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Yonel Z, Kocher T, Chapple I, Dietrich T, Völzke H, Nauck M, Collins G, Gray L, Holtfreter B. Development and External Validation of a Multivariable Prediction Model to Identify Nondiabetic Hyperglycemia and Undiagnosed Type 2 Diabetes: Diabetes Risk Assessment in Dentistry Score (DDS). J Dent Res 2023; 102:170-177. [PMID: 36254392 PMCID: PMC9893389 DOI: 10.1177/00220345221129807] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to develop and externally validate a score for use in dental settings to identify those at risk of undiagnosed nondiabetic hyperglycemia (NDH) or type 2 diabetes (T2D). The Studies of Health in Pomerania (SHIP) project comprises 2 representative population-based cohort studies conducted in northeast Germany. SHIP-TREND-0, 2008 to 2012 (the development data set) had 3,339 eligible participants, with 329 having undiagnosed NDH or T2D. Missing data were replaced using multiple imputation. Potential covariates were selected for inclusion in the model using backward elimination. Heuristic shrinkage was used to reduce overfitting, and the final model was adjusted for optimism. We report the full model and a simplified paper-based point-score system. External validation of the model and score employed an independent data set comprising 2,359 participants with 357 events. Predictive performance, discrimination, calibration, and clinical utility were assessed. The final model included age, sex, body mass index, smoking status, first-degree relative with diabetes, presence of a dental prosthesis, presence of mobile teeth, history of periodontal treatment, and probing pocket depths ≥5 mm as well as prespecified interaction terms. In SHIP-TREND-0, the model area under the curve (AUC) was 0.72 (95% confidence interval [CI] 0.69, 0.75), calibration in the large was -0.025. The point score AUC was 0.69 (95% CI 0.65, 0.72), with sensitivity of 77.0 (95% CI 76.8, 77.2), specificity of 51.5 (95% CI 51.4, 51.7), negative predictive value of 94.5 (95% CI 94.5, 94.6), and positive predictive value of 17.0 (95% CI 17.0, 17.1). External validation of the point score gave an AUC of 0.69 (95% CI 0.66, 0.71), sensitivity of 79.2 (95% CI 79.0, 79.4), specificity of 49.9 (95% CI 49.8, 50.00), negative predictive value 91.5 (95% CI 91.5, 91.6), and positive predictive value of 25.9 (95% CI 25.8, 26.0). A validated prediction model involving dental variables can identify NDH or undiagnosed T2DM. Further studies are required to validate the model for different European populations.
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Affiliation(s)
- Z. Yonel
- Periodontal Research Group, School of
Dentistry, College of Medical and Dental Science, University of Birmingham,
Edgbaston, Birmingham, UK
| | - T. Kocher
- Department of Restorative Dentistry,
Periodontology, Endodontology, and Preventive and Paediatric Dentistry, University
Medicine Greifswald, Greifswald, Germany
| | - I.L.C. Chapple
- Periodontal Research Group, School of
Dentistry, College of Medical and Dental Science, University of Birmingham,
Edgbaston, Birmingham, UK
| | - T. Dietrich
- Periodontal Research Group, School of
Dentistry, College of Medical and Dental Science, University of Birmingham,
Edgbaston, Birmingham, UK
| | - H. Völzke
- German Centre for Cardiovascular
Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Study of Health in
Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine,
University Medicine Greifswald, Greifswald, Germany
| | - M. Nauck
- German Centre for Cardiovascular
Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Institute for Laboratory Medicine and
Clinical Chemistry, University Medicine Greifswald, Greifswald, Germany
| | - G. Collins
- Centre for Statistics in Medicine,
University of Oxford, Oxford UK
| | - L.J. Gray
- Department of Health Sciences,
University of Leicester, University Road, Leicester, UK
| | - B. Holtfreter
- Department of Restorative Dentistry,
Periodontology, Endodontology, and Preventive and Paediatric Dentistry, University
Medicine Greifswald, Greifswald, Germany
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Lehnert K, Gross S, Bahls M, Ulbricht S, Winter T, Nauck M, Felix SB, Doerr M, Grabmaier U. s-VCAM-1 is an independent predictor of all-cause mortality in patients with dilated cardiomyopathy and hypokinetic non-dilated cardiomyopathy. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): University Medicine Munich University Medicine Greifswald
Introduction
The vascular cell adhesion molecule-1 (VCAM-1) is overexpressed in a number of different inflammatory processes on activated endothelium. This could be shown in both a mouse model for autoimmune myocarditis and in human heart tissue from patients with lymphocytic myocarditis.
In addition to the tissue-bound one, a soluble isoform of VCAM-1 (s-VCAM-1) can also be detected in the blood. Higher levels have been associated with worse clinical outcome in chronic heart failure patients of different etiology and other patient groups.
Purpose
Since both inflammation and fibrosis are key processes involved in the pathogenesis of dilated cardiomyopathy (DCM) and hypokinetic non-dilated cardiomyopathy (HNDC), we aimed to investigate the prognostic value of s-VCAM-1 plasma levels for survival in a large cohort of DCM and HNDC patients.
Methods
The cohort comprised of patients with a primary diagnosis of DCM, defined as reduced left ventricular ejection fraction (LVEF <45%), increased left ventricular enddiastolic diameter according to HENRY score (LVEDD >117%) at time of diagnosis as well as HNDC, defined as a reduced left ventricular ejection fraction (LVEF <45%) but no increased LVEDD according to HENRY score (LVEDD < =117%). Exclusion criteria were primary valvular diseases (≥ second degree), acute myocarditis, cancer, chronic alcoholism, coronary artery disease with epicardial stenosis >50%, peripheral artery occlusive disease, known auto-immune disease and heart failure of other origins. Levels of s-VCAM-1 were measured in human plasma using an enzyme-linked immunosorbent assay (R&D Systems, USA). A Cox proportional hazard model for the association between s-VCAM-1 and all-cause mortality was adjusted for age, sex, time since symptom-onset, LVEF, kidney function (eGFR-CKDEPI), CRP and NT-proBNP.
Results
A total of 334 DCM patients were included in this single-center cohort (78.4 % males) with a mean age of 54.0 years [interquartile range [IQR] 47.0, 63.2). On average time since symptom onset was 1.5 years (IQR 0.1, 1.1), LVEF 30.7 % (IQR 25, 37), LVEDD 67.1 mm (IQR 62, 72). During a median follow-up of 12.4 years (IQR 10.1, 13.9), a total of 118 (35.3 %) patients died. Multivariable-adjusted cox regression model revealed a significantly increased all-cause mortality risk with increasing levels of s-VCAM-1 (p for trend =0.039), (hazard ratio [HR] 1.00045 (Conf. Interval 1.00002, 1.00087) for VCAM increase of 1 ng/mL, for increase of 100 ng/ml HR 1.046 (Conf- interval 1.002, 1.091), for increase of 1000ng/ml HR 1.57 (Conf_interval 1.02-2.41) (Kaplan Meier survival estimates see Figure 1, median s-VCAM-1 = 664 ng/ml, IQR 515,874).
Conclusions
s-VCAM-1 predicts long-term survival in DCM patients independent of NT-pro-BNP and other risk determinants. Further research needs to evaluate whether this biomarker proves useful in monitoring and planning management of DCM and HNDC patients (e.g. more intensive management in high-risk patients).
Abstract Figure. Kaplan-Meier survival estimates
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Affiliation(s)
- K Lehnert
- University Medicine Greifswald, DZHK (German Centre for Cardiovascular Research), partner site, Internal Medicine B, Greifswald, Germany
| | - S Gross
- University Medicine Greifswald, DZHK (German Centre for Cardiovascular Research), partner site, Internal Medicine B, Greifswald, Germany
| | - M Bahls
- University Medicine Greifswald, DZHK (German Centre for Cardiovascular Research), partner site, Internal Medicine B, Greifswald, Germany
| | - S Ulbricht
- University Medicine Greifswald/ German Centre for Cardiovascular Research partner site Greifswald, Institute for Community Medicine, Department Prevention Research and Social Medicine, Greifswald, Germany
| | - T Winter
- University Medicine Greifswald, Institute of Clinical Chemistry and Laboratory Medicine, Integrated Research Biobank, Greifswald, Germany
| | - M Nauck
- University Medicine Greifswald, Institute of Clinical Chemistry and Laboratory Medicine, DZHK partner site Greifswald, Greifswald, Germany
| | - SB Felix
- University Medicine Greifswald, DZHK (German Centre for Cardiovascular Research), partner site, Internal Medicine B, Greifswald, Germany
| | - M Doerr
- University Medicine Greifswald, DZHK (German Centre for Cardiovascular Research), partner site, Internal Medicine B, Greifswald, Germany
| | - U Grabmaier
- Ludwig-Maximilians University, Department of Internal Medicine I, DZHK (German Centre of Cardiovascular Research) partner site, Munich, Germany
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3
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Hauser T, Dornberger V, Malzahn U, Grebe SJ, Liu D, Störk S, Nauck M, Friedrich N, Dörr M, Wanner C, Krane V, Hammer F. The effect of spironolactone on diastolic function in haemodialysis patients. Int J Cardiovasc Imaging 2021; 37:1927-1936. [PMID: 33544240 PMCID: PMC8255262 DOI: 10.1007/s10554-021-02176-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/25/2021] [Indexed: 11/25/2022]
Abstract
Heart failure with preserved ejection fraction (HFpEF) is highly prevalent in patients on maintenance haemodialysis (HD) and lacks effective treatment. We investigated the effect of spironolactone on cardiac structure and function with a specific focus on diastolic function parameters. The MiREnDa trial examined the effect of 50 mg spironolactone once daily versus placebo on left ventricular mass index (LVMi) among 97 HD patients during 40 weeks of treatment. In this echocardiographic substudy, diastolic function was assessed using predefined structural and functional parameters including E/e’. Changes in the frequency of HFpEF were analysed using the comprehensive ‘HFA-PEFF score’. Complete echocardiographic assessment was available in 65 individuals (59.5 ± 13.0 years, 21.5% female) with preserved left ventricular ejection fraction (LVEF > 50%). At baseline, mean E/e’ was 15.2 ± 7.8 and 37 (56.9%) patients fulfilled the criteria of HFpEF according to the HFA-PEFF score. There was no significant difference in mean change of E/e’ between the spironolactone group and the placebo group (+ 0.93 ± 5.39 vs. + 1.52 ± 5.94, p = 0.68) or in mean change of left atrial volume index (LAVi) (1.9 ± 12.3 ml/m2 vs. 1.7 ± 14.1 ml/m2, p = 0.89). Furthermore, spironolactone had no significant effect on mean change in LVMi (+ 0.8 ± 14.2 g/m2 vs. + 2.7 ± 15.9 g/m2; p = 0.72) or NT-proBNP (p = 0.96). Treatment with spironolactone did not alter HFA-PEFF score class compared with placebo (p = 0.63). Treatment with 50 mg of spironolactone for 40 weeks had no significant effect on diastolic function parameters in HD patients. The trial has been registered at clinicaltrials.gov (NCT01691053; first posted Sep. 24, 2012).
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Affiliation(s)
- T Hauser
- Division of Nephrology, Department of Medicine I, University Hospital Würzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany.
| | - V Dornberger
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - U Malzahn
- Clinical Trial Centre, University Hospital Würzburg, Würzburg, Germany
| | - S J Grebe
- Department of Paediatrics, University Hospital of Erlangen, Erlangen, Germany
| | - D Liu
- Division of Nephrology, Department of Medicine I, University Hospital Würzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany
- Comprehensive Heart Failure Centre, University and University Hospital Würzburg, Würzburg, Germany
| | - S Störk
- Division of Nephrology, Department of Medicine I, University Hospital Würzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany
- Comprehensive Heart Failure Centre, University and University Hospital Würzburg, Würzburg, Germany
| | - M Nauck
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - N Friedrich
- Institute for Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - C Wanner
- Division of Nephrology, Department of Medicine I, University Hospital Würzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany
- Comprehensive Heart Failure Centre, University and University Hospital Würzburg, Würzburg, Germany
| | - V Krane
- Division of Nephrology, Department of Medicine I, University Hospital Würzburg, Oberduerrbacher Str. 6, 97080, Wuerzburg, Germany
- Comprehensive Heart Failure Centre, University and University Hospital Würzburg, Würzburg, Germany
| | - F Hammer
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
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4
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Normann N, Tietz G, Kühn A, Fuchs C, Balau V, Schulz K, Kolata J, Schuerholz T, Petersmann A, Stentzel S, Steil L, Kuhn SO, Meissner K, Völker U, Nauck M, Steinmetz I, Raafat D, Gründling M, Bröker BM. Pathogen-specific antibody profiles in patients with severe systemic infections. Eur Cell Mater 2020; 39:171-182. [PMID: 32301500 DOI: 10.22203/ecm.v039a11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Infections are often caused by pathobionts, endogenous bacteria that belong to the microbiota. Trauma and surgical intervention can allow bacteria to overcome host defences, ultimately leading to sepsis if left untreated. One of the main defence strategies of the immune system is the production of highly specific antibodies. In the present proof-of-concept study, plasma antibodies against 9 major pathogens were measured in sepsis patients, as an example of severe systemic infections. The binding of plasma antibodies to bacterial extracellular proteins was quantified using a semi-automated immunoblot assay. Comparison of the pathogen-specific antibody levels before and after infection showed an increase in plasma IgG in 20 out of 37 tested patients. This host-directed approach extended the results of pathogen-oriented microbiological and PCR diagnostics: a specific antibody response to additional bacteria was frequently observed, indicating unrecognised poly-microbial invasion. This might explain some cases of failed, seemingly targeted antibiotic treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - B M Bröker
- Department of Immunology, University Medicine Greifswald, Greifswald,
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5
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Nauck MA, Holle H, Kahle M, Tytko A, Deacon CF, Holst JJ, Meier JJ. No evidence of tachyphylaxis for insulinotropic actions of glucose-dependent insulinotropic polypeptide (GIP) in subjects with type 2 diabetes, their first-degree relatives, or in healthy subjects. Peptides 2020; 125:170176. [PMID: 31669136 DOI: 10.1016/j.peptides.2019.170176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/12/2019] [Accepted: 10/14/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND, AIMS In patients with type 2 diabetes, the lost insulinotropic effect of the incretin hormone glucose-dependent insulinotropic polypeptide (GIP) is more apparent after continuous versus bolus administration. To test whether the difference might be explained by rapid tachyphylaxis in response to elevated concentrations of GIP, and whether patients with type 2 diabetes and their relatives are more susceptible to tachyphylaxis than healthy subjects. PATIENTS AND METHODS In a two-way crossover design, insulinotropic responses to repeated bolus injection (50 pmol/kg body weight at 30 and 120 min) and continuous infusion of GIP (2 pmol.kg-1.min-1 from 30 to 180 min) under hyperglycaemic clamp conditions (8.5 mmol/l) was compared in age- gender- and weight-matched patients with type 2 diabetes, first degree relatives of such patients, and healthy subjects. RESULTS Insulin secretory responses to the first and second GIP bolus were not significantly different in any of the subject groups. Subjects with type 2 diabetes had a significant relative impairment versus healthy subjects with continuous (C-peptide, -13.2 %, p < 0.05), but not with repeated bolus administration of GIP (+11.1 %, n.s.). First-degree relatives tended to hyper-secrete insulin with bolus or continuous administrations of GIP. CONCLUSIONS Rapid tachyphylaxis in response to continuous exposure to slightly supraphysiological concentrations of GIP does not explain the reduced insulinotropic response to GIP infusions in patients with type 2 diabetes or their first-degree relatives.
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Affiliation(s)
- M A Nauck
- Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany; Diabetes Center Bochum-Hattingen, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany.
| | - H Holle
- Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany
| | - M Kahle
- Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany; Diabetes Center Bochum-Hattingen, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - A Tytko
- Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany
| | - C F Deacon
- Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Biomedical Sciences, Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - J J Holst
- Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Biomedical Sciences, Panum Institute, University of Copenhagen, Copenhagen, Denmark
| | - J J Meier
- Diabetes Center Bochum-Hattingen, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
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6
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Bonk S, Van DAS, Frenzel S, Wittfeld K, Hosten N, Nauck M, Völzke H, Grabe HJ. Moderating effects of serum vitamin D on brain structure. PHARMACOPSYCHIATRY 2020. [DOI: 10.1055/s-0039-3403028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S Bonk
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - der Auwera S Van
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - St Frenzel
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - K Wittfeld
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - N Hosten
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - M Nauck
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - H Völzke
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - HJ Grabe
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
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Garvert L, Roshchupkin GV, Völzke H, Nauck M, Milaneschi Y, Grabe J, Van der Auwera S. Genome-wide pleiotropy between depression and body mass index. PHARMACOPSYCHIATRY 2020. [DOI: 10.1055/s-0039-3403015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- L Garvert
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - GV Roshchupkin
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - H Völzke
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - M Nauck
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - Y Milaneschi
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - J Grabe
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
| | - S Van der Auwera
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Germany
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Müller TD, Finan B, Bloom SR, D'Alessio D, Drucker DJ, Flatt PR, Fritsche A, Gribble F, Grill HJ, Habener JF, Holst JJ, Langhans W, Meier JJ, Nauck MA, Perez-Tilve D, Pocai A, Reimann F, Sandoval DA, Schwartz TW, Seeley RJ, Stemmer K, Tang-Christensen M, Woods SC, DiMarchi RD, Tschöp MH. Glucagon-like peptide 1 (GLP-1). Mol Metab 2019; 30:72-130. [PMID: 31767182 PMCID: PMC6812410 DOI: 10.1016/j.molmet.2019.09.010] [Citation(s) in RCA: 769] [Impact Index Per Article: 153.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/10/2019] [Accepted: 09/22/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The glucagon-like peptide-1 (GLP-1) is a multifaceted hormone with broad pharmacological potential. Among the numerous metabolic effects of GLP-1 are the glucose-dependent stimulation of insulin secretion, decrease of gastric emptying, inhibition of food intake, increase of natriuresis and diuresis, and modulation of rodent β-cell proliferation. GLP-1 also has cardio- and neuroprotective effects, decreases inflammation and apoptosis, and has implications for learning and memory, reward behavior, and palatability. Biochemically modified for enhanced potency and sustained action, GLP-1 receptor agonists are successfully in clinical use for the treatment of type-2 diabetes, and several GLP-1-based pharmacotherapies are in clinical evaluation for the treatment of obesity. SCOPE OF REVIEW In this review, we provide a detailed overview on the multifaceted nature of GLP-1 and its pharmacology and discuss its therapeutic implications on various diseases. MAJOR CONCLUSIONS Since its discovery, GLP-1 has emerged as a pleiotropic hormone with a myriad of metabolic functions that go well beyond its classical identification as an incretin hormone. The numerous beneficial effects of GLP-1 render this hormone an interesting candidate for the development of pharmacotherapies to treat obesity, diabetes, and neurodegenerative disorders.
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Affiliation(s)
- T D Müller
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Pharmacology and Experimental Therapy, Institute of Experimental and Clinical Pharmacology and Toxicology, Eberhard Karls University Hospitals and Clinics, Tübingen, Germany.
| | - B Finan
- Novo Nordisk Research Center Indianapolis, Indianapolis, IN, USA
| | - S R Bloom
- Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
| | - D D'Alessio
- Division of Endocrinology, Duke University Medical Center, Durham, NC, USA
| | - D J Drucker
- The Department of Medicine, Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital, University of Toronto, Ontario, M5G1X5, Canada
| | - P R Flatt
- SAAD Centre for Pharmacy & Diabetes, Ulster University, Coleraine, Northern Ireland, UK
| | - A Fritsche
- German Center for Diabetes Research (DZD), Neuherberg, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; Division of Endocrinology, Diabetology, Vascular Disease, Nephrology and Clinical Chemistry, Department of Internal Medicine, University of Tübingen, Tübingen, Germany
| | - F Gribble
- Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, Wellcome Trust-Medical Research Council, Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - H J Grill
- Institute of Diabetes, Obesity and Metabolism, Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - J F Habener
- Laboratory of Molecular Endocrinology, Massachusetts General Hospital, Harvard University, Boston, MA, USA
| | - J J Holst
- Novo Nordisk Foundation Center for Basic Metabolic Research, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - W Langhans
- Physiology and Behavior Laboratory, ETH Zurich, Schwerzenbach, Switzerland
| | - J J Meier
- Diabetes Division, St Josef Hospital, Ruhr-University Bochum, Bochum, Germany
| | - M A Nauck
- Diabetes Center Bochum-Hattingen, St Josef Hospital (Ruhr-Universität Bochum), Bochum, Germany
| | - D Perez-Tilve
- Department of Internal Medicine, University of Cincinnati-College of Medicine, Cincinnati, OH, USA
| | - A Pocai
- Cardiovascular & ImmunoMetabolism, Janssen Research & Development, Welsh and McKean Roads, Spring House, PA, 19477, USA
| | - F Reimann
- Metabolic Research Laboratories and Medical Research Council Metabolic Diseases Unit, Wellcome Trust-Medical Research Council, Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - D A Sandoval
- Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - T W Schwartz
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, DL-2200, Copenhagen, Denmark; Department of Biomedical Sciences, University of Copenhagen, DK-2200, Copenhagen, Denmark
| | - R J Seeley
- Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - K Stemmer
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - M Tang-Christensen
- Obesity Research, Global Drug Discovery, Novo Nordisk A/S, Måløv, Denmark
| | - S C Woods
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - R D DiMarchi
- Novo Nordisk Research Center Indianapolis, Indianapolis, IN, USA; Department of Chemistry, Indiana University, Bloomington, IN, USA
| | - M H Tschöp
- German Center for Diabetes Research (DZD), Neuherberg, Germany; Division of Metabolic Diseases, Department of Medicine, Technische Universität München, Munich, Germany; Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
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9
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Lehnert K, Gross S, Baumeister SE, Ewert R, Glaeser S, Nauck M, Felix SB, Doerr M, Bahls M. P4409Cardiorespiratory fitness is inversely associated with the inflammatory status in the general population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Low-grade systemic chronic inflammation is a major risk factor for cardiometabolic diseases. Higher physical activity has athero- and cardioprotective effects, potentially through its anti-inflammatory properties. However, the relation between resting inflammatory status and cardiorespiratory fitness (CRF) in population-based settings remains to be elucidated. While previous research has shown inverse associations between CRF and high-sensitive C-reactive protein (hs-CRP) levels, relations with other inflammatory markers are not yet well examined.
Purpose
We assessed the relation between markers of CRF (i.e. maximal oxygen uptake [VO2peak], oxygen uptake at the anaerobic threshold [VO2@AT], oxygen pulse [O2HRmax] and maximal workload [max. Watt]) and hs-CRP as well as total white blood cell (WBC), monocyte, neutrophil, lymphocyte, eosinophil and basophil counts.
Methods
Data of the population-based cohort Study of Health in Pomerania (SHIP) was used (n=1,481; 51% male; age range 20–81 years). CRF was assessed using standardized cardio-pulmonary exercise testing (CPET) according to a modified Jones protocol. The Dimension Vista 500 analytical system was used to measure hs-CRP concentrations. Fluorescence-activated cell sorting was used to assess total as well as subpopulation WBC count. We excluded subjects with missing data, anti-rheumatic/steroid/anti-inflammatory medication as well as chronic inflammatory and hepatic diseases, gastritis, hepatitis infection, severe renal disease, chronic lung disease, asthma, chronic bronchitis, previous myocardial infarction, left ventricular ejection fraction <40% and previous cancer. Linear regression models, adjusted for age, sex, current smoking and lean-mass, were used to assess the relation between CPET and inflammatory parameters.
Results
A 14 ml/min (95%-confidence interval [CI] −23 to −6, p=0.004) lower VO2peak was associated with a one mg/L higher hs-CRP. A lower VO2peak was also related with a one Gpt/L greater WBC (β: −42. 95% CI: −55 to −27 ml/min, p<0.001) as well as neutrophil (β: −57, 95% CI: −77 to −36 ml/min, p<0.001), lymphocyte (β: −63, 95% CI: −107 to 19 ml/min, p=0.005) and monocyte count (β: −204, 95% CI: −360 to −47 ml/min, p=0.011). No significant associations were found for eosinophil and basophil count. Similar results were found for VO2@AT, O2HRmax and max. Watt.
Conclusion
Results suggest an inverse association between CRF and resting inflammatory status. Our non-significant findings with regards to eosinophils and basophils may be expected since these cell types are generally involved in type 2 immune responses related to allergic skin and airway inflammation as well as immunity against parasites. Overall, our results imply that potential biological mechanisms underlying the athero- and cardioprotective effects of high CRF may be related to lower chronic inflammation in fitter individuals.
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Affiliation(s)
- K Lehnert
- University Medicine of Greifswald, Internal Medicine B, Greifswald, Germany
| | - S Gross
- University Medicine of Greifswald, Internal Medicine B, Greifswald, Germany
| | - S E Baumeister
- Ludwig-Maximilians University, UNIKA-T Augsburg, Munich, Germany
| | - R Ewert
- University Medicine of Greifswald, Internal Medicine B, Greifswald, Germany
| | - S Glaeser
- Vivantes Clinics for Health, Berlin, Germany
| | - M Nauck
- University of Greifswald, Institute of Clinical Chemistry and Laboratory Medicine, Greifswald, Germany
| | - S B Felix
- University Medicine of Greifswald, Internal Medicine B, Greifswald, Germany
| | - M Doerr
- University Medicine of Greifswald, Internal Medicine B, Greifswald, Germany
| | - M Bahls
- University Medicine of Greifswald, Internal Medicine B, Greifswald, Germany
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10
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Verma S, Bain S, Honoré J, Mann J, Nauck M, Pratley R, Rasmussen S, Sejersten Ripa M, Zinman B, Buse J. IMPACT OF MICROVASCULAR DISEASE ON CARDIORENAL OUTCOMES IN TYPE 2 DIABETES: AN ANALYSIS FROM THE LEADER AND SUSTAIN 6 CLINICAL TRIALS. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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11
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Urbaneck I, Lorenz F, Materzok I, Maletzki L, Pietzner M, Budde K, Nauck M, Felix SB, Doerr M, Bahls M. P6277The impact of exercise training in combination with statin use on skeletal muscle mitochondrial oxidative phosphorylation and metabolomics in obese rats. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Exercise training (ET) and statin treatment both alter skeletal muscle function.
Purpose
We investigated the effects of a combined exercise and statin use on skeletal muscle mitochondrial oxidative phosphorylation (OxPhos) and metabolic alterations in obese rats.
Methods
Eight-week-old male Wistar rats were used. A total of 14 animals received standard chow, while 46 rats were fed a high-fat diet (HFD) for 20 weeks. After 8 weeks, the rats were randomized into 6 groups: sedentary (n=8), ET (n=6), sedentary with HFD (n=11), ET with HFD (n=11), statin with HFD (n=13) and ET with HFD and statins (n=11). Simvastatin (10mg/d/kg) was added to the drinking water. ET was performed for 12 weeks, 5 days/week for 1 h/day at 18 m/min in a motorized running wheel. OxPhos was assessed by complex-specific antibodies and targeted metabolomics using the Biocrates p180 kit. All experiments were done on frozen samples of the M. gastrocnemicus. An ANOVA with fixed effects for diet, exercise, statin treatment and statin-exercise interaction was used to identify significantly different metabolites.
Results
Statin use was associated with significantly lower cholesterol levels, but did not affect exercise duration and intensity compared to none-use. In sedentary animals, HFD increased OxPhos complex II (succinate dehydrogenase), complex IV (cytochrome-c-oxidase) and V (ATP synthase) while statin treatment diminished this increase in all complexes. HFD increased complex IV independent of statin treatment but had no effect on complex II and V in ET rats. Complex IV was increased due to ET only in HFD fed rats compared to rats on normal chow but decreased in contrast to sedentary animals on a HFD. With regards to metabolomics, we found 57 metabolites which were influenced by HFD while no metabolites were identified with a significant effect for ET. A significant statin-exercise interaction was found for three lysophosphatidylcholines (lysoPC a C26.0, lysoPC a C26.1, lysoPC a C24.0), one phosphatidylcholine (PC aa C42.6) and one sphingomyelin (SM C16.1). HFD decreased the concentration of all mentioned metabolites compared to standard chow fed animals. Likewise, ET increased the concentration of metabolites compared to sedentary animals on HFD. Statin treatment led to an increase, while statin in combination with ET did not rescue this effect.
Conclusion
HFD induced severely impaired skeletal muscle OxPhos independent of ET and statin treatment. Our findings suggest a limiting rate of NADH production in the tricarboxylic acid cycle as a potential mechanism. However, ET prevented the increase in cytochrome-c-oxidation while statins blocked the HFD induced increase in ATP synthase. Our metabolomics results imply that future research should consider the lipotoxic effects of a HFD when assessing skeletal muscle alterations due to ET or statins. Of particular interest could be the 5 metabolites that have been shown to be impacted by a statin-exercise interaction.
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Affiliation(s)
- I Urbaneck
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - F Lorenz
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - I Materzok
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - L Maletzki
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - M Pietzner
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - K Budde
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - M Nauck
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - S B Felix
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - M Doerr
- Universitaetsmedizin Greifswald, Greifswald, Germany
| | - M Bahls
- Universitaetsmedizin Greifswald, Greifswald, Germany
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12
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Abstract
The aim of the present study was to construct a biological age score reflecting one’s physiologic capability and aging condition with respect to tooth loss over 10 y. From the follow-up to the population-based Study of Health in Pomerania (i.e., SHIP-2), 2,049 participants were studied for their baseline biomarker measures 10 y before (i.e., in SHIP-0). Metabolic and periodontal data were regressed onto chronological age to construct a score designated as “biological age.” For either sex separately, the impact of this individualized score was used to predict tooth loss in the follow-up cohort in comparison with each participant’s chronological age. Outcome data after 10 y with respect to tooth loss, periodontitis, obesity, and inflammation were shown to be better for biologically younger subjects than as expected by their chronological age, whereas for the older subjects, data were worse. Especially for tooth loss, a striking increase was observed in subjects whose biological age at baseline appeared to be higher than their chronological age. Biological age produced significantly better tooth loss predictions than chronological age ( P < 0.001). Areas under receiver operating characteristic curves for tooth loss of ≥3 teeth in men during follow-up were 0.811 and 0.745 for biological and chronological age, respectively. For women, these figures were 0.788 and 0.724. For total tooth loss, areas under the curve were 0.890 and 0.749 in men and 0.872 and 0.752 in women. Biological age combines various measures into a single score and allows identifying individuals at increased risk of tooth loss.
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Affiliation(s)
- P. Meisel
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
| | - C. Pink
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
| | - M. Nauck
- Institute of Clinical Chemistry and Laboratory Diagnostics, University Medicine Greifswald, Greifswald, Germany
| | - H. Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - T. Kocher
- Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany
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13
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Liebsch C, Pitchika V, Pink C, Samietz S, Kastenmüller G, Artati A, Suhre K, Adamski J, Nauck M, Völzke H, Friedrich N, Kocher T, Holtfreter B, Pietzner M. The Saliva Metabolome in Association to Oral Health Status. J Dent Res 2019; 98:642-651. [PMID: 31026179 DOI: 10.1177/0022034519842853] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is one of the most prevalent oral diseases worldwide and is caused by multifactorial interactions between host and oral bacteria. Altered cellular metabolism of host and microbes releases a number of intermediary end products known as metabolites. There is an increasing interest in identifying metabolites from oral fluids such as saliva to widen the understanding of the complex pathogenesis of periodontitis. It is believed that some metabolites might serve as indicators toward early detection and screening of periodontitis and perhaps even for monitoring its prognosis in the future. Because contemporary periodontal screening methods are deficient, there is an urgent need for novel approaches in periodontal screening procedures. To this end, we associated oral parameters (clinical attachment level, periodontal probing depth, supragingival plaque, supragingival calculus, number of missing teeth, and removable denture) with a large set of salivary metabolites ( n = 284) obtained by mass spectrometry among a subsample ( n = 909) of nondiabetic participants from the Study of Health in Pomerania (SHIP-Trend-0). Linear regression analyses were performed in age-stratified groups and adjusted for potential confounders. A multifaceted image of associated metabolites ( n = 107) was revealed with considerable differences according to age groups. In the young (20 to 39 y) and middle-aged (40 to 59 y) groups, metabolites were predominantly associated with periodontal variables, whereas among the older subjects (≥60 y), tooth loss was strongly associated with metabolite levels. Metabolites associated with periodontal variables were clearly linked to tissue destruction, host defense mechanisms, and bacterial metabolism. Across all age groups, the bacterial metabolite phenylacetate was significantly associated with periodontal variables. Our results revealed alterations of the salivary metabolome in association with age and oral health status. Among our comprehensive panel of metabolites, periodontitis was significantly associated with the bacterial metabolite phenylacetate, a promising substance for further biomarker research.
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Affiliation(s)
- C Liebsch
- 1 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - V Pitchika
- 1 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - C Pink
- 1 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - S Samietz
- 2 Department of Prosthetic Dentistry, Gerodontology and Biomaterials, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - G Kastenmüller
- 3 Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - A Artati
- 4 Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, Neuherberg, Germany
| | - K Suhre
- 3 Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Neuherberg, Germany.,5 Weill Cornell Medicine-Qatar, Education City, Qatar Foundation, Doha, Qatar
| | - J Adamski
- 4 Institute of Experimental Genetics, Genome Analysis Center, Helmholtz Zentrum München, Neuherberg, Germany.,6 Lehrstuhl für Experimentelle Genetik, Technische Universität München, Freising-Weihenstephan, Germany.,7 German Center for Diabetes Research (DZD e.V.), München-Neuherberg, Germany
| | - M Nauck
- 8 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,9 DZHK (German Center for Cardiovascular Research), Greifswald, Germany
| | - H Völzke
- 9 DZHK (German Center for Cardiovascular Research), Greifswald, Germany.,10 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - N Friedrich
- 8 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,9 DZHK (German Center for Cardiovascular Research), Greifswald, Germany
| | - T Kocher
- 1 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - B Holtfreter
- 1 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Pediatric and Preventive Dentistry, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - M Pietzner
- 8 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,9 DZHK (German Center for Cardiovascular Research), Greifswald, Germany
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14
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Hannemann A, Wallaschofski H, Nauck M, Marschall P, Flessa S, Grabe H, Schmidt C, Baumeister S. Vitamin D and health care costs: Results from two independent population-based cohort studies. Clin Nutr 2018; 37:2149-2155. [DOI: 10.1016/j.clnu.2017.10.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 10/19/2017] [Accepted: 10/22/2017] [Indexed: 01/06/2023]
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15
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Verma S, Leiter L, Mazer C, Bain S, Buse J, Marso S, Nauck M, Zinman B, Bosch-Traberg H, Frimer-Larsen H, Michelsen M, Bhatt D. LIRAGLUTIDE REDUCES CARDIOVASCULAR EVENTS AND MORTALITY IN TYPE 2 DIABETES INDEPENDENT OF LDL CHOLESTEROL AND STATIN USE: RESULTS OF THE LEADER TRIAL. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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16
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Seufert J, Nauck M, Rosenstock J, Hansen T, Vrazic H, Vilsboll T. P2857Increase in pulse rate with semaglutide did not result in increased adverse cardiac events in subjects with type 2 diabetes in the SUSTAIN 6 cardiovascular outcomes trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2857] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Seufert
- University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - M Nauck
- Ruhr University Bochum (RUB), St Josef Hospital, Bochum, Germany
| | - J Rosenstock
- Dallas Diabetes Research Center at Medical City, Dallas, United States of America
| | - T Hansen
- Novo Nordisk A/S, Søborg, Denmark
| | - H Vrazic
- Novo Nordisk A/S, Søborg, Denmark
| | - T Vilsboll
- Steno Diabetes Center Copenhagen, Copenhagen, Denmark
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17
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Husain M, Bain SC, Mann JFE, Nauck M, Poulter N, Baeres FMM, Goldman B, Bloch Thomsen A, Marso S. P2518Arrythmias and heart rate increase in the LEADER trial and relation to risk of cardiovascular events. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Husain
- Toronto General Hospital Research Institute, Toronto, Canada
| | - S C Bain
- Swansea University, Swansea, United Kingdom
| | - J F E Mann
- Friedrich Alexander University, Erlangen, Germany
| | - M Nauck
- Ruhr University Bochum (RUB), Bochum, Germany
| | - N Poulter
- Imperial College London, London, United Kingdom
| | | | | | | | - S Marso
- HCA Midwest Health Heart & Vascular Institute, Kansas City, United States of America
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18
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Verma S, Leiter LA, Mazer CD, Bain SC, Buse J, Marso S, Nauck M, Zinman B, Bosch-Traberg H, Frimer-Larsen H, Michelsen MM, Bhatt DL. P2858Liraglutide reduces cardiovascular events and mortality in type 2 diabetes independent of LDL cholesterol and statin use: results of the LEADER trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Verma
- St. Michael's Hospital, Cardiac Surgery, Toronto, Canada
| | | | - C D Mazer
- University of Toronto, Toronto, Canada
| | - S C Bain
- Swansea University, Swansea, United Kingdom
| | - J Buse
- University of North Carolina Hospitals, Chapel Hill, United States of America
| | - S Marso
- HCA Midwest Health Heart & Vascular Institute, Kansas City, United States of America
| | - M Nauck
- Ruhr University Bochum (RUB), Bochum, Germany
| | - B Zinman
- University of Toronto, Toronto, Canada
| | | | | | | | - D L Bhatt
- Harvard Medical School, Boston, United States of America
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19
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Friedrich N, Skaaby T, Pietzner M, Budde K, Thuesen B, Nauck M, Linneberg A. Identification of urine metabolites associated with 5-year changes in biomarkers of glucose homoeostasis. Diabetes & Metabolism 2018; 44:261-268. [DOI: 10.1016/j.diabet.2017.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/09/2017] [Accepted: 05/23/2017] [Indexed: 01/11/2023]
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20
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Böker J, Völzke H, Nauck M, Hannemann A, Friedrich N. Associations of insulin-like growth factor-I and insulin-like growth factor binding protein-3 with bone quality in the general adult population. Clin Endocrinol (Oxf) 2018; 88:830-837. [PMID: 29498081 DOI: 10.1111/cen.13588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/30/2018] [Accepted: 02/22/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Growth hormone (GH) and its main mediator, insulin-like growth factor-I (IGF-I), play a significant role in bone metabolism. The relations between IGF-I and bone mineral density (BMD) or osteoporosis have been assessed in previous studies but whether the associations are sex-specific remains uncertain. Moreover, only a few studies examined bone quality assessed by quantitative ultrasound (QUS). We aimed to investigate these associations in the general population of north-east Germany. DESIGN AND MEASUREMENTS Data from 1759 men and 1784 women who participated in the baseline examination of the Study of Health in Pomerania (SHIP)-Trend were used. IGF-I and IGF-binding protein-3 (IGFBP-3) concentrations were measured on the IDS-iSYS multidiscipline automated analyser (Immunodiagnostic Systems Limited). QUS measurements were performed at the heel (Achilles InSight, GE Healthcare). Sex-specific linear and multinomial logistic regression models adjusted for potential confounders were calculated. RESULTS Linear regression analyses revealed significant positive associations between IGF-I and IGF-I/IGFBP-3 ratio, a marker for free IGF-I, with all QUS parameters in men. Among women, we found an inverse association between IGF-I and the QUS-based fracture risk but no association with any other QUS parameter. There was no association between IGFBP-3 and the QUS-based fracture risk. CONCLUSIONS Our data suggest an important role of IGF-I on bone quality in men. The observed association of IGF-I with the QUS-based stiffness index and QUS-based fracture risk in this study might animate clinicians to refer patients with low IGF-I levels, particularly men, to a further evaluation of risk factors for osteoporosis and a detailed examination of the skeletal system.
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Affiliation(s)
- J Böker
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - M Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - A Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - N Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
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21
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Süße M, Hannich M, Petersmann A, Zylla S, Pietzner M, Nauck M, Dressel A. Kappa free light chains in cerebrospinal fluid to identify patients with oligoclonal bands. Eur J Neurol 2018; 25:1134-1139. [PMID: 29683546 DOI: 10.1111/ene.13667] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/09/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE The gold standard for detection of intrathecal immunoglobulin synthesis is the measurement of oligoclonal bands (OCB). In the diagnosis of multiple sclerosis, the kappa free light chains (KFLC) index has a similar sensitivity and specificity as OCB. This study investigated whether determination of the KFLC index could be used to predict the presence of OCB. METHODS The KFLC index was determined prospectively from 295 paired serum and cerebrospinal fluid samples. KFLC were determined by nephelometry using the N Latex FLC kappa kit (Siemens Healthcare Diagnostics Products GmbH) on the BN Prospec analyzer (Siemens Healthcare Diagnostics Products GmbH) (cohort I). A cut-off value was determined using receiver operating characteristic analysis in relation to OCB positivity. These results were validated prospectively in 96 samples (cohort II) as well as retrospectively in samples of 46 patients known to be OCB positive (cohort III). We also compared the agreement of two commercially available nephelometric KFLC assays. RESULTS In cohort I, a KFLC index of 3.61 yielded 100% sensitivity and 88% specificity. Prospective validation of this cut-off value in cohort II showed 92% sensitivity and 96% specificity. In cohort III, a sensitivity of 93% was achieved. Comparison of Siemens and Binding Site (Birmingham, UK) assays revealed good agreement (r2 = 0.86). CONCLUSIONS The KFLC index with a cut-off value of 3.61 had high diagnostic accuracy to predict immunoglobulin G synthesis via OCB analysis. Determination of the KFLC index provided a quantitative parameter that could be used as an initial diagnostic step in inflammatory central nervous system disorders before measuring OCB.
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Affiliation(s)
- M Süße
- Department of Neurology, University Medicine Greifswald, Greifswald
| | - M Hannich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald
| | - A Petersmann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald
| | - S Zylla
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald
| | - M Pietzner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald
| | - M Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald
| | - A Dressel
- Department of Neurology, Carl-Thieme Klinikum Cottbus, Cottbus, Germany
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22
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Bain S, Araki E, Desouza C, Garg S, Rose L, Tsoukas G, Bergan EQ, Derving Karsbøl J, Devries JH, Nauck M. Semaglutid reduzierte den HbA1c in allen Subgruppen des Ausgangs-HbA1c (SUSTAIN 1 – 5). DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S Bain
- Swansea University Medical School, Swansea, United Kingdom
| | - E Araki
- Kumamoto University, Kumamoto, Japan
| | - C Desouza
- University of Nebraska Medical Center, Omaha, United States
| | - S Garg
- Aurora, Colorado, United States
| | - L Rose
- Diabetes Münster, Münster, Germany
| | - G Tsoukas
- Department of Medicine, Montreal, Canada
| | | | | | - JH Devries
- University of Amsterdam, Amsterdam, Netherlands
| | - M Nauck
- Universitätsklinikum St. Josef-Hospital, Bochum, Germany
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23
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Poulter N, Mann J, Fonseca V, Mosenzon O, Raz I, Frimer-Larsen H, Scholten BJ, Idorn T, Nauck M. Liraglutid reduzierte MACE (Major Cardiovascular Events, schwere unerwünschte kardiovaskuläre Ereignisse) bei Patienten mit chronischer Nierenerkrankung: Ergebnisse aus der LEADER Studie. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- N Poulter
- Imperial College London, London, United Kingdom
| | - J Mann
- KfH Nierenzentrum, München, Germany
| | - V Fonseca
- Tulane University Health Sciences Center, New Orleans, United States
| | - O Mosenzon
- Diabetes Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - I Raz
- Diabetes Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | | | | | - T Idorn
- Novo Nordisk A/S, Søborg, Denmark
| | - M Nauck
- Universitätsklinikum St. Josef-Hospital, Bochum, Germany
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24
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Davis T, Poulter N, Bain S, Buse J, Monk-Hansen T, Nauck M, Rasmussen S, Pratley R, Zinman B, Ørsted D, Marso S. Risk of Major Cardiovascular Events in Patients With Type 2 Diabetes With and Without Prior CV Events: Results From The LEADER Trial. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hannich M, Wallaschofski H, Nauck M, Reincke M, Adolf C, Völzke H, Rettig R, Hannemann A. Physiological Aldosterone Concentrations Are Associated with Alterations of Lipid Metabolism: Observations from the General Population. Int J Endocrinol 2018; 2018:4128174. [PMID: 29780416 PMCID: PMC5892232 DOI: 10.1155/2018/4128174] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/15/2018] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Aldosterone and high-density lipoprotein cholesterol (HDL-C) are involved in many pathophysiological processes that contribute to the development of cardiovascular diseases. Previously, associations between the concentrations of aldosterone and certain components of the lipid metabolism in the peripheral circulation were suggested, but data from the general population is sparse. We therefore aimed to assess the associations between aldosterone and HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol, triglycerides, or non-HDL-C in the general adult population. METHODS Data from 793 men and 938 women aged 25-85 years who participated in the first follow-up of the Study of Health in Pomerania were obtained. The associations of aldosterone with serum lipid concentrations were assessed in multivariable linear regression models adjusted for sex, age, body mass index (BMI), estimated glomerular filtration rate (eGFR), and HbA1c. RESULTS The linear regression models showed statistically significant positive associations of aldosterone with LDL-C (β-coefficient = 0.022, standard error = 0.010, p = 0.03) and non-HDL-C (β-coefficient = 0.023, standard error = 0.009, p = 0.01) as well as an inverse association of aldosterone with HDL-C (β-coefficient = -0.022, standard error = 0.011, p = 0.04). CONCLUSIONS The present data show that plasma aldosterone is positively associated with LDL-C and non-HDL-C and inversely associated with HDL-C in the general population. Our data thus suggests that aldosterone concentrations within the physiological range may be related to alterations of lipid metabolism.
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Affiliation(s)
- M. Hannich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - H. Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany
| | - M. Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany
| | - M. Reincke
- Medical Department IV, Klinikum Innenstadt, Ludwig-Maximilian University of Munich, Munich, Germany
| | - C. Adolf
- Medical Department IV, Klinikum Innenstadt, Ludwig-Maximilian University of Munich, Munich, Germany
| | - H. Völzke
- German Centre for Cardiovascular Research, Partner site Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - R. Rettig
- Institute of Physiology, University Medicine Greifswald, Greifswald, Germany
| | - A. Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
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Skaaby T, Taylor AE, Thuesen BH, Jacobsen RK, Friedrich N, Møllehave LT, Hansen S, Larsen SC, Völker U, Nauck M, Völzke H, Hansen T, Pedersen O, Jørgensen T, Paternoster L, Munafò M, Grarup N, Linneberg A. Estimating the causal effect of body mass index on hay fever, asthma and lung function using Mendelian randomization. Allergy 2018; 73:153-164. [PMID: 28675761 DOI: 10.1111/all.13242] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Observational studies have shown that body mass index (BMI) is positively associated with asthma. However, observational data are prone to confounding and reverse causation. In Mendelian randomization, genetic variants are used as unconfounded markers of exposures to examine causal effects. We examined the causal effect of BMI on asthma, hay fever, allergic sensitization, serum total immunoglobulin E (IgE), forced expiratory volume in one-second (FEV1) and forced vital capacity (FVC). METHODS We included 490 497 participants in the observational and 162 124 participants in the genetic analyses. A genetic risk score (GRS) was created using 26 BMI-associated single nucleotide polymorphisms (SNPs). Results were pooled in meta-analyses and expressed as odds ratios (ORs) or β-estimates with 95% confidence interval (CI). RESULTS The GRS was significantly associated with asthma (OR=1.009; 95% CI: 1.004, 1.013), but not with hay fever (OR= 0.998; 95% CI: 0.994, 1.002) or allergic sensitization (OR=0.999; 95% CI: 0.986, 1.012) per BMI-increasing allele. The GRS was significantly associated with decrease in FEV1: β=-0.0012 (95% CI: -0.0019, -0.0006) and FVC: β=-0.0022 (95% CI: -0.0031, -0.0014) per BMI-increasing allele. Effect sizes estimated by instrumental variable analyses were OR=1.07 (95% CI: 1.03, 1.10) for asthma, a 9 ml decrease in FEV1 (95% CI: 2.0-15 mL decrease) and a 16 ml decrease in FVC (95% CI: 7.0-24 mL decrease) per 1 kg/m2 higher BMI. CONCLUSIONS The results support the conclusion that increasing BMI is causally related to higher prevalence of asthma and decreased lung function, but not with hay fever or biomarkers of allergy.
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Affiliation(s)
- T. Skaaby
- Research Centre for Prevention and Health Centre for Health Capital Region of Denmark Copenhagen Denmark
| | - A. E. Taylor
- MRC Integrative Epidemiology Unit (IEU) The University of Bristol Bristol UK
- UK Centre for Tobacco and Alcohol Studies School of Experimental Psychology University of Bristol Bristol UK
| | - B. H. Thuesen
- Research Centre for Prevention and Health Centre for Health Capital Region of Denmark Copenhagen Denmark
| | - R. K. Jacobsen
- Research Centre for Prevention and Health Centre for Health Capital Region of Denmark Copenhagen Denmark
| | - N. Friedrich
- Research Centre for Prevention and Health Centre for Health Capital Region of Denmark Copenhagen Denmark
- Institute of Clinical Chemistry and Laboratory Medicine University Medicine Greifswald Greifswald Germany
| | - L. T. Møllehave
- Research Centre for Prevention and Health Centre for Health Capital Region of Denmark Copenhagen Denmark
| | - S. Hansen
- Research Centre for Prevention and Health Centre for Health Capital Region of Denmark Copenhagen Denmark
| | - S. C. Larsen
- Research unit for Dietary Studies The Parker Institute Frederiksberg and Bispebjerg Hospitals The Capital Region Frederiksberg Denmark
| | - U. Völker
- Interfaculty Institute for Genetics and Functional Genomics University Medicine and Ernst‐Moritz‐Arndt University Greifswald Greifswald Germany
| | - M. Nauck
- Institute of Clinical Chemistry and Laboratory Medicine University Medicine Greifswald Greifswald Germany
| | - H. Völzke
- Institute for Community Medicine University Medicine Greifswald Greifswald Germany
| | - T. Hansen
- Section on Metabolic Genetics Faculty of Health and Medical Sciences The Novo Nordisk Foundation Center for Basic Metabolic Research University of Copenhagen Copenhagen Denmark
| | - O. Pedersen
- Section on Metabolic Genetics Faculty of Health and Medical Sciences The Novo Nordisk Foundation Center for Basic Metabolic Research University of Copenhagen Copenhagen Denmark
| | - T. Jørgensen
- Research Centre for Prevention and Health Centre for Health Capital Region of Denmark Copenhagen Denmark
- Department of Public Health Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Faculty of Medicine Aalborg University Aalborg Denmark
| | - L. Paternoster
- MRC Integrative Epidemiology Unit (IEU) The University of Bristol Bristol UK
| | - M. Munafò
- MRC Integrative Epidemiology Unit (IEU) The University of Bristol Bristol UK
- UK Centre for Tobacco and Alcohol Studies School of Experimental Psychology University of Bristol Bristol UK
| | - N. Grarup
- Section on Metabolic Genetics Faculty of Health and Medical Sciences The Novo Nordisk Foundation Center for Basic Metabolic Research University of Copenhagen Copenhagen Denmark
| | - A. Linneberg
- Research Centre for Prevention and Health Centre for Health Capital Region of Denmark Copenhagen Denmark
- Department of Clinical Experimental Research Rigshospitalet Glostrup Denmark
- Department of Clinical Medicine Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
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Van der Auwera S, Peyrot WJ, Milaneschi Y, Hertel J, Baune BT, Breen G, Byrne EM, Dunn EC, Fisher HL, Homuth G, Levinson DF, Lewis CM, Mills N, Mullins N, Nauck M, Pistis G, Preisig M, Rietschel M, Ripke S, Sullivan PF, Teumer A, Völzke H, Boomsma DI, Wray NR, Penninx BWJH, Grabe HJ. Genome-wide gene-environment interaction in depression: A systematic evaluation of candidate genes: The childhood trauma working-group of PGC-MDD. Am J Med Genet B Neuropsychiatr Genet 2018; 177:40-49. [PMID: 29159863 PMCID: PMC5726923 DOI: 10.1002/ajmg.b.32593] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/28/2017] [Accepted: 08/08/2017] [Indexed: 12/16/2022]
Abstract
Gene by environment (GxE) interaction studies have investigated the influence of a number of candidate genes and variants for major depressive disorder (MDD) on the association between childhood trauma and MDD. Most of these studies are hypothesis driven and investigate only a limited number of SNPs in relevant pathways using differing methodological approaches. Here (1) we identified 27 genes and 268 SNPs previously associated with MDD or with GxE interaction in MDD and (2) analyzed their impact on GxE in MDD using a common approach in 3944 subjects of European ancestry from the Psychiatric Genomics Consortium who had completed the Childhood Trauma Questionnaire. (3) We subsequently used the genome-wide SNP data for a genome-wide case-control GxE model and GxE case-only analyses testing for an enrichment of associated SNPs. No genome-wide significant hits and no consistency among the signals of the different analytic approaches could be observed. This is the largest study for systematic GxE interaction analysis in MDD in subjects of European ancestry to date. Most of the known candidate genes/variants could not be supported. Thus, their impact on GxE interaction in MDD may be questionable. Our results underscore the need for larger samples, more extensive assessment of environmental exposures, and greater efforts to investigate new methodological approaches in GxE models for MDD.
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Affiliation(s)
| | - S Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - WJ Peyrot
- Department of Psychiatry, Vrije Universiteit Medical Center and GGZ in Geest, Amsterdam, The Netherlands
| | - Y Milaneschi
- Department of Psychiatry, Vrije Universiteit Medical Center and GGZ in Geest, Amsterdam, The Netherlands
| | - J Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - BT Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - G Breen
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, Great Britain,NIHR BRC for Mental Health, King's College London, London, Great Britain
| | - EM Byrne
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - EC Dunn
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, US,Department of Psychiatry, Massachusetts General Hospital, Boston, US,Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Massachusetts General Hospital, Boston, US
| | - HL Fisher
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, Great Britain
| | - G Homuth
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine and Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - DF Levinson
- Psychiatry & Behavioral Sciences, Stanford University, Stanford, US
| | - CM Lewis
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, Great Britain,Department of Medical & Molecular Genetics, King's College London, London, Great Britain
| | - N Mills
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - N Mullins
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, Great Britain
| | - M Nauck
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany,Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - G Pistis
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - M Preisig
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - S Ripke
- Medical and Population Genetics, Broad Institute, Cambridge, US,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, US,Department of Psychiatry and Psychotherapy, University medicine Berlin Campus Charité Mitte, Berlin, Germany
| | - PF Sullivan
- Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden,Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, US,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, US
| | - A Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | | | - DI Boomsma
- Dept of Biological Psychology & EMGO+ Institute for Health and Care Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - NR Wray
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia,Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - BWJH Penninx
- Department of Psychiatry, Vrije Universiteit Medical Center and GGZ in Geest, Amsterdam, The Netherlands
| | - HJ Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
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28
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Leiter L, Poulter N, Bain S, Buse J, Monk-Hansen T, Nauck M, Rasmussen S, Pratley R, Zinman B, Ørsted D, Marso S. RISK OF MAJOR CARDIOVASCULAR EVENTS IN PATIENTS WITH TYPE 2 DIABETES WITH AND WITHOUT PRIOR CARDIOVASCULAR EVENTS: RESULTS FROM THE LEADER TRIAL. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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29
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Grotevendt A, Wallaschofski H, Reincke M, Adolf C, Quinkler M, Nauck M, Hoffmann W, Rettig R, Hannemann A. Associations of aldosterone and renin concentrations with inflammation-the Study of Health in Pomerania and the German Conn's Registry. Endocrine 2017. [PMID: 28638984 DOI: 10.1007/s12020-017-1348-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Chronic inflammation is an age-independent and body mass index-independent contributor to the development of multi-morbidity. Alterations of the renin-angiotensin-aldosterone system are observed within the context of proinflammatory states. We assessed circulating aldosterone, renin, and inflammatory biomarker concentrations in healthy, normotensive subjects and patients with primary aldosteronism. METHODS We included 1177 normotensive individuals from the population-based Study of Health in Pomerania (first follow-up, Study of Health in Pomerania-1) and 103 primary aldosteronism patients from the German Conn's Registry. A 1:1 matching for sex, age, body mass index, smoking status, diabetes mellitus, and the estimated glomerular filtration rate was performed to determine whether primary aldosteronism patients exhibit higher inflammatory biomarker concentrations than normotensive controls. The associations of plasma aldosterone concentration or plasma renin concentration with circulating fibrinogen concentrations, white blood cell count, and high sensitive C-reactive protein concentrations in the normotensive sample were determined with multivariable linear and logistic regression analyses. RESULTS 1:1 matched primary aldosteronism patients demonstrated significantly (p < 0.01) higher plasma aldosterone concentration (198 vs. 47 ng/l), lower plasma renin concentration (3.1 vs. 7.7 ng/l) and higher high sensitive C-reactive protein concentrations (1.5 vs. 1.0 mg/l) than normotensive controls. Within the normotensive cohort, plasma renin concentration but not plasma aldosterone concentration was positively associated with fibrinogen concentrations and white blood cell count. Further, a J-shaped association between plasma renin concentration and high sensitive C-reactive protein concentrations was detected. CONCLUSIONS High plasma aldosterone concentration in a primary aldosteronism cohort and high plasma renin concentration in normotensive subjects are associated with increased concentrations of inflammatory biomarkers. This suggests a link between the renin-angiotensin-aldosterone system and inflammatory processes in patients with primary aldosteronism and even in normotensive subjects.
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Affiliation(s)
- A Grotevendt
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, D-17475, Greifswald, Germany
| | - H Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, D-17475, Greifswald, Germany
| | - M Reincke
- Medical Department IV, Klinikum Innenstadt, Ludwig-Maximilians-University Munich, Munich, Germany
| | - C Adolf
- Medical Department IV, Klinikum Innenstadt, Ludwig-Maximilians-University Munich, Munich, Germany
| | - M Quinkler
- Endocrinology in Charlottenburg, Berlin, Germany
| | - M Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, D-17475, Greifswald, Germany
| | - W Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - R Rettig
- Institute of Physiology, University Medicine Greifswald, Greifswald, Germany
| | - A Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, D-17475, Greifswald, Germany.
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30
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Rahe C, Nauck M, Berger K. Zusammenhang zwischen Depression und Diabetes mellitus Typ 2 unter Berücksichtigung des Erkrankungsschweregrads der Depression. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Rahe
- Universität Münster, Institut für Epidemiologie und Sozialmedizin, Münster
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg
| | - M Nauck
- Universitätsmedizin Greifswald, Institut für Klinische Chemie und Laboratoriumsmedizin, Greifswald
| | - K Berger
- Universität Münster, Institut für Epidemiologie und Sozialmedizin, Münster
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg
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31
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Quast DR, Nauck MA, Bechara FG, Meier JJ. A case series of verrucae vulgares mimicking hyperkeratosis in individuals with diabetic foot ulcers. Diabet Med 2017; 34:1165-1168. [PMID: 28523836 DOI: 10.1111/dme.13387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Diabetic foot ulcers are a common complication in the advanced stages of diabetes mellitus. Certain lesions may be refractory to usual treatments with prolonged healing. In these cases, differential diagnoses to classical ulcers should be considered. Although plantar warts are a common and easy-to-diagnose finding in the general population, diagnosis can be challenging in people with diabetic foot ulcers, as they mimic hyperkeratosis in these people. CASE REPORT We report seven cases of people with diabetic foot ulcers and verrucae vulgares mimicking treatment-refractory hyperkeratosis, presenting to our centre between 2014 and 2016. Diagnosis was aided by the clinical presentation, followed by dermoscopy and punch biopsy. Treatment included topical application of 5-fluoruracil and salicylic acid (four people), cryotherapy (three people) and surgical excision (three people), all in combination with local pressure offloading. In five people, the verrucae were completely removed after a mean treatment period of 9.4 months; two individuals were lost to follow-up. CONCLUSION Verrucae may be more common in people with diabetic foot lesions and polyneuropathy than generally assumed. Typical findings include small, pinhead-sized bleedings within and surrounding hyperkeratous lesions. These findings should alert the clinician for the potential presence of a verruca. In such cases, biopsy should be performed to enable specific diagnosis and treatment.
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Affiliation(s)
- D R Quast
- Diabetes Division, Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Germany
| | - M A Nauck
- Diabetes Division, Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Germany
| | - F G Bechara
- Department of Dermatology, St. Josef-Hospital, Ruhr-University Bochum, Germany
| | - J J Meier
- Diabetes Division, Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Germany
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32
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Akinkugbe AA, Avery CL, Barritt AS, Cole SR, Lerch M, Mayerle J, Offenbacher S, Petersmann A, Nauck M, Völzke H, Slade GD, Heiss G, Kocher T, Holtfreter B. Do Genetic Markers of Inflammation Modify the Relationship between Periodontitis and Nonalcoholic Fatty Liver Disease? Findings from the SHIP Study. J Dent Res 2017; 96:1392-1399. [PMID: 28732187 DOI: 10.1177/0022034517720924] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
An association between periodontitis and nonalcoholic fatty liver disease (NAFLD) has been reported by experimental animal and epidemiologic studies. This study investigated whether circulating levels of serum C-reactive protein (CRP) and a weighted genetic CRP score representing markers of inflammatory burden modify the association between periodontitis and NAFLD. Data came from 2,481 participants of the Study of Health in Pomerania who attended baseline examination that occurred between 1997 and 2001. Periodontitis was defined as the percentage of sites (0%, <30%, ≥30%) with probing pocket depth (PD) ≥4 mm, and NAFLD status was determined using liver ultrasound assessment. Serum CRP levels were assayed at a central laboratory, and single-nucleotide polymorphisms previously identified through genome-wide association studies as robustly associated with serum CRP were combined into a weighted genetic CRP score (wGSCRP). Logistic regression models estimated the association between periodontitis and NAFLD within strata of serum CRP and separately within strata of the wGSCRP. The prevalence of NAFLD was 26.4% (95% confidence interval [CI], 24.6, 28.1) while 17.8% (95% CI, 16.0-19.6) had ≥30% of sites with PD ≥4 mm. Whereas the wGSCRP was not a modifier ( Pinteraction = 0.8) on the multiplicative scale, serum CRP modified the relationship between periodontitis and NAFLD ( Pinteraction = 0.01). The covariate-adjusted prevalence odds ratio of NAFLD comparing participants with ≥30% of sites with PD ≥4 mm to those with no site affected was 2.39 (95% CI, 1.32-4.31) among participants with serum CRP <1 mg/L. The corresponding estimate was 0.97 (95% CI, 0.57-1.66) for participants with serum CRP levels of 1 to 3 mg/L and 1.12 (95% CI, 0.65-1.93) for participants with serum CRP >3 mg/L. Periodontitis was positively associated with higher prevalence odds of NAFLD, and this relationship was modified by serum CRP levels.
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Affiliation(s)
- A A Akinkugbe
- 1 Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - C L Avery
- 1 Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A S Barritt
- 2 Department of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S R Cole
- 1 Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Lerch
- 3 Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - J Mayerle
- 4 Department of Medicine, Ludwig-Maximilians University, Munich, Germany
| | - S Offenbacher
- 5 Department of Periodontology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A Petersmann
- 6 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ernst-Moritz-Arndt-University, Greifswald, Germany
| | - M Nauck
- 6 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ernst-Moritz-Arndt-University, Greifswald, Germany
| | - H Völzke
- 7 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany, and German Center of Diabetes Research, Site Greifswald, Germany
| | - G D Slade
- 8 Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - G Heiss
- 1 Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - T Kocher
- 9 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - B Holtfreter
- 10 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Nauck MA, Kragh N, Mann JF, Lüdemann J, Jacob S, Rieck M, Bosch-Traberg H, Pocock S. Bewertung des Gesundheitszustandes mithilfe des EQ-5D bei Teilnehmern der LEADER Studie mit Typ 2 Diabetes (T2D). DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- MA Nauck
- Ruhr-Universität Bochum, St. Josef Hospital, Klinische Forschung, Abteilung Diabetologie, Medizinische Klinik I, Bochum, Germany
| | - N Kragh
- Novo Nordisk A/S, Soeborg, Denmark
| | - JF Mann
- Friedrich Alexander Universität Erlangen, Abteilung Nephrologie, Erlangen, Germany
| | - J Lüdemann
- Diabetes- und Fußzentrum 'diabetes falkensee', Falkensee, Germany
| | - S Jacob
- Praxis für Prävention und Therapie, Villingen-Schwenningen, Germany
| | - M Rieck
- Novo Nordisk Pharma GmbH, Mainz, Germany
| | | | - S Pocock
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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Mann JF, Nauck MA, Jacob S, Lüdemann J, Brown-Frandsen K, Daniels GH, Kristensen P, Nissen SE, Pocock S, Poulter NR, Ravn LS, Rasmussen S, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Rieck M, Baeres FM, Marso SP, Buse JB. Liraglutid und renale Endpunkte bei Typ 2 Diabetes: Ergebnisse der LEADER Studie. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- JF Mann
- Friedrich Alexander Universität Erlangen, Abteilung Nephrologie, Erlangen, Germany
| | - MA Nauck
- Ruhr-University Bochum, St. Josef Hospital, Klinische Forschung, Abteilung Diabetologie, Medizinische Klinik I, Bochum, Germany
| | - S Jacob
- Praxis für Prävention und Therapie, Villingen-Schwenningen, Germany
| | - J Lüdemann
- Diabetes- und Fußzentrum 'diabetes falkensee', Falkensee, Germany
| | | | - GH Daniels
- Massachusetts General Hospital, Boston, United States
| | | | - SE Nissen
- Cleveland Clinic, Department of Cardiovascular Medicine, Cleveland, United States
| | - S Pocock
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - NR Poulter
- Imperial College London, London, United Kingdom
| | - LS Ravn
- Novo Nordisk A/S, Soeborg, Denmark
| | | | - WM Steinberg
- George Washington University Medical Center, Department of Medicine, Rockville, United States
| | | | - B Zinman
- University of Toronto, Mount Sinai Hospital, Sinai Centre for Diabetes, Toronto, Canada
| | - RM Bergenstal
- Park Nicollet Institute for Research and Education, International Diabetes Center, Minneapolis, United States
| | - M Rieck
- Novo Nordisk Pharma GmbH, Mainz, Germany
| | | | - SP Marso
- University of Texas Southwestern, Department of Internal Medicine, Dallas, United States
| | - JB Buse
- University of North Carolina, School of Medicine, Department of Medicine, Chapel Hill, United States
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Lange V, Dörr M, Schminke U, Völzke H, Nauck M, Wallaschofski H, Hannemann A. The Association between Bone Quality and Atherosclerosis: Results from Two Large Population-Based Studies. Int J Endocrinol 2017; 2017:3946569. [PMID: 28852407 PMCID: PMC5568612 DOI: 10.1155/2017/3946569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/03/2017] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE It is highly debated whether associations between osteoporosis and atherosclerosis are independent of cardiovascular risk factors. We aimed to explore the associations between quantitative ultrasound (QUS) parameters at the heel with the carotid artery intima-media thickness (IMT), the presence of carotid artery plaques, and the ankle-brachial index (ABI). METHODS The study population comprised 5680 men and women aged 20-93 years from two population-based cohort studies: Study of Health in Pomerania (SHIP) and SHIP-Trend. QUS measurements were performed at the heel. The extracranial carotid arteries were examined with B-mode ultrasonography. ABI was measured in a subgroup of 3853 participants. Analyses of variance and linear and logistic regression models were calculated and adjusted for major cardiovascular risk factors. RESULTS Men but not women had significantly increased odds for carotid artery plaques with decreasing QUS parameters independent of diabetes mellitus, dyslipidemia, and hypertension. Beyond this, the QUS parameters were not significantly associated with IMT or ABI in fully adjusted models. CONCLUSIONS Our data argue against an independent role of bone metabolism in atherosclerotic changes in women. Yet, in men, associations with advanced atherosclerosis, exist. Thus, men presenting with clinical signs of osteoporosis may be at increased risk for atherosclerotic disease.
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Affiliation(s)
- V. Lange
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M. Dörr
- Department for Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - U. Schminke
- Department for Neurology, University Medicine Greifswald, Greifswald, Germany
| | - H. Völzke
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M. Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - H. Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research, Partner Site Greifswald, Greifswald, Germany
| | - A. Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- *A. Hannemann:
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Müller-Wieland D, Petermann A, Nauck M, Heinemann L, Kerner W, Müller U, Landgraf R. Definition, Klassifikation und Diagnostik des Diabetes mellitus. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-115159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Landgraf R, Kellerer M, Fach E, Gallwitz B, Hamann A, Joost H, Klein H, Müller-Wieland D, Nauck M, Reuter H, Schreiber S, Siegel E. Praxisempfehlungen DDG/DGIM. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-114151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - E. Fach
- Studienzentrum Stephanskirchen
| | - B. Gallwitz
- Medizinische Klinik IV, Universitätsklinikum Tübingen
| | - A. Hamann
- Medizinische Klinik IV, Hochtaunuskliniken gGmbH, Bad Homburg v.d.H
| | - H. Joost
- Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DIfE), Nuthetal
| | - H. Klein
- Medizinische Klinik I, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum
| | | | - M. Nauck
- St. Josef-Hospital, Klinikum der Ruhr-Universität, Bochum
| | - H. Reuter
- Innere Medizin/Diabetologie, GP Ambulantes Medizinisches Zentrum, Jena
| | | | - E. Siegel
- Abteilung für Innere Medizin – Gastroenterologie, Diabetologie/Endokrinologie und Ernährungsmedizin, St. Josefskrankenhaus Heidelberg GmbH
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Meisel P, Pink C, Nauck M, Jablonowski L, Voelzke H, Kocher T. Magnesium/Calcium Ratio in Serum Predicts Periodontitis and Tooth Loss in a 5-Year Follow-up. JDR Clin Trans Res 2016; 1:266-274. [PMID: 30931742 DOI: 10.1177/2380084416663458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
In the cross-sectional Study of Health in Pomerania (SHIP-0), subjects with an adequate magnesium supply had a lower risk of periodontal disease and more teeth than those with low magnesium levels. The authors analyzed 5-y follow-up data (SHIP-1) to determine whether the baseline magnesium levels had a long-term effect on attachment level and number of teeth lost. Of the participants examined dentally in the baseline study, 3,300 (75%) were examined for progression or recession of periodontal attachment level after 5 y. For 2,432 subjects, the authors related the outcome variables of periodontal attachment level and tooth loss to baseline characteristics, especially serum magnesium and calcium concentrations, as well as systemic markers of inflammation. The progression of periodontitis was associated with the magnesium/calcium (Mg/Ca) ratio at baseline in a dose-dependent manner. Progression of mean attachment loss was prevented in the upper quartile of the Mg/Ca ratio ( P < 0.001) with antagonistic effects of magnesium and calcium irrespective of inflammatory state. With respect to tooth loss, Mg/Ca exerted dimorphic effects. In inflammatory states as indicated by high C-reactive protein (>3 mg/L), tooth loss was prevented in subjects with high Mg/Ca ratio (incidence rate ratio = 0.60, 95% confidence interval: 0.45 to 0.80, P = 0.001), but the contrary was observed in subjects with low C-reactive protein levels (incidence rate ratio = 1.14, 95% confidence interval: 0.97 to 1.34, NS). Similar results were observed with stratifying the regression on tooth loss by interleukin 6 or fibrinogen threshold. An adequate magnesium serum level and Mg/Ca balance may prevent progression of attachment level and tooth loss, especially in inflammatory states. Knowledge Transfer Statement: The results of this study present evidence that an adequate magnesium supply may be important in the prevention of periodontal diseases and future tooth loss. A diet high in magnesium could improve periodontal health, notwithstanding its beneficial effects on systemic disease. In populations with a high prevalence of hypomagnesemia, additional intake of supplements is advisable.
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Affiliation(s)
- P Meisel
- 1 Dental Clinics, Unit of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - C Pink
- 1 Dental Clinics, Unit of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - M Nauck
- 2 Department of Clinical Chemistry and Laboratory Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - L Jablonowski
- 1 Dental Clinics, Unit of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - H Voelzke
- 3 Department of Community Medicine, University Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - T Kocher
- 1 Dental Clinics, Unit of Periodontology, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
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Seufert J, Bailey T, Barkholt Christensen S, Nauck MA. Impact of diabetes duration on achieved reductions in glycated haemoglobin, fasting plasma glucose and body weight with liraglutide treatment for up to 28 weeks: a meta-analysis of seven phase III trials. Diabetes Obes Metab 2016; 18:721-4. [PMID: 26679282 PMCID: PMC5324626 DOI: 10.1111/dom.12623] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 10/08/2015] [Accepted: 12/14/2015] [Indexed: 12/20/2022]
Abstract
This meta-analysis of seven randomized, placebo-controlled studies (total 3222 patients) evaluated whether type 2 diabetes (T2D) duration affects the changes in blood glucose control and body weight that can be achieved with liraglutide and placebo. With liraglutide 1.2 mg, shorter diabetes duration was associated with a significantly greater, but clinically non-relevant, difference in glycated haemoglobin (HbA1c) reduction (p < 0.05), i.e. a 0.18% (1.96 mmol/mol) reduction in HbA1c per 10 years shorter diabetes duration. With liraglutide 1.8 mg, shorter diabetes duration was associated with a small but statistically significant trend for greater fasting plasma glucose (FPG) reduction (p < 0.05), i.e. a 0.38 mmol/l reduction in FPG per 10 years shorter diabetes duration. Neither the liraglutide 1.8 mg nor placebo results showed a significant association between HbA1c and diabetes duration and neither the liraglutide 1.2 mg nor placebo results showed a significant association between FPG and diabetes duration. Likewise, neither liraglutide nor placebo showed a significant association between change in weight and diabetes duration. These results suggest diabetes duration has a clinically negligible effect on achievable blood glucose control and weight outcomes with liraglutide and placebo in patients with T2D.
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Affiliation(s)
- J Seufert
- Division of Endocrinology and Diabetology Department of Internal Medicine II, University Hospital of Freiburg, Freiburg, Germany
| | - T Bailey
- AMCR Institute Inc, Escondido, CA, USA
| | | | - M A Nauck
- Division of Diabetology Medical Department, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
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Abd El Aziz M, Kahle M, Meier JJ, Nauck MA. Metaanalyse von direkten Vergleichsstudien zwischen Therapie mit GLP-1 Rezeptor-Agonisten oder Insulin: Unterschied für kurz- und lang-wirksame Medikamente? DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1584101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kahle M, Schulze H, Meier JJ, Nauck MA. Vorhersage des Insulinpumpen-Basalratenprofils einschließlich individueller zirkadianer Rhythmen anhand klinischer Charakteristika bei Patienten mit Typ 1-Diabetes. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Buchholz C, Kahle M, Nauck MA. Basalinsulin-Therapie bei Typ 2-Diabetes: Welche Patientencharakteristika entscheiden über Erfolg bzw. die Notwendigkeit zu einer weiteren Therapie-Intensivierung? DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Haase M, Kahle M, Janert M, Nauck M. Prospektiver Vergleich von Fastentagen über 24h mit Erlaubnis für Snacks mit vernachlässigbarem Kohlenhydratgehalt bzw. konsequentem Fasten bei Patienten mit Typ 1-Diabetes. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nauck M. Incretin therapies: highlighting common features and differences in the modes of action of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. Diabetes Obes Metab 2016; 18:203-16. [PMID: 26489970 PMCID: PMC4785614 DOI: 10.1111/dom.12591] [Citation(s) in RCA: 274] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 10/12/2015] [Accepted: 10/17/2015] [Indexed: 12/26/2022]
Abstract
Over the last few years, incretin-based therapies have emerged as important agents in the treatment of type 2 diabetes (T2D). These agents exert their effect via the incretin system, specifically targeting the receptor for the incretin hormone glucagon-like peptide 1 (GLP-1), which is partly responsible for augmenting glucose-dependent insulin secretion in response to nutrient intake (the 'incretin effect'). In patients with T2D, pharmacological doses/concentrations of GLP-1 can compensate for the inability of diabetic β cells to respond to the main incretin hormone glucose-dependent insulinotropic polypeptide, and this is therefore a suitable parent compound for incretin-based glucose-lowering medications. Two classes of incretin-based therapies are available: GLP-1 receptor agonists (GLP-1RAs) and dipeptidyl peptidase-4 (DPP-4) inhibitors. GLP-1RAs promote GLP-1 receptor (GLP-1R) signalling by providing GLP-1R stimulation through 'incretin mimetics' circulating at pharmacological concentrations, whereas DPP-4 inhibitors prevent the degradation of endogenously released GLP-1. Both agents produce reductions in plasma glucose and, as a result of their glucose-dependent mode of action, this is associated with low rates of hypoglycaemia; however, there are distinct modes of action resulting in differing efficacy and tolerability profiles. Furthermore, as their actions are not restricted to stimulating insulin secretion, these agents have also been associated with additional non-glycaemic benefits such as weight loss, improvements in β-cell function and cardiovascular risk markers. These attributes have made incretin therapies attractive treatments for the management of T2D and have presented physicians with an opportunity to tailor treatment plans. This review endeavours to outline the commonalities and differences among incretin-based therapies and to provide guidance regarding agents most suitable for treating T2D in individual patients.
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Affiliation(s)
- M Nauck
- Division of Diabetology, Medical Department I, St. Josef Hospital (Ruhr University Bochum), Bochum, Germany
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Kahle M, Varnhorn A, Schulze H, Tepelmann S, Nauck M. Optimierte Basalratenprofile bei 339 Patienten mit Typ-1-Diabetes unter Insulinpumpenbehandlung. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0041-110392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- M. Kahle
- Diabetologie/Innere Medizin I, St. Josef-Hospital (Ruhr-Universität Bochum), Bochum, Germany
| | - A. Varnhorn
- Innere Medizin/Diabetologie, Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany
| | - H. Schulze
- Innere Medizin/Diabetologie, Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany
| | - S. Tepelmann
- Innere Medizin/Diabetologie, Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany
| | - M. Nauck
- Diabetologie/Innere Medizin I, St. Josef-Hospital (Ruhr-Universität Bochum), Bochum, Germany
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Tsourdi E, Wallaschofski H, Rauner M, Nauck M, Pietzner M, Rettig R, Ittermann T, Völzke H, Völker U, Hofbauer LC, Hannemann A. Thyrotropin serum levels are differentially associated with biochemical markers of bone turnover and stiffness in women and men: results from the SHIP cohorts. Osteoporos Int 2016; 27:719-27. [PMID: 26264603 DOI: 10.1007/s00198-015-3276-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/30/2015] [Indexed: 12/21/2022]
Abstract
UNLABELLED In two large German population-based cohorts, we showed positive associations between serum thyrotropin (TSH) concentrations and the Fracture Risk Assessment score (FRAX) in men and positive associations between TSH concentrations and bone turnover markers in women. INTRODUCTION The role of thyroid hormones on bone stiffness and turnover is poorly defined. Existing studies are confounded by differences in design and small sample size. We assessed the association between TSH serum concentrations and bone stiffness and turnover in the SHIP cohorts, which are two population-based cohorts from a region in Northern Germany comprising 2654 men and women and 3261 men and women, respectively. METHODS We calculated the bone stiffness index using quantitative ultrasound (QUS) at the calcaneus, employed FRAX score for assessment of major osteoporotic fractures, and measured bone turnover markers, N-terminal propeptide of type I procollagen (P1NP), bone-specific alkaline phosphatase (BAP), osteocalcin, and type I collagen cross-linked C-telopeptide (CTX) in all subjects and sclerostin in a representative subgroup. RESULTS There was no association between TSH concentrations and the stiffness index in both genders. In men, TSH correlated positively with the FRAX score both over the whole TSH range (p < 0.01) and within the reference TSH range (p < 0.01). There were positive associations between TSH concentrations and P1NP, BAP, osteocalcin, and CTX (p < 0.01) in women but not in men. There was no significant association between TSH and sclerostin levels. CONCLUSIONS TSH serum concentrations are associated with gender-specific changes in bone turnover and stiffness.
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Affiliation(s)
- E Tsourdi
- Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - H Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- Schwerpunktpraxis für Diabetes und Hormonerkrankungen, Erfurt, Germany
| | - M Rauner
- Department of Medicine III, Technische Universität Dresden, Dresden, Germany
| | - M Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M Pietzner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - R Rettig
- Institute of Physiology, University Medicine Greifswald, Greifswald, Karlsburg, Germany
| | - T Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - U Völker
- Functional Genomics Laboratory, University Medicine Greifswald, Greifswald, Germany
| | - L C Hofbauer
- Department of Medicine III, Technische Universität Dresden, Dresden, Germany.
- Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany.
| | - A Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
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Becht FS, Walther K, Martin E, Nauck MA. Fasting C-peptide and Related Parameters Characterizing Insulin Secretory Capacity for Correctly Classifying Diabetes Type and for Predicting Insulin Requirement in Patients with Type 2 Diabetes. Exp Clin Endocrinol Diabetes 2016; 124:148-56. [PMID: 26824281 DOI: 10.1055/s-0035-1565177] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND/AIMS C-peptide allows estimation of insulin secretion even in the presence of insulin treatment. C-peptide may be suitable for the differential diagnosis of type 1 and type 2 diabetes, and, within type 2 diabetes, of insulin-requiring vs. non-insulin-requiring patients. Relating C-peptide concentrations to ambient glucose levels might improve its diagnostic potential. PATIENTS/METHODS The diagnostic value (a) fasting C-peptide, (b) C-peptide/glucose ratios, and (c) the HOMA-ßC-peptide-index for predicting a diagnosis of type 1 (vs. type 2) diabetes were assessed. SETTING Specialised hospital for the care of diabetic patients (inpatient treatment). 303 patients with type 1 diabetes and 841 patients with type 2 diabetes. MAIN OUTCOME MEASURE Odds ratios and 95% confidence intervals for a clinical diagnosis of type 1 diabetes or for insulin treatment by deciles of (a) fasting C-peptide, (b) C-peptide/glucose ratios, and (c) HOMA-ßC-peptide-index. RESULTS Low C-peptide concentrations were associated with a high odds ratio for type 1 diabetes and vice versa (p<0.0001). Concentrations of 0.13-0.36 nmol/l did not discriminate. C-peptide/glucose ratios or HOMA-ßC-Peptide did not perform better. The ability of all 3 parameters to predict the necessity for insulin treatment within the population of type 2-diabetic patients was low. CONCLUSIONS Fasting C-peptide and derived parameters help to differentiate type 1 from type 2 diabetes, but there is a range of C-peptide concentrations that does not help discriminate. Relating C-peptide to glucose did not improve diagnostic accuracy. C-peptide does not help predicting a need for insulin treatment in patients with type 2 diabetes.
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Affiliation(s)
- F S Becht
- Diabeteszentrum Bad Lauterberg (Harz), Germany (where work was performed)
| | - K Walther
- Diabeteszentrum Bad Lauterberg (Harz), Germany (where work was performed)
| | - E Martin
- Diabeteszentrum Bad Lauterberg (Harz), Germany (where work was performed)
| | - M A Nauck
- Diabeteszentrum Bad Lauterberg (Harz), Germany (where work was performed)
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Landgraf R, Kellerer M, Fach E, Gallwitz B, Hamann A, Joost H, Klein H, Müller-Wieland D, Nauck M, Reuter H, Schreiber S, Siegel E, Matthaei S. Praxisempfehlungen DDG/DGIM. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | | | - E. Fach
- Studienzentrum Stephanskirchen
| | - B. Gallwitz
- Medizinische Klinik IV, Universitätsklinikum Tübingen
| | - A. Hamann
- Medizinische Klinik IV, Hochtaunuskliniken gGmbH, Bad Homburg v.d.H
| | - H. Joost
- Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DIfE), Nuthetal
| | - H. Klein
- Medizinische Klinik I, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum
| | | | - M. Nauck
- St. Josef-Hospital, Klinikum der Ruhr-Universität, Bochum
| | - H. Reuter
- Innere Medizin/Diabetologie, GP Ambulantes Medizinisches Zentrum, Jena
| | | | - E. Siegel
- Abteilung für Innere Medizin – Gastroenterologie, Diabetologie/Endokrinologie und Ernährungsmedizin, St. Josefskrankenhaus Heidelberg GmbH
| | - S. Matthaei
- Fachabteilung für Diabetologie, Endokrinologie und Stoffwechselerkrankungen am Christlichen Krankenhaus Diabetes-Zentrum Quakenbrück
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Ahmann A, Rodbard HW, Rosenstock J, Lahtela JT, de Loredo L, Tornøe K, Boopalan A, Nauck MA. Efficacy and safety of liraglutide versus placebo added to basal insulin analogues (with or without metformin) in patients with type 2 diabetes: a randomized, placebo-controlled trial. Diabetes Obes Metab 2015; 17:1056-64. [PMID: 26179619 PMCID: PMC5054929 DOI: 10.1111/dom.12539] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/24/2015] [Accepted: 07/02/2015] [Indexed: 02/06/2023]
Abstract
AIM To confirm the superiority, compared with placebo, of adding liraglutide to pre-existing basal insulin analogue ± metformin in adults with inadequately controlled type 2 diabetes [glycated haemoglobin (HbA1c) 7.0-10.0% (53-86 mmol/mol)]. METHODS In this 26-week, double-blind, parallel-group study, conducted in clinics or hospitals, 451 subjects were randomized 1 : 1 to once-daily liraglutide 1.8 mg (dose escalated from 0.6 and 1.2 mg/day, respectively, for 1 week each; n = 226) or placebo (n = 225) added to their pre-existing basal insulin analogue (≥20 U/day) ± metformin (≥1500 mg/day). After randomization, insulin adjustments above the pre-study dose were not allowed. The primary endpoint was HbA1c change. RESULTS After 26 weeks, HbA1c decreased more with liraglutide [-1.3% (-14.2 mmol/mol)] than with placebo [-0.1% (-1.2 mmol/mol); p < 0.0001]. More subjects on liraglutide reached HbA1c targets: <7.0% (59% vs 14%; p < 0.0001) and ≤6.5% (43% vs 4%; p < 0.0001) using slightly less insulin (35.8 IU vs 40.1 IU). Greater decreases from baseline (estimated treatment differences vs placebo; p < 0.0001) occurred in fasting plasma glucose (-1.3 mmol/l), seven-point glucose profiles (-1.6 mmol/l), body weight (-3.1 kg) and systolic blood pressure (-5.0 mmHg). Transient gastrointestinal adverse events (nausea: 22.2% vs 3.1%) and minor hypoglycaemia (18.2% vs 12.4%) were more frequent with liraglutide than placebo, and pulse increased (4.5 beats/min) compared with placebo. No severe hypoglycaemia or pancreatitis occurred. CONCLUSIONS Adding liraglutide to a basal insulin analogue ± metformin significantly improved glycaemic control, body weight and systolic blood pressure compared with placebo. Typical gastrointestinal symptoms and minor hypoglycaemia were more frequent with liraglutide.
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Affiliation(s)
- A Ahmann
- Oregon Health and Science University, Portland, OR, USA
| | - H W Rodbard
- Endocrine and Metabolic Consultants, Rockville, MD, USA
| | - J Rosenstock
- Dallas Diabetes and Endocrine Center at Medical City, Dallas, TX, USA
| | - J T Lahtela
- University Hospital, Tampere University, Tampere, Finland
| | - L de Loredo
- Servicio Diabetología y Nutrición, Hospital Privado de Córdoba S.A., Córdoba, Argentina
| | - K Tornøe
- Medical and Science, GLP-1 and Obesity, Novo Nordisk A/S, Søborg, Denmark
| | - A Boopalan
- Novo Nordisk Service Centre, India Pvt Ltd, Bangalore, India
| | - M A Nauck
- Division of Diabetology, Medical Department I, St. Josef-Hospital (Ruhr-Universität Bochum), Bochum, Germany
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Weinstock RS, Guerci B, Umpierrez G, Nauck MA, Skrivanek Z, Milicevic Z. Safety and efficacy of once-weekly dulaglutide versus sitagliptin after 2 years in metformin-treated patients with type 2 diabetes (AWARD-5): a randomized, phase III study. Diabetes Obes Metab 2015; 17:849-58. [PMID: 25912221 PMCID: PMC5008205 DOI: 10.1111/dom.12479] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/10/2015] [Accepted: 04/17/2015] [Indexed: 11/30/2022]
Abstract
AIMS To compare the once-weekly glucagon-like peptide-1 (GLP-1) receptor dulaglutide with the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin after 104 weeks of treatment. METHODS This AWARD-5 study was a multicentre, double-blind trial that randomized participants to dulaglutide (1.5 or 0.75 mg) or sitagliptin 100 mg for 104 weeks or placebo (reported separately) for 26 weeks. Change in glycated haemoglobin (HbA1c) concentration from baseline was the primary efficacy measure. A total of 1098 participants with HbA1c concentrations ≥7.0% (≥53.0 mmol/mol) and ≤9.5% (≤80.3 mmol/mol) were randomized, and 657 (59.8%) completed the study. We report results for dulaglutide and sitagliptin at the final endpoint. RESULTS Changes in HbA1c at 104 weeks were (least squares mean ± standard error) -0.99 ± 0.06% (-10.82 ± 0.66 mmol/mol), -0.71 ± 0.07% (-7.76 ± 0.77 mmol/mol) and -0.32 ± 0.06% (-3.50 ± 0.66 mmol/mol) for dulaglutide 1.5 mg, dulaglutide 0.75 mg and sitagliptin, respectively (p < 0.001, both dulaglutide doses vs sitagliptin). Weight loss was greater with dulaglutide 1.5 mg (p < 0.001) and similar with 0.75 mg versus sitagliptin (2.88 ± 0.25, 2.39 ± 0.26 and 1.75 ± 0.25 kg, respectively). Gastrointestinal adverse events were more common with dulaglutide 1.5 and 0.75 mg versus sitagliptin (nausea 17 and 15% vs 7%, diarrhoea 16 and 12% vs 6%, vomiting 14 and 8% vs 4% respectively). Pancreatic, thyroid, cardiovascular and hypersensitivity safety were similar across groups. CONCLUSIONS Dulaglutide doses provided superior glycaemic control and dulaglutide 1.5 mg resulted in greater weight reduction versus sitagliptin at 104 weeks, with acceptable safety.
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Affiliation(s)
- R S Weinstock
- Endocrinology, Diabetes and Metabolism, Upstate Medical University, Syracuse, NY, USA
| | - B Guerci
- Diabetology, Metabolic Disease and Nutrition, University of Lorraine, CIC Inserm ILCV, CHU, Nancy, France
| | - G Umpierrez
- Diabetes & Endocrinology, Emory University, Atlanta, GA, USA
| | - M A Nauck
- Diabeteszentrum Bad Lauterberg, Bad Lauterberg, Germany
| | - Z Skrivanek
- Lilly Research Laboratories, Indianapolis, IN, USA
| | - Z Milicevic
- Lilly Research Laboratories, Vienna, Austria
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