, 26426, Republic of Korea
| | - Tae Hyung Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea
| | - Hyung Joon Yim
- Division of Gastroenterology, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea
| | - Young Kul Jung
- Division of Gastroenterology, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea
| | - Do Seon Song
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eileen L Yoon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 04763, Republic of Korea
| | - Hee Yeon Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seong Hee Kang
- Division of Gastroenterology, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea
| | - Young Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, 04401, Republic of Korea
| | - Jeong-Ju Yoo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, 14584, Republic of Korea
| | - Sung Won Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Gil Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, 42415, Republic of Korea
| | - Ji Won Park
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea
| | - Soung Won Jeong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, 04401, Republic of Korea
| | - Young Joo Jin
- Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Hyoung Su Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea
| | - Ki Tae Suk
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea
| | - Moon Young Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Ilsanro, Wonju, 26426, Republic of Korea
| | - Sang Gyune Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, 14584, Republic of Korea
| | - Won Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, 07061, Republic of Korea
| | - Jae Young Jang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, 04401, Republic of Korea
| | - Jin Mo Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Joon Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym Medical Center, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea
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Melamud MM, Bobrik DV, Brit PI, Efremov IS, Buneva VN, Nevinsky GA, Akhmetova EA, Asadullin AR, Ermakov EA. Biochemical, Hematological, Inflammatory, and Gut Permeability Biomarkers in Patients with Alcohol Withdrawal Syndrome with and without Delirium Tremens. J Clin Med 2024; 13:2776. [PMID: 38792318 PMCID: PMC11121978 DOI: 10.3390/jcm13102776] [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: 04/19/2024] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Delirium Tremens (DT) is known to be a serious complication of alcohol withdrawal syndrome (AWS). Neurotransmitter abnormalities, inflammation, and increased permeability are associated with the pathogenesis of AWS and DT. However, the biomarkers of these conditions are still poorly understood. Methods: In this work, biochemical, hematologic, inflammatory, and gut permeability biomarkers were investigated in the following three groups: healthy controls (n = 75), severe AWS patients with DT (n = 28), and mild/moderate AWS without DT (n = 97). Blood sampling was performed after resolution of the acute condition (on 5 ± 1 day after admission) to collect clinical information from patients and to investigate associations with clinical scales. Biomarker analysis was performed using automated analyzers and ELISA. Inflammatory biomarkers included the erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hsCRP), and platelet-to-lymphocyte ratio (PLR). Results: Among the biochemical biomarkers, only glucose, total cholesterol, and alanine aminotransferase (ALT) changed significantly in the analyzed groups. A multiple regression analysis showed that age and ALT were independent predictors of the CIWA-Ar score. Hematologic biomarker analysis showed an increased white blood cell count, and the elevated size and greater size variability of red blood cells and platelets (MCV, RDWc, and PDWc) in two groups of patients. Gut permeability biomarkers (FABP2, LBP, and zonulin) did not change, but were associated with comorbid pathologies (alcohol liver disease and pancreatitis). The increase in inflammatory biomarkers (ESR and PLR) was more evident in AWS patients with DT. Cluster analysis confirmed the existence of a subgroup of patients with evidence of high inflammation, and such a subgroup was more frequent in DT patients. Conclusions: These findings contribute to the understanding of biomarker variability in AWS patients with and without DT and support the heterogeneity of patients by the level of inflammation.
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Affiliation(s)
- Mark M. Melamud
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia; (M.M.M.); (V.N.B.); (G.A.N.)
| | - Daria V. Bobrik
- Department of Psychiatry and Addiction, Bashkir State Medical University, 450008 Ufa, Russia; (D.V.B.); (E.A.A.); (A.R.A.)
| | - Polina I. Brit
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Ilia S. Efremov
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia;
| | - Valentina N. Buneva
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia; (M.M.M.); (V.N.B.); (G.A.N.)
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Georgy A. Nevinsky
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia; (M.M.M.); (V.N.B.); (G.A.N.)
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
| | - Elvina A. Akhmetova
- Department of Psychiatry and Addiction, Bashkir State Medical University, 450008 Ufa, Russia; (D.V.B.); (E.A.A.); (A.R.A.)
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia;
| | - Azat R. Asadullin
- Department of Psychiatry and Addiction, Bashkir State Medical University, 450008 Ufa, Russia; (D.V.B.); (E.A.A.); (A.R.A.)
- Institute of Personalized Psychiatry and Neurology, Shared Core Facilities, V.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology, 192019 Saint Petersburg, Russia;
| | - Evgeny A. Ermakov
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, 630090 Novosibirsk, Russia; (M.M.M.); (V.N.B.); (G.A.N.)
- Department of Natural Sciences, Novosibirsk State University, 630090 Novosibirsk, Russia
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Rutledge S, Hulbert L, Charter-Harris J, Smith A, Owens-Gary M. A qualitative exploration of facilitators and barriers to adopting a healthy lifestyle among Black, Hispanic, and American Indian males with diabetes or at risk for type 2 diabetes. ETHNICITY & HEALTH 2024; 29:447-464. [PMID: 38842432 DOI: 10.1080/13557858.2024.2359377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES Higher prevalence of several chronic diseases occurs in men in the United States, including diabetes and prediabetes. Of the 34 million adults with diabetes and 88 million with prediabetes there is a higher prevalence of both conditions in men compared to women. Black, Hispanic, and American Indian men have some of the highest rates of diabetes and diabetes complications. Adopting a healthy lifestyle including healthy eating and physical activity, is important in preventing type 2 diabetes and diabetes complications. DESIGN This study included six focus groups that explored facilitators and barriers to adopting a healthy lifestyle in Black, Hispanic, and American Indian men with diabetes or at risk for type 2 diabetes. Thematic analysis was used to identify facilitators and barriers to adopting a healthy lifestyle. RESULTS Participants included males 18 years of age and older identifying as Black, Hispanic, or American Indian and diagnosed with prediabetes, diabetes, hypertension, or otherwise at risk for type 2 diabetes. Thirty-seven men participated, 19 diagnosed with diabetes and 18 at risk for type 2 diabetes. Fourteen Black, 14 Hispanic, and 9 American Indian men participated. The themes of facilitators to a healthy lifestyle included: family and the social network; psychosocial factors; health status, health priorities and beliefs about aging; knowledge about health and healthy behavior; and healthy community resources. Themes of barriers to a healthy lifestyle also included: mistrust of the health care system, cost, and low socioeconomic status. CONCLUSIONS This study underscores the complexity of factors involved in adopting a healthy lifestyle for some racial and ethnic minority men with diabetes or at risk for type 2 diabetes.
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Affiliation(s)
- Stephanie Rutledge
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - LaShonda Hulbert
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jasmine Charter-Harris
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Akimi Smith
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle Owens-Gary
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Tseng PY, Sung FC, Muo CH, Lan YC, Hser YI, Chien SHL, Wang JY. Risk of diabetes and hypertension in a population with alcohol use disorders. BMC Public Health 2024; 24:868. [PMID: 38515085 PMCID: PMC10956217 DOI: 10.1186/s12889-024-18318-y] [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: 12/06/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND A population-based follow-up study assessing the risk of developing hypertension and diabetes associated with alcohol use disorder (AUD) is crucial. We investigated this relationship by using insurance claims data from Taiwan. METHODS From the claims data, an AUD cohort (N = 60,590) diagnosed between 2000 and 2006 and a non-AUD comparison cohort (N = 60,590) without the diagnosis of hypertension or diabetes at baseline were established and matched by propensity scores estimated by baseline demographic status and the Charlson comorbidity index (CCI). We assessed the incidence rates of hypertension and/or diabetes at the end of 2016 and used Cox's method to estimate the related hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Relative to the comparison cohort, the AUD cohort had an approximately 1.70-fold higher incidence of hypertension (35.1 vs. 20.7 per 1,000 person-years), with an adjusted HR (aHR) of 1.72 (95% CI: 1.68-1.76), 2.16-fold higher incidence of diabetes (20.2 vs. 9.36 per 1,000 person-years), with an aHR of 2.18 (95% CI: 2.11-2.24), and 1.91-fold higher incidence of both diabetes and hypertension (10.3 vs. 5.38 per 1,000 person-years) with an aHR of 2.02 (95% CI: 1.94-2.10). The incidence rates of all outcomes were greater in men than in women, whereas the HRs were greater for AUD in women than for AUD in men relative to the respective comparison patients. The risk increased further for subjects with CCI ≥ 1, which was higher in the AUD cohort. CONCLUSIONS The increased risk of developing diabetes and hypertension in patients with AUD, especially the differences noted according to gender, indicates that clinicians should address potential comorbidities in these patients.
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Affiliation(s)
- Pei-Ying Tseng
- Department of Public Health, China Medical University, 406, Taichung, Taiwan
- Department of Medicine, Lee's General Hospital, 358, Yuanli, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, 404, Taichung, Taiwan
- Department of Health Services Administration, China Medical University College of Public Health, 406, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, 413, Taichung, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, 404, Taichung, Taiwan
| | - Yu-Ching Lan
- Expert Labs, IBM Taiwan Corporation, 110, Taipei, Taiwan
| | - Yih-Ing Hser
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 90095, Los Angeles, CA, USA
| | - Sarina Hui-Lin Chien
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, 100 Jingmao Rd. Sec. 1, Beitun Dist, 406, Taichung, Taiwan.
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Hagström H, Hegmar H, Moreno C. Interactions between the metabolic syndrome and alcohol consumption increases the risk of liver disease. United European Gastroenterol J 2024; 12:168-176. [PMID: 38381115 PMCID: PMC10954435 DOI: 10.1002/ueg2.12524] [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: 06/21/2023] [Accepted: 11/06/2023] [Indexed: 02/22/2024] Open
Abstract
Alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD, recently renamed metabolic dysfunction-associated steatotic liver disease [MASLD]) share many features, including certain pathophysiological mechanisms, susceptibility genes, and histological lesions. However, the natural history of the two diseases, studied separately, is significantly different, with ALD being associated with a higher risk of cirrhosis and liver-related mortality. Moreover, evidence suggests an interactive effect between ALD and metabolic risk factors that are associated with NAFLD on the risk of progressive fibrosis and development of cirrhosis. Patients with both a high consumption of alcohol and metabolic risk factors, such as obesity or diabetes, should therefore be considered a particularly high-risk group for cirrhosis. Additional studies regarding the efficacy of screening for advanced liver fibrosis or cirrhosis in these risk groups are needed. The most effective and established method for reducing the risk of progression in ALD is alcohol abstinence, whereas weight loss is effective in NAFLD. In this narrative review, we introduce the reader to the literature of the field and present key studies showing this interactive effect.
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Affiliation(s)
- Hannes Hagström
- Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Hannes Hegmar
- Division of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Christophe Moreno
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
- Faculté de Médecine, Laboratory of Experimental Gastroenterology, Université Libre de Bruxelles, Brussels, Belgium
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Inomata S, Arima H, Fukuda T, Ozawa H, Yamamoto T. Smoking and diabetes cause telomere shortening among alcohol use disorder patients. Sci Rep 2024; 14:4701. [PMID: 38409427 PMCID: PMC10897475 DOI: 10.1038/s41598-024-55195-2] [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: 11/29/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
The length of telomeres located at the ends of chromosomes has attracted attention as an indicator of cellular and individual aging. Various diseases or stresses cause telomere shortening, and it has been reported that alcohol use disorder patients actually have shorter telomeres than healthy patients. However, the factors that contribute to the reduction in telomere length among alcohol use disorder patients have not been clarified in detail. Therefore, in this study, we explored the factors that reduce telomere length in alcohol use disorder patients. A questionnaire survey and a measurement of leukocyte telomere length were conducted among alcohol use disorder patients. The mean telomere length of leukocyte was measured by ∆∆Ct analysis using a real-time PCR. We compared the telomere length between alcohol use disorder patients and the control group (Japanese special health check-up examinee). Moreover, we searched for factors associated with telomere length from drinking/smoking characteristics and history of comorbidities. A total of 74 subjects had alcohol use disorder, and 68 were in the control group. Compared to the control group, alcohol use disorder patients had significantly shorter telomere lengths (p < 0.001). A multivariate analysis revealed that a longer duration of smoking resulted in a significantly shorter telomere length (p = 0.0129). In addition, a comparison of the telomere length between the groups with and without a history of suffering from each disease revealed that telomere length was significantly shorter in the group with diabetes than in the group without diabetes (p = 0.0371). This study reveals that in individuals with alcohol dependence, particularly, prolonged smoking habits and the presence of diabetes contribute to telomere shortening. Medication and support for abstinence from alcohol has been mainly provided for alcohol use disorder patients. Our findings demonstrate a potential support approach via smoking cessation programs and controlling diabetes, which may be helpful to suppress the shortening of healthy life expectancy among alcohol use disorder patients.
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Affiliation(s)
- Shinsaku Inomata
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, Japan
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
| | - Hiroaki Arima
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan.
| | | | - Hiroki Ozawa
- Department of Global Mental Health Science, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, Japan
| | - Taro Yamamoto
- Graduate School of Biomedical Sciences, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, Japan
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
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Jiang L, Yang Z, Liu G, Xia Z, Yang G, Gong H, Wang J, Wang L. A feature optimization study based on a diabetes risk questionnaire. Front Public Health 2024; 12:1328353. [PMID: 38463161 PMCID: PMC10920272 DOI: 10.3389/fpubh.2024.1328353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/05/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction The prevalence of diabetes, a common chronic disease, has shown a gradual increase, posing substantial burdens on both society and individuals. In order to enhance the effectiveness of diabetes risk prediction questionnaires, optimize the selection of characteristic variables, and raise awareness of diabetes risk among residents, this study utilizes survey data obtained from the risk factor monitoring system of the Centers for Disease Control and Prevention in the United States. Methods Following univariate analysis and meticulous screening, a more refined dataset was constructed. This dataset underwent preprocessing steps, including data distribution standardization, the application of the Synthetic Minority Oversampling Technique (SMOTE) in combination with the Round function for equilibration, and data standardization. Subsequently, machine learning (ML) techniques were employed, utilizing enumerated feature variables to evaluate the strength of the correlation among diabetes risk factors. Results The research findings effectively delineated the ranking of characteristic variables that significantly influence the risk of diabetes. Obesity emerges as the most impactful factor, overshadowing other risk factors. Additionally, psychological factors, advanced age, high cholesterol, high blood pressure, alcohol abuse, coronary heart disease or myocardial infarction, mobility difficulties, and low family income exhibit correlations with diabetes risk to varying degrees. Discussion The experimental data in this study illustrate that, while maintaining comparable accuracy, optimization of questionnaire variables and the number of questions can significantly enhance efficiency for subsequent follow-up and precise diabetes prevention. Moreover, the research methods employed in this study offer valuable insights into studying the risk correlation of other diseases, while the research results contribute to heightened societal awareness of populations at elevated risk of diabetes.
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Affiliation(s)
- Liangjun Jiang
- College of Information and Communication Engineering, State Key Lab of Marine Resource Utilization in South China Sea, Hainan University, Haikou, China
| | - Zerui Yang
- School of Electronics and Information, Yangtze University, Jingzhou, China
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Zhenhua Xia
- School of Electronics and Information, Yangtze University, Jingzhou, China
| | - Guangyao Yang
- School of Electronics and Information, Yangtze University, Jingzhou, China
| | - Haimei Gong
- College of Information and Communication Engineering, State Key Lab of Marine Resource Utilization in South China Sea, Hainan University, Haikou, China
| | - Jing Wang
- E-link Wisdom Co., Ltd., Shenzhen, China
| | - Lei Wang
- College of Information and Communication Engineering, State Key Lab of Marine Resource Utilization in South China Sea, Hainan University, Haikou, China
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Abbas D, Ciricillo JA, Elom HA, Moon AM. Extrahepatic Health Effects of Alcohol Use and Alcohol-associated Liver Disease. Clin Ther 2023; 45:1201-1211. [PMID: 37806811 DOI: 10.1016/j.clinthera.2023.08.018] [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: 05/16/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Alcohol use disorder (AUD) is a growing public health concern and an important contributor to global morbidity and mortality. While the hepatotoxic effects of alcohol are well known, the adverse effects of alcohol are manifested in almost every organ system. With the growing public health impact of AUD, the aim of this narrative review is to highlight the epidemiology and burden of AUD and its association with extrahepatic diseases including malignancy and disorders of the gastrointestinal (GI), cardiovascular, immunologic, neurologic, endocrine, and hematologic systems. METHODS A narrative review of the literature was performed to identify studies addressing the epidemiology, pathophysiology, clinical manifestations, and therapy of extrahepatic health manifestations of alcohol use. FINDINGS In the United States, an estimated 14.5 million people have AUD and approximately 88,000 adults die yearly due to alcohol-related causes. The consumption of alcohol and AUD is associated with injuries, violence, cancers, nonmalignant conditions of the GI system, infections, effects on the cardiovascular system, and neurodegenerative diseases. These conditions contribute to the increased mortality associated with AUD and are burdensome to patients and caregivers. IMPLICATIONS Increased awareness of the extrahepatic manifestations of AUD, screening for AUD using validated screening tools, such as the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) score, and offering evidence-based interventions to patients with AUD is imperative to reduce the public health burden of AUD. Although historically controversial, recent evidence suggests that any level of alcohol consumption can have negative health consequences. Further research is warranted to determine if any amount of alcohol is safe for consumption. Public health efforts are warranted to help curtail the growing burden of AUD.
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Affiliation(s)
- Daniyal Abbas
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina
| | - Jacob A Ciricillo
- Department of Internal Medicine, University of Cincinnati Medicine Center, Cincinnati, Ohio
| | - Hilary A Elom
- Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Andrew M Moon
- Department of Gastroenterology and Hepatology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
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Kollányi Z, Bálint L, Susovits K, Csépe P, Kovács K. Inequalities in Diabetes Mortality Between Microregions in Hungary. Int J Public Health 2023; 68:1606161. [PMID: 38024213 PMCID: PMC10643225 DOI: 10.3389/ijph.2023.1606161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives: Regional differences in diabetes mortality are high in Hungary. In our cross-sectional study, we aim to reveal the drivers of the inequalities in diabetes mortality across the 197 microregions of Hungary. To account for the influence of changes in healthcare and social conditions, we compared two periods (2009-12 and 2013-16). Methods: Traditional and re-conceptualized deprivation- and healthcare provison measures were used in OLS regression models. Results: Microregions with a high proportion of population living in "service deserts," especially in regard to the lack of grocery stores, suffer the highest rates of diabetes mortality. Alcohol-related mortality has been proven to be a similarly and surprisingly strong predictor of diabetes mortality. Conclusion: Food provision should be supported in areas characterized by low service density, and alcohol policy should be strengthened and targeted.
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Affiliation(s)
- Zsófia Kollányi
- Faculty of Social Sciences, Eötvös Loránd University, Budapest, Hungary
| | - Lajos Bálint
- Hungarian Demographic Research Institute (HDRI), Budapest, Hungary
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
| | - Kitti Susovits
- National Institute of Pharmacy and Nutrition (Hungary), Budapest, Hungary
| | - Péter Csépe
- Department of Public Health, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Katalin Kovács
- Hungarian Demographic Research Institute (HDRI), Budapest, Hungary
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10
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Surani A, Carroll TB, Javorsky BR, Raff H, Findling JW. Alcohol-induced Cushing syndrome: report of eight cases and review of the literature. Front Endocrinol (Lausanne) 2023; 14:1199091. [PMID: 37409223 PMCID: PMC10319132 DOI: 10.3389/fendo.2023.1199091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/05/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction Alcohol-induced hypercortisolism (AIH) is underrecognized and may masquerade as neoplastic hypercortisolism [Cushing syndrome (CS)] obscuring its diagnosis. Objective and methods In order to characterize AIH, we performed a chart review of eight patients (4 males and 4 females; 2014-2022) referred for evaluation and treatment of neoplastic hypercortisolism - six for inferior petrosal sinus sampling, one due to persistent CS after unilateral adrenalectomy, and one for pituitary surgery for Cushing disease (CD). Five underwent dDAVP stimulation testing. Results All eight patients had clinical features of hypercortisolism and plasma ACTH levels within or above the reference interval confirming hypothalamic-pituitary mediation. All had abnormal low-dose dexamethasone suppression test and increased late-night salivary cortisol. Only one had increased urine cortisol excretion. In contrast to CD, the 5 patients tested had blunted or absent ACTH and cortisol responses to desmopressin. Two had adrenal nodules and one had abnormal pituitary imaging. Most patients underreported their alcohol consumption and one denied alcohol use. Elevated blood phosphatidyl ethanol (PEth) was required in one patient to confirm excessive alcohol use. All patients had elevations of liver function tests (LFTs) with AST>ALT. Conclusion AIH is an under-appreciated, reversible cause of non-neoplastic hypercortisolism that is indistinguishable from neoplastic CS. Incidental pituitary and adrenal imaging abnormalities as well as under-reporting of alcohol consumption further confound the diagnosis. Measurement of PEth helps to confirm an alcohol use disorder. Elevations of LFTs (AST>ALT) and subnormal ACTH and cortisol responses to dDAVP help to distinguish AIH from neoplastic hypercortisolism.
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Affiliation(s)
- Asif Surani
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Ty B. Carroll
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Bradley R. Javorsky
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Medicine. Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI, United States
| | - Hershel Raff
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Departments of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
- Departments of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - James W. Findling
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Departments of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
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11
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Wolde HF, Molla MD, Aragie H, Adugna DG, Teferi ET, Melese EB, Assefa YA, Kifle H, Worku YB, Belay DG, Kibret AA. High burden of diabetes and prediabetes among cancer patients at University of Gondar comprehensive specialized hospital, Northwest Ethiopia. Sci Rep 2023; 13:9431. [PMID: 37296304 PMCID: PMC10256839 DOI: 10.1038/s41598-023-36472-y] [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: 11/10/2022] [Accepted: 06/04/2023] [Indexed: 06/12/2023] Open
Abstract
Cancer and diabetes mellitus (DM) are diagnosed within the same individual more frequently and share common risk factors. Although diabetes among cancer patients may result in more aggressive clinical courses of cancer, there is limited evidence about its burden and associated factors. Hence, this study aimed to assess the burden of diabetes and prediabetes among cancer patients and its associated factors. Institution-based cross-sectional study was conducted at the University of Gondar comprehensive specialized hospital from 10 January to 10 March 2021. A systematic random sampling technique was used to select 423 cancer patients. The data was collected using a structured interviewer-administered questionnaire. Prediabetes and diabetes diagnosis was made based on World Health Organization (WHO) criteria. Bi-variable and multivariable binary logistic regression models were fitted to identify factors associated with the outcome. Adjusted Odds Ratio (AOR) with a 95% confidence interval was estimated to show the direction and strength of associations. Variables with a p-value less than 0.05 in the multivariable model were considered significantly associated with the outcome. The final analysis was based on 384 patients with cancer. The proportion of prediabetes and diabetes was 56.8% (95% CI 51.7, 61.7) and 16.7% (95% CI 13.3, 20.8), respectively. Alcohol consumption was found to increase the odds of elevated blood sugar among cancer patients (AOR: 1.96; 95%CI: 1.11, 3.46). The burden of prediabetes and diabetes is alarmingly high among cancer patients. Besides, alcohol consumption was found to increase the odds of having elevated blood sugar among cancer patients. Hence, it is essential to recognize cancer patients are at high risk of having elevated blood sugar and design strategies to integrate diabetes and cancer care.
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Affiliation(s)
- Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meseret Derbew Molla
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hailu Aragie
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Dagnew Getnet Adugna
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ephrem Tafesse Teferi
- Department of Internal Medicine School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalkachew Belayneh Melese
- Department of Internal Medicine School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohannes Awoke Assefa
- Department of Occupational Therapy School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtu Kifle
- Department of Human Anatomy, School of Medicine, 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
| | - Daniel Gashaneh Belay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Ayelign Kibret
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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12
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Parker KM, Tucker LA, Bailey BW, Davidson LE. Relationship between Sitting Time and Insulin Resistance in 6931 U.S. Adults: The Mediating Role of Abdominal Adiposity. J Diabetes Res 2023; 2023:5015572. [PMID: 37265574 PMCID: PMC10232095 DOI: 10.1155/2023/5015572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 06/03/2023] Open
Abstract
This cross-sectional investigation examined the relationship between sitting time and insulin resistance in 6931 U.S. adults. The mediating effects of several covariates were evaluated. Self-reported sitting time, measured in minutes per day, was the exposure variable. Insulin resistance (IR), indexed using the natural log of the homeostatic model assessment of insulin resistance (L-HOMA-IR), was the outcome variable. This study used data collected from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). Results showed a strong, positive, dose-response association between sitting time and insulin resistance after adjusting for age, sex, race, and year of assessment (F = 12.6, p < 0.0001). Across the sitting time tertiles (low, moderate, and high), the L-HOMA-IR means (±SE) each differed from each other (0.37 ± 0.008, 0.40 ± 0.012, and 0.43 ± 0.012). Further controlling for cigarette smoking and physical activity did not alter the significance of the relationship. Adding body mass index (BMI) to the demographic covariates weakened the relationship, but it remained significant. However, the association was no longer significant after adjusting for the demographic covariates and waist circumference (F = 1.1, p = 0.3349). None of the L-HOMA-IR means (±SE) differed from each other (0.40 ± 0.007, 0.41 ± 0.009, and 0.41 ± 0.008). Overall, waist circumference was a powerful mediating variable between sitting time and insulin resistance. Apparently, time spent sitting is a powerful predictor of IR. However, much of the association between sitting time and IR is a function of differences in waist size. As a strong measure of abdominal adiposity and a significant predictor of multiple metabolic diseases, managing waist size is a health practice to consider when insulin resistance is a concern.
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Affiliation(s)
- Kayla M. Parker
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - Larry A. Tucker
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - Bruce W. Bailey
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - Lance E. Davidson
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
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13
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Lam HYP, Liang TR, Peng SY. Prevention of the Pro-Aggressive Effects of Ethanol-Intoxicated Mice by Schisandrin B. Nutrients 2023; 15:nu15081909. [PMID: 37111128 PMCID: PMC10146817 DOI: 10.3390/nu15081909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Excessive alcohol consumption can lead to serious health complications, with liver and neurological complications being the most important. In Western nations, alcoholic liver disease accounts for 50% of mortality from end-stage liver disease and is the second most common cause of liver transplants. In addition to direct damage, hepatic encephalopathy may also arise from alcohol consumption. However, effective treatment for liver disease, as well as neurological injury, is still lacking today; therefore, finding an efficacious alternative is urgently needed. In the current study, the preventive and therapeutic effects of Schisandrin B (Sch B) against ethanol-induced liver and brain injuries were investigated. By using two treatment models, our findings indicated that Sch B can effectively prevent and ameliorate alcoholic liver diseases, such as resolving liver injuries, lipid deposition, inflammasome activation, and fibrosis. Moreover, Sch B reverses brain damage and improves the neurological function of ethanol-treated mice. Therefore, Sch B may serve as a potential treatment option for liver diseases, as well as subsequential brain injuries. Furthermore, Sch B may be useful in preventive drug therapy against alcohol-related diseases.
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Affiliation(s)
- Ho Yin Pekkle Lam
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Ting-Ruei Liang
- PhD Program in Pharmacology and Toxicology, Tzu Chi University, Hualien 970, Taiwan
| | - Shih-Yi Peng
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien 970, Taiwan
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14
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Yang Z, Yang H, Wang W, Zhao H, Meng P, Xie Y, Sun Y. A flexible electrochemical sensor for simultaneous determination of glucose (Glu) and ethanol (Eth) using ZnO and Pd nanoparticles. J APPL ELECTROCHEM 2023. [DOI: 10.1007/s10800-023-01898-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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15
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Asouzu Johnson J, Ndou R, Mbajiorgu EF. Interactions of alcohol and combination antiretroviral (cART) drug in diabetic male Sprague Dawley rats: Hippocampal perturbations and toxicosis. Toxicol Rep 2023; 10:155-170. [PMID: 36718377 PMCID: PMC9883146 DOI: 10.1016/j.toxrep.2023.01.009] [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: 11/04/2022] [Revised: 01/07/2023] [Accepted: 01/19/2023] [Indexed: 01/21/2023] Open
Abstract
Hippocampal pathology in diabetes is constantly investigated but the resultant health impact of the concomitant presence of alcohol and combined antiretroviral therapy (cART) in diabetes requires further studies to delineate toxicities inimical to hippocampal normal function. Forty-eight male Sprague Dawley rats were divided into eight groups (n = 6): negative control (NC), alcohol (AL), cART (AV), alcohol-cART (AA), diabetic control (DB), diabetes-alcohol (DAL), diabetes-cART (DAV), and diabetes-alcohol-cART (DAA) exposure groups. Following diabetes induction and sub-chronic (90 days) treatment exposure, hippocampal homogenates were profiled for pro-inflammatory cytokines and oxidative stress (MDA and GPx) using immunoassay, while apoptotic genes (BAX, Bcl2, and Caspase-3), insulin receptor genes (INSR and IRS-1), and blood-brain barrier (BBB) junctional proteins (claudin-5, and occludin) gene expression were assessed using qPCR. Histomorphology of hippocampal neuronal number, nuclei area, and volume of dentate gyrus and neurogenesis were accessed using Giemsa stain, Ki67, and DCX histochemistry respectively. A central hippocampal effect that underpins all treatments is the reduction of DG neuronal number and antioxidant (GPx), highlighting the venerability of the hippocampal dentate gyrus neurons to diabetes, alcohol, cART, and their combinatorial interactions. Additionally, elevated BAX, Bcl2, and IRS1 mRNA levels in the DAL group, and their downregulation in AA, suggests IRS-1-regulated apoptosis due to differential modulating effects of alcohol treatment in diabetes (DAL) in contrast to alcohol with cART (AA). Although the interaction in AA therapy ameliorated the independent alcohol and cART effects on MDA levels, pro-inflammatory cytokines, and DCX, the interaction in AA exacerbated a deficiency in the expression of INSR, IRS-1 (insulin sensitivity), and BBB mRNA which are implicated in the pathogenies of diabetes. Furthermore, the diabetic comorbidity groups (DAV, DAL, and DAA) all share a central effect of elevated hippocampal oxidative stress, BAX, and Caspase-3 mRNA expression with the reduced number of hippocampal neurons, dentate gyrus volume, and neurogenesis, highlighting neurodegenerative and cognitive deficiency implication of these comorbidity treatments. Considering these findings, assessment of hippocampal well-being in patients with these comorbidities/treatment combinations is invaluable and caution is advised particularly in alcohol use with cART prophylaxis in diabetes.
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16
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Counteractive Effects of Choline Geranate (CAGE) ILs and Ethanol on Insulin's Stability-A Leap Forward towards Oral Insulin Formulation. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27155031. [PMID: 35956982 PMCID: PMC9370287 DOI: 10.3390/molecules27155031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/29/2022] [Accepted: 08/05/2022] [Indexed: 12/02/2022]
Abstract
Choline geranate (CAGE) ionic liquids (ILs) stabilize insulin, thereby aiding its oral delivery, whereas ethanol (EtOH) affects its stability by disrupting the hydrophobic interactions. In this study, cognizance of the stabilization mechanism of insulin dimer in the presence of both CAGE ILs and EtOH mixtures is achieved through biased and unbiased molecular dynamics (MD) simulations. Here, two order parameters are employed to study the insulin dimer dissociation using well-tempered metadynamics (WT-MetaD). The stability of insulin is found to be strongly maintained until a 0.20 mole fraction of EtOH. Besides, higher concentrations of EtOH marginally affect the insulin stability. Moreover, geranate anions form a higher number of H-bonding interactions with water molecules, which aids insulin stabilization. Conversely, the addition of EtOH minimizes the water-mediated H-bonding interactions of geranate. Additionally, geranate traps the EtOH molecules, thereby preventing the interactions between insulin and EtOH. Furthermore, the free energy landscape (FEL) reveals the absence of dimer dissociation along with noticeable deviations in the distances R and the number of contacts Q. The dimerization free energy of insulin was calculated to be −16.1 kcal/mol at a 0.20 mole fraction of EtOH. Moreover, increments in mole fractions of EtOH effectuate a decrease in the insulin stability. Thus, the present study represents CAGE ILs as efficient insulin dimer stabilizes at low concentrations of EtOH.
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17
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Santra A, Mallick A. Prevalence of hypertension among individuals with diabetes and its determinants: Evidences from the National Family Health Survey 2015-16, India. Ann Hum Biol 2022; 49:133-144. [PMID: 35499256 DOI: 10.1080/03014460.2022.2072525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The incidence of Diabetes mellitus (DM) has escalated in recent decades, and the risk of diabetes-related mortality has increased dramatically due to the co-existence of hypertension (HTN). DM and HTN, having similar aetiology and disease mechanism, are influenced by lifestyle factors and greatly contribute to critical health complications. AIM The present study attempted to explore the co-existence of DM-HTN and the potential determinants considering rapid upsurge of both the diseases. SUBJECTS AND METHODS National Family Health Survey data were used, which included 7092 adult diabetic individuals, to find out the prevalence rate of HTN in diabetic persons in India. Appropriate statistical analyses were performed to accomplish the study objectives. RESULTS Prevalence rate of HTN in diabetic individuals was approximately 37%. Higher BMI was associated with DM-HTN co-existence. In males, increased age, higher BMI, alcohol consumption, poorest wealth index, and non-smoking (tobacco) were the significant determinants of the co-existence of DM-HTN, while in females, they were increased age, higher BMI, and geographical region. CONCLUSION This study unveiled the significance of healthy lifestyle maintenance and equitable health care services to prevent HTN among the diabetics, along with promotion of the awareness and management of DM and HTN through appropriate pharmacological treatments.
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Affiliation(s)
- Arpita Santra
- Biological Anthropology Unit, Indian Statistical Institute, 203, B.T. Road, Kolkata - 108
| | - Akash Mallick
- Biological Anthropology Unit, Indian Statistical Institute, 203, B.T. Road, Kolkata - 108
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18
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Prevalence and associations of metabolic syndrome in patients with alcohol use disorder. Sci Rep 2022; 12:2625. [PMID: 35173187 PMCID: PMC8850419 DOI: 10.1038/s41598-022-06010-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 01/14/2022] [Indexed: 11/14/2022] Open
Abstract
Excessive alcohol consumption has been associated with different components of the metabolic syndrome (MetS) such as arterial hypertension, dyslipidemia, type 2 diabetes or obesity. We aimed to analyze the prevalence and associations of MetS in patients with Alcohol Use Disorder (AUD). Cross-sectional study in heavy drinkers admitted for the treatment of AUD between 2013 and 2017. Medical comorbidity, anthropometric data, alcohol use and biological parameters were obtained. MetS was established according to the harmonized definition. A total of 728 patients (22% women) were included; median age was 47 years (IQR: 40–53.5), median alcohol consumption was 160 g/day (IQR: 115–240) and prevalence of MetS was 13.9%. The multivariate analysis showed a significant dose–response effect of estimated glomerular filtration (eGFR) and MetS: relative to patients with eGFR > 90 mL/min, those with eGFR (60–90 mL/min) and those with eGFR < 60 mL/min were 1.93 times (95% CI 1.18–3.15) and 5.61 times (95% CI 1.66–19.0) more likely to have MetS, respectively. MetS was significantly associated with hyperuricemia (OR 2.28, 95% CI 1.36–3.82) and elevated serum GGT (OR 3.67, 95% CI 1.80–7.46). Furthermore, for every increase of 1 year in age, the probability of MetS increased significantly (OR 1.03, 95% CI 1.01–1.05). MetS in heavy drinkers is independently associated with reduced kidney function and metabolic risk factors including hyperuricemia and elevated serum GGT.
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Ichimata S, Hata Y, Nishida N. Clinicopathologic Appearance of Advanced Ketoacidosis With Basal Vacuolation in Renal Tubules. Arch Pathol Lab Med 2021; 146:1102-1113. [PMID: 34936698 DOI: 10.5858/arpa.2021-0226-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Basal vacuolization (BV) in renal tubules is a histopathologic hallmark of advanced ketoacidosis that enables us to retrospectively diagnose these cases. OBJECTIVE.— To clarify the pathologic background and serologic findings of ketoacidosis with BV, and to reveal the pathologic findings by each pathologic background. DESIGN.— We examined 664 serial autopsy cases. A systemic histopathologic examination and measurement of serum β-hydroxybutyrate concentration were performed for the cases with BV. The extent of steatosis and fibrosis in the organs and the degree of coronary artery stenosis were semiquantitatively investigated. Immunohistochemistry for adipophilin was also performed to analyze its usefulness for the pathologic diagnosis. RESULTS.— Basal vacuolization was found in 16 cases, all of which showed a pathologic serum β-hydroxybutyrate concentration. The main background of ketoacidosis was considered as alcohol abuse in 6 cases, diabetes in 5, malnutrition in 3, and hypothermia and infection in 1 case each. Severe hepatic fibrosis was observed only in the alcohol-abuser group. Moreover, cardiac steatosis was more severe in patients with possible alcohol abuse than in those with other causes. Immunohistochemistry for adipophilin showed immunoreactivity consistent with BV in 13 of 16 cases. There was no correlation between β-hydroxybutyrate concentration and either the postmortem or storage interval. CONCLUSIONS.— Basal vacuolization may be a useful finding for detecting ketoacidosis cases in a postmortem investigation. Serum β-hydroxybutyrate was a stable and reliable compound for the definitive diagnosis of ketoacidosis in such cases. The present study showed that pathologic changes in some organs may vary by each pathologic background of ketoacidosis with BV.
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Affiliation(s)
- Shojiro Ichimata
- From the Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yukiko Hata
- From the Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Naoki Nishida
- From the Department of Legal Medicine, Faculty of Medicine, University of Toyama, Toyama, Japan
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Messina MP, Battagliese G, D’Angelo A, Ciccarelli R, Pisciotta F, Tramonte L, Fiore M, Ferraguti G, Vitali M, Ceccanti M. Knowledge and Practice towards Alcohol Consumption in a Sample of University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189528. [PMID: 34574453 PMCID: PMC8467782 DOI: 10.3390/ijerph18189528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 01/09/2023]
Abstract
Objective: Alcohol affects many human systems and is involved in the pathogenesis of other diseases. Particular attention must be paid to alcohol consumption among young people. It has been shown that 25% of young people's deaths are attributable to alcohol, and around 35 million people aged over 11 had consumed at least one alcoholic beverage in 2015. Study Design: Young people aged 18-24 were the most vulnerable to binge drinking in Italy, and 50.6% of teenagers drunk alcohol. Only a few studies in the literature have investigated those habits in university students. This study aims to examine alcohol use habits in a population of university students in Italy. Methods: Between 2018 and 2019, an anonymous online questionnaire was randomly sent to university students from 17 different universities in a network of research centres to study alcohol use disorders. The survey included socio-demographic information, questions about alcohol use, knowledge about alcohol consumption, and related risks. Used questionnaires were the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and the Drinking Motive Questionnaire-Revised (DMQ-R). Results: the AUDIT-C revealed that 53.3% of students were high-risk drinkers. Regarding binge drinking habits, 13.1% of students admitted to binge drinking behavior at least once a month. In our sample, male students are more likely to be low-risk drinkers than female peers (p < 0.008). Students from northern Italy are more likely to be high-risk drinkers (p = 0.003). Beer (65.9%) and wine (60.9%) were the most consumed alcoholic beverages. The most common places to drink alcohol were pubs (85.5%). The most likely motivations to drink alcohol were enhancement (40.43%), social (38.39%), coping (15.63%), and social pressure or conformity (5.55%). Only 43.8% of participants reported having attended an educational course on alcohol. Conclusions: University students were not fully aware of the implications of alcohol misuse and will be part of the adult society as critical figures and future leaders. It is imperative to inform students about alcohol consumption risks and investigate the motivations to drink. Stress, anxiety, and social pressure are only a few issues young people are exposed to. Special attention must be paid to young people and their coping strategies that involve substance abuse by using educative, preventive, and motivational approaches.
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Affiliation(s)
- Marisa Patrizia Messina
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, 00185 Rome, Italy; (M.P.M.); (A.D.)
| | - Gemma Battagliese
- Centro di Riferimento Alcologico della Regione Lazio, Mental Health Department, ASL Roma 1, 00185 Rome, Italy;
| | - Alessio D’Angelo
- Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, 00185 Rome, Italy; (M.P.M.); (A.D.)
| | - Rosaria Ciccarelli
- Centro di Riferimento Alcologico della Regione Lazio, Mental Health Department, ASL Roma 1, 00185 Rome, Italy;
| | - Fabiola Pisciotta
- Società Italiana per il Trattamento dell’Alcolismo e le sue Complicanze (SITAC), ASL Roma1, Sapienza University of Rome, 00185 Rome, Italy; (R.C.); (F.P.)
| | - Luigi Tramonte
- Faculty of Medicine and Dentistry, Sapienza University of Rome, 00185 Rome, Italy;
| | - Marco Fiore
- Institute of Biochemistry and Cell Biology (IBCN-CNR), 00185 Rome, Italy;
| | - Giampiero Ferraguti
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy;
| | | | - Mauro Ceccanti
- Centro di Riferimento Alcologico della Regione Lazio, Mental Health Department, ASL Roma 1, 00185 Rome, Italy;
- Correspondence:
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21
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Kaigorodova TV, Kryukova IA. Тhe impact of alcohol abuse on the development of non-communicable diseases (analytical review). Public Health 2021. [DOI: 10.21045/2782-1676-2021-1-2-48-61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The harmful use of alcohol is a risk factor for the development of non-communicable diseases (NCDs), such as cancer, cardiovascular disease, gastrointestinal diseases, diabetes and others. In addition to morbidity, alcohol abuse increases mortality, especially at young ages. An important characteristic is the frequency and amount of alcohol consumed by a person. The more often and more a person abuses alcohol, the higher the risk of developing NCDs and the mortality rate. Purpose of the study: analysis of publications of the World Health Organization and scientific publications of foreign researchers on the influence of alcohol on the development of non-communicable diseases.Materials and research methods. Content analysis of documents of the World Health Organization and foreign studies on the assessment of the impact of alcohol In total, 48 documents of international organizations were analyzed, including the World Health Organization (WHO), the United Nations (UN), the International Agency for Research on Cancer (IARC-IARC) and the World Bank, as well as 211 scientific publications. Of these, 19 documents were selected, which included materials from WHO, UN, IARC and the World Bank on the impact of alcohol abuse on health, and 63 scientific publications on this topic. Selection criterion: the content in the documents of materials that adequately describe the impact of alcohol abuse on health as a risk factor for the development of various diseases.Results. An analysis of the documents and publications presented revealed a large massif of evidence that the harmful use of alcohol is a causal factor in the development of a number of noncommunicable diseases, an increase in mortality and disability at earlier stages of life, and the development of a link between harmful use of alcohol and a number of mental and behavioral disorders.
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Affiliation(s)
- T. V. Kaigorodova
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
| | - I. A. Kryukova
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation
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Gardas BB, Ghongade NP, Jagtap AH. Application of multi‐criteria decision‐making approach in healthcare surgical management. JOURNAL OF MULTI-CRITERIA DECISION ANALYSIS 2021. [DOI: 10.1002/mcda.1753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Bhaskar B. Gardas
- Department of Mechanical Engineering M.H. Saboo Siddik College of Engineering Mumbai Maharashtra India
| | - Nilesh P. Ghongade
- Department of Mechanical Engineering M.H. Saboo Siddik College of Engineering Mumbai Maharashtra India
| | - Annasaheb H. Jagtap
- Department of Mechanical Engineering M.H. Saboo Siddik College of Engineering Mumbai Maharashtra India
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Moderate Consumption of Beer and Its Effects on Cardiovascular and Metabolic Health: An Updated Review of Recent Scientific Evidence. Nutrients 2021; 13:nu13030879. [PMID: 33803089 PMCID: PMC8001413 DOI: 10.3390/nu13030879] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 12/21/2022] Open
Abstract
There is growing interest in the potential health-related effects of moderate alcohol consumption and, specifically, of beer. This review provides an assessment of beer-associated effects on cardiovascular and metabolic risk factors to identify a consumption level that can be considered “moderate”. We identified all prospective clinical studies and systematic reviews that evaluated the health effects of beer published between January 2007 and April 2020. Five of six selected studies found a protective effect of moderate alcohol drinking on cardiovascular disease (beer up to 385 g/week) vs. abstainers or occasional drinkers. Four out of five papers showed an association between moderate alcohol consumption (beer intake of 84 g alcohol/week) and decreased mortality risk. We concluded that moderate beer consumption of up to 16 g alcohol/day (1 drink/day) for women and 28 g/day (1–2 drinks/day) for men is associated with decreased incidence of cardiovascular disease and overall mortality, among other metabolic health benefits.
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Kodidela S, Shaik FB, Chinta V, Mohammad SA, Pasala C, Mittameedi CM, Maddu N, Wudayagiri R, Nallanchakravarthula V. Possible ameliorative role of green tea on chronic alcohol mediated renal toxicity of STZ -induced diabetic rats. CLINICAL NUTRITION EXPERIMENTAL 2020. [DOI: 10.1016/j.yclnex.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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25
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de Paiva FTF, Stival MM, de Lima LR, de Oliveira Silva A, de Sousa Barbalho YG, da Costa MVG, da Silva ICR, Funghetto SS. Predictive factors for reduced functional mobility in elderly diabetics and non-diabetics. Int J Diabetes Dev Ctries 2020. [DOI: 10.1007/s13410-020-00873-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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26
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Jurado-Fasoli L, Merchan-Ramirez E, Martinez-Tellez B, Acosta FM, Sanchez-Delgado G, Amaro-Gahete FJ, Muñoz Hernandez V, Martinez-Avila WD, Ortiz-Alvarez L, Xu H, Arias Téllez MJ, Ruiz-López MD, Llamas-Elvira JM, Gil Á, Labayen I, Ruiz JR. Association between dietary factors and brown adipose tissue volume/ 18F-FDG uptake in young adults. Clin Nutr 2020; 40:1997-2008. [PMID: 32994069 DOI: 10.1016/j.clnu.2020.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/04/2020] [Accepted: 09/12/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study the association between usual dietary factors (dietary energy density, nutrient intake, food group consumption, and dietary pattern) and brown adipose tissue (BAT) volume/18F-fluorodeoxyglucose (18F-FDG) uptake after personalized cold exposure in young healthy adults. METHODS A total of 122 young adults (n = 82 women; 22.0 ± 2.1 years old; 24.8 ± 4.8 kg/m2) took part in this cross-sectional study. Dietary factors were measured via a food frequency questionnaire and three non-consecutive 24 h recalls. Dietary energy density (foods and caloric beverages included) and macronutrient intakes were subsequently estimated using EvalFINUT® software, food group consumption was estimated from the food frequency questionnaire, and different dietary patterns and quality indices were determined according to the reference methods. BAT volume, BAT 18F-FDG uptake, and skeletal muscle 18F-FDG uptake were assessed by static 18F-FDG positron-emission tomography and computed tomography (PET-CT) scans after a 2 h personalized exposure to cold. RESULTS A direct association was detected between dietary energy density and BAT Standardized Uptake Value (SUV)mean (β = 0.215; R2 = 0.044; P = 0.022), and between ethanol consumption and BAT volume (β = 0.215; R2 = 0.044; P = 0.022). The a priori Mediterranean dietary pattern was inversely associated with BAT SUVmean and SUVpeak (β = -0.273; R2 = 0.075; P = 0.003 and β = -0.255; R2 = 0.066; P = 0.005 respectively). In addition, the diet quality index for a Mediterranean diet and a pro-inflammatory dietary pattern (as determined via the dietary inflammatory index) were directly associated with BAT SUVmean and SUVpeak (SUVmean: β = 0.238; R2 = 0.053; P = 0.013 and β = 0.256; R2 = 0.052; P = 0.012 respectively; SUVpeak: β = 0.278; R2 = 0.073; P = 0.003 and β = 0.248; R2 = 0.049; P = 0.016 respectively). After controlling for multiplicity and possible confounders (sex, the evaluation wave and BMI), all the detected associations persisted. CONCLUSION Dietary factors are slightly associated with BAT volume and/or 18F-FDG uptake after a personalized cold exposure in young adults. Our results provide an overall picture of the potential relationships between dietary factors and BAT-related variables in humans.
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Affiliation(s)
- Lucas Jurado-Fasoli
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain; EFFECTS 262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18071, Granada, Spain.
| | - Elisa Merchan-Ramirez
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain
| | - Borja Martinez-Tellez
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain; Department of Medicine, Division of Endocrinology, Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 2333 ZA, Leiden, the Netherlands
| | - Francisco M Acosta
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain
| | - Guillermo Sanchez-Delgado
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain; Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
| | - Francisco J Amaro-Gahete
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain; EFFECTS 262 Research Group, Department of Medical Physiology, School of Medicine, University of Granada, 18071, Granada, Spain
| | - Victoria Muñoz Hernandez
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain
| | - Wendy D Martinez-Avila
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain
| | - Lourdes Ortiz-Alvarez
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain; Department of Biochemistry and Molecular Biology II, University of Granada, 18071, Granada, Spain
| | - Huiwen Xu
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain; Department of Biochemistry and Molecular Biology II, University of Granada, 18071, Granada, Spain
| | - María José Arias Téllez
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain; Department of Nutrition, Faculty of Medicine, University of Chile, Independence, 1027, Santiago, Chile
| | - María Dolores Ruiz-López
- Department of Nutrition and Food Sciences, Faculty of Pharmacy, University of Granada, Campus de Cartuja, s.n, 18071, Granada, Spain; Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 (a) pta, Armilla, 18016, Granada, Spain; Institute of Nutrition and Food Technology "José Mataix," Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100, Granada, Spain
| | - Jose M Llamas-Elvira
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain
| | - Ángel Gil
- Department of Biochemistry and Molecular Biology II, University of Granada, 18071, Granada, Spain; Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3 (a) pta, Armilla, 18016, Granada, Spain; Institute of Nutrition and Food Technology "José Mataix," Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Avenida del Conocimiento s/n, Armilla, 18100, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs. GRANADA), Granada, Spain; CIBEROBN (Physiopathology of Obesity and Nutrition CB12/03/30038), Instituto de Salud Carlos III (ISCIII), 28029, Madrid, Spain
| | - Idoia Labayen
- Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, Campus de Arrosadía, 31008, Pamplona, Spain
| | - Jonatan R Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, 18007, Granada, Spain; Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18011, Granada, Spain
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Antioxidant properties of plant polyphenols in the counteraction of alcohol-abuse induced damage: Impact on the Mediterranean diet. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.104012] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Prevalence and Associated Factors of Diabetes Mellitus in Hosanna Town, Southern Ethiopia. Ann Glob Health 2020; 86:18. [PMID: 32140428 PMCID: PMC7047764 DOI: 10.5334/aogh.2663] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background/Objectives Diabetes is a global public health problem, and its burden is rising, particularly in developing countries. However, limited data is available from sub-Sahara African communities to assess and monitor the disease burden. The study aimed to determine the prevalence and associated factors of diabetes in Hosanna, Ethiopia. Methods A community-based cross-sectional study was conducted among 634 randomly selected adults in Hosanna. The study participants were recruited by multi-stage stratified sampling. A face-to-face interview using a structured questionnaire was administered by trained nurses. Anthropometry, blood pressure and fasting blood glucose levels were measured. Diabetes mellitus was considered when the fasting blood glucose level was ≥126 mg/dl on two separate measurements or when the participant self-reported a previous diagnosis of diabetes by healthcare providers or when the participant was currently receiving treatment for diabetes. Multi-variable binary logistic regression was used to identify factors associated with diabetes mellitus. Findings The overall prevalence of diabetes was found to be 5.7% (95% CI; 4.0-7.7), out of which more than one third (36%) were not aware of it prior to the survey. Nearly two thirds (61.1%) of the diabetic participants were also found to be hypertensive. In the multi-variable analysis, diabetes was associated with current alcohol use, sitting on average of more than 8 hours/day, abnormal BMI and being hypertensive. Conclusion The prevalence of diabetes among the adult population in the town is alarming. If appropriate measures to address the burden are not emplaced, it might result in serious complications to the patients and unnecessarily high costs to the health system of the country. Active screening for raised blood glucose level should be given due consideration, particularly in the community setting. Designing health education programs on the importance of physical activity and the risks of alcohol use should also be considered.
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Owolabi EO, Goon DT, Ajayi AI. Efficacy, acceptability and feasibility of daily text-messaging in promoting glycaemic control and other clinical outcomes in a low-resource setting of South Africa: A randomised controlled trial. PLoS One 2019; 14:e0224791. [PMID: 31774842 PMCID: PMC6881007 DOI: 10.1371/journal.pone.0224791] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/17/2019] [Indexed: 12/31/2022] Open
Abstract
South Africa is confronted with a high burden of diabetes, the majority of which are poorly controlled. The use of mHealth, specifically text messaging for fostering health, is evolving and studies on its efficacy, the majority of which were conducted in developed countries, have documented mixed findings. There is no such study done amongst patients living with diabetes in the resource-poor settings of South Africa. The aim of this study is to determine the efficacy, acceptability and feasibility of text-messaging in improving glycaemic control and other clinical outcomes among individuals living with diabetes in low-resource settings in Eastern Cape, South Africa. The study adopted a multi-centre, two-arm, parallel, randomised-controlled trial design. The study was conducted amongst patients with an uncontrolled glycaemic status. Participants were randomly assigned to the intervention (n = 108) and the control arm (n = 108). Participants in the intervention arm received daily educational text messages on diabetes for six months. Data was collected at baseline and six months post-intervention. Blood glucose, blood pressure and anthropometric measurements followed standard procedure. Mixed-model analysis was used to assess the impact of the text messages on blood glucose while linear regression was used to assess its effect on other clinical outcomes such as weight, body mass index, systolic and diastolic blood pressure. The mean age of the participants was 60.64 (SD± 11.58) years. The majority of the participants had a secondary level of education (95.3%) and earned 104.80 to 991.42 USD per month (67.7%). Both arms of the study showed improvement in their blood glucose levels, but the intervention did not have any significant effect, the mean adjusted change in blood glucose was 0.26 (-0.81 to 1.32), p = 0.634. Also, the intervention did not have any significant effect on weight, body mass index, systolic and diastolic blood pressure. Almost all participants (90.74%) were pleased with the intervention and felt it was helpful. Of those who participated in the intervention, 91% completed the follow-up after 6 months. Unidirectional text-messaging was acceptable and feasible amongst adults living with diabetes in this setting. However, its efficacy in improving glycaemic status and other clinical outcomes remains doubtful. Trial Registration: Pan African Clinical Trial Registry PACTR201810599931422.
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Affiliation(s)
- Eyitayo Omolara Owolabi
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| | - Daniel Ter Goon
- Department of Nursing Science, Faculty of Health Sciences, University of Fort Hare, East London, South Africa
| | - Anthony Idowu Ajayi
- Population Dynamics and Reproductive Health Unit, African Population and Health Research Centre, APHRC Campus, Nairobi, Kenya
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Sharma B, Khanal VK, Jha N, Pyakurel P, Gurung GN. Study of the magnitude of diabetes and its associated risk factors among the tuberculosis patients of Morang, Eastern Nepal. BMC Public Health 2019; 19:1545. [PMID: 31752802 PMCID: PMC6873766 DOI: 10.1186/s12889-019-7891-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 11/01/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND WHO addresses the infectious disease like Tuberculosis, and non- communicable disease like Diabetes among the top 10 causes of death worldwide, which collectively leads to increasing mortality and premature death especially in developing countries. Hence, the present study aims to assess the prevalence of diabetes and its associated risk factors among the tuberculosis patient of Morang, Eastern Nepal. METHODS A cross-sectional study was carried out among the 320 respondents undergoing tuberculosis treatment of Morang district. Respondents from eight randomly selected DOTS centers were selected purposively. The Fasting Blood Sugar and 2-h Post-Prandial Blood Sugar were assessed in the laboratory of respective DOTS center by the glucose oxidase method. An interview for socio-demographic and other variables was conducted using a pretested semi-structured questionnaire based on WHO-STEP Instrument for chronic disease and excerpt from DASS-21 was used for the variable stress. RESULTS The prevalence of diabetes, pre-diabetic and glucose intolerance among tuberculosis patient was 11.9, 17.2, and 17.8% respectively. Additionally, the univariate analysis reported, user of tobacco products, current alcohol consumers, family history of diabetes and stress level, to have positive association with diabetes, while the multivariate analysis reported, the current alcohol consumer as the significant predictor of diabetes among the tuberculosis patient. CONCLUSION A significant portion of the respondents were diabetic, impaired glucose tolerance and pre-diabetic, which supports the fact of diabetes being comorbid with tuberculosis. Hence, it shifts the focus on the bidirectional screening of tuberculosis and diabetes.
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Affiliation(s)
- Babita Sharma
- School of Public Health and Community Medicine (SPHCM), B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Vijay Kumar Khanal
- School of Public Health and Community Medicine (SPHCM), B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Nilambar Jha
- School of Public Health and Community Medicine (SPHCM), B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Prajjwal Pyakurel
- School of Public Health and Community Medicine (SPHCM), B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Gyanu Nepal Gurung
- School of Public Health and Community Medicine (SPHCM), B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
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Thyrotoxic Periodic Paralysis with Sensory Deficits in Young African American Male: A Case Report and Literature Review. ACTA ACUST UNITED AC 2019; 7:138-142. [PMID: 31404457 PMCID: PMC6688769 DOI: 10.12691/ajmcr-7-7-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Thyrotoxic periodic paralysis is a sporadic entity characterized by hypokalemia and paralysis in the setting of hyperthyroidism. TPP is most commonly described in young Asian males. Studies have shown an association with mutations affecting inward rectifying potassium channels. The pathophysiology involves Na+-K+- ATPase channel causing an increased intracellular shift of potassium ions in the hyperthyroid state and in the presence of another precipitating condition. Most cases of thyrotoxic periodic paralysis are defined in young Asian males of 20–40 years of age, here we present an interesting case of thyrotoxic periodic paralysis in 32-year-old African American male, who presented with sudden onset weakness in the bilateral lower extremity and left upper extremity. Interestingly, the patient also has sensory deficits, a feature not known to be associated with thyrotoxic periodic paralysis.
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Guimarães VA, Fernandes KS, Lucchese R, Vera I, Martins BCT, Amorim TAD, Guimarães RA. [Prevalence and factors associated with alcohol use during pregnancy in a maternity hospital in Goiás, Central Brazil]. CIENCIA & SAUDE COLETIVA 2019; 23:3413-3420. [PMID: 30365860 DOI: 10.1590/1413-812320182310.24582016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 10/05/2016] [Indexed: 11/22/2022] Open
Abstract
The scope of this article is to estimate the prevalence and factors associated with alcohol use during pregnancy. It involved a cross-sectional study in a sample of 361 pregnant women in a reference service for gynecological and prenatal care. The data related to socio-demographic characteristics, alcohol use and potential associated factors were collected through face-to-face interviews. Poisson regression with robust variance was used to identify factors associated with the outcome analyzed. The consumption of alcohol in the sample was 17.7% (95% CI: 95% CI: 14.1% to 22.0%). A history of pre-gestational or gestational diabetes, suicidal ideation and tobacco use in the last 30 days was associated with alcohol use during pregnancy (p < 0.05). The study showed a high prevalence of alcohol use during the current pregnancy and its association with important factors. Actions such as screening for alcohol and advice on problems associated with the use of this substance, especially during the prenatal period, can contribute to effective reduction of alcohol use in pregnant women and related maternal and fetal injuries.
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Affiliation(s)
- Vanessa Alves Guimarães
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Kelly Silveira Fernandes
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Roselma Lucchese
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Ivânia Vera
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Bruno César Teodoro Martins
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Thiago Aquino de Amorim
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Rafael Alves Guimarães
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
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Jurado-Fasoli L, Amaro-Gahete FJ, De-la-O A, Gutiérrez Á, Castillo MJ. Alcohol consumption and S-Klotho plasma levels in sedentary healthy middle-aged adults: A cross sectional study. Drug Alcohol Depend 2019; 194:107-111. [PMID: 30419404 DOI: 10.1016/j.drugalcdep.2018.09.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/10/2018] [Accepted: 09/21/2018] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Alcohol consumption is related to several diseases and injuries that accelerate the ageing process and increase the mortality and morbidity risk. The soluble form of the α-Klotho gene (called S-Klotho) is widely considered as a powerful anti-ageing biomarker. AIM The aim of the present study was to analyze the association between alcohol consumption and S-Klotho plasma levels in sedentary middle-aged adults. METHODS 74 (39 women) middle-aged sedentary adults (40-65 years old) participated in the present study. Alcohol consumption was assessed with a food frequency questionnaire previously validated and with three non-consecutive 24-hours recall. The S-Klotho plasma levels were measured by ELISA using a soluble α-Klotho ELISA assay kit. RESULTS Total alcoholic drinks consumption was negatively associated with S-Klotho plasma levels (β=-17.031; R2 = 0.096, P = 0.013). Furthermore, we observed that higher consumption of total alcoholic drinks is associated with lower S-Klotho plasma levels in middle-aged sedentary adults controlling for BMI (β=-16.372; R2 = 0.201, P = 0.011), LMI (β=-31.854; R2 = 0.305, P = 0.010) and for FMI β=-13.337; R2 = 0.075, P = 0.049). CONCLUSION In conclusion, our study shows that total alcoholic drinks consumption is negatively associated with the S-Klotho plasma levels in middle-aged sedentary adults.
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Affiliation(s)
- Lucas Jurado-Fasoli
- Department of Medical Physiology, School of Medicine, University of Granada, Spain.
| | - Francisco J Amaro-Gahete
- Department of Medical Physiology, School of Medicine, University of Granada, Spain; PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Spain
| | - Alejandro De-la-O
- Department of Medical Physiology, School of Medicine, University of Granada, Spain
| | - Ángel Gutiérrez
- Department of Medical Physiology, School of Medicine, University of Granada, Spain
| | - Manuel J Castillo
- Department of Medical Physiology, School of Medicine, University of Granada, Spain.
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Blood Viscosity, Glycemic Markers and Blood Pressure: A Study in Middle-Aged Normotensive and Hypertensive Type 2 Diabetics. Indian J Clin Biochem 2018; 35:102-108. [PMID: 32071502 DOI: 10.1007/s12291-018-0798-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/17/2018] [Indexed: 12/19/2022]
Abstract
Altered blood viscosity (BV) may affect blood pressure (BP) and develops further complications in diabetes. A case-control study was performed to examine the relationship of erythrocyte sedimentation rate (ESR), hematocrit, fibrinogen, and BV with glycemic markers and BP in middle-aged normotensive and hypertensive type 2 diabetic patients and healthy controls. A total of 145 participants between age group 30-50 years divided into three groups; controls (n = 60), type 2 diabetes mellitus (T2DM, n = 55), and T2DM with hypertension (T2DM + HTN, n = 30). ESR and hematocrit were determined by Wintrobe's method. Plasma fibrinogen was measured using Lempert method and BV calculated using Merill's formula. T2DM and T2DM + HTN patients had higher fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), ESR, and fibrinogencompared to controls. In both male and female SBP, DBP, MAP, FPG, and HbA1c were significantly higher in T2DM and T2DM + HTN groups, compared to controls. Further, linear regression analysis revealed a positive association of ESR and fibrinogen with SBP, DBP, MAP, FPG, HbA1c, and positive diabetic status in all participants. Also, in the same analysis, BV showed a positive association with SBP, DBP, and MAP. The association of ESR and fibrinogenwith glycemic markers and BP in diabetes supporting the value of emerging marker's for early prediction of T2DM and hypertension.
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Punjani N, Flannigan R, Oliffe JL, McCreary DR, Black N, Goldenberg SL. Unhealthy Behaviors Among Canadian Men Are Predictors of Comorbidities: Implications for Clinical Practice. Am J Mens Health 2018; 12:2183-2193. [PMID: 30222015 PMCID: PMC6199435 DOI: 10.1177/1557988318799022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Men's poor health behaviors are an increasingly prevalent issue with long-term consequences. This study broadly samples Canadian men to obtain information regarding health behaviors as a predictor of downstream medical comorbidities. A survey of Canadian men included questions regarding demographics, comorbidities, and health behaviors (smoking and alcohol consumption, sleep and exercise behaviors, and dietary habits). Health behaviors were classified as either healthy or unhealthy based upon previous studies and questionnaire thresholds. Multivariate regression was performed to determine predictors for medical comorbidities. The 2,000 participants were aged 19-94 (median 48, interquartile range 34-60). Approximately half (47.4%) were regular smokers, 38.7% overused alcohol, 53.9% reported unhealthy sleep, 48.9% had low levels of exercise, and 61.8% had unhealthy diets. On multivariate analysis, regular smoking predicted heart disease (OR 2.08, p < .01), elevated cholesterol (OR 1.35, p = .02), type 2 diabetes (OR 1.57, p = .02), osteoarthritis (OR 1.43, p = .04), and depression (OR 1.62, p < .01). Alcohol overuse predicted hypertension (OR 1.40, p < .01) and protected against type 2 diabetes (OR 0.61, p < .01). Unhealthy sleep predicted hypertension (OR 1.46, p < .01), erectile dysfunction (OR 1.50, p = .04), and depression (OR 1.87, p < .01). Low levels of exercise predicted hypertension (OR 1.30, p = .03) and elevated cholesterol (OR 1.27, p = .05). Finally, unhealthy diet predicted depression (OR 1.65, p < .01). This study confirms the association of poor health behaviors and comorbidities common to middle-aged and older men. The results emphasize the potential scope of targeted gender-sensitized public awareness campaigns and interventions to reduce common male disease, morbidity, and mortality.
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Affiliation(s)
- Nahid Punjani
- Division of Urology, Western University, London, ON, Canada
| | - Ryan Flannigan
- Weill Cornell Medicine, Department of Urology, Male Reproduction & Microsurgery, New York, NY, USA
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
| | - John L. Oliffe
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | - Nick Black
- Intensions Consulting, Vancouver, BC, Canada
| | - S. Larry Goldenberg
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
- Canadian Men’s Health Foundation, Vancouver, BC, Canada
- S. Larry Goldenberg, CM, OBC, MD, FRCSC, FACS, FCAHS, Department of Urologic Sciences, University of British Columbia, 2775 Laurel Street, 6th floor, Vancouver, BC V5Z1M9, Canada.
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Mehta M, Satsangi S, Duseja A, Taneja S, Dhiman RK, Chawla Y. Can Alcoholic Liver Disease and Nonalcoholic Fatty Liver Disease Co-Exist? J Clin Exp Hepatol 2017; 7:121-126. [PMID: 28663676 PMCID: PMC5478941 DOI: 10.1016/j.jceh.2017.01.112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/29/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) by definition would require exclusion of significant alcohol intake. Present study was aimed to assess the prevalence of various components of metabolic syndrome (MS) in patients with alcoholic cirrhosis (AC) and to study the affect of its presence on the severity of liver disease, testing the hypothesis if alcoholic liver disease (ALD) and NAFLD could co-exist. METHODS In a retrospective analysis of 16 months data, 81 patients with AC were analysed for the prevalence of MS. The diagnosis of AC was based on the history of alcohol intake, clinical examination, serum biochemistry, hematological parameters, exclusion of other causes of chronic liver disease, imaging and upper gastrointestinal endoscopy. Severity of liver disease was assessed by Child-Turcott-Pugh (CTP) score. MS was assessed as per the ATP III criteria and the affect of MS on CTP score was evaluated. RESULTS All 81 patients with AC were male [mean age 50.9 ± 9.5, mean CTP score 8.38 ± 1.66]. But for three patients (3.7%) all other 78 patients (96.3%) with AC had at least one component of MS. Forty-three (53.0%) patients had full blown MS with three or more components of MS. Sixty-one (75.30%) patients were either overweight [22 (27.1%)] or obese [39 (48.1%)], with a mean BMI of 25.35 ± 3.86 kg/m2. Type II DM was present in 40 (25%) and 28 (34.5%) patients were hypertensive. Twenty-two (27.2%) patients had hypertriglyceridemia and 52 (64.2%) had low HDL. Eleven (13.6%) patients had Child's A cirrhosis, 46 (56.8%) had Child's B and 24 (29.6%) patients had Child's C cirrhosis. Even though not significant statistically, patients with Child's C cirrhosis (17, 70.83%) had higher presence of MS in comparison to Child's A (7, 63.6%) and B (19, 41.3%) cirrhosis. CONCLUSION MS is common in patients with AC. Presence of MS may be contributing towards severity of liver disease in these patients indirectly suggesting the co-existence of ALD and NAFLD.
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Affiliation(s)
| | | | - Ajay Duseja
- Address for correspondence: Ajay Duseja, Department of Hepatology, Sector 12, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. Tel.: +91 172 2756336; fax: +91 0172 2744401.Department of Hepatology, Sector 12, Post Graduate Institute of Medical Education and ResearchChandigarh160012India
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Hoyt LR, Randall MJ, Ather JL, DePuccio DP, Landry CC, Qian X, Janssen-Heininger YM, van der Vliet A, Dixon AE, Amiel E, Poynter ME. Mitochondrial ROS induced by chronic ethanol exposure promote hyper-activation of the NLRP3 inflammasome. Redox Biol 2017; 12:883-896. [PMID: 28463821 PMCID: PMC5413213 DOI: 10.1016/j.redox.2017.04.020] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/10/2017] [Accepted: 04/10/2017] [Indexed: 02/07/2023] Open
Abstract
Alcohol use disorders are common both in the United States and globally, and are associated with a variety of co-morbid, inflammation-linked diseases. The pathogenesis of many of these ailments are driven by the activation of the NLRP3 inflammasome, a multi-protein intracellular pattern recognition receptor complex that facilitates the cleavage and secretion of the pro-inflammatory cytokines IL-1β and IL-18. We hypothesized that protracted exposure of leukocytes to ethanol would amplify inflammasome activation, which would help to implicate mechanisms involved in diseases associated with both alcoholism and aberrant NLRP3 inflammasome activation. Here we show that long-term ethanol exposure of human peripheral blood mononuclear cells and a mouse macrophage cell line (J774) amplifies IL-1β secretion following stimulation with NLRP3 agonists, but not with AIM2 or NLRP1b agonists. The augmented NRLP3 activation was mediated by increases in iNOS expression and NO production, in conjunction with increases in mitochondrial membrane depolarization, oxygen consumption rate, and ROS generation in J774 cells chronically exposed to ethanol (CE cells), effects that could be inhibited by the iNOS inhibitor SEITU, the NO scavenger carboxy-PTIO, and the mitochondrial ROS scavenger MitoQ. Chronic ethanol exposure did not alter K+ efflux or Zn2+ homeostasis in CE cells, although it did result in a lower intracellular concentration of NAD+. Prolonged administration of acetaldehyde, the product of alcohol dehydrogenase (ADH) mediated metabolism of ethanol, mimicked chronic ethanol exposure, whereas ADH inhibition prevented ethanol-induced IL-1β hypersecretion. Together, these results indicate that increases in iNOS and mitochondrial ROS production are critical for chronic ethanol-induced IL-1β hypersecretion, and that protracted exposure to the products of ethanol metabolism are probable mediators of NLRP3 inflammasome hyperactivation. Chronic ethanol exposure amplifies NLRP3 inflammasome-induced IL-1β secretion. NO and mitochondrial ROS mediate chronic ethanol-augmented IL-1β secretion. Alcohol dehydrogenase-generated metabolites cause NLRP3 inflammasome over-activation.
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Affiliation(s)
- Laura R Hoyt
- Vermont Lung Center, University of Vermont, Burlington, VT 05405, USA; Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Matthew J Randall
- Vermont Lung Center, University of Vermont, Burlington, VT 05405, USA; Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Jennifer L Ather
- Vermont Lung Center, University of Vermont, Burlington, VT 05405, USA; Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Daniel P DePuccio
- Department of Chemistry, University of Vermont, Burlington, VT 05405, USA
| | - Christopher C Landry
- Department of Chemistry, University of Vermont, Burlington, VT 05405, USA; Cellular, Molecular, and Biomedical Sciences Graduate Program, University of Vermont, Burlington, VT 05405, USA
| | - Xi Qian
- Vermont Lung Center, University of Vermont, Burlington, VT 05405, USA; Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Yvonne M Janssen-Heininger
- Vermont Lung Center, University of Vermont, Burlington, VT 05405, USA; Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT 05405, USA; Cellular, Molecular, and Biomedical Sciences Graduate Program, University of Vermont, Burlington, VT 05405, USA
| | - Albert van der Vliet
- Vermont Lung Center, University of Vermont, Burlington, VT 05405, USA; Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT 05405, USA; Cellular, Molecular, and Biomedical Sciences Graduate Program, University of Vermont, Burlington, VT 05405, USA
| | - Anne E Dixon
- Vermont Lung Center, University of Vermont, Burlington, VT 05405, USA; Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Eyal Amiel
- Department of Medical Laboratory and Radiation Sciences, University of Vermont, Burlington, VT 05405, USA; Cellular, Molecular, and Biomedical Sciences Graduate Program, University of Vermont, Burlington, VT 05405, USA
| | - Matthew E Poynter
- Vermont Lung Center, University of Vermont, Burlington, VT 05405, USA; Division of Pulmonary Disease and Critical Care, Department of Medicine, University of Vermont, Burlington, VT 05405, USA; Cellular, Molecular, and Biomedical Sciences Graduate Program, University of Vermont, Burlington, VT 05405, USA.
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Sanvisens A, Zuluaga P, Fuster D, Rivas I, Tor J, Marcos M, Chamorro AJ, Muga R. Long-Term Mortality of Patients with an Alcohol-Related Wernicke–Korsakoff Syndrome. Alcohol Alcohol 2017; 52:466-471. [DOI: 10.1093/alcalc/agx013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 02/24/2017] [Indexed: 12/17/2022] Open
Abstract
Abstract
Aims
To characterize a series of contemporary patients with alcohol-related Wernicke's encephalopathy (WE) or Korsakoff's syndrome (KS) and to update the current prognosis of disease.
Methods
Retrospective and prospective study of patients diagnosed with an alcohol-related WE or KS between 2002 and 2011 in a tertiary hospital. Socio-demographic, alcohol use characteristics, signs and symptoms, co-morbidity and blood parameters were obtained at admission. Patients were followed up until 2013 and causes of death were ascertained through the review of charts.
Results
Sixty-one patients were included (51 with WE and 10 with KS). Among patients with WE, 78% were men and age at diagnosis was 57 years (interquartile range (IQR): 49–66). Twenty-three percent fulfilled the classic WE triad. Regarding Caine's criteria for WE, 70.6% presented with at least two out of four signs or symptoms. Median follow-up of patients with WE syndrome was 5.3 years (IQR: 2.6–8.8), the cumulated mortality was 45% and death rate of 7.4 × 100 person-years (95% confidence interval (CI): 4.8–10.9). Overall, 50% of patients would be expected to die within 8 years of WE episode and main causes of death included serious bacterial infections (44.5%) and cancer (33.3%).
Conclusions
Survival of patients with an alcohol-related Wernicke–Korsakoff syndrome is poor; pursuing treatment of alcohol use disorder and early diagnosis of thiamine deficiency is a priority for improving clinical outcomes.
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Affiliation(s)
- Arantza Sanvisens
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra. Canyet s/n, 08916 Badalona, Spain
| | - Paola Zuluaga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra. Canyet s/n, 08916 Badalona, Spain
| | - Daniel Fuster
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra. Canyet s/n, 08916 Badalona, Spain
| | - Inmaculada Rivas
- Municipal Centre for Substance Abuse Treatment (Centro Delta), IMSP-Badalona, C/Termes Romanes 12, 08911 Badalona, Spain
| | - Jordi Tor
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra. Canyet s/n, 08916 Badalona, Spain
| | - Miguel Marcos
- 3Department of Internal Medicine, Alcoholism Unit, Hospital Universitario de Salamanca, Paseo de San Vicente, 88-182, 37007 Salamanca, Spain
| | - Antonio J. Chamorro
- 3Department of Internal Medicine, Alcoholism Unit, Hospital Universitario de Salamanca, Paseo de San Vicente, 88-182, 37007 Salamanca, Spain
| | - Roberto Muga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Ctra. Canyet s/n, 08916 Badalona, Spain
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Vancampfort D, Mugisha J, Hallgren M, De Hert M, Probst M, Monsieur D, Stubbs B. The prevalence of diabetes mellitus type 2 in people with alcohol use disorders: a systematic review and large scale meta-analysis. Psychiatry Res 2016; 246:394-400. [PMID: 27788459 DOI: 10.1016/j.psychres.2016.10.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 10/10/2016] [Indexed: 02/06/2023]
Abstract
Type 2 Diabetes Mellitus (T2DM) is highly predictive of cardiovascular diseases and is associated with worse quality of life and increased healthcare utilisation. The current meta-analysis aimed to (i) describe the pooled prevalence of T2DM in people with alcohol use disorders (AUDs), (ii) investigate the impact of demographic, clinical and treatment factors, and (iii) compare T2DM prevalences in AUDs versus the general population. The trim and fill adjusted pooled T2DM prevalence among 3998 people with AUDs (age range 34.8-51.1 years; 76.6% male) (N studies=7) was 12.4% (95%CI=11.8-13.9%). Higher T2DM prevalences were observed in studies with a higher mean age and a higher percentage of male participants, and in studies with self- or physician reported T2DM assessment. A trend for higher T2DM prevalences was found in inpatient settings, in studies assessing T2DM with the gold-standard oral glucose tolerance test compared with fasting glucose only, and with studies including patients with a higher percentage of physical co-morbidity. Although healthy control data are lacking, the pooled prevalence is similar to that observed in people with severe mental illness who are considered a high-risk group. Routine screening and multidisciplinary management of T2DM in people with AUDs is needed.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium.
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda; Kyambogo University, Kampala, Uganda
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinksa Institute, Stockholm, Sweden
| | - Marc De Hert
- KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - Michel Probst
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Dirk Monsieur
- KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
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Haass-Koffler CL, Giovenco DE, Lee MR, Zywiak WH, de la Monte SM, Kenna GA, Swift RM, Leggio L. Serum Insulin Levels Are Reduced by Intravenous Ghrelin Administration but Do Not Correlate with Alcohol Craving in Alcohol-Dependent Individuals. Int J Neuropsychopharmacol 2016; 19:pyw048. [PMID: 27207912 PMCID: PMC5091823 DOI: 10.1093/ijnp/pyw048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/25/2016] [Accepted: 05/03/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Increasing evidence supports a role for appetite-regulating pathways like ghrelin, insulin, and leptin in alcoholism. We previously reported that intravenous (i.v.) exogenous ghrelin increases alcohol craving. We also reported i.v. ghrelin reduces endogenous serum leptin, whose levels, in turn, negatively correlated with alcohol craving. Exogenous ghrelin administration decreases insulin secretion both in vitro and in vivo experiments. This study tested the hypothesis that i.v. ghrelin may also decrease endogenous serum insulin levels in alcoholic individuals. Additionally, we explored possible correlations between serum insulin and alcohol craving, since a correlation between insulin and alcohol craving was previously reported. METHODS This was a double-blind, placebo-controlled human laboratory study ( n =43). Non-treatment-seeking, alcohol-dependent, heavy drinkers were randomized to receive i.v. ghrelin or placebo, followed by an alcohol cue-reactivity procedure. RESULTS There was a main effect for i.v. ghrelin, compared to placebo in reducing serum insulin ( P <.05). There was also a time effect ( P <.001) but not ghrelin x time interaction ( P >.05). We did not find a correlation between the reduction of serum insulin and alcohol craving ( P >.05). The change in serum insulin was consistent with a parallel reduction in serum connective-peptide in the ghrelin group compared with placebo, although this difference did not reach statistical significance ( P =.076). No similar effects were found for other glucose-regulating hormones analyzed i.e. glucagon, glucagon-like peptide-1, and gastric inhibitory peptide ( P s>.05). CONCLUSIONS These findings indicate i.v. ghrelin administration has an effect on reducing serum insulin in alcohol-dependent individuals; however, the reduction of insulin did not correlate with changes in alcohol cue-elicited craving. We speculate that, unlike for leptin, the interactions between ghrelin and insulin relationship are limited at the peripheral level. However, mechanistic studies are needed to investigate this hypothesis.
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Chen JH, Michiue T, Inamori-Kawamoto O, Ikeda S, Ishikawa T, Maeda H. Comprehensive investigation of postmortem glucose levels in blood and body fluids with regard to the cause of death in forensic autopsy cases. Leg Med (Tokyo) 2015; 17:475-82. [PMID: 26593993 DOI: 10.1016/j.legalmed.2015.08.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/24/2015] [Accepted: 08/27/2015] [Indexed: 01/08/2023]
Abstract
The serum glucose level is regulated within a narrow range by multiple factors under physiological conditions, but is greatly modified in the death process and after death. The present study comprehensively investigated glucose levels in blood and body fluids, including pericardial fluid (PCF), cerebrospinal fluid (CSF) and vitreous humor, reviewing forensic autopsy cases (n=672). Right heart blood glucose level was often higher than at other sites, and the CSF glucose level was the lowest, showing greater dissociation in acute/subacute death cases. The glucose level was higher in the diabetic (high HbA1c) than in the non-diabetic (low HbA1c) group at each site (p<0.01-0.0001). Fatal diabetic ketoacidosis cases had evidently high glucose levels at each site; whereas in the non-diabetic group, blood glucose level was higher in fatal alcohol abuse, saltwater drowning, electrocution, cerebrovascular disease and sudden cardiac death due to ischemic heart disease. Fatal methamphetamine (MA) abuse, sepsis, malnutrition (starvation) and hypoglycemia due to antidiabetics showed markedly lower blood glucose levels. Ketones in bilateral cardiac blood and PCF were increased in diabetic ketoacidosis and fatal alcohol abuse as well as in most cases of hyperthermia (heatstroke), hypothermia (cold exposure) and malnutrition. These findings suggest that combined analysis of glucose, HbA1c and ketones in blood and body fluids is useful to investigate not only fatal diabetic metabolic disorders but also death processes due to other causes, including alcohol and MA abuse, as well as thermal disorders, sepsis and malnutrition.
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Affiliation(s)
- Jian-Hua Chen
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan.
| | - Tomomi Michiue
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan
| | - Osamu Inamori-Kawamoto
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan
| | - Sayuko Ikeda
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan
| | - Takaki Ishikawa
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan
| | - Hitoshi Maeda
- Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan; Forensic Autopsy Section, Medico-legal Consultation and Postmortem Investigation Support Center (MLCPI-SC), c/o Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan
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Welcome M, Pereverzev V. Glycemic Allostasis during Mental Activities on Fasting in Non-alcohol Users and Alcohol Users with Different Durations of Abstinence. Ann Med Health Sci Res 2014; 4:S199-207. [PMID: 25364589 PMCID: PMC4212377 DOI: 10.4103/2141-9248.141959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Glycemic allostasis is the process by which blood glucose stabilization is achieved through the balancing of glucose consumption rate and release into the blood stream under a variety of stressors. This paper reviews findings on the dynamics of glycemic levels during mental activities on fasting in non-alcohol users and alcohol users with different periods of abstinence. Referred articles for this review were searched in the databases of PubMed, Scopus, DOAJ and AJOL. The search was conducted in 2013 between January 20 and July 31. The following keywords were used in the search: alcohol action on glycemia OR brain glucose OR cognitive functions; dynamics of glycemia, dynamics of glycemia during mental activities; dynamics of glycemia on fasting; dynamics of glycemia in non-alcohol users OR alcohol users; glycemic regulation during sobriety. Analysis of the selected articles showed that glycemic allostasis during mental activities on fasting is poorly regulated in alcohol users even after a long duration of sobriety (1-4 weeks after alcohol consumption), compared to non-alcohol users. The major contributor to the maintenance of euglycemia during mental activities after the night's rest (during continuing fast) is gluconeogenesis.
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Affiliation(s)
- Mo Welcome
- Department of Normal Physiology, Belarusian State Medical University, Minsk, Belarus
| | - Va Pereverzev
- Department of Normal Physiology, Belarusian State Medical University, Minsk, Belarus
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More VR, Cheng Q, Donepudi AC, Buckley DB, Lu ZJ, Cherrington NJ, Slitt AL. Alcohol cirrhosis alters nuclear receptor and drug transporter expression in human liver. Drug Metab Dispos 2013; 41:1148-55. [PMID: 23462698 DOI: 10.1124/dmd.112.049676] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Unsafe use of alcohol results in approximately 2.5 million deaths worldwide, with cirrhosis contributing to 16.6% of reported deaths. Serum insulin levels are often elevated in alcoholism and may result in diabetes, which is why alcoholic liver disease and diabetes often are present together. Because there is a sizable population with these diseases alone or in combination, the purpose of this study was to determine whether transporter expression in human liver is affected by alcoholic cirrhosis, diabetes, and alcoholic cirrhosis coexisting with diabetes. Transporters aid in hepatobiliary excretion of many drugs and toxic chemicals and can be determinants of drug-induced liver injury. Drug transporter expression and transcription factor-relative mRNA and protein expression in normal, diabetic, cirrhotic, and cirrhosis with diabetes human livers were quantified. Cirrhosis significantly increased ABCC4, 5, ABCG2, and solute carrier organic anion (SLCO) 2B1 mRNA expression and decreased SLCO1B3 mRNA expression in the liver. ABCC1, 3-5, and ABCG2 protein expression was also upregulated by alcoholic cirrhosis. ABCC3-5 and ABCG2 protein expression was also upregulated in diabetic cirrhosis. Cirrhosis increased nuclear factor E2-related factor 2 mRNA expression, whereas it decreased pregnane-X-receptor and farnesoid-X-receptor mRNA expression in comparison with normal livers. Hierarchical cluster analysis indicated that expressions of ABCC2, 3, and 6; SLCO1B1 and 1B3; and ABCC4 and 5 were more closely related in the livers from this cohort. Overall, alcoholic cirrhosis altered transporter expression in human liver.
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Affiliation(s)
- Vijay R More
- Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
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Piyathilake CJ, Badiga S, Alvarez RD, Partridge EE, Johanning GL. A lower degree of PBMC L1 methylation is associated with excess body weight and higher HOMA-IR in the presence of lower concentrations of plasma folate. PLoS One 2013; 8:e54544. [PMID: 23358786 PMCID: PMC3554730 DOI: 10.1371/journal.pone.0054544] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 12/14/2012] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Identification of associations between global DNA methylation and excess body weight (EBW) and related diseases and their modifying factors are an unmet research need that may lead to decreasing DNA methylation-associated disease risks in humans. The purpose of the current study was to evaluate the following; 1) Association between the degree of peripheral blood mononuclear cell (PBMC) L1 methylation and folate, and indicators of EBW, 2) Association between the degree of PBMC L1 methylation and folate, and insulin resistance (IR) as indicated by a higher homeostasis model assessment (HOMA-IR). METHODS The study population consisted of 470 child-bearing age women diagnosed with abnormal pap. The degree of PBMC L1 methylation was assessed by pyrosequencing. Logistic regression models specified indicators of EBW (body mass index-BMI, body fat-BF and waist circumference-WC) or HOMA-IR as dependent variables and the degree of PBMC L1 methylation and circulating concentrations of folate as the independent predictor of primary interest. RESULTS Women with a lower degree of PBMC L1 methylation and lower plasma folate concentrations were significantly more likely to have higher BMI, % BF or WC (OR = 2.49, 95% CI:1.41-4.47, P = 0.002; OR = 2.49, 95% CI:1.40-4.51, P = 0.002 and OR = 1.98, 95% = 1.14-3.48 P = 0.0145, respectively) and higher HOMA-IR (OR = 1.78, 95% CI:1.02-3.13, P = 0.041). CONCLUSION Our results demonstrated that a lower degree of PBMC L1 methylation is associated with excess body weight and higher HOMA-IR, especially in the presence of lower concentrations of plasma folate.
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Affiliation(s)
- Chandrika J Piyathilake
- The Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA.
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