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Arredondo Eve A, Tunc E, Mehta D, Yoo JY, Yilmaz HE, Emren SV, Akçay FA, Madak Erdogan Z. PFAS and their association with the increased risk of cardiovascular disease in postmenopausal women. Toxicol Sci 2024; 200:312-323. [PMID: 38758093 DOI: 10.1093/toxsci/kfae065] [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] [Indexed: 05/18/2024] Open
Abstract
Cardiovascular diseases (CVDs) are one of the major causes of death globally. In addition to traditional risk factors such as unhealthy lifestyles (smoking, obesity, sedentary) and genetics, common environmental exposures, including persistent environmental contaminants, may also influence CVD risk. Per- and polyfluoroalkyl substances (PFASs) are a class of highly fluorinated chemicals used in household consumer and industrial products known to persist in our environment for years, causing health concerns that are now linked to endocrine disruptions and related outcomes in women, including interference of the cardiovascular and reproductive systems. In postmenopausal women, higher levels of PFAS are observed than in premenopausal women due to the cessation of menstruation, which is crucial for PFAS excretion. Because of these findings, we explored the association between perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), and perfluorobutanesulfonic acid in postmenopausal women from our previously established CVD study. We used liquid chromatography with tandem mass spectrometry, supported by machine learning approaches, and the detection and quantification of serum metabolites and proteins. Here, we show that PFOS can be a good predictor of coronary artery disease, whereas PFOA can be an intermediate predictor of coronary microvascular disease. We also found that the PFAS levels in our study are significantly associated with inflammation-related proteins. Our findings may provide new insight into the potential mechanisms underlying the PFAS-induced risk of CVDs in this population. This study shows that exposure to PFOA and PFOS is associated with an increased risk of cardiovascular disease in postmenopausal women. PFOS and PFOA levels correlate with amino acids and proteins related to inflammation. These circulating biomarkers contribute to the etiology of CVD and potentially implicate a mechanistic relationship between PFAS exposure and increased risk of cardiovascular events in this population.
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Affiliation(s)
- Alicia Arredondo Eve
- Department of Food Science and Human Nutrition, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Elif Tunc
- Research and Training Hospital, Katip Celebi University, Izmir, 35310, Turkey
| | - Dhruv Mehta
- Department of Computer Science, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Jin Young Yoo
- Department of Food Science and Human Nutrition, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Huriye Erbak Yilmaz
- Research and Training Hospital, Katip Celebi University, Izmir, 35310, Turkey
- Izmir Biomedicine and Genome Center, Balcova, Izmir, 35340, Turkey
| | - Sadık Volkan Emren
- Research and Training Hospital, Katip Celebi University, Izmir, 35310, Turkey
| | | | - Zeynep Madak Erdogan
- Department of Food Science and Human Nutrition, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
- Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
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Pei L, Lai F, Chen W, Zeng R, Chen N, Li Y, Xiao H, Cao X. Pancreatic-derived factor predicts remission of impaired glucose tolerance women with history of gestational diabetes. Diabetes Res Clin Pract 2023; 204:110892. [PMID: 37657647 DOI: 10.1016/j.diabres.2023.110892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/16/2023] [Accepted: 08/30/2023] [Indexed: 09/03/2023]
Abstract
AIM To clarify whether pancreatic derived factor (PANDER) predicts the remission of impaired glucose tolerance (IGT) due to lifestyle intervention among women with history of gestational diabetes mellitus (GDM). METHODS IGT women with GDM history in a prospective cohort study were enrolled at 4-12 weeks postpartum and grouped based on PANDER level at recruitment. After lifestyle intervention, glucose metabolism examined was performed at one year postpartum. The relation between PANDER level and glycemic outcome was analyzed with logistic regression and receiver operating characteristic (ROC) curves. RESULTS In total, 48.7% (55/113) of subjects returned to normal glucose tolerance at one year postpartum. Compared to those with low PANDER group, women among high PANDER group and very high PANDER group were associated with a lower remission of IGT. These associations remained in multivariable logistic regression. The area under the ROC curve (AUC) of PANDER level for the remission of IGT was 0.702 (95% CI 0.595-0.809). When PANDER level was combined with clinical information, the AUC reached 0.812 (95% CI 0.725-0.899; P < 0.001). CONCLUSION Circulating PANDER concentration is inversely associated with the remission of IGT in women with GMD history at one year postpartum.
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Affiliation(s)
- Ling Pei
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fenghua Lai
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenzhan Chen
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rui Zeng
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Nan Chen
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanbing Li
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haipeng Xiao
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaopei Cao
- Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
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Zee B, Lee J, Lai M, Chee P, Rafferty J, Thomas R, Owens D. Digital solution for detection of undiagnosed diabetes using machine learning-based retinal image analysis. BMJ Open Diabetes Res Care 2022; 10:10/6/e002914. [PMID: 36549873 PMCID: PMC9809219 DOI: 10.1136/bmjdrc-2022-002914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Undiagnosed diabetes is a global health issue. Previous studies have estimated that about 24.1%-75.1% of all diabetes cases are undiagnosed, leading to more diabetic complications and inducing huge healthcare costs. Many current methods for diabetes diagnosis rely on metabolic indices and are subject to considerable variability. In contrast, a digital approach based on retinal image represents a stable marker of overall glycemic status. RESEARCH DESIGN AND METHODS Our study involves 2221 subjects for developing a classification model, with 945 subjects with diabetes and 1276 controls. The training data included 70% and the testing data 30% of the subjects. All subjects had their retinal images taken using a non-mydriatic fundus camera. Two separate data sets were used for external validation. The Hong Kong testing data contain 734 controls without diabetes and 660 subjects with diabetes, and the UK testing data have 1682 subjects with diabetes. RESULTS The 10-fold cross-validation using the support vector machine approach has a sensitivity of 92% and a specificity of 96.2%. The separate testing data from Hong Kong provided a sensitivity of 99.5% and a specificity of 91.1%. For the UK testing data, the sensitivity is 98.0%. The accuracy of the Caucasian retinal images is comparable with that of the Asian data. It implies that the digital method can be applied globally. Those with diabetes complications in both Hong Kong and UK data have a higher probability of risk of diabetes compared with diabetes subjects without complications. CONCLUSIONS A digital machine learning-based method to estimate the risk of diabetes based on retinal images has been developed and validated using both Asian and Caucasian data. Retinal image analysis is a fast, convenient, and non-invasive technique for community health applications. In addition, it is an ideal solution for undiagnosed diabetes prescreening.
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Affiliation(s)
- Benny Zee
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
- Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, People's Republic of China
| | - Jack Lee
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Maria Lai
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Peter Chee
- St. John Hospital, Hospital Authority of Hong Kong, Hong Kong, People's Republic of China
| | - James Rafferty
- Centre for Biomathematics, Swansea University, Swansea, Wales, UK
| | - Rebecca Thomas
- Biomedical Science, Swansea University, Swansea, Wales, UK
| | - David Owens
- Biomedical Science, Swansea University, Swansea, Wales, UK
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Fang F, Wang N, Yan S, Wang L, Lu Y, Li J, Li H, Pham G, Li C, Leng SX, Tian H. Impaired glucose tolerance predicts all-cause mortality among older men at high risk for cardiovascular disease in China. Prim Care Diabetes 2019; 13:495-504. [PMID: 30862424 DOI: 10.1016/j.pcd.2019.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 01/06/2023]
Abstract
AIMS To investigate the potential association between impaired glucose tolerance (IGT) and all-cause mortality among older men at high risk for cardiovascular disease (CVD) in China. METHODS In this prospective observational study, 460 older men aged ≥60 years were determined to have either IGT or normal glucose tolerance (NGT) based on an oral glucose tolerance test conducted between May 2005 and May 2007. IGT and NGT were diagnosed according to the 1999 WHO diagnostic criteria. All subjects were followed until March 2017. The primary outcome studied was all-cause mortality. Multivariate Cox models were used to estimate relative risk for all-cause mortality. RESULTS During a mean follow-up of 11.2 years, forty-three (21.4%) subjects in the IGT group and twenty-nine (11.2%) subjects in the NGT group died (HR 2.05, 95% CI 1.28-3.28, P=0.003). Multivariate Cox proportional-hazards analysis demonstated that IGT was significantly associated with increased risk for all-cause mortality, composite cardiovascular outcome, nonfatal stroke and heart failure after adjusting for potential confounding factors. Logistic regression analysis showed that IGT at baseline (P<0.05) rather than incident type 2 diabetes was a risk factor of all-cause mortality. CONCLUSIONS IGT was significantly associated with all-cause mortality in older Chinese men at high risk for CVD.
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Affiliation(s)
- Fusheng Fang
- Department of Health Care, Chinese PLA General Hospital, Beijing, China; Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ning Wang
- Department of Health Care, Chinese PLA General Hospital, Beijing, China
| | - Shuangtong Yan
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Liangchen Wang
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Yanhui Lu
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Jian Li
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Huifen Li
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gabriel Pham
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chunlin Li
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Sean Xiao Leng
- Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Hui Tian
- Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China.
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Flanagan TW, Sebastian MN, Battaglia DM, Foster TP, Maillet EL, Nichols CD. Activation of 5-HT 2 Receptors Reduces Inflammation in Vascular Tissue and Cholesterol Levels in High-Fat Diet-Fed Apolipoprotein E Knockout Mice. Sci Rep 2019; 9:13444. [PMID: 31530895 PMCID: PMC6748996 DOI: 10.1038/s41598-019-49987-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/25/2019] [Indexed: 01/14/2023] Open
Abstract
Coronary artery disease (CAD) is a progressive cardiovascular syndrome characterized by cholesterol-induced focal arterial lesions that impair oxygen delivery to the heart. As both innate and adaptive immune cells play critical roles in the formation and progression of arterial plaques and endothelial cell dysfunction, CAD is commonly viewed as a chronic inflammatory disorder. Our lab has previously discovered that 5-HT2A receptor activation with the 5-HT2 receptor selective agonist (R)-2,5-dimethoxy-4-iodoamphetamine [(R)-DOI] has potent anti-inflammatory activity in both cell culture and whole animal models. Here we have examined the putative therapeutic effects of (R)-DOI in the ApoE−/− high fat model of cardiovascular disease. Subcutaneously implanted osmotic minipumps were used to infuse sustained low rates (0.15 μg / hr) of (R)-DOI∙HCl to mice fed a high-fat “Western” diet. (R)-DOI treated mice had significant reductions in expression levels of mRNA for inflammatory markers like Il6 in vascular tissue, normalized glucose homeostasis, and reduced circulating cholesterol levels. As cardiovascular disease is a leading cause of death both globally and in the Western world, activation of 5-HT2A receptors at sub-behavioral levels may represent a new strategy to treat inflammation-based cardiovascular disease.
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Affiliation(s)
- Thomas W Flanagan
- Department of Pharmacology and Experimental Therapeutics Louisiana State University Health Sciences Center 1901 Perdido St, New Orleans, LA, 70112, USA
| | - Melaine N Sebastian
- Department of Pharmacology and Experimental Therapeutics Louisiana State University Health Sciences Center 1901 Perdido St, New Orleans, LA, 70112, USA
| | - Diana M Battaglia
- Department of Microbiology, Immunology, and Parasitology Louisiana State University Health Sciences Center 1901 Perdido St, New Orleans, LA, 70112, USA
| | - Timothy P Foster
- Department of Microbiology, Immunology, and Parasitology Louisiana State University Health Sciences Center 1901 Perdido St, New Orleans, LA, 70112, USA
| | - Emeline L Maillet
- Eleusis Benefit Corporation 11 East 44th St., Suite 104, New York, NY, 10017, USA
| | - Charles D Nichols
- Department of Pharmacology and Experimental Therapeutics Louisiana State University Health Sciences Center 1901 Perdido St, New Orleans, LA, 70112, USA.
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Wang S, Li G, Zuo H, Yang H, Ma L, Feng J, Niu Y, Ma L, Liu S, Qi T, Liu X. Association of insulin, C-peptide and blood lipid patterns in patients with impaired glucose regulation. BMC Endocr Disord 2019; 19:75. [PMID: 31307454 PMCID: PMC6631747 DOI: 10.1186/s12902-019-0400-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To investigate any associations between blood glucose (BG) and lipid levels in patients with different glucose tolerance statuses, including type 2 diabetes (T2DM) and impaired glucose regulation (IGR) cases as well as normal glucose tolerance (NGT) individuals. METHODS A total of 354 participants were recruited to this study including 174 in the T2DM group, 112 in the IGR group and 68 in the NGT group. We compared BG, insulin and C-peptide (CP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) serum levels during a 3 h oral glucose tolerance test (OGTT) in the 3 groups. RESULTS Basic overall HbA1c serum concentration percentages were 5.52, 6.33 and 9.76% for the NTG, IGR and T2DM cases. During the OGTT, insulin secretion in the IGR group was almost double that of the T2DM group. CP levels were highest in the IGR patients and OGTT related BG concentrations were highest in the T2DM group followed by IGR, but in the IGR group hyperglycemia was less pronounced than in T2DM patients (P < 0.001). Compared to the NGT group, TC, TG and LDL-C serum concentrations were significantly higher (P ≤ 0.001) and HDL-C concentrations were significantly lower (P ≤ 0.001) in IGR and T2DM cases compared to the NTG group. CONCLUSIONS IGR led to similar unfavorable blood lipid patterns compared with T2DM patients and an imbalance of insulin and CP serum concentrations during an OGTT.
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Affiliation(s)
- Shujin Wang
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Guohong Li
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Hong Zuo
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Hua Yang
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Lei Ma
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Jia Feng
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Yu Niu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Liming Ma
- Department of Clinical laboratory, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Songfang Liu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Ting Qi
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
| | - Xufeng Liu
- Department of Endocrinology, Ninth Hospital of Xi’an, No. 151 South Second Ring Road, Xi’an, Shaanxi 710054 China
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Abudawood M, Tabassum H, Ansar S, Almosa K, Sobki S, Ali MN, Aljohi A. Assessment of gender-related differences in vitamin D levels and cardiovascular risk factors in Saudi patients with type 2 diabetes mellitus. Saudi J Biol Sci 2018; 25:31-36. [PMID: 29379353 PMCID: PMC5775082 DOI: 10.1016/j.sjbs.2017.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 03/14/2017] [Accepted: 04/02/2017] [Indexed: 12/13/2022] Open
Abstract
Diabetes is a major risk factor for cardiovascular disease (CVD) including stroke, coronary heart disease, and peripheral artery disease. It remains a leading cause of mortality throughout the world, affecting both women and men. This investigation was aimed to study gender based differences in cardiovascular risk factors of adult population with type-2 diabetes mellitus (T2DM) and to check the correlation between serum HbA1C, lipid profile and serum vitamin D levels, in T2DM patients of Riyadh, Saudi Arabia. This hospital-based cross-sectional study involving subjects was divided into two gender based groups; normal male (800), diabetic male (800) and normal female (800) and T2DM females (800). Blood samples were analyzed for fasting glucose (FBG), HbA1c, total cholesterol (TC), triglycerides (Tg), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and serum levels of 25(OH)-vitamin D in all groups. All the glycemic control parameters and lipid profile parameters were found to be significantly different in diabetic vs non-diabetic group (p < 0.001) in both genders. The results also show that vitamin D concentration decreased significantly (p < 0.001) in diabetic patients than the healthy individuals in both the genders. Vitamin-D and HbA1C were negatively correlated in both males and females in T2DM patients and significant at P < 0.05. Our study reveals that dyslipidemia remains one of the major risk factors of CVD in T2DM. In addition to dyslipidemia, decreased levels of vitamin-D associated with increased HbA1C alarms the early diagnosis of Type 2 Diabetes.
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Affiliation(s)
- Manal Abudawood
- Department of Clinical Laboratory Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Hajera Tabassum
- Department of Clinical Laboratory Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sabah Ansar
- Department of Clinical Laboratory Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Khalid Almosa
- Center for Health Studies, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Samia Sobki
- Central Military Laboratory & Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mir Naiman Ali
- Department of Microbiology, Mumtaz Degree & P.G. College, Hyderabad, India
| | - Ali Aljohi
- Central Military Laboratory & Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Gomez-Arbelaez D, Sánchez-Vallejo G, Perez M, Garcia RG, Arguello JF, Peñaherrera E, Duarte YC, Casanova ME, Accini JL, Sotomayor A, Camacho PA, Lopez-Jaramillo P. [Hyperglycaemia is associated with worse outcomes in Latin-American individuals with acute myocardial infarction]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28:9-18. [PMID: 26596523 DOI: 10.1016/j.arteri.2015.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/15/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Alterations in glucose metabolism have been reported as risk and poor prognostic factors for acute myocardial infarction (AMI); however in Latin-American population this information is limited. Thus, an evaluation was performed on the association between glycaemic status and short- and long-term outcomes in patients with a first AMI. METHODS A multicentre, prospective, observational, cohort study was conducted in 8 hospitals from Colombia and Ecuador. RESULTS A total of 439 patients with confirmed AMI were included, of which 305 (69.5%) had prediabetes or type2 diabetes mellitus (DM2). Compared with normal glycaemia group, patients with known DM2 had greater risk of prolonged hospital stay (HR: 2.60, 95%CI: 1.38-4.92, P=.003), Killip class iii/iv (HR: 9.46, 95%CI: 2.20-40.62, P=.002), and in-hospital heart failure (HR: 10.76, 95%CI: 3.37-34.31, P<.001). Patients with prediabetes, new DM2, and known DM2 showed higher rates of major adverse cardiovascular events after 3years follow-up. CONCLUSION Glucose metabolism abnormalities have an important significance in the short- and long-term prognosis in Latin-American patients that survive a first AMI.
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Affiliation(s)
- Diego Gomez-Arbelaez
- Fundación Oftalmológica de Santander-FOSCAL, Floridablanca, Colombia; Instituto de Investigaciones MASIRA, Facultad de Medicina, Universidad de Santander-UDES, Bucaramanga, Colombia; División de Endocrinología, Escuela de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Gregorio Sánchez-Vallejo
- Universidad del Quindío, Hospital San Juan de Dios, Fundación Cardiomet-Cequin, Armenia, Colombia
| | - Maritza Perez
- Departamento de Medicina Interna, Universidad Militar Nueva Granada, Bogotá, Colombia
| | - Ronald Gerardo Garcia
- Instituto de Investigaciones MASIRA, Facultad de Medicina, Universidad de Santander-UDES, Bucaramanga, Colombia; Fundación Cardiovascular de Colombia-FCV , Floridablanca, Colombia
| | | | | | | | | | - Jose Luis Accini
- Unidad de Cuidados Intensivos, Clínica Jaller, Universidad Libre, Barranquilla, Colombia
| | | | | | - Patricio Lopez-Jaramillo
- Fundación Oftalmológica de Santander-FOSCAL, Floridablanca, Colombia; Instituto de Investigaciones MASIRA, Facultad de Medicina, Universidad de Santander-UDES, Bucaramanga, Colombia.
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Buysschaert M, Medina JL, Bergman M, Shah A, Lonier J. Prediabetes and associated disorders. Endocrine 2015; 48:371-93. [PMID: 25294012 DOI: 10.1007/s12020-014-0436-2] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 09/20/2014] [Indexed: 12/14/2022]
Abstract
Prediabetes represents an elevation of plasma glucose above the normal range but below that of clinical diabetes. Prediabetes includes individuals with IFG, IGT, IFG with IGT and elevated HbA1c levels. Insulin resistance and β-cell dysfunction are characteristic of this disorder. The diagnosis of prediabetesis is vital as both IFG and IGT are indeed well-known risk factors for type 2 diabetes with a greater risk in the presence of combined IFG and IGT. Furthermore, as will be illustrated in this review, prediabetes is associated with associated disorders typically only considered in with established diabetes. These include cardiovascular disease, periodontal disease, cognitive dysfunction, microvascular disease, blood pressure abnormalities, obstructive sleep apnea, low testosterone, metabolic syndrome, various biomarkers, fatty liver disease, and cancer. As the vast majority of individuals with prediabetes are unaware of their diagnosis, it is therefore vital that the associated conditions are identified, particularly in the presence of mild hyperglycemia, so they may benefit from early intervention.
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Affiliation(s)
- Martin Buysschaert
- Department of Endocrinology and Diabetology, University Clinic Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Sebai H, Selmi S, Rtibi K, Gharbi N, Sakly M. Protective Effect ofLavandula stoechasandRosmarinus officinalisEssential Oils Against Reproductive Damage and Oxidative Stress in Alloxan-Induced Diabetic Rats. J Med Food 2015; 18:241-9. [DOI: 10.1089/jmf.2014.0040] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Hichem Sebai
- Laboratoire de Physiologie Intégrée, Faculté des Sciences de Bizerte, Zarzouna, Tunisia
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, Béja, Tunisia
| | - Slimen Selmi
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, Béja, Tunisia
- Laboratoire de Physiologie Animale, Département des Sciences de la Vie, Faculté des Sciences de Tunis, Tunis, Tunisia
| | - Kais Rtibi
- Laboratoire de Nutrition et Physiologie Animale, Institut Supérieur de Biotechnologie de Béja, Béja, Tunisia
| | - Najoua Gharbi
- Laboratoire de Physiologie Animale, Département des Sciences de la Vie, Faculté des Sciences de Tunis, Tunis, Tunisia
| | - Mohsen Sakly
- Laboratoire de Physiologie Intégrée, Faculté des Sciences de Bizerte, Zarzouna, Tunisia
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Liu Y, Li J, Zhang Z, Tang Y, Chen Z, Wang Z. Endocrinological analysis of endothelium-dependent vasodilation in middle-aged patients with impaired glucose tolerance during prediabetes mellitus. Exp Ther Med 2014; 7:697-702. [PMID: 24520270 PMCID: PMC3919930 DOI: 10.3892/etm.2014.1482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 12/20/2013] [Indexed: 12/20/2022] Open
Abstract
Impaired glucose tolerance (IGT) is a pre-diabetic metabolic state involving heterogeneous and dynamic changes between the normal and diabetic state. The present study aimed to investigate the endocrine regulation of endothelium-dependent dysfunction in middle-aged patients with IGT and in patients with a normal glucose tolerance (NGT). An oral glucose tolerance test was performed to determine the NGT and IGT states. Physiological and biochemical analyses were performed. The carotid artery structure and function were investigated with Doppler supersonic diagnostic equipment. The functioning of the vascular endothelium was analyzed with physiological and biochemical indices in the IGT group. The results showed a significant reduction in endothelium-dependent vasodilation, but not in endothelium-independent vasodilation in the IGT group compared with those of the NGT group. It was identified that the intima-media thickness of the carotid artery and expression levels of endothelin-1 were significantly higher, whereas the endothelium-derived factor C-type natriuretic peptide levels were significantly lower in the IGT group compared with those in the NGT group. Notably, significant correlations were identified between endocrinological changes and body composition, including fat and glucose metabolism, in the IGT group. Our data indicate that vascular endothelial functions may be impaired by fat and glucose metabolism and body composition in IGT patients during prediabetes mellitusare.
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Affiliation(s)
- Yiping Liu
- Laboratory of Sport Physiology and Biomedicine, School of Physical Education and Sport Sciences, College of Life Sciences, Fujian Normal University, Fuzhou, Fuijian 350007, P.R. China ; Provincial Key Laboratory for Developmental Biology and Neurosciences, College of Life Sciences, Fujian Normal University, Fuzhou, Fuijian 350007, P.R. China
| | - Jianwei Li
- Department of Ultrasound, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Zhenghong Zhang
- Provincial Key Laboratory for Developmental Biology and Neurosciences, College of Life Sciences, Fujian Normal University, Fuzhou, Fuijian 350007, P.R. China
| | - Yedong Tang
- Provincial Key Laboratory for Developmental Biology and Neurosciences, College of Life Sciences, Fujian Normal University, Fuzhou, Fuijian 350007, P.R. China
| | - Zuosong Chen
- Laboratory of Sport Physiology and Biomedicine, School of Physical Education and Sport Sciences, College of Life Sciences, Fujian Normal University, Fuzhou, Fuijian 350007, P.R. China
| | - Zhengchao Wang
- Provincial Key Laboratory for Developmental Biology and Neurosciences, College of Life Sciences, Fujian Normal University, Fuzhou, Fuijian 350007, P.R. China
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Monday OM, Uzoma AI. Histological changes and antidiabetic activities of Icacina trichantha tuber extract in beta-cells of alloxan induced diabetic rats. Asian Pac J Trop Biomed 2013; 3:628-33; discussion 633. [PMID: 23905020 PMCID: PMC3703556 DOI: 10.1016/s2221-1691(13)60127-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 07/15/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To investigate the antidiabetic, hypolipidaemic activities and histopathological changes of Icacina trichantha (I. trichantha) tuber extract in alloxan induced diabetic rats. METHODS In the present study, 80% methanol extract of I. trichantha tuber was tested on alloxan induced diabetic rats. They were randomly grouped into control (distilled water and glibenclamide) and experimental (200, 400 and 600 mg/kg body weight). Diabetes was induced by a single intraperitoneal injection of 160 mg/kg body weight of alloxan. Blood glucose levels were measured using blood glucose test strips with AccuCheck Advantage II glucometer at 1, 3, 6, and 24 h on the first day and 1 h after treatment on Day 7, 14 and 21. Blood samples were collected and centrifuged to separate serum for estimation of lipid profile and other biochemical parameters. Histopathological changes in diabetic rats pancreas were also studied after extract treatment. RESULTS Daily oral administration of I. trichantha tuber extract (200, 400, and 600 mg/kg body weight) and glibenclamide (2 mg/kg) showed beneficial effects on blood glucose level (P<0.01) as well as improving liver, kidney functions and hyperlipidaemia due to diabetes. The extract had a favourable effect on the histopathological changes of the pancreas in alloxan induced diabetes. CONCLUSIONS I. trichantha tuber extracts posses antidiabetic activities as well as improve liver and renal profile and total lipids levels. I. trichantha tuber extracts also have favourable effects to inhibit the histopathological changes of the pancreas in alloxan induced diabetes.
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Affiliation(s)
- Onakpa Michael Monday
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Abuja, PMB 117, Abuja, Nigeria.
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Liu Y, Li J, Zhang Z, Tang Y, Chen Z, Wang Z. Effects of exercise intervention on vascular endothelium functions of patients with impaired glucose tolerance during prediabetes mellitus. Exp Ther Med 2013; 5:1559-1565. [PMID: 23837031 PMCID: PMC3702621 DOI: 10.3892/etm.2013.1064] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 03/19/2013] [Indexed: 12/23/2022] Open
Abstract
Endothelial dysfunction (ED) is an early pathophysiological change in patients with impaired glucose tolerance (IGT) during prediabetes mellitus. This study was designed to test the hypothesis that exercise intervention contributes to the reversal of vascular endothelium-dependent dysfunction in middle-aged patients with IGT. Following exercise intervention, significant changes in endothelin (ET)-1, C-type natriuretic peptide (CNP), ΔDia-P, oral glucose tolerance test (OGTT)2h, fasting insulin, homeostasis model of assessment-insulin resistance (HOMA-IR), body fat percentage, waist circumference and waist to hip ratio were measured. However, no marked changes in carotid artery intima-media thickness (IMT), fasting blood glucose and BMI were observed following exercise intervention. Validity analysis of index changes in the two exercise intervention groups further confirmed there was no change. Exercise intervention increased CNP levels, decreased ET-1 levels and increased ΔDia-P, indicating improved vascular endothelium function. Decreased HOMA-IR following exercise suggests enhanced insulin sensitivity. Exercise intervention also improved glucose metabolism via decreased OGTT2h and fasting insulin. In addition, decreased waist circumference, ratio of waist to hip and body fat percentage following exercise intervention improved changes of body composition, including BMI, body fat and waist circumference. These results indicate that exercise intervention may reverse vascular endothelium-dependent dysfunction in middle-aged patients with IGT. This study also provided direct clinical data supporting the use of exercise intervention to prevent diabetes mellitus (DM) during the early stage.
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Affiliation(s)
- Yiping Liu
- Laboratory of Sport Physiology and Biomedicine, School of Physical Education and Sport Sciences, Fuzhou, Fujian 350007; ; Provincial Key Laboratory for Developmental Biology and Neurosciences, College of Life Sciences, Fujian Normal University, Fuzhou, Fujian 350007
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Gemfibrozil and its combination with metformin on pleiotropic effect on IL-10 and adiponectin and anti-atherogenic treatment in insulin resistant type 2 diabetes mellitus rats. Inflammopharmacology 2012; 21:137-45. [DOI: 10.1007/s10787-012-0154-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2012] [Accepted: 10/08/2012] [Indexed: 11/25/2022]
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Doerr R, Hoffmann U, Otter W, Heinemann L, Hunger-Battefeld W, Kulzer B, Klinge A, Lodwig V, Amann-Zalan I, Sturm D, Tschoepe D, Spitzer SG, Stumpf J, Lohmann T, Schnell O. Oral glucose tolerance test and HbA₁c for diagnosis of diabetes in patients undergoing coronary angiography: [corrected] the Silent Diabetes Study. Diabetologia 2011; 54:2923-30. [PMID: 21773683 DOI: 10.1007/s00125-011-2253-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 06/21/2011] [Indexed: 10/18/2022]
Abstract
AIMS/HYPOTHESIS The primary aim of this study was to compare the results of HbA(1c) measurements with those of an OGTT for early diagnosis of 'silent diabetes' in patients with coronary artery disease (CAD) undergoing angiography without prediagnosed diabetes. A secondary aim was to investigate the correlation between the extent of CAD and the glycaemic status of the patient. METHODS Data from 1,015 patients admitted for acute (n = 149) or elective (n = 866) coronary angiography were analysed. Patients with known diabetes were excluded from the study. Using the OGTT results, patients were classified as having normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or diabetes. According to the results of the HbA(1c) measurements, patients were classified into three groups: normal (HbA(1c) <5.7% [<39 mmol/mol]), borderline (HbA(1c) 5.7-6.4% [39-47 mmol/mol]) and diabetes (HbA(1c) ≥6.5% [≥48 mmol/mol]). RESULTS Based on the OGTT, 513 patients (51%) were classified with NGT, 10 (1%) with IFG, 349 (34%) with IGT and 149 (14%) were diagnosed with diabetes. According to HbA(1c) measurements, 588 patients (58%) were classified as normal, 385 (38%) as borderline and 42 (4%) were diagnosed with diabetes. The proportion of patients with IGT and diabetes increased with the extent of CAD (IGT ρ = 0.14, p < 0.001, diabetes ρ = 0.09, p = 0.01). No differences in HbA(1c) were seen among the groups with different extents of CAD (p = 0.652). CONCLUSIONS/INTERPRETATION An OGTT should be performed routinely for diagnosis of diabetes in patients with CAD undergoing coronary angiography, since HbA(1c) measurement alone appears to miss a substantial proportion of patients with silent diabetes. A limitation of the study is that the OGTT was not performed before the angiography.
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Affiliation(s)
- R Doerr
- Praxisklinik Herz und Gefaesse, Dresden, Germany
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Ndong M, Uehara M, Katsumata SI, Suzuki K. Effects of Oral Administration of Moringa oleifera Lam on Glucose Tolerance in Goto-Kakizaki and Wistar Rats. J Clin Biochem Nutr 2011; 40:229-33. [PMID: 18398501 PMCID: PMC2275769 DOI: 10.3164/jcbn.40.229] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Accepted: 12/27/2006] [Indexed: 11/22/2022] Open
Abstract
Medicinal plants constitute an important source of potential therapeutic agents for diabetes. In the present study, we investigated the effects of Moringa oleifera (MO) Lam, Moringacea, on glucose tolerance in Wistar rats and Goto-Kakizaki (GK) rats, modeled type 2 diabetes. Major polyphenols in MO powder were quercetin glucosides, rutin, kaempferol glycosides and chlorogenic acids by HPLC analysis. As the results of glucose tolerance test, MO significantly decreased the blood glucose at 20, 30, 45and 60 min for GK rats and at 10, 30 and 45 min for Wistar rats (p<0.05) compared to the both controls after glucose administration. The area under the curve of changes in the blood glucose was significantly higher in the GK control group than in the GK plus MO group (p<0.05) in the periods 30–60 min and 60–120 min. Furthermore, MO significantly decreased stomach emptying in GK rats (p<0.05). The results indicated that MO has an ameliorating effect for glucose intolerance, and the effect might be mediated by quercetin-3-glucoside and fiber contents in MO leaf powder. The action of MO was greater in GK rats than in Wistar rats.
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Affiliation(s)
- Moussa Ndong
- Department of Nutritional Science, Faculty of Applied Bioscience, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan
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Abnormalities in circadian blood pressure variability and endothelial function: pragmatic markers for adverse cardiometabolic profiles in asymptomatic obese adults. Cardiovasc Diabetol 2010; 9:58. [PMID: 20868493 PMCID: PMC2955642 DOI: 10.1186/1475-2840-9-58] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 09/24/2010] [Indexed: 02/01/2023] Open
Abstract
Background Cardiovascular disease (CVD) risk, although perceived to be high, is often difficult to demonstrate in disease free (healthy) obese adults. Hypothesis Changes in circadian blood pressure variability (CBPV) and endothelial function (EF) may be early correlates of cardiometabolic disorders. Methods Asymptomatic men and women in 3 groups: normal weight (n = 10), overweight (n = 10) and obese (n = 15) were evaluated. Blood pressure and heart rate were recorded over 7 days: every 30 minutes during the day and every 60 minutes during the night, by automatic ambulatory monitoring. Resting EF was assessed in a fasting state between 8-10 AM by brachial ultrasound. Anthropometric and cardiometabolic indicators were measured and correlations with CBPV and EF were investigated. Results The 3 groups had (Mean(SD)) BMI: 22.6(1.6), 27(3) and 34(5) kg/m2, respectively, weight: 64(16), 79(14), 95(16) kg and waist circumference: 79(9), 93(10), 107(13) cm. None in normal-weight or overweight groups had abnormal CBPV, while 8 of 15 obese adults had one or more CBPV abnormities (p < 0.05). Obese adults with CBPV abnormalities had elevated hs-CRP (15.3(9.3) mg/L), fibrinogen (593(97) mg/dl), fasting serum glucose (102(16) mg/dL), and cardiac risk ratios (Total-C/HDL-C: 5.2(1.9), LDL-C/HDL-C: 3.1(1.4)). Adults in the 3 respective groups who did not have CBPV abnormalities had flow-mediated brachial artery dilatation (FMD) of 0.22(0.06); 0.20(0.04), 0.23(0.02) mm over resting diameter. Obese participants with CBPV abnormalities (Mesor-hypotension, circadian hyper amplitude tension, elevated pulse pressure), had attenuated FMD at 78, 52, and 56% of resting reference diameter (means 0.18(0.07), 0.12(0.08), and 0.13(0.05) mm; p < 0.05), respectively. Conclusions Asymptomatic obese adults with abnormal CBPV and EF exhibit unfavorable cardiometabolic profiles.
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Kumari U, Heese K. Cardiovascular dementia - a different perspective. Open Biochem J 2010; 4:29-52. [PMID: 20448820 PMCID: PMC2864432 DOI: 10.2174/1874091x01004010029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Revised: 01/12/2010] [Accepted: 01/22/2010] [Indexed: 02/08/2023] Open
Abstract
The number of dementia patients has been growing in recent years and dementia represents a significant threat to aging people all over the world. Recent research has shown that the number of people affected by Alzheimer's disease (AD) and dementia is growing at an epidemic pace. The rapidly increasing financial and personal costs will affect the world's economies, health care systems, and many families. Researchers are now exploring a possible connection among AD, vascular dementia (VD), diabetes mellitus (type 2, T2DM) and cardiovascular diseases (CD). This correlation may be due to a strong association of cardiovascular risk factors with AD and VD, suggesting that these diseases share some biologic pathways. Since heart failure is associated with an increased risk of AD and VD, keeping the heart healthy may prove to keep the brain healthy as well. The risk for dementia is especially high when diabetes mellitus is comorbid with severe systolic hypertension or heart disease. In addition, the degree of coronary artery disease (CAD) is independently associated with cardinal neuropathological lesions of AD. Thus, the contribution of T2DM and CD to AD and VD implies that cardiovascular therapies may prove useful in preventing AD and dementia.
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Affiliation(s)
- Udhaya Kumari
- Division of Cell and Molecular Biology, School of Biological Sciences, College of Science, Nanyang Technological University, 60 Nanyang Drive, Singapore 637551
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Miyamura M, Schnell O, Yamashita C, Yoshioka T, Matsumoto C, Mori T, Ukimura A, Kitaura Y, Matsumura Y, Ishizaka N, Hayashi T. Effects of Acarbose on the Acceleration of Postprandial Hyperglycemia–Induced Pathological Changes Induced by Intermittent Hypoxia in Lean Mice. J Pharmacol Sci 2010; 114:32-40. [DOI: 10.1254/jphs.10014fp] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Schnell O, Otter W, Standl E. The Munich Myocardial Infarction Registry: translating the European Society of Cardiology (ESC) and European Association for the Study of Diabetes (EASD) guidelines on diabetes, pre-diabetes, and cardiovascular disease into clinical practice. Diabetes Care 2009; 32 Suppl 2:S326-30. [PMID: 19875574 PMCID: PMC2811455 DOI: 10.2337/dc09-s332] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Oliver Schnell
- 1Diabetes Research Institute, Munich/Neuherberg, Germany.
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Thorisdottir RL, Parkner T, Chen JW, Ejskjaer N, Christiansen J. A Comparison of Pharmacokinetics and Pharmacodynamics of Biphasic Insulin Aspart 30, 50, 70 and Pure Insulin Aspart: A Randomized, Quadruple Crossover Study. Basic Clin Pharmacol Toxicol 2009; 104:216-21. [DOI: 10.1111/j.1742-7843.2008.00355.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Blood pressure (BP) exhibits a circadian variation characterized by a morning increase, followed by a small postprandial valley and a deeper descent during nocturnal rest. Although abnormal 24-h variability (abnormal circadian variability (ACV)) predicts adverse cardiovascular disease (CVD) outcomes, a 7-day automatic ambulatory BP monitoring (ABPM) and subsequent chronobiologic analysis of the gathered data, permits identification of consistency of any abnormal circadian variation. To test whether normal overweight healthy men and women with prediabetes differed from subjects with normoglycemia in having ACV with a 7-day ABPM. Consent for a 7-day ABPM was obtained from subjects with family history of diabetes mellitus, who were participating in the screening phase for a randomized, double blind, placebo-controlled weight loss trial in prediabetics to prevent progression to diabetes mellitus. The automatic 7-day ABPM device recorded BP and heart rate every 30 min during the day and every 60 min during the night. Normoglycemic and prediabetic subjects matched for age, sex, race, BP, BMI, waist circumference and glycemic control, differed statistically significantly only in their fasting and/or 2-h postprandial serum glucose concentrations. Chronobiologically-interpreted 7-day ABPM uncovered no abnormalities in normoglycemics, whereas prediabetics had a statistically significantly higher incidence of high mean BP (MESOR-hypertension), excessive pulse pressure and/or circadian hyper-amplitude-tension (CHAT) (P<0.001). ACV detected with 7-day ABPM may account for the enhanced CVD risk in prediabetes. These findings provide a basis for larger-scale studies to assess the predictive value of 7-day ABPM over the long term.
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Garlic (Allium sativum) and ginger (Zingiber officinale) attenuate structural nephropathy progression in streptozotocin-induced diabetic rats. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.eclnm.2007.12.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Standl E, Schnell O. Insulin as a first-line therapy in type 2 diabetes: should the use of sulfonylureas be halted? Diabetes Care 2008; 31 Suppl 2:S136-9. [PMID: 18227474 DOI: 10.2337/dc08-s234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Eberhard Standl
- Munich Diabetes Research Institute, Kölner Pl.1, D-80804 Munich, Germany.
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Alhassan S, Kiazand A, Balise RR, King AC, Reaven GM, Gardner CD. Metabolic syndrome: do clinical criteria identify similar individuals among overweight premenopausal women? Metabolism 2008; 57:49-56. [PMID: 18078858 PMCID: PMC2254306 DOI: 10.1016/j.metabol.2007.08.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2006] [Accepted: 08/20/2007] [Indexed: 12/15/2022]
Abstract
The purpose of this analysis was to determine to what extent the clinical criteria for metabolic syndrome (MetSyn) proposed by the World Health Organization (WHO), the European Group for Study of Insulin Resistance (EGIR), the National Cholesterol Education Program Adult Treatment Panel III (ATP III), and the International Diabetes Foundation (IDF); triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio >/=3.0; and enlarged waist circumference (>/=88 cm) and elevated TG (>/=129 mg/dL) (EWET) identified similar or different overweight women and, secondarily, to examine the effect of 7% weight reduction on MetSyn status. Metabolic syndrome was determined among 256 premenopausal women (age = 41 +/- 6 years, body mass index [BMI] = 32 +/- 4 kg/m(2)) participating in a dietary weight loss clinical trial based on the clinical criteria proposed by WHO, EGIR, ATP III, and IDF. The prevalence of TG/HDL-C ratio >/=3.0 and EWET was determined and compared with MetSyn status. Based on the clinical criteria, 16.1% (EGIR), 20.7% (WHO), 31.0% (ATP III), and 31.8% (IDF) of participants met the criteria for MetSyn; 30.3% and 31.8% had TG/HDL-C >/=3.0 and EWET, respectively. Between 77% and 99% of participants were similarly classified across the clinical criteria. The highest and lowest agreements were between ATP III and IDF (kappa = 0.98; 95% confidence interval, 0.96-1.0) and WHO and IDF (kappa = 0.39; 95% confidence interval, 0.26-0.51), respectively. The TG/HDL-C ratio >/=3.0 and EWET moderately agreed with all 4 clinical criteria for MetSyn (kappa range, 0.36-0.59). Among those diagnosed with MetSyn at baseline, 64.0% to 75.0% of the participants who lost >/=7% and 25.8% to 55.6% of participants who lost <7% of their baseline body weight in 6 months no longer met the various clinical criteria for MetSyn, TG/HDL-C >/=3.0, or EWET. Our findings indicate that MetSyn varies substantially between clinical criteria, which raise questions about the clinical utility of these criteria. Regardless of MetSyn clinical criteria, >/=7% reduction in body weight has a beneficial impact on variables used to define MetSyn.
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Affiliation(s)
- Sofiya Alhassan
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA 94305, USA.
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White J, Guerin T, Swanson H, Post S, Zhu H, Gong M, Liu J, Everson WV, Li XA, Graf GA, Ballard HO, Ross SA, Smart EJ. Diabetic HDL-associated myristic acid inhibits acetylcholine-induced nitric oxide generation by preventing the association of endothelial nitric oxide synthase with calmodulin. Am J Physiol Cell Physiol 2008; 294:C295-305. [DOI: 10.1152/ajpcell.00042.2007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In the current study, we examined whether diabetes affected the ability of HDL to stimulate nitric oxide (NO) production. Using HDL isolated from both diabetic humans and diabetic mouse models, we found that female HDL no longer induced NO synthesis, despite containing equivalent amounts of estrogen as nondiabetic controls. Furthermore, HDL isolated from diabetic females and males prevented acetylcholine-induced stimulation of NO generation. Analyses of both the human and mouse diabetic HDL particles showed that the HDLs contained increased levels of myristic acid. To determine whether myristic acid associated with HDL particles was responsible for the decrease in NO generation, myristic acid was added to HDL isolated from nondiabetic humans and mice. Myristic acid-associated HDL inhibited the generation of NO in a dose-dependent manner. Importantly, diabetic HDL did not alter the levels of endothelial NO synthase or acetylcholine receptors associated with the cells. Surprisingly, diabetic HDL inhibited ionomycin-induced stimulation of NO production without affecting ionomycin-induced increases in intracellular calcium. Further analysis indicated that diabetic HDL prevented calmodulin from interacting with endothelial NO synthase (eNOS) but did not affect the activation of calmodulin kinase or calcium-independent mechanisms for stimulating eNOS. These studies are the first to show that a specific fatty acid associated with HDL inhibits the stimulation of NO generation. These findings have important implications regarding cardiovascular disease in diabetic patients.
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Perriello G, Pampanelli S, Brunetti P, di Pietro C, Mariz S. Long-term effects of pioglitazone versus gliclazide on hepatic and humoral coagulation factors in patients with type 2 diabetes. Diab Vasc Dis Res 2007; 4:226-30. [PMID: 17907113 DOI: 10.3132/dvdr.2007.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This study compared the long-term effects of pioglitazone and gliclazide on the production of coagulation factors in patients with type 2 diabetes. Patients (n=283) with glycosylated haemoglobin > 7.5% were randomised to receive either pioglitazone (30-45 mg/day) or gliclazide (80-320 mg/day) for one year. Coagulation factors were measured at baseline and at six and 12 months. While both pioglitazone and gliclazide induced a comparable improvement in glycaemic control, only pioglitazone improved insulin sensitivity. Pioglitazone significantly (p < or = 0.001) decreased circulating levels of von Willebrand factor (-9.7%, -9.4%) and plasminogen activator inhibitor-1 (-16.8 ng/ml, -12.3 ng/ml), and increased levels of antithrombin-III (+1.3 mg/dL, +1.5 mg/dL) after six and 12 months, respectively. The beneficial effects of pioglitazone on glycaemic control, lipid homeostasis, and coagulation and thrombosis, may improve vascular outcomes in patients with type 2 diabetes.
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Affiliation(s)
- Gabriele Perriello
- Section of Internal Medicine, Endocrinology and Metabolism, Department of Internal Medicine, University of Perugia, Perugia, Italy.
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Julius U, Jauhiainen M, Ehnholm C, Pietzsch J. Lipid transfer protein activities in subjects with impaired glucose tolerance. Clin Chem Lab Med 2007; 45:237-43. [PMID: 17311515 DOI: 10.1515/cclm.2007.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Impaired glucose tolerance (IGT) is associated with an increased risk of atherosclerosis that may be due in part to dyslipidemia. The purpose of this study was to assess the regulatory role of lipid transfer proteins in the development of this dyslipidemia. METHODS Activities of cholesterol ester transfer protein (CETP) and phospholipid transfer protein (PLTP), as well as lipid and protein components of the major lipoprotein fractions, were evaluated in probands with IGT and were compared with those in subjects with normal glucose tolerance. The effect of a fat-rich meal on these variables was also investigated. RESULTS IGT probands had a higher triglyceride content in subfractions of low- (LDL) and high-density lipoprotein (HDL). IGT patients had higher fasting CETP activity. The latter was positively correlated with HDL2 triglycerides and negatively with HDL3 total cholesterol. PLTP activity and mass were not higher in IGT patients. However, PLTP activity correlated with components of VLDL and LDL and was influenced by the type of obesity. Neither CETP and PLTP activities nor PLTP mass were altered by a fat-rich meal. PLTP and CETP activities correlated in both fasting and postprandial conditions. CONCLUSIONS Increased fasting CETP activity may contribute to increased risk of atherosclerosis in subjects with IGT.
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Affiliation(s)
- Ulrich Julius
- Medical Clinics and Outpatient Department III, University Hospital, Dresden, Germany.
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