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Afonso MVR, Lopes RB, Andrade EF, Pereira LJ. Game-based learning enhances students' understanding of endocrine physiology in veterinary medicine. Adv Physiol Educ 2024; 48:155-163. [PMID: 38234294 DOI: 10.1152/advan.00182.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/19/2024]
Abstract
Endocrine physiology is a complex subject for students. Game-based learning (GBL) and case-based learning (CBL) are active methodologies that are widely used because of their potential for motivation and greater proximity to the reality of modern students. We evaluated the effectiveness of GBL and CBL among veterinary medicine students compared with a control group using peer tutoring. Students (n = 106) from two institutions volunteered to participate in this study. The participants were submitted to a pretest questionnaire and subsequently were divided into three paired groups by their performance on the pretest exam: 1) traditional class + peer tutoring, 2) traditional class + GBL, and 3) traditional class + CBL. After the students completed the activities, their performance was once again evaluated by applying a new test with the same initial 10 questions and another set of 10 different questions. The students' perceptions and satisfaction with the methodologies and learning strategies were assessed. Anxiety was assessed with the State-Trait Anxiety Inventory before and after the conventional class and after the active methodologies. The GBL group significantly improved their correct answers compared with the baseline (P < 0.05), with no significant difference from CBL and peer tutoring. Anxiety levels did not differ regardless of the time of evaluation or the teaching methodology applied. GBL promoted a greater perception of the stimulus for self-study and problem-solving ability and contributed to the development of group dynamics compared with the group who received CBL (P < 0.05). In conclusion, GBL showed better results than peer tutoring and CBL.NEW & NOTEWORTHY We compared the supplementary use of game-based learning, case-based learning, and peer tutoring in the study of endocrine physiology by veterinary students and observed a slight advantage for game-based learning over the other two methodologies. The game was developed by the authors and is an unprecedented tool that can prove useful to improve knowledge acquisition in students of veterinary medicine. Thus, game-based learning is an effective supplementary teaching strategy.
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Affiliation(s)
| | - Rodrigo Braga Lopes
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Eric Francelino Andrade
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
| | - Luciano José Pereira
- Health Sciences Department, Universidade Federal de Lavras (UFLA), Lavras, Minas Gerais, Brazil
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Shan J, Ye M, Ku E, McCulloch CE, Langan SM, Abuabara K. Fasting blood glucose and insulin are not associated with atopic dermatitis in a pediatric population: A longitudinal cohort study from the Avon Longitudinal Study of Parents and Children. JAAD Int 2024; 15:12-14. [PMID: 38371671 PMCID: PMC10869312 DOI: 10.1016/j.jdin.2023.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Affiliation(s)
- Judy Shan
- Department of Dermatology, University of California, San Francisco, California
| | - Morgan Ye
- Department of Dermatology, University of California, San Francisco, California
| | - Elaine Ku
- Division of Nephrology, Departments of Medicine and Pediatrics, University of California, San Francisco, California
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California
| | - Charles E. McCulloch
- Department of Epidemiology & Biostatistics, University of California, San Francisco, California
| | - Sinéad M. Langan
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Katrina Abuabara
- Department of Dermatology, University of California, San Francisco, California
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3
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Cowart K, Coon S, Carris NW. A Review of the Safety and Efficacy of Bexagliflozin for the Management of Type 2 Diabetes. Ann Pharmacother 2024; 58:514-522. [PMID: 37568270 DOI: 10.1177/10600280231190443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE To review the pharmacology of bexagliflozin in addition to its safety and efficacy from available clinical trials used for its approval, as well as available clinical evidence to date. DATA SOURCES A search of the National Institutes of Health Clinical Trials Registry (http://www.clinicaltrials.gov) and PubMed database was performed from inception through June 1, 2023. STUDY SELECTION AND DATA EXTRACTION QUANTIFICATION The following study designs were included: meta-analyses, systematic review, clinical trial, or observational study design. Abstracts and drug monographs were also reviewed. Narrative or scoping reviews were excluded. Only articles in the English language and those evaluating the pharmacology, pharmacokinetics, safety, or efficacy of bexaglifozin in humans were included. DATA SYNTHESIS Bexagliflozin reduces hemoglobin A1c ~0.5% with similar reductions in systolic blood pressure and body weight to other SGLT2 inhibitors. No cardiovascular outcomes trial is published, nor ongoing at this time. Adverse effects are similar to other SGLT2 inhibitors (genital mycotic and urinary tract infections, increased urination) including a warning for lower extremity amputation similar to canagliflozin. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE IN COMPARISON TO EXISTING DRUGS Although no cost-effectiveness data are available, statements from the manufacturer suggest a competitive price point. Given limited trial data, lower cost, if chosen, may create a temporary niche for bexagliflozin pending generic availability of other SGLT2 inhibitors. However, given lack of cardiovascular and renal outcome data, empagliflozin, dapagliflozin, or canagliflozin may be preferred. CONCLUSION Bexagliflozin appears safe and effective as monotherapy and add-on pharmacological therapy for the treatment of T2D.
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Affiliation(s)
- Kevin Cowart
- Taneja College of Pharmacy, Morsani College of Medicine, and College of Public Health, University of South Florida, Tampa, FL, USA
| | - Scott Coon
- Taneja College of Pharmacy and Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Nicholas W Carris
- Taneja College of Pharmacy and Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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Braun V, Ceglarek U, Gaudl A, Gawinecka J, Müller D, Rauh M, Weber M, Seger C. Evaluation of five multisteroid LC‒MS/MS methods used for routine clinical analysis: comparable performance was obtained for nine analytes. Clin Chem Lab Med 2024; 62:900-910. [PMID: 38038605 DOI: 10.1515/cclm-2023-0847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVES A mass spectrometry (LC‒MS/MS)-based interlaboratory comparison study was performed for nine steroid analytes with five participating laboratories. The sample set contained 40 pooled samples of human serum generated from preanalyzed leftovers. To obtain a well-balanced distribution across reference intervals of each steroid, the leftovers first underwent a targeted mixing step. METHODS All participants measured a sample set once using their own multianalyte protocols and calibrators. Four participants used in-house developed measurement platforms, including IVD-CE certified calibrators, which were used by three participants; the 5th lab used the whole LC‒MS kit from an IVD manufacturer. All labs reported results for 17-hydroxyprogesterone, androstenedione, cortisol, and testosterone, and four labs reported results for 11-deoxycortisol, corticosterone, cortisone, dehydroepiandrosterone sulfate (DHEAS), and progesterone. RESULTS Good or acceptable overall comparability was found in Bland‒Altman and Passing‒Bablok analyses. Mean bias against the overall mean remained less than ±10 % except for DHEAS, androstenedione, and progesterone at one site and for cortisol and corticosterone at two sites (max. -18.9 % for androstenedione). The main analytical problems unraveled by this study included a bias not previously identified in proficiency testing, operator errors, non-supported matrix types and higher inaccuracy and imprecision at lower ends of measuring intervals. CONCLUSIONS This study shows that intermethod comparison is essential for monitoring the validity of an assay and should serve as an example of how external quality assessment could work in addition to organized proficiency testing schemes.
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Affiliation(s)
- Valentin Braun
- Institute of Pharmacy/Pharmacognosy, CCB - Centrum of Chemistry and Biomedicine, University of Innsbruck, Innsbruck, Austria
- Dr. Risch Ostschweiz AG, Buchs, Switzerland
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Alexander Gaudl
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Joanna Gawinecka
- Institute of Clinical Chemistry, University Hospital Zurich, Zürich, Switzerland
| | - Daniel Müller
- Institute of Clinical Chemistry, University Hospital Zurich, Zürich, Switzerland
- Department of Clinical Chemistry and Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Manfred Rauh
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | | | - Christoph Seger
- Institute of Pharmacy/Pharmacognosy, CCB - Centrum of Chemistry and Biomedicine, University of Innsbruck, Innsbruck, Austria
- Dr. Risch Ostschweiz AG, Buchs, Switzerland
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5
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Goodridge JD. The importance of addressing the research gap in transmasculine individuals: pharmacological and research considerations. Br J Clin Pharmacol 2024:e16086. [PMID: 38653949 DOI: 10.1111/bcp.16086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
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Blunschi F, Schofield I, Muthmann S, Bauer NB, Hazuchova K. Development and validation of a questionnaire to assess health-related quality-of-life in cats with hyperthyroidism. J Vet Intern Med 2024. [PMID: 38647174 DOI: 10.1111/jvim.17083] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 11/23/2023] [Accepted: 04/05/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Health-related quality-of-life (HRQoL) assessment tools are becoming increasingly important for the assessment of diseases in veterinary medicine. OBJECTIVES To develop a tool to assess the HRQoL of hyperthyroid cats and their owners. ANIMALS Cats with hyperthyroidism (n = 229) and without hyperthyroidism (n = 322). METHODS Cross-sectional study design. A preliminary list of 28 questions relating to the HRQoL of hyperthyroid cats and the influence their cat's disease might have on owners was created. Each question consisted of 2 subquestions: (1) "how often does the item apply"; (2) "how strongly does the item affect HRQoL." The questionnaire was refined based on statistical analysis, including Mann-Whitney-U tests on each item, comparing the results from cats with and without hyperthyroidism. Internal consistency and reliability of the questions were measured by Cronbach's alpha (α). P < .05 was considered significant. RESULTS Overall, 25/28 questions were retained within the final HRQoL tool, which had an excellent internal consistency (α = .92). The tool produced a score between 0 and 382 (lower scores meaning better HRQoL). The median HRQoL score was 87.5 (range, 2-348) for cats with hyperthyroidism, and 27 (range, 0-249) for cats without (P < .001), suggesting the HRQoL was poorer in hyperthyroid cats. CONCLUSIONS AND CLINICAL IMPORTANCE This validated HRQoL tool is useful to reliably quantify the influence of hyperthyroidism on the quality-of-life of affected cats and their owners. In the future, it could be considered of assistance in the clinical assessment of cats with hyperthyroidism.
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Affiliation(s)
- Fabienne Blunschi
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Giessen, Germany
| | | | - Sofie Muthmann
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Giessen, Germany
| | - Natali B Bauer
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Giessen, Germany
| | - Katarina Hazuchova
- Department of Veterinary Clinical Sciences, Small Animal Clinic, Justus-Liebig-University, Giessen, Germany
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7
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Hervé J, Haurogné K, Allard M, Sourice S, Lindenbaum P, Bach JM, Lieubeau B. Spontaneous Akt2 deficiency in a colony of NOD mice exhibiting early diabetes. Sci Rep 2024; 14:9100. [PMID: 38643275 PMCID: PMC11032318 DOI: 10.1038/s41598-024-60021-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 02/02/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
Diabetes constitutes a major public health problem, with dramatic consequences for patients. Both genetic and environmental factors were shown to contribute to the different forms of the disease. The monogenic forms, found both in humans and in animal models, specially help to decipher the role of key genes in the physiopathology of the disease. Here, we describe the phenotype of early diabetes in a colony of NOD mice, with spontaneous invalidation of Akt2, that we called HYP. The HYP mice were characterised by a strong and chronic hyperglycaemia, beginning around the age of one month, especially in male mice. The phenotype was not the consequence of the acceleration of the autoimmune response, inherent to the NOD background. Interestingly, in HYP mice, we observed hyperinsulinemia before hyperglycaemia occurred. We did not find any difference in the pancreas' architecture of the NOD and HYP mice (islets' size and staining for insulin and glucagon) but we detected a lower insulin content in the pancreas of HYP mice compared to NOD mice. These results give new insights about the role played by Akt2 in glucose homeostasis and argue for the ß cell failure being the primary event in the course of diabetes.
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McElwain CJ, Manna S, Musumeci A, Sylvester I, Rouchon C, O'Callaghan AM, Ebad MAB, McCarthy FP, McCarthy CM. Defective Visceral Adipose Tissue Adaptation in Gestational Diabetes Mellitus. J Clin Endocrinol Metab 2024; 109:1275-1284. [PMID: 38035802 PMCID: PMC11031241 DOI: 10.1210/clinem/dgad699] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 08/25/2023] [Revised: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 12/02/2023]
Abstract
CONTEXT Gestational diabetes mellitus (GDM) is a complex obstetric condition affecting localized glucose metabolism, resulting in systemic metabolic dysfunction. OBJECTIVE This cross-sectional study aimed to explore visceral adipose tissue (VAT) as an integral contributor to GDM, focusing on elucidating the specific contribution of obesity and GDM pathology to maternal outcomes. METHODS Fifty-six nulliparous pregnant women were recruited, including normal glucose tolerant (NGT) (n = 30) and GDM (n = 26) participants. Participants were subgrouped as nonobese (BMI <30 kg/m2) or obese (BMI ≥30 kg/m2). Metabolic markers in circulation, VAT, and placenta were determined. Morphological analysis of VAT and immunoblotting of the insulin signaling cascade were performed. RESULTS GDM participants demonstrated hyperinsulinemia and elevated homeostatic model assessment for insulin resistance (HOMA-IR) scores relative to NGT participants. The GDM-obese subgroup had significant VAT adipocyte hypoplasia relative to NGT-nonobese tissue. GDM-obese VAT had significantly lower insulin receptor substrate (IRS)-2 expression, with elevated ser312 phosphorylation of IRS-1, relative to NGT-nonobese. GDM-obese participants had significantly elevated circulating leptin levels and placental adipsin secretion, while GDM-nonobese participants had elevated circulating adipsin levels with reduced placental adiponectin secretion. CONCLUSION These findings suggest that GDM-obese pregnancy is specifically characterized by inadequate VAT remodeling and dysfunctional molecular signaling, which contribute to insulin resistance and hinder metabolic health.
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Affiliation(s)
- Colm J McElwain
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork T12XF62, Ireland
| | - Samprikta Manna
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork T12DC4A, Ireland
| | - Andrea Musumeci
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork T12XF62, Ireland
| | - Isaac Sylvester
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork T12XF62, Ireland
| | - Chloé Rouchon
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork T12XF62, Ireland
| | - Anne Marie O'Callaghan
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork T12XF62, Ireland
| | - Mustafa Abdalla Bakhit Ebad
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork T12XF62, Ireland
| | - Fergus P McCarthy
- Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Cork T12DC4A, Ireland
| | - Cathal M McCarthy
- Department of Pharmacology and Therapeutics, Western Gateway Building, University College Cork, Cork T12XF62, Ireland
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Kilic A, Emecen Sanli M, Ozsaydı Aktasoglu E, Gokalp S, Biberoğlu G, Inci A, Okur I, Suheyl Ezgu F, Tumer L. Endocrinological and metabolic profile of Gaucher disease patients treated with enzyme replacement therapy. J Pediatr Endocrinol Metab 2024; 0:jpem-2023-0504. [PMID: 38624096 DOI: 10.1515/jpem-2023-0504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/11/2023] [Accepted: 03/12/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES Gaucher Disease (GD) is a lysosomal storage disease caused by glucocerebrosidase (GCase) enzyme deficiency. Gaucher cells transformed from the macrophages by progressive sphingolipid accumulation and infiltrate bone marrow, spleen, liver, and other organs. The accumulation of substrate causes inflammation, compromised cellular homeostasis, and disturbed autophagy. It has been hypothesized that this proinflammatory state of GD leads cytokines and chemokines release. As a result of inflammatory process, the cellular dysfunction caused by disruption of cellular signaling, organelle dysfunction, or autoimmune antibodies may affect endocrine profile of GD patients such as hormone levels, lipid profile, and bone mineral density status. METHODS A total of 13 patients confirmed to have GD, 12 non-neuronopathic type and one subacute neuronopathic type, were enrolled in our study. RESULTS The median treatment duration in the enzyme therapy was 13.33 years (9-26 years). At least one endocrinological abnormality was detected in blood tests of nine patients. Hyperinsulinism was the most common finding although fasting blood glucose levels HgbA1c levels were normal in all patients. Two patients had osteopenia, and osteoporosis was detected in two patients. Low HDL levels were detected in six patients, but HDL levels below 23 mg/dL associated with disease severity have been detected in two patients who have not receiving enzyme replacement therapy. None of patients had thyroidal dysfunction. CONCLUSIONS This study had revealed endocrinological abnormalities in GD patients that have not led any severe morbidity in our patients. However, thyroid hormone abnormalities, insulin resistance, or lipid profile abnormalities may cause unpredictable comorbidities. Endocrinological assessment in GD patients in routine follow-up may prevent possible clinical manifestation in long term as well as can define efficacy of ERT on endocrine abnormalities.
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Affiliation(s)
- Ayse Kilic
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
| | - Merve Emecen Sanli
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
| | - Ekin Ozsaydı Aktasoglu
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
| | - Sabire Gokalp
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
| | - Gürsel Biberoğlu
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
| | - Aslı Inci
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
| | - Ilyas Okur
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
| | - Fatih Suheyl Ezgu
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
| | - Leyla Tumer
- Department of Pediatrics, Department of Inborn Metabolic Diseases, Gazı University Faculty of Medicine, Eminiyet Mahallesi, Yenimahalle/Ankara, Türkiye
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Sartorius AM, Rokicki J, Birkeland S, Bettella F, Barth C, de Lange AMG, Haram M, Shadrin A, Winterton A, Steen NE, Schwarz E, Stein DJ, Andreassen OA, van der Meer D, Westlye LT, Theofanopoulou C, Quintana DS. An evolutionary timeline of the oxytocin signaling pathway. Commun Biol 2024; 7:471. [PMID: 38632466 PMCID: PMC11024182 DOI: 10.1038/s42003-024-06094-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 01/19/2023] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
Oxytocin is a neuropeptide associated with both psychological and somatic processes like parturition and social bonding. Although oxytocin homologs have been identified in many species, the evolutionary timeline of the entire oxytocin signaling gene pathway has yet to be described. Using protein sequence similarity searches, microsynteny, and phylostratigraphy, we assigned the genes supporting the oxytocin pathway to different phylostrata based on when we found they likely arose in evolution. We show that the majority (64%) of genes in the pathway are 'modern'. Most of the modern genes evolved around the emergence of vertebrates or jawed vertebrates (540 - 530 million years ago, 'mya'), including OXTR, OXT and CD38. Of those, 45% were under positive selection at some point during vertebrate evolution. We also found that 18% of the genes in the oxytocin pathway are 'ancient', meaning their emergence dates back to cellular organisms and opisthokonta (3500-1100 mya). The remaining genes (18%) that evolved after ancient and before modern genes were classified as 'medium-aged'. Functional analyses revealed that, in humans, medium-aged oxytocin pathway genes are highly expressed in contractile organs, while modern genes in the oxytocin pathway are primarily expressed in the brain and muscle tissue.
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Affiliation(s)
- Alina M Sartorius
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Jaroslav Rokicki
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway
| | - Siri Birkeland
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
- Natural History Museum, University of Oslo, Oslo, Norway
| | - Francesco Bettella
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Medical Genetics, Division of Laboratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Claudia Barth
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ann-Marie G de Lange
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Marit Haram
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Alexey Shadrin
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Adriano Winterton
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Nils Eiel Steen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Emanuel Schwarz
- Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Dennis van der Meer
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway
| | | | - Daniel S Quintana
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine and Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway.
- NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway.
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Kitagawa Y, Maloney SK, Pool KR, Webster D, Ohkura S, Blache D, Ding L. Behavioural and physiological responses to stressors in sheep with temperament classified by genotype or phenotype. Sci Rep 2024; 14:8147. [PMID: 38584170 PMCID: PMC10999442 DOI: 10.1038/s41598-024-58959-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 12/04/2023] [Accepted: 04/04/2024] [Indexed: 04/09/2024] Open
Abstract
The single nucleotide polymorphism (SNP) rs107856856, located in the tryptophan hydroxylase-2 gene, is associated with the behavioural phenotype for sheep temperament measured at weaning. Here, we tested the association between that SNP and physiological and behavioural responses to stressors in adult sheep. Two groups of adult sheep, one with genotype A/A (calm genotype) and the other with G/G (nervous genotype) in rs107856856, were selected from 160 sheep and were exposed, twice, to an open-field arena and an isolation box test (IBT). During each repeat, the behaviour and physiological responses (cortisol, prolactin, dehydroepiandrosterone [DHEA], brain derived neurotrophic factor [BDNF], characteristics of the response of body temperature, and oxidative stress) were measured. The behavioural and physiological responses of the sheep were compared between genotypes and also between groups classified on their phenotype as assessed by their initial isolation box score ("low responders" and "high responders"). The SNP rs107856856 had some effects on the behavioural phenotype (IBT score) but no effects on the physiological response to stress (cortisol, prolactin, DHEA, BDNF, oxidative stress or changes in body temperature) in the adult sheep, probably because the sheep were exposed, and therefore had adapted, to human contact during their life.
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Affiliation(s)
- Yuri Kitagawa
- Laboratory of Animal Production Science, Graduate School of Bioagricultural Sciences, Nagoya University, Togo-cho, Aichi, Japan
- School of Agriculture and Environment, M087, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia
| | - Shane K Maloney
- School of Human Sciences, M309, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia
| | - Kelsey R Pool
- School of Agriculture and Environment, M087, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia
| | - Dane Webster
- School of Human Sciences, M309, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia
| | - Satoshi Ohkura
- Laboratory of Animal Production Science, Graduate School of Bioagricultural Sciences, Nagoya University, Togo-cho, Aichi, Japan
| | - Dominique Blache
- College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, China.
- School of Agriculture and Environment, M087, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia.
| | - Luoyang Ding
- College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, China.
- School of Agriculture and Environment, M087, The University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia.
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12
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Ridder LO, Balle CM, Skakkebæk A, Lind-Holst M, Nielsen MM, Hermann P, Hansen S, Nielsen DG, Knorr S, Andersen NH, Viuff MH, Berglund A, Gravholt CH. Endocrine, cardiac and neuropsychological aspects of adult congenital adrenal hyperplasia. Clin Endocrinol (Oxf) 2024. [PMID: 38572909 DOI: 10.1111/cen.15055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 03/23/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To investigate the metabolic, cardiovascular, and neuropsychological phenotype, quality of life (QoL), and hormonal regulation in individuals with congenital adrenal hyperplasia (CAH), a group of autosomal recessive disorders characterized by impaired synthesis of cortisol in the adrenal cortex and, if untreated compensatory hyperandrogenism. CAH is associated with an increased cardiovascular and metabolic morbidity, possibly due to overtreatment with glucocorticoids, leading to weight gain, insulin resistance, and metabolic syndrome. DESIGN, PARTICIPANTS, MEASUREMENTS Thirty-seven individuals with CAH and 33 age- and sex-matched controls were evaluated at a single centre at Aarhus University Hospital with echocardiography, electrocardiogram, 24-h blood pressure, biochemistry, anthropometrics, and autism spectrum, anxiety, depression, personality, cognitive failures, and QoL were assessed using questionnaires. RESULTS CAH individuals had lower height than controls (170.5 vs. 182.9 cm in males and 160.2 vs. 170.1 cm in females, p < 0.01). Compared with female controls, females with CAH had higher haemoglobin (8.8 vs. 8.2 mmol/L, p = 0.003) and BMI (29.7 vs. 25.5 kg/m2, p = 0.006), reduced insulin sensitivity (HOMA-IR): 2.7 vs. 1.9, p = 0.018), prolonged E-wave deceleration time (193 vs. 174 cm, p = 0.015), and E/é ratios (5.4 vs. 4.5, p = 0.017), and lower self-reported QoL. Males with CAH had more cognitive complaints (p = 0.034) and higher autistic scores (19.9 vs. 14.9; p = 0.068) compared with male controls. More individuals with CAH than controls reported writing problems. CONCLUSION A sex-specific comorbidity profile is evident in CAH, with females presenting with decreased metabolic and overall self-reported health, whereas males with CAH presented with increased cognitive complaints and autistic traits.
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Affiliation(s)
- Lukas Ochsner Ridder
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Anne Skakkebæk
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Marie Lind-Holst
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Mølby Nielsen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Pernille Hermann
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Stinus Hansen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | | | - Sine Knorr
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Steno Diabetes Center, Aarhus University Hospital, Aarhus, Denmark
| | | | - Mette Hansen Viuff
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Agnethe Berglund
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Claus Højbjerg Gravholt
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
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13
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de Luis D, Izaola O, Primo D, López Gómez JJ, Pacheco D. Role of rs2282679 in 25-hydroxyvitamin D levels and insulin resistance after a sleeve gastrectomy. Nutr Diabetes 2024; 14:12. [PMID: 38570479 PMCID: PMC10991311 DOI: 10.1038/s41387-024-00272-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 09/11/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND & AIMS Some studies have reported links between 25-hydroxyvitamin D levels and the presence of obesity and some genetic variants. The aim of our design was to evaluate the effects of rs2282679 genetic variant of CG gene on 25-hydroxyvitamin D levels, weight loss and metabolic parameters after a robotic sleeve gastrectomy in premenopausal females with obesity. METHODS 76 participants were enrolled. 25-hydroxyvitamin D levels, biochemical evaluation and anthropometric parameters were registered before surgery and after 3, 6 and 12 months follow up. Genotype of rs2282679 CG gene was evaluated. RESULTS The improvements in anthropometric parameters, blood pressure and lipid profile were similar in both genotypes (TT vs TG + GG). Basal insulin levels and HOMA-IR were greater in G allele carriers than non-carriers (Delta: 6.7 ± 1.2 mUI/L; p = 0.01) and (Delta: 1.3 ± 0.1 units; p = 0.02). 25-hydroxyvitamin D levels were lower in G allele carriers than non-carriers (Delta: 8.1 ± 1.1 ng/dl; p = 0.03). The levels of insulin and HOMA-IR remained greater in G allele carriers than non-carriers throughout all the visits. The levels of 25-hydroxyvitamin D remained lower in G allele carriers than non-G allele. The average level of 25-hydroxyvitamin D at 12 months in non-G allele carriers were above 30 ng/dl (36.0 ± 3.1 ng/dl) and the level in G allele carriers were below (24.9 ± 4.9 ng/dl). CONCLUSIONS rs 2282679 (GC) was related with low 25 hydroxyvitamin D levels and insulin resistance. In addition, the presence of G allele produced a decrease in the improvement of 25-hydroxyvitamin D levels and insulin resistance after weight loss during 12 months.
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Affiliation(s)
- Daniel de Luis
- Endocrinology and Nutrition Research Center, School of Medicine, Valladolid, Spain.
- Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain.
| | - Olatz Izaola
- Endocrinology and Nutrition Research Center, School of Medicine, Valladolid, Spain
- Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - David Primo
- Endocrinology and Nutrition Research Center, School of Medicine, Valladolid, Spain
- Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - Juan José López Gómez
- Endocrinology and Nutrition Research Center, School of Medicine, Valladolid, Spain
- Department of Endocrinology and Nutrition, Hospital Clinico Universitario, University of Valladolid, Valladolid, Spain
| | - David Pacheco
- Endocrinology and Nutrition Research Center, School of Medicine, Valladolid, Spain
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14
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Lee J, Song Y, Kim YA, Kim I, Cha J, Lee SW, Ko Y, Kim CS, Kim S, Lee S. Characterization of a new selective glucocorticoid receptor modulator with anorexigenic activity. Sci Rep 2024; 14:7844. [PMID: 38570726 PMCID: PMC10991430 DOI: 10.1038/s41598-024-58546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 11/26/2023] [Accepted: 04/01/2024] [Indexed: 04/05/2024] Open
Abstract
Obesity, a worldwide epidemic, leads to various metabolic disorders threatening human health. In response to stress or fasting, glucocorticoid (GC) levels are elevated to promote food intake. This involves GC-induced expression of the orexigenic neuropeptides in agouti-related protein (AgRP) neurons of the hypothalamic arcuate nucleus (ARC) via the GC receptor (GR). Here, we report a selective GR modulator (SGRM) that suppresses GR-induced transcription of genes with non-classical glucocorticoid response elements (GREs) such as Agrp-GRE, but not with classical GREs, and via this way may serve as a novel anti-obesity agent. We have identified a novel SGRM, 2-O-trans-p-coumaroylalphitolic acid (Zj7), a triterpenoid extracted from the Ziziphus jujube plant, that selectively suppresses GR transcriptional activity in Agrp-GRE without affecting classical GREs. Zj7 reduces the expression of orexigenic genes in the ARC and exerts a significant anorexigenic effect with weight loss in both high fat diet-induced obese and genetically obese db/db mouse models. Transcriptome analysis showed that Zj7 represses the expression of a group of orexigenic genes including Agrp and Npy induced by the synthetic GR ligand dexamethasone (Dex) in the hypothalamus. Taken together, Zj7, as a selective GR modulator, showed beneficial metabolic activities, in part by suppressing GR activity in non-classical GREs in orexigenic genes. This study demonstrates that a potential anorexigenic molecule may allow GRE-specific inhibition of GR transcriptional activity, which is a promising approach for the treatment of metabolic disorders.
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Affiliation(s)
- Junekyoung Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea
| | - Yeonghun Song
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea
| | - Young A Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea
| | - Intae Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea
| | - Jooseon Cha
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea
| | - Su Won Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea
| | - Yoonae Ko
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea
| | - Chong-Su Kim
- Department of Food and Nutrition, College of Natural Information Sciences, Dongduk Women's University, Seoul, 02748, Korea
| | - Sanghee Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea.
| | - Seunghee Lee
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, 08826, Korea.
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15
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Doi-Tanaka Y, Tamura I, Shiroshita A, Fujimura T, Shirafuta Y, Maekawa R, Taketani T, Sato S, Sugino N. Differential gene expression in decidualized human endometrial stromal cells induced by different stimuli. Sci Rep 2024; 14:7726. [PMID: 38565619 PMCID: PMC10987566 DOI: 10.1038/s41598-024-58065-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 12/04/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
Decidualization can be induced by culturing human endometrial stromal cells (ESCs) with several decidualization stimuli, such as cAMP, medroxyprogesterone acetate (MPA) or Estradiol (E2). However, it has been unclear how decidualized cells induced by different stimuli are different. We compared transcriptomes and cellular functions of decidualized ESCs induced by different stimuli (MPA, E2 + MPA, cAMP, and cAMP + MPA). We also investigated which decidualization stimulus induces a closer in vivo decidualization. Differentially expressed genes (DEGs) and altered cellular functions by each decidualization stimuli were identified by RNA-sequence and gene-ontology analysis. DEGs was about two times higher for stimuli that use cAMP (cAMP and cAMP + MPA) than for stimuli that did not use cAMP (MPA and E2 + MPA). cAMP-using stimuli altered the cellular functions including angiogenesis, inflammation, immune system, and embryo implantation whereas MPA-using stimuli (MPA, E2 + MPA, and cAMP + MPA) altered the cellular functions associated with insulin signaling. A public single-cell RNA-sequence data of the human endometrium was utilized to analyze in vivo decidualization. The altered cellular functions by in vivo decidualization were close to those observed by cAMP + MPA-induced decidualization. In conclusion, decidualized cells induced by different stimuli have different transcriptome and cellular functions. cAMP + MPA may induce a decidualization most closely to in vivo decidualization.
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Affiliation(s)
- Yumiko Doi-Tanaka
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan
| | - Isao Tamura
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan.
| | - Amon Shiroshita
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan
| | - Taishi Fujimura
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan
| | - Yuichiro Shirafuta
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan
| | - Ryo Maekawa
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan
| | - Toshiaki Taketani
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan
| | - Shun Sato
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan
| | - Norihiro Sugino
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Minamikogushi 1-1-1, Ube, 755-8505, Japan
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Kays Mohammed Ali Y, Dolin TG, Damm Nybing J, Lykke J, Hvid Linden F, Høgh-Schmidt E, Sørensen TIA, Christensen JF, Nielsen YJW, Stenfatt Larsen J, Madsbad S, Sidenius Johansen J, Svane MS, Lang Lehrskov L. Change in abdominal obesity after colon cancer surgery - effects of left-sided and right-sided colonic resection. Int J Obes (Lond) 2024; 48:533-541. [PMID: 38172335 PMCID: PMC10978490 DOI: 10.1038/s41366-023-01445-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/21/2023] [Revised: 11/29/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Excess abdominal visceral adipose tissue (VAT) is associated with metabolic diseases and poor survival in colon cancer (CC). We assessed the impact of different types of CC surgery on changes in abdominal fat depots. MATERIAL AND METHODS Computed tomography (CT)-scans performed preoperative and 3 years after CC surgery were analyzed at L3-level for VAT, subcutaneous adipose tissue (SAT) and total adipose tissue (TAT) areas. We assessed changes in VAT, SAT, TAT and VAT/SAT ratio after 3 years and compared the changes between patients who had undergone left-sided and right-sided colonic resection in the total population and in men and women separately. RESULTS A total of 134 patients with stage I-III CC undergoing cancer surgery were included. Patients who had undergone left-sided colonic resection had after 3 years follow-up a 5% (95% CI: 2-9%, p < 0.01) increase in abdominal VAT, a 4% (95% CI: 2-6%, p < 0.001) increase in SAT and a 5% increase (95% CI: 2-7%, p < 0.01) in TAT. Patients who had undergone right-sided colonic resection had no change in VAT, but a 6% (95% CI: 4-9%, p < 0.001) increase in SAT and a 4% (95% CI: 1-7%, p < 0.01) increase in TAT after 3 years. Stratified by sex, only males undergoing left-sided colonic resection had a significant VAT increase of 6% (95% CI: 2-10%, p < 0.01) after 3 years. CONCLUSION After 3 years follow-up survivors of CC accumulated abdominal adipose tissue. Notably, those who underwent left-sided colonic resection had increased VAT and SAT, whereas those who underwent right-sided colonic resection demonstrated solely increased SAT.
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Affiliation(s)
- Younes Kays Mohammed Ali
- Department of Endocrinological Research, Copenhagen University Hospital -Amager and Hvidovre, Hvidovre, Denmark
- Department of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Troels Gammeltoft Dolin
- Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- CopenAge, Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark
| | - Janus Damm Nybing
- Department of Radiology, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark
| | - Jakob Lykke
- Department of Surgery, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Frederik Hvid Linden
- Department of Radiology, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark
| | - Erik Høgh-Schmidt
- Department of Radiology, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Frank Christensen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences at the University of Southern Denmark, Odense, Denmark
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
| | - Yousef J W Nielsen
- Department of Radiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Jim Stenfatt Larsen
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Sten Madsbad
- Department of Endocrinological Research, Copenhagen University Hospital -Amager and Hvidovre, Hvidovre, Denmark
| | - Julia Sidenius Johansen
- Department of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Maria Saur Svane
- Department of Endocrinological Research, Copenhagen University Hospital -Amager and Hvidovre, Hvidovre, Denmark
- Department of Gastrointestinal Surgery, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Louise Lang Lehrskov
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
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17
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Imhof RL, Todd A, Davidge-Pitts CJ, Alavi A. Hidradenitis suppurativa in transgender and gender diverse patients: A retrospective review with examination of the role of hormone therapy. J Am Acad Dermatol 2024; 90:845-847. [PMID: 38086516 DOI: 10.1016/j.jaad.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Reese L Imhof
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
| | - Austin Todd
- Department of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota
| | | | - Afsaneh Alavi
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
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18
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Yap SHA, Philip S, Graveling AJ, Abraham P, Downs D. Creating a SNOMED CT reference set for common endocrine disorders based on routine clinic correspondence. Clin Endocrinol (Oxf) 2024; 100:343-349. [PMID: 37555365 DOI: 10.1111/cen.14951] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/04/2023] [Revised: 06/13/2023] [Accepted: 07/13/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Routine clinical coding of clinical outcomes in outpatient consultations still lags behind the coding of episodes of inpatient care. Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) offers an opportunity for standardised coding of key clinical information. Identifying the most commonly required SNOMED terms and grouping these into a reference set will aid future adoption in routine clinical care. OBJECTIVE To create a common endocrinology reference set to standardise the coding for outcomes of outpatient endocrine consultations, using a semi-automated extraction of information from existing clinical correspondence. METHODS Retrospective review of data from an adult tertiary outpatient endocrine clinic between 2018 and 2019. A total of 1870 patients from postcodes within two regional areas of NHS Grampian (Aberdeen City and Aberdeenshire) attended the clinic. Following consultation, an automated script extracted each problem statement which was manually coded using the 'disorder' concepts from SNOMED CT (UK edition). RESULTS The review identified 298 relevant endocrine diagnoses, 99 findings and 142 procedures. There were a total of 88 (29.5%) commonly seen endocrine conditions (e.g., Graves' disease, anterior hypopituitarism and Addison's disease) and 210 (70.5%) less commonly seen endocrine conditions. Subsequently, consultant endocrinologists completed a survey regarding the common endocrine conditions; 28 conditions have 100% agreement, 25 have 90%-99% agreement, 31 have 50%-89% agreement and 4 have less than 59% agreement (which were excluded). CONCLUSION Automated text parsing of structured endocrine correspondence allowed the creation of a SNOMED CT reference set for common endocrine disorders. This will facilitate funding and planning of service provision in endocrinology by allowing more accurate characterisation of the patient cohorts needing specialist endocrine care.
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Affiliation(s)
- Shao Hao Alan Yap
- JJR Macleod Centre for Diabetes & Endocrinology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Sam Philip
- JJR Macleod Centre for Diabetes & Endocrinology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Alex J Graveling
- JJR Macleod Centre for Diabetes & Endocrinology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Prakash Abraham
- JJR Macleod Centre for Diabetes & Endocrinology, Aberdeen Royal Infirmary, Aberdeen, UK
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Fornwald CR, Russo-Alvarez G, Pantalone KM, Zeleznikar E, Parker M, McCorkindale N, Butler R, Hermiller T. Endocrinology/Primary Care Pharmacy Collaboration vs Endocrinology Care Alone in Patients With Type 2 Diabetes and A1c >9. J Pharm Technol 2024; 40:78-84. [PMID: 38525094 PMCID: PMC10959080 DOI: 10.1177/87551225231224251] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/26/2024] Open
Abstract
Background: Type 2 diabetes (T2D) requires close collaboration between patients and their care management team, often including endocrinology. Primary care pharmacist impact on diabetes management in collaboration with endocrinology is not well established. Objective: To assess if pharmacy and endocrinology collaboration results in a greater A1c reduction in patients with T2D vs endocrinology alone. Methods: This retrospective, observational cohort study was conducted in adult outpatients with T2D and baseline A1c >9% who saw endocrinology within 1 year preceding the study period (January 1, 2021 to January 1, 2022). Patients were included if they had a follow-up A1c 6 months (±90 days) from index date and completed at least 1 endocrinology visit during the study period. Patients managed by endocrinology/primary care pharmacist collaboration (Endo/PharmD) were compared with those who received endocrinology care alone (Endo). Primary outcome was change in A1c from baseline to 6 months. Secondary outcomes included total number of completed visits and percentage of patients achieving A1c <6.5%, <7%, <8%, and <9% between groups at 6 months. Results: A total of 418 patients were included (22 Endo/PharmD, 396 Endo). The change in follow-up A1c was not significantly different between groups, -0.481% (standard error [SE] = 0.396); P = 0.6179. Endo/PharmD patients had significantly more provider visits during the study period (5.3 ± 2.3 vs 2.3 ± 1.2; P < 0.001). No significant difference was observed in odds of A1c goal attainment between groups at 6 months. Conclusion and Relevance: Endocrinology/primary care pharmacist collaboration occurred infrequently but was associated with a trend toward greater A1c reduction in patients with T2D and A1c >9%.
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Affiliation(s)
| | | | - Kevin M. Pantalone
- Department of Endocrinology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Marcie Parker
- Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Robert Butler
- Quantitative Health Sciences Department, Learner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Taylor Hermiller
- Department of Pharmacy, Cleveland Clinic Foundation, Cleveland, OH, USA
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20
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Godsland IF, Johnston DG, Alberti K, Oliver N. The importance of intravenous glucose tolerance test glucose stimulus for the evaluation of insulin secretion. Sci Rep 2024; 14:7451. [PMID: 38548796 PMCID: PMC10978989 DOI: 10.1038/s41598-024-54584-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/14/2024] [Indexed: 04/01/2024] Open
Abstract
For 100 years, the Intravenous glucose tolerance test (IVGTT) has been used extensively in researching the pathophysiology of diabetes mellitus and AIRg-the IVGTT-induced acute insulin response to the rapid rise in circulating glucose-is a key measure of insulin secretory capacity. For an effective evaluation of AIRg, IVGTT glucose loading should be adjusted for glucose distribution volume (gVOL) to provide an invariant, trend-free immediate rise in circulating glucose (ΔG0). Body weight-based glucose loads have been widely used but whether these achieve a trend-free ΔG0 does not appear to have been investigated. By analysing variation in AIRg, ΔG0 and gVOL with a range of IVGTT loads, both observed and simulated, we explored the hypothesis that there would be an optimum anthropometry-based IVGTT load calculation that, by achieving a trend-free ΔG0, would not compromise evaluation of AIRg as an index of beta cell function. Data derived from patient and research volunteer records for 3806 IVGTT glucose and insulin profiles. Among the non-obese, as gVOL rose, weight increased disproportionately rapidly. Consequently, the IVGTT glucose load needed for an invariant ΔG0 was progressively overestimated, accounting for 47% of variation in AIRg. Among the obese, ΔG0 was trend-free yet AIRg increased by 11.6% per unit body mass index, consistent with a more proportionate increase in weight with gVOL and a hyperinsulinaemic adaptation to adiposity-associated insulin resistance. Simulations further confirmed our hypothesis by demonstrating that a body surface area-based IVGTT load calculation could provide for a more generally invariant IVGTT ΔG0.
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Affiliation(s)
- Ian F Godsland
- Division of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK.
- Wynn Reader in Human Metabolism, Section of Metabolic Medicine, Faculty of Medicine, Imperial College London (St Mary's Campus), Room G1, Norfolk Place, London, W2 2NH, UK.
| | - Desmond G Johnston
- Division of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Department of Diabetes and Endocrinology, St Marys Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Kgmm Alberti
- Division of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Nick Oliver
- Division of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
- Department of Diabetes and Endocrinology, St Marys Hospital, Imperial College Healthcare NHS Trust, London, UK
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21
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Doğan D, Çelik T. Research trends on the gut microbiota in endocrine metabolism: a thematic and bibliometric analysis. Front Cell Infect Microbiol 2024; 14:1371727. [PMID: 38585653 PMCID: PMC10995354 DOI: 10.3389/fcimb.2024.1371727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Background Gut microbiota studies in the field of endocrinology metabolism have attracted increasing attention in recent years. To comprehensively assess the evolving landscape of this research field, we conducted a thorough bibliometric analysis of gut microbiota studies in endocrinology metabolism indexed in the Web of Science database. Methods We collected and analyzed 3,339 original research articles and reviews published from 1972 to 2023. Using various bibliometric indicators, we investigated publication trends, country contributions, international collaborations, prolific authors, top journals, and influential articles. Results Our analysis revealed a significant upsurge in publications after 2010, indicating a growing scientific interest in microbiota and endocrinology metabolism. Keyword and thematic analyses have identified gut microbiota, obesity, diabetes, and inflammation as core research themes. Additionally, the roles of probiotics and prebiotics are increasingly researched for their therapeutic effects in shaping the microbiota. Conclusion This study reveals that research in endocrinology metabolism is increasingly decoding the connection between gut microbiota and diseases. There's also a growing focus on microbiota manipulation, which points to a shift towards personalized medicine. Future research should focus on integrating these findings into clinical practice, moving from lab-based studies to real-world patient care.
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Affiliation(s)
- Durmus Doğan
- Department of Pediatric Medicine, Division of Pediatric Endocrinology, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Taylan Çelik
- Department of Pediatric Medicine, Division of Pediatric Infectious Diseases, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
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22
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Bentele UU, Klink ESC, Benz ABE, Meier M, Gaertner RJ, Denk BF, Dimitroff SJ, Unternaehrer E, Pruessner JC. The effect of cognitive reappraisal and early-life maternal care on neuroendocrine stress responses. Sci Rep 2024; 14:6837. [PMID: 38514744 PMCID: PMC10957921 DOI: 10.1038/s41598-024-57106-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 11/17/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
Early-life adversity (ELA) is related to profound dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, reflected in both, blunted or exaggerated cortisol stress responses in adulthood. Emotion regulation strategies such as cognitive reappraisal might contribute to this inconsistent finding. Here, we investigate an interaction of early-life maternal care (MC), where low MC represents a form of ELA, and instructed emotion regulation on cortisol responses to acute stress. Ninety-three healthy young women were assigned to a low (n = 33) or high (n = 60) MC group, based on self-reported early-life MC. In the laboratory, participants received regulation instructions, asking to cognitively reappraise (reappraisal group, n = 45) or to focus on senses (control group, n = 48) during subsequent stress exposure, induced by the Trier Social Stress Test. Salivary cortisol and subjective stress levels were measured repeatedly throughout the experiment. Multilevel model analyses confirmed a MC by emotion regulation interaction effect on cortisol trajectories, while controlling for hormonal status. Individuals with low MC in the control compared with the reappraisal group showed increased cortisol responses; individuals with high MC did not differ. These results highlight the significance of emotion regulation for HPA axis stress regulation following ELA exposure. They provide methodological and health implications, indicating emotion regulation as a promising target of treatment interventions for individuals with a history of ELA.
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Affiliation(s)
- Ulrike U Bentele
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Universitaetsstrasse 10, 78464, Constance, Germany.
| | - Elea S C Klink
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Universitaetsstrasse 10, 78464, Constance, Germany
| | - Annika B E Benz
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Universitaetsstrasse 10, 78464, Constance, Germany
| | - Maria Meier
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Universitaetsstrasse 10, 78464, Constance, Germany
- Child- and Adolescent Research Department, University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
| | - Raphaela J Gaertner
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Universitaetsstrasse 10, 78464, Constance, Germany
| | - Bernadette F Denk
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Universitaetsstrasse 10, 78464, Constance, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Constance, Germany
| | | | - Eva Unternaehrer
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Universitaetsstrasse 10, 78464, Constance, Germany
- Child- and Adolescent Research Department, University Psychiatric Clinics Basel (UPK), University of Basel, Basel, Switzerland
| | - Jens C Pruessner
- Department of Psychology, Division of Neuropsychology, University of Konstanz, Universitaetsstrasse 10, 78464, Constance, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Constance, Germany
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23
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Baek DC, Kang JY, Lee JS, Lee EJ, Son CG. Linking alterations in estrogen receptor expression to memory deficits and depressive behavior in an ovariectomy mouse model. Sci Rep 2024; 14:6854. [PMID: 38514828 PMCID: PMC10958029 DOI: 10.1038/s41598-024-57611-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 11/17/2023] [Accepted: 03/20/2024] [Indexed: 03/23/2024] Open
Abstract
The high risk of neurological disorders in postmenopausal women is an emerging medical issue. Based on the hypothesis of altered estrogen receptors (ERα and β) after the decline of estrogen production, we investigated the changes in ERs expressions across brain regions and depressive/amnesic behaviors. C57BL/6J female mice were ovariectomized (OVX) to establish a menopausal condition. Along with behavior tests (anxiety, depression, and memory), the expression of ERs, microglial activity, and neuronal activity was measured in six brain regions (hippocampus, prefrontal cortex, striatum, raphe nucleus, amygdala, and hypothalamus) from 4 to 12 weeks after OVX. Mice exhibited anxiety- and depressive-like behaviors, as well as memory impairment. These behavioral alterations have been linked to a suppression in the expression of ERβ. The decreased ERβ expression coincided with microglial-derived neuroinflammation, as indicated by notable activations of Ionized calcium-binding adapter molecule 1 and Interleukin-1beta. Additionally, the activity of brain-derived neurotrophic factor (BDNF), particularly in the hippocampus, decreased in a time-dependent manner from 4 to 12 weeks post-OVX. Our study provides evidence shedding light on the susceptibility to memory impairment and depression in women after menopause. This susceptibility is associated with the suppression of ERβ and alteration of ERα in six brain regions.
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Affiliation(s)
- Dong-Cheol Baek
- Institute of Bioscience & Integrative Medicine, Daejeon Korean Hospital of Daejeon University, Daedukdae-ro 176 bun-gil 75, Daejeon, 35235, Republic of Korea
| | - Ji-Yun Kang
- Institute of Bioscience & Integrative Medicine, Daejeon Korean Hospital of Daejeon University, Daedukdae-ro 176 bun-gil 75, Daejeon, 35235, Republic of Korea
| | - Jin-Seok Lee
- Institute of Bioscience & Integrative Medicine, Daejeon Korean Hospital of Daejeon University, Daedukdae-ro 176 bun-gil 75, Daejeon, 35235, Republic of Korea
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, Daejeon Korean Hospital of Daejeon University, Daedukdae-ro 176 bun-gil 75, Daejeon, 35235, Republic of Korea
| | - Chang-Gue Son
- Institute of Bioscience & Integrative Medicine, Daejeon Korean Hospital of Daejeon University, Daedukdae-ro 176 bun-gil 75, Daejeon, 35235, Republic of Korea.
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24
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Song M, Kwak SH, Kim J. Risk prediction and interaction analysis using polygenic risk score of type 2 diabetes in a Korean population. Sci Rep 2024; 14:6790. [PMID: 38514700 PMCID: PMC10957984 DOI: 10.1038/s41598-024-55945-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 01/29/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
Joint modelling of genetic and environmental risk factors can provide important information to predict the risk of type 2 diabetes (T2D). Therefore, to predict the genetic risk of T2D, we constructed a polygenic risk score (PRS) using genotype data of one Korean cohort, KARE (745 cases and 2549 controls), and the genome-wide association study summary statistics of Biobank Japan. We evaluated the performance of PRS in an independent Korean cohort, HEXA (5684 cases and 35,703 controls). Individuals with T2D had a significantly higher mean PRS than controls (0.492 vs. - 0.078, p ≈ 0 ). PRS predicted the risk of T2D with an AUC of 0.658 (95% CI 0.651-0.666). We also evaluated interaction between PRS and waist circumference (WC) in the HEXA cohort. PRS exhibited a significant sub-multiplicative interaction with WC (ORinteraction 0.991, 95% CI 0.987-0.995, pinteraction = 4.93 × 10-6) in T2D. The effect of WC on T2D decreased as PRS increased. The sex-specific analyses produced similar interaction results, revealing a decreased WC effect on T2D as the PRS increased. In conclusion, the risk of WC for T2D may differ depending on PRS and those with a high PRS might develop T2D with a lower WC threshold. Our findings are expected to improve risk prediction for T2D and facilitate the identification of individuals at an increased risk of T2D.
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Affiliation(s)
- Minsun Song
- Department of Statistics & Research Institute of Natural Sciences, Sookmyung Women's University, Seoul, 04310, Korea
| | - Soo Heon Kwak
- Department of Internal Medicine, Seoul National University Hospital, Seoul, 03080, Korea.
| | - Jihyun Kim
- Department of Statistics, Sookmyung Women's University, Seoul, 04310, Korea
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25
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Namkoong J, Andraweera PH, Pathirana M, Munawar D, Downie M, Edwards S, Averbuj P, Arstall MA. A systematic review and meta-analysis of the diagnosis and surgical management of carcinoid heart disease. Front Cardiovasc Med 2024; 11:1353612. [PMID: 38572311 PMCID: PMC10987853 DOI: 10.3389/fcvm.2024.1353612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Carcinoid heart disease (CHD), a complication of carcinoid syndrome (CS), is a rare condition that can lead to right sided valvular heart disease and has been traditionally associated with a poor prognosis. We conducted a systematic review and meta-analysis to explore the accuracy of biomarkers and echocardiography in diagnosing CHD amongst patients who are already known to have neuroendocrine tumours and to assess whether surgical management of CHD leads to a reduction in mortality. Methods A systematic literature search of MEDLINE, EMBASE, EBM Reviews, Google Scholar, ClinicalTrials.gov was conducted. All studies on patients with carcinoid heart disease (CHD) reporting on biomarkers, echocardiographic and surgical outcomes were included. The National Heart, Lung, and Blood Institute quality assessment tool was used to assess the methodological study quality. Data analysis was performed using Stata Statistical Software and R Studio, and individual meta-analyses were performed for biomarkers, echocardiographic findings, and surgical outcomes. Results A total of 36 articles were included in the systematic review analysis. N terminal pro-brain natriuretic peptide (NTproBNP) and 5-hydroxyindole acetate (5-HIAA) levels were higher in patients with CHD compared with those without CHD. 32% of CS patients had echocardiographic evidence of cardiac involvement, of which 79% involved tricuspid valve abnormalities. Moderate-severe tricuspid regurgitation was the most common echocardiographic abnormality (70% of patients). However, these analyses had substantial heterogeneity due to the high variability of cardiac involvement across studies. Pooled surgical mortality for CHD was 11% at 1 month, 31% at 12 months and 56% at 24 months. When assessing surgical outcomes longitudinally, the one-month surgical results showed a trend towards more recent surgeries having lower mortality rates than those reported in earlier years, however this was not statistically significant. Discussion There is not enough data in current literature to determine a clear cut-off value of NTproBNP and 5-HIAA to help diagnose or determine CHD severity. Surgical management of CHD is yet to show significant mortality benefit, and there are no consistent comparisons to medical treatment in current literature.
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Affiliation(s)
- Jenny Namkoong
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Prabha H. Andraweera
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Maleesa Pathirana
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Dian Munawar
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Michael Downie
- SA Health Library Service, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Suzanne Edwards
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Paula Averbuj
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Margaret A. Arstall
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
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26
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Cromb D, Radomska M, Thalange N, Cawley P. Fifteen-minute consultation: Investigation and management of hypoglycaemia in the term-born infant. Arch Dis Child Educ Pract Ed 2024; 109:73-81. [PMID: 36347599 DOI: 10.1136/archdischild-2021-323568] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/15/2022] [Accepted: 10/14/2022] [Indexed: 11/09/2022]
Abstract
Hypoglycaemia in term infants is very common. Deciding on appropriate investigations and management is often challenging. The aims of this article are to help with understanding when, how and why to investigate symptoms of hypoglycaemia in full-term infants (born ≥37 weeks' gestational age).
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Affiliation(s)
- Daniel Cromb
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Neonatology, Evelina London Children's Hospital, London, UK
| | | | - Nandu Thalange
- Department of Paediatric Endocrinology, Al Jalila Children's Specialty Hospital, Dubai, UAE
| | - Paul Cawley
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Department of Neonatology, Evelina London Children's Hospital, London, UK
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27
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Rosenberg AGW, Mochèl K, Hähner LM, Ruules L, Davidse K, Bos-Roubos AG, van Dijk SA, Zillikens MC, Taal W, van der Lely AJ, de Graaff LCG. Endocrine and non-endocrine causes of fatigue in adults with Neurofibromatosis type 1. Front Endocrinol (Lausanne) 2024; 14:1119159. [PMID: 38560379 PMCID: PMC10978575 DOI: 10.3389/fendo.2023.1119159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/18/2023] [Indexed: 04/04/2024] Open
Abstract
Context Neurofibromatosis type 1 (NF1) is a complex system disorder, caused by alterations in RAS pathways. NF1 adults often suffer from chronic and severe fatigue, for which they are frequently referred to Internal Medicine/Endocrinology. Seeking medical help often leads to (invasive) diagnostic procedures. To prevent the personal and financial burden of this disabling fatigue, it is crucial to know the causes. Objective To explore somatic causes and provide practical recommendations for the approach to fatigue in adults with NF1. Design Cross-sectional. All adults with NF1 (N = 133) who visited our Endocrinology department underwent a systematic health screening, including a medical questionnaire, structured interview, complete physical examination, biochemical measurements and additional tests if indicated. Main outcome measure Prevalence of endocrine and non-endocrine health problems between NF1 adults with and without fatigue. Results In our cohort, 75% of NF1 adults experienced fatigue. The most frequent endocrine disorders were vitamin D deficiency (28%), obesity (18%) and hypothyroidism (8%). The most frequent non-endocrine internal disorder was high blood pressure (42%). None of the disorders differed significantly between adults with and without fatigue. Conclusions Endocrine and non-endocrine disorders were equally present in our cohort of NF1 adults with and without fatigue. This suggests that the high prevalence of fatigue in NF1 adults is not explained by these somatic disorders. An alternative explanation for fatigue might be deficits in cognitive functioning and other neuropsychological processes in NF1. Based on our results and review of the literature, we provide a clinical algorithm for the approach to fatigue in NF1 adults, including somatic and psychological assessment.
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Affiliation(s)
- Anna G. W. Rosenberg
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Ké Mochèl
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Lorena M. Hähner
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Lara Ruules
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Kirsten Davidse
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Anja G. Bos-Roubos
- Center of Excellence for Neuropsychiatry, Vincent van Gogh, Venray, Netherlands
| | - Sarah A. van Dijk
- Department of Neurology/Neuro-Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands
- ENCORE-Dutch Center of Reference for Neurodevelopmental Disorders, Rotterdam, Netherlands
| | - M. Carola Zillikens
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- ERN BOND, European Reference Network for Rare Bone Diseases, Rotterdam, Netherlands
- ENDO-ERN, European Reference Network on Rare Endocrine Conditions, Rotterdam, Netherlands
- Academic Centre for Rare Bone Disorders, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Walter Taal
- Department of Neurology/Neuro-Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands
- ENCORE-Dutch Center of Reference for Neurodevelopmental Disorders, Rotterdam, Netherlands
| | - Aart J. van der Lely
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- ENDO-ERN, European Reference Network on Rare Endocrine Conditions, Rotterdam, Netherlands
| | - Laura C. G. de Graaff
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- ENCORE-Dutch Center of Reference for Neurodevelopmental Disorders, Rotterdam, Netherlands
- ENDO-ERN, European Reference Network on Rare Endocrine Conditions, Rotterdam, Netherlands
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28
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Crisafulli S, Fontana A, L'Abbate L, Vitturi G, Cozzolino A, Gianfrilli D, De Martino MC, Amico B, Combi C, Trifirò G. Machine learning-based algorithms applied to drug prescriptions and other healthcare services in the Sicilian claims database to identify acromegaly as a model for the earlier diagnosis of rare diseases. Sci Rep 2024; 14:6186. [PMID: 38485706 PMCID: PMC10940660 DOI: 10.1038/s41598-024-56240-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
Acromegaly is a rare disease characterized by a diagnostic delay ranging from 5 to 10 years from the symptoms' onset. The aim of this study was to develop and internally validate machine-learning algorithms to identify a combination of variables for the early diagnosis of acromegaly. This retrospective population-based study was conducted between 2011 and 2018 using data from the claims databases of Sicily Region, in Southern Italy. To identify combinations of potential predictors of acromegaly diagnosis, conditional and unconditional penalized multivariable logistic regression models and three machine learning algorithms (i.e., the Recursive Partitioning and Regression Tree, the Random Forest and the Support Vector Machine) were used, and their performance was evaluated. The random forest (RF) algorithm achieved the highest Area under the ROC Curve value of 0.83 (95% CI 0.79-0.87). The sensitivity in the test set, computed at the optimal threshold of predicted probabilities, ranged from 28% for the unconditional logistic regression model to 69% for the RF. Overall, the only diagnosis predictor selected by all five models and algorithms was the number of immunosuppressants-related pharmacy claims. The other predictors selected by at least two models were eventually combined in an unconditional logistic regression to develop a meta-score that achieved an acceptable discrimination accuracy (AUC = 0.71, 95% CI 0.66-0.75). Findings of this study showed that data-driven machine learning algorithms may play a role in supporting the early diagnosis of rare diseases such as acromegaly.
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Affiliation(s)
| | - Andrea Fontana
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Luca L'Abbate
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Giacomo Vitturi
- Department of Diagnostics and Public Health, University of Verona, P.Le L.A. Scuro 10, 37124, Verona, Italy
| | - Alessia Cozzolino
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniele Gianfrilli
- Section of Medical Pathophysiology and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | | | - Beatrice Amico
- Department of Computer Science, University of Verona, Verona, Italy
| | - Carlo Combi
- Department of Computer Science, University of Verona, Verona, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, P.Le L.A. Scuro 10, 37124, Verona, Italy.
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29
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Zhang F, Yu Z. Mendelian randomization study on insulin resistance and risk of hypertension and cardiovascular disease. Sci Rep 2024; 14:6191. [PMID: 38485964 PMCID: PMC10940700 DOI: 10.1038/s41598-023-46983-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/07/2022] [Indexed: 03/18/2024] Open
Abstract
Observational studies have suggested that insulin resistance (IR) is associated with hypertension and various cardiovascular diseases. However, the presence of a causal relationship between IR and cardiovascular disease remains unclear. Here, we applied Mendelian randomization (MR) approaches to address the causal association between genetically determined IR and the risk of cardiovascular diseases. Our primary genetic instruments comprised 53 SNPs associated with IR phenotype from a GWAS of up to 188,577 participants. Genetic association estimates for hypertension and venous thromboembolism (VTE) were extracted from UK Biobank, estimates for atrial fibrillation (AF) were extracted from the hitherto largest GWAS meta-analysis on AF, estimates for heart failure were extracted from HERMES Consortium, estimates for peripheral artery disease (PAD) and aortic aneurysm were extracted from the FinnGen Study. The main analyses were performed using the random-effects inverse-variance weighted approach, and complemented by sensitivity analyses and multivariable MR analyses. Corresponding to 55% higher fasting insulin adjusted for body mass index, 0.46 mmol/L lower high-density lipoprotein cholesterol and 0.89 mmol/L higher triglyceride, one standard deviation change in genetically predicted IR was associated with increased risk of hypertension (odds ratio (OR) 1.06, 95% CI 1.04-1.08; P = 1.91 × 10-11) and PAD (OR 1.90, 95% CI 1.43-2.54; P = 1.19 × 10-5). Suggestive evidence was obtained for an association between IR and heart failure (OR per SD change in IR: 1.19, 95% CI 1.01-1.41, P = 0.041). There was no MR evidence for an association between genetically predicted IR and atrial fibrillation, VTE, and aortic aneurysm. Results were widely consistent across all sensitivity analyses. In multivariable MR, the association between IR and PAD was attenuated after adjustment for lipids (P = 0.347) or BMI (P = 0.163). Our findings support that genetically determined IR increases the risk of hypertension and PAD.
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Affiliation(s)
- Fangfang Zhang
- Department of Outpatient, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China
| | - Zhimin Yu
- Department of Geriatrics, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, China.
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Guo Y, Qiu Y, Xue T, Zhou Y, Yan P, Liu S, Liu S, Zhao W, Zhang N. Association between glycemic variability and short-term mortality in patients with acute kidney injury: a retrospective cohort study of the MIMIC-IV database. Sci Rep 2024; 14:5945. [PMID: 38467770 PMCID: PMC10928232 DOI: 10.1038/s41598-024-56564-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 09/27/2023] [Accepted: 03/08/2024] [Indexed: 03/13/2024] Open
Abstract
Acute kidney injury (AKI) represents a significant challenge to global public health problem and is associated with poor outcomes. There is still considerable debate about the effect of mean blood glucose (MBG) and coefficient of variation (CV) of blood glucose on the short-term mortality of AKI patients. This retrospective cohort study aimed to explore the association between glycemic variability and short-term mortality in patients with AKI. Data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database were analyzed, including 6,777 adult AKI patients. MBG and CV on the first day of ICU admission were calculated to represent the overall glycemic status and variability during the ICU stay in AKI patients. The primary outcome indicator was ICU 30-day mortality of AKI patients. Multivariate Cox regression analysis and smoothed curve fitting were used to assess the relationship between blood glucose levels and mortality. Eventually, the ICU 30-day mortality rate of AKI patients was 23.5%. The increased MBG and CV were significantly correlated with ICU 30-day mortality (hazards ratio (HR) = 1.20, 95% confidence interval (CI) 1.14-1.27; HR = 1.08, 95% CI 1.03-1.13). The smoothed curve fitting showed a U-shaped relationship between MBG on the first day of ICU admission and ICU 30-day mortality (inflection point = 111.3 mg/dl), while CV had a linear relationship with 30-day ICU mortality. Thus, we conclude that MBG and CV were significantly associated with short-term mortality in intensive care patients with AKI. Tighter glycemic control may be an effective measure to improve the prognosis of patients with AKI.
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Affiliation(s)
- Yifan Guo
- Department of Endocrinology and Nephropathy, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Qiu
- Department of Endocrinology, Miyun Hospital District, The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Taiqi Xue
- Department of Endocrinology and Nephropathy, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Zhou
- Department of Endocrinology and Nephropathy, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Pu Yan
- Department of Endocrinology and Nephropathy, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Shiyi Liu
- Department of Nephropathy, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Shiwei Liu
- Department of Endocrinology and Nephropathy, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Wenjing Zhao
- Department of Nephrology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
| | - Ning Zhang
- Department of Endocrinology and Nephropathy, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
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Assié G, Allassonnière S. Artificial intelligence in endocrinology: on track towards great opportunities. J Clin Endocrinol Metab 2024:dgae154. [PMID: 38466742 DOI: 10.1210/clinem/dgae154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/06/2023] [Revised: 02/13/2024] [Accepted: 03/08/2024] [Indexed: 03/13/2024]
Abstract
In endocrinology, the types and quantity of digital data are increasing rapidly. Computing capabilities are also developing at an incredible rate, as illustrated by the recent expansion in the use of popular generative artificial intelligence (AI) applications. Numerous diagnostic and therapeutic devices using AI have already entered routine endocrine practice, and developments in this field are expected to continue to accelerate. Endocrinologists will need to be supported in managing AI applications. Beyond technological training, interdisciplinary vision is needed to encompass the ethical and legal aspects of AI, to manage the profound impact of AI on patient/provider relationships, and to maintain an optimal balance between human input and AI in endocrinology.
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Affiliation(s)
- Guillaume Assié
- Université Paris Cité, CNRS UMR8104, INSERM U1016, Institut Cochin, F-75014, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Service d'endocrinologie, Center for Rare Adrenal Diseases, Paris, France
| | - Stéphanie Allassonnière
- Université Paris Cité, UFR Medecine, Paris France
- HeKA, Centre de Recherche des Cordeliers, UPCité, Inria, Inserm, SU
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Jmel H, Sarno S, Giuliani C, Boukhalfa W, Abdelhak S, Luiselli D, Kefi R. Genetic diversity of variants involved in drug response among Tunisian and Italian populations toward personalized medicine. Sci Rep 2024; 14:5842. [PMID: 38462643 PMCID: PMC10925599 DOI: 10.1038/s41598-024-55239-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 03/01/2023] [Accepted: 02/21/2024] [Indexed: 03/12/2024] Open
Abstract
Adverse drug reactions (ADR) represent a significant contributor to morbidity and mortality, imposing a substantial financial burden. Genetic ancestry plays a crucial role in drug response. The aim of this study is to characterize the genetic variability of selected pharmacogenes involved with ADR in Tunisians and Italians, with a comparative analysis against global populations. A cohort of 135 healthy Tunisians and 737 Italians were genotyped using a SNP array. Variants located in 25 Very Important Pharmacogenes implicated in ADR were extracted from the genotyping data. Distribution analysis of common variants in Tunisian and Italian populations in comparison to 24 publicly available worldwide populations was performed using PLINK and R software. Results from Principle Component and ADMIXTURE analyses showed a high genetic similarity among Mediterranean populations, distinguishing them from Sub-Saharan African and Asian populations. The Fst comparative analysis identified 27 variants exhibiting significant differentiation between the studied populations. Among these variants, four SNPs rs622342, rs3846662, rs7294, rs5215 located in SLC22A1, HMGCR, VKORC1 and KCNJ11 genes respectively, are reported to be associated with ethnic variability in drug responses. In conclusion, correlating the frequencies of genotype risk variants with their associated ADRs would enhance drug outcomes and the implementation of personalized medicine in the studied populations.
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Affiliation(s)
- Haifa Jmel
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, Tunis, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
- Genetic Typing DNA Service Pasteur Institute, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Stefania Sarno
- Laboratory of Molecular Anthropology & Centre for Genome Biology, Department of Biological, Geological and Environmental Sciences (BiGeA), University of Bologna, Bologna, Italy
| | - Cristina Giuliani
- Laboratory of Molecular Anthropology & Centre for Genome Biology, Department of Biological, Geological and Environmental Sciences (BiGeA), University of Bologna, Bologna, Italy
| | - Wided Boukhalfa
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, Tunis, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
| | - Sonia Abdelhak
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, Tunis, Tunisia
- University of Tunis El Manar, Tunis, Tunisia
| | - Donata Luiselli
- Laboratory of Ancient DNA (aDNALab), Department of Cultural Heritage (DBC), University of Bologna, Ravenna, Italy
| | - Rym Kefi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, Tunis, Tunisia.
- University of Tunis El Manar, Tunis, Tunisia.
- Genetic Typing DNA Service Pasteur Institute, Institut Pasteur de Tunis, Tunis, Tunisia.
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Wong THT, Mo JMY, Zhou M, Zhao JV, Schooling CM, He B, Luo S, Au Yeung SL. A two-sample Mendelian randomization study explores metabolic profiling of different glycemic traits. Commun Biol 2024; 7:293. [PMID: 38459184 PMCID: PMC10923832 DOI: 10.1038/s42003-024-05977-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/27/2024] [Indexed: 03/10/2024] Open
Abstract
We assessed the causal relation of four glycemic traits and type 2 diabetes liability with 167 metabolites using Mendelian randomization with various sensitivity analyses and a reverse Mendelian randomization analysis. We extracted instruments for fasting glucose, 2-h glucose, fasting insulin, and glycated hemoglobin from the Meta-Analyses of Glucose and Insulin-related traits Consortium (n = 200,622), and those for type 2 diabetes liability from a meta-analysis of multiple cohorts (148,726 cases, 965,732 controls) in Europeans. Outcome data were from summary statistics of 167 metabolites from the UK Biobank (n = 115,078). Fasting glucose and 2-h glucose were not associated with any metabolite. Higher glycated hemoglobin was associated with higher free cholesterol in small low-density lipoprotein. Type 2 diabetes liability and fasting insulin were inversely associated with apolipoprotein A1, total cholines, lipoprotein subfractions in high-density-lipoprotein and intermediate-density lipoproteins, and positively associated with aromatic amino acids. These findings indicate hyperglycemia-independent patterns and highlight the role of insulin in type 2 diabetes development. Further studies should evaluate these glycemic traits in type 2 diabetes diagnosis and clinical management.
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Affiliation(s)
- Tommy H T Wong
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Jacky M Y Mo
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Mingqi Zhou
- Department of Biological Chemistry, School of Medicine, University of California Irvine, Irvine, CA, USA
- Center for Epigenetics and Metabolism, University of California Irvine, Irvine, CA, USA
| | - Jie V Zhao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Baoting He
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Shan Luo
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Shiu Lun Au Yeung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Razbek J, Bao L, Zhang Y, Daken M, Cao M. Causal association study of the dynamic development of the metabolic syndrome based on longitudinal data. Sci Rep 2024; 14:5448. [PMID: 38443462 PMCID: PMC10914715 DOI: 10.1038/s41598-024-55693-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 04/04/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
The dynamic progression of metabolic syndrome (MetS) includes developmental deterioration and reverse recovery; however, the key factors in this bidirectional progression have not been identified. Our study aimed to use the data obtained from the China Health and Retirement Longitudinal Study (CHARLS) and construct a Bayesian network to explore the causal relationship between influential factor and the development and recovery of MetS. Followed up at 4 years, forward progression of MetS occurred in 1543 and reverse recovery of MetS occurred in 1319 of 5581 subjects. Bayesian Networks showed that hyperuricemia and body mass index (BMI) levels directly influenced progression of MetS, and gender, exercise and age play an indirect role through hyperuricemia and BMI levels; high hemoglobin A1c (HbA1c) and BMI levels directly influenced recovery of MetS, and gender and exercise play an indirect role through BMI levels. Bayesian Network inference found that the rate of progression of MetS in subjects with hyperuricemia increases from 36 to 60%, the rate of progression of MetS in subjects with overweight or obese increases from 36 to 41% and the rate of reverse recovery rate of MetS in subjects with high HbA1c decreased from 33 to 20%. Therefore, attention to individuals at high risk of hyperuricemia, high HbA1c levels, and overweight/obesity should be enhanced, with early detection and following healthy behavioral interventions to prevent, control and delay the progression of MetS and its components.
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Affiliation(s)
- Jaina Razbek
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Liangliang Bao
- Department of Postgraduate Management Section, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yan Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Mayisha Daken
- Department of Epidemic Prevention, Karamay Centre for Disease Control and Prevention, Karamay, China
| | - Mingqin Cao
- Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, China.
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Khalili S, Safavi-Naini SAA, Zarand P, Masoumi S, Farsi Y, Hosseinpanah F, Azizi F. Metabolic health's central role in chronic kidney disease progression: a 20-year study of obesity-metabolic phenotype transitions. Sci Rep 2024; 14:5244. [PMID: 38438600 PMCID: PMC10912755 DOI: 10.1038/s41598-024-56061-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/01/2024] [Indexed: 03/06/2024] Open
Abstract
This study investigates the risk of chronic kidney disease (CKD) across four metabolic phenotypes: Metabolically Healthy-No Obesity (MH-NO), Metabolically Unhealthy-No obesity (MU-NO), Metabolically Healthy-Obesity (MH-O), and Metabolically Unhealthy-Obesity (MU-O). Data from the Tehran Lipid and Glucose Study, collected from 1999 to 2020, were used to categorize participants based on a BMI ≥ 30 kg/m2 and metabolic health status, defined by the presence of three or four of the following components: high blood pressure, elevated triglycerides, low high-density lipoprotein, and high fasting blood sugar. CKD, characterized by a glomerular filtration rate < 60 ml/min/1.72 m2. The hazard ratio (HR) of CKD risk was evaluated using Cox proportional hazard models. The study included 8731 participants, with an average age of 39.93 years, and identified 734 incidents of CKD. After adjusting for covariates, the MU-O group demonstrated the highest risk of CKD progression (HR 1.42-1.87), followed by the MU-NO group (HR 1.33-1.67), and the MH-O group (HR 1.18-1.54). Persistent MU-NO and MU-O posed the highest CKD risk compared to transitional states, highlighting the significance of exposure during early adulthood. These findings emphasize the independent contributions of excess weight and metabolic health, along with its components, to CKD risk. Therefore, preventive strategies should prioritize interventions during early-adulthood.
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Affiliation(s)
- Shayesteh Khalili
- Department of Internal Medicine, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Amir Ahmad Safavi-Naini
- Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Paniz Zarand
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Safdar Masoumi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yeganeh Farsi
- Department of Internal Medicine, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 23, Parvaneh StreetVelenjak, P.O. Box: 19395-4763, Tehran, 19395-4763, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Muhammed OS, Hassen M, Taye M, Beyene E, Bedru B, Tileku M. Treatment burden and regimen fatigue among patients with HIV and diabetes attending clinics of Tikur Anbessa specialized hospital. Sci Rep 2024; 14:5221. [PMID: 38433234 PMCID: PMC10909857 DOI: 10.1038/s41598-024-54609-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024] Open
Abstract
Nascent studies showed that patients with chronic medical illnesses such as diabetes mellitus (DM) and HIV/AIDS are highly vulnerable to face both treatment burden and regimen fatigue. However, an attempt made so far in this sphere in sub-Saharan African health care context is dearth. Thus, this study aimed to determine the level of treatment burden and regimen fatigue of diabetic and HIV patients attending adult diabetic and ART clinics of TASH and explore patients' and health care workers' propositions to reduce treatment burden and regimen fatigue. An explanatory sequential mixed methods study was conducted at the adult HIV and DM clinics of TASH, Addis Ababa, Ethiopia from February 01-March 30, 2022. Simple random and purposive sampling techniques were employed to select participants for quantitative and qualitative studies, respectively. Descriptive analysis was done to summarize the quantitative data. Logistic and linear regression analyses were performed to identify predictors of treatment burden and regimen fatigue, respectively. P value < 0.05 was considered statistically significant. Qualitative data was analyzed by using a thematic analysis. A total of 300 patients (200 diabetes and 100 HIV) were included in the quantitative study. For the qualitative study, 14 patients and 10 health care workers (six nurses and four medical doctors) were included. Participants' mean global Treatment Burden Questionnaire (TBQ) and Treatment Regimen Fatigue Scale (TRFS) score were 28.86 ± 22.13 and - 42.82 ± 17.45, respectively. Roughly, 12% of patients experienced a high treatment burden. The presence of two or more comorbidities (adjusted odds ratio [AOR] = 7.95, 95% confidence interval [CI] 1.59-39.08), daily ingestion of more than five types of prescribed medications (AOR = 6.81, 95%CI 1.59-29.14), and good knowledge about DM and/or HIV (AOR = 0.33, 95%CI 0.12-0.92) were predictors of treatment burden. Poor availability of medications (β = 0.951, p < 0.001) was the only predictor of regimen fatigue. Patients and health care workers primarily proposed to foster self-care efficacy, advance administrative services of the clinic and hospital, and improve healthcare system provision. The findings of this study unveiled that a considerable proportion of patients experienced low levels of treatment burden and regimen fatigue. This study showed that boosting the patients' self-care efficacy, upgrading administrative services of the clinic and hospital, and promoting the healthcare system provision had enormous significance in reducing treatment burden and regimen fatigue. Therefore, when designing patient-specific healthcare interventions for both HIV and diabetic patients' various factors affecting both treatment burden and regimen fatigue should be considered to achieve the desired goals of therapy.
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Affiliation(s)
- Oumer Sada Muhammed
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, School of Pharmacy, Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia.
| | - Minimize Hassen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melaku Taye
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eyob Beyene
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Beshir Bedru
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, School of Pharmacy, Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia
| | - Melaku Tileku
- Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, School of Pharmacy, Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia
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Jee SB, Sawal A. Physiological Changes in Pregnant Women Due to Hormonal Changes. Cureus 2024; 16:e55544. [PMID: 38576690 PMCID: PMC10993087 DOI: 10.7759/cureus.55544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
Pregnancy affects many organ systems and causes significant physiological changes that are mainly caused by changes in hormone levels. This review explores the complex interactions between pregnancy-related hormonal changes and renal function, providing insights into the practical applications of these relationships. Extensive literature searches were conducted, combining data from several sources to produce thorough knowledge. Essential discoveries include changes in renal hemodynamics, calcium/phosphorus level variations, thyroid gland hypertrophy, changed function, and cardiovascular adaptations. The review also addresses how sex hormones affect immunological responses, emphasizing their importance for conditions like multiple sclerosis. Additionally impacted is the gastrointestinal tract, which results in symptoms like nausea and heartburn. Comprehending these physiological changes is essential for proficient therapeutic handling, guaranteeing the best possible health for both the mother and the fetus. The study emphasizes the importance of specialized medical treatment during pregnancy and calls for more investigation to clarify the intricacies of these physiological changes.
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Affiliation(s)
- Sohan B Jee
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Sawangi (Meghe) Wardha, Wardha, IND
| | - Anupama Sawal
- Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Sawangi (Meghe) Wardha, Wardha, IND
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Johannsen ML, Poulsen LC, Mamsen LS, Grøndahl ML, Englund ALM, Lauritsen NL, Carstensen EC, Styrishave B, Yding Andersen C. The intrafollicular concentrations of biologically active cortisol in women rise abruptly shortly before ovulation and follicular rupture. Hum Reprod 2024; 39:578-585. [PMID: 38268234 DOI: 10.1093/humrep/deae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 07/17/2023] [Revised: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
STUDY QUESTION What is the temporal activity and the concentration in follicular fluid (FF) of the anti-inflammatory steroid cortisol during the ovulatory process in humans? SUMMARY ANSWER Intrafollicular concentrations of cortisol become massively upregulated close to ovulation concomitant with an exceptionally high biological activity securing a timely and efficient termination of inflammatory processes. WHAT IS KNOWN ALREADY Ovulation has been described as a local, controlled inflammatory process resulting in the degeneration of the follicle wall which facilitate oocyte extrusion. Ovulation also affects the glucocorticoid metabolism of granulosa cells (GCs) and although de novo synthesis of cortisol only occurs in the adrenal cortex, the mid-cycle surge has been shown to induce a change from high expression of HSD11B2, inactivating cortisol to cortisone, to high expression of HSD11B1 which reversibly catalyses cortisol production from cortisone. Furthermore, high concentrations of progesterone and 17OH-progesterone within follicles may cause dislodging of cortisol from cortisol binding protein (CBP) thereby activating the biological activity of cortisol. STUDY DESIGN, SIZE, DURATION This prospective cohort study included 50 women undergoing fertility treatment according to a standard antagonist protocol at a university hospital-affiliated fertility clinic in Denmark. PARTICIPANTS/MATERIALS, SETTING, METHODS Women donated FF and GCs from one follicle for research purpose aspirated at one of four time points during the process of final maturation of follicles: T = 0 h, T = 12 h, T = 17 h, T = 32 h. A second sample was collected at oocyte pick up at T = 36 h. The concentration of cortisol and cortisone together with a range of sex steroids was measured by LC-MS/MS in FF collected at the five time points mentioned above. Whole genome microarray data, validated by q-PCR analysis, was used to evaluate gene expression of CYP11B1, CYP21A2, HSD11B1, HSD11B2, and NR3C1 in GCs at the same time points. MAIN RESULTS AND THE ROLE OF CHANCE The concentration of cortisol was significantly increased from a few nM at 0 h to around 100-140 nM (P ≤ 0.0001) at 32-36 h, whilst cortisone was almost constant from 0 to 17 h at a concentration of between 90 and 100 nM being significantly reduced to 25-40 nM (P ≤ 0.0001) at 32-36 h. This was paralleled by a 690-fold upregulation of HSD11B1 from 0 to 12 h increasing to a more than 20.000-fold change at 36 h. HSD11B2 was quickly downregulated 15- to 20-fold after ovulation induction. Concentrations of progesterone and 17OH-progesterone increased during the ovulatory process to high levels which in essence displaces cortisol from its binding protein CBP due to similar binding affinities. Furthermore, a significant decrease in 11-deoxycortisol expression was seen, but CYP11B1 expression was below detection limit in GCs. LIMITATIONS, REASONS FOR CAUTION The study included women undergoing ovarian stimulation and results may differ from the natural cycle. More observations at each specific time point may have strengthened the conclusions. Furthermore, we have not been able to measure the actual active biological concentration of cortisol. WIDER IMPLICATIONS OF THE FINDINGS For the first time, this study collectively evaluated the temporal pattern of cortisol and cortisone concentrations during human ovulation, rendering a physiological framework for understanding potential dysregulations in the inflammatory reaction of ovulation. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the University Hospital of Copenhagen, Rigshospitalet, and Novo Nordisk Foundation grant number NNF21OC00700556. Interreg V ÔKS through ReproUnion (www.reprounion.eu); Region Zealand Research Foundation. The funders had no role in study design, collection of data, analyses, writing of the article, or the decision to submit it for publication. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M L Johannsen
- Laboratory of Reproductive Biology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen Ø, Denmark
- Toxicolgy and Drug Metabolism group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Ø, Denmark
| | - L C Poulsen
- Fertility Clinic, University Hospital of Copenhagen, Herlev and Gentofte Hospital, Herlev, Denmark
| | - L S Mamsen
- Laboratory of Reproductive Biology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen Ø, Denmark
| | - M L Grøndahl
- Fertility Clinic, University Hospital of Copenhagen, Herlev and Gentofte Hospital, Herlev, Denmark
| | - A L M Englund
- Fertility Clinic, Zealand University Hospital, Køge, Denmark
| | - N L Lauritsen
- Toxicolgy and Drug Metabolism group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Ø, Denmark
| | - E C Carstensen
- Toxicolgy and Drug Metabolism group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Ø, Denmark
| | - B Styrishave
- Toxicolgy and Drug Metabolism group, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Ø, Denmark
| | - C Yding Andersen
- Faculty of Health and Medical Science, Institute for Clinical Medicine, University of Copenhagen, Copenhagen N, Denmark
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Saif HS, Al-Ansari B, Raza G, Ghorabah M. Approach to the Management of Hypertriglyceridemia Complicated With Acute Pancreatitis in Pregnancy: A Case Report. Cureus 2024; 16:e56006. [PMID: 38606269 PMCID: PMC11007583 DOI: 10.7759/cureus.56006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
This is a case of a 32-year-old woman, Gravida 3 para 2, previous two cesarean sections, who presented to our emergency department at 24+3 weeks of gestation complaining of severe epigastric pain radiating to the back. She was diagnosed with severe hypertriglyceridemia complicated with acute pancreatitis and was managed by a multi-disciplinary team, which included obstetrics, gastroenterology, endocrinology, hematology, nutrition, and ICU team. Initially, conservative treatment was employed for her management. She was placed on nil per oral status and initiated on a normal saline infusion at a rate of 150 ml/hour, along with insulin infusion at 0.1 unit/kg/hour and dextrose (D5) at 80 ml/hour. Additionally, she received omeprazole, meropenem, clexane (40 mg once daily subcutaneous injection), iron, vitamin supplements, and analgesics as required. Subsequently, due to the failure of the initial conservative medical management, the patient was admitted to the ICU. Plasmapheresis was performed after the insertion of a vascath, using 3000 ml of albumin 5% as replacement fluid and oral calcium. Following this, she was prescribed Omacor (Omega 3) at a dosage of 2 grams orally twice daily, along with a low carbohydrate and fat diet, to manage her triglyceride levels. After the removal of the central line, her triglycerides increased to 14.3 mmol/L, leading to the initiation of fenofibrate at a daily dose of one tablet. With persistent elevation to 16.4 mmol/L, Lipitor at 40 mg once daily was introduced. Following this intervention, her triglyceride levels stabilized, and her overall condition improved. She was discharged at 25+1 weeks with a prescribed regimen, and scheduled follow-ups were arranged in the endocrine and obstetrics clinics. At 36 weeks of gestation, she presented to the emergency room with abdominal, back, and leg pain. Fetal distress, indicated by fetal tachycardia (170-180 bpm) on cardiotocography, prompted an urgent category 1 cesarean section, which proceeded without complications.
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Affiliation(s)
- Hamad S Saif
- General Practice, King Hamad University Hospital, Busaiteen, BHR
| | - Basma Al-Ansari
- Obstetrics and Gynecology, King Hamad University Hospital, Busaiteen, BHR
| | - Gulmeen Raza
- Obstetrics and Gynecology, King Hamad University Hospital, Busaiteen, BHR
| | - Maha Ghorabah
- Obstetrics and Gynecology, King Hamad University Hospital, Busaiteen, BHR
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40
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Bertin FR, Frank N, Breuhaus BA, Schott HC, Kritchevsky JE. Diagnosis and management of thyroid disorders and thyroid hormone supplementation in adult horses and foals. Equine Vet J 2024; 56:243-252. [PMID: 37533378 DOI: 10.1111/evj.13981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023]
Abstract
Equine thyroid disorders pose a diagnostic challenge in clinical practice because of the effects of nonthyroidal factors on the hypothalamic-pituitary-thyroid axis, and the horse's ability to tolerate wide fluctuations in thyroid hormone concentrations and survive without a thyroid gland. While benign thyroid tumours are common in older horses, other disorders like primary hypothyroidism or hyperthyroidism in adult horses and congenital hypothyroidism in foals are rare. There is a common misunderstanding regarding hypothyroidism in adult horses, especially when associated with the clinical profile of obesity, lethargy, and poor performance observed in dogs and humans. Low blood thyroid hormone concentrations are often detected in horses as a secondary response to metabolic and disease states, including with the nonthyroidal illness syndrome; however, it is important to note that low thyroid hormone concentrations in these cases do not necessarily indicate hypothyroidism. Assessing equine thyroid function involves measuring thyroid hormone concentrations, including total and free fractions of thyroxine (T4) and triiodothyronine (T3); however, interpreting these results can be challenging due to the pulsatile secretion of thyroid hormones and the many factors that can affect their concentrations. Dynamic testing, such as the thyrotropin-releasing hormone stimulation test, can help assess the thyroid gland response to stimulation. Although true hypothyroidism is extremely rare, thyroid hormone supplementation is commonly used in equine practice to help manage obesity and poor performance. This review focuses on thyroid gland pathophysiology in adult horses and foals, interpretation of blood thyroid hormone concentrations, and evaluation of horses with thyroid disorders. It also discusses the use of T4 supplementation in equine practice.
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Affiliation(s)
- François-René Bertin
- School of Veterinary Science at The University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Nicholas Frank
- College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Babetta A Breuhaus
- College of Veterinary Medicine at North Caroline State University, Raleigh, North Carolina, USA
| | - Harold C Schott
- College of Veterinary Medicine at Michigan State University, East Lansing, Michigan, USA
| | - Janice E Kritchevsky
- College of Veterinary Medicine at Purdue University, West Lafayette, Indiana, USA
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Travail V, Fernandez Sanchez C, Costo JM, Valentine N, Conroy M, Lee V, Bouziopoulos D, Bateman K, Gatehouse E, Cruzado‐Perez J, Pollard D, Lamb V, Juvet F, Kelly D. Assessment of the likelihood of hypothyroidism in dogs diagnosed with and treated for hypothyroidism at primary care practices: 102 cases (2016-2021). J Vet Intern Med 2024; 38:931-941. [PMID: 38314891 PMCID: PMC10937491 DOI: 10.1111/jvim.16993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND There is a possibility that an incorrect diagnosis of hypothyroidism could be made in euthyroid dogs, and the prevalence of hypothyroidism in the dog population remains unknown. OBJECTIVES To retrospectively assess the percentage of dogs diagnosed with, and treated for, hypothyroidism at first opinion practice which are likely to be hypothyroid and require levothyroxine supplementation. ANIMALS One hundred two client-owned dogs were included in this study. MATERIALS AND METHODS The computerized databases of 7 first opinion practices were searched to identify dogs treated with levothyroxine supplementation. Three European College of Veterinary Internal Medicine-Companian Animals (ECVIM-CA) diplomates independently assigned 1 of 4 clinical assessments to each case as follows: confirmed or likely hypothyroid, hypothyroidism suspected but not confirmed, hypothyroidism considered unlikely, and no reason to suspect hypothyroidism. They commented as to whether or not they thought levothyroxine supplementation was appropriate. RESULTS The clinical assessments of "confirmed or likely hypothyroid"; "Hypothyroidism suspected but not confirmed"; "Hypothyroidism considered unlikely"; and "No reason to suspect hypothyroidism" was assigned respectively by Clinician 1 to 38.2%, 5.9%, 3.9%, and 52% of cases, by Clinician 2 to 48%, 22.6%, 22.6%, 6.9% of cases, and by Clinician 3 to 55.9%, 11.8%, 13.7% and 18.6%. Clinician 1, Clinician 2, and Clinician 3 considered levothyroxine supplementation not indicated in 58.8%, 52.9%, and 45.1% of cases, respectively. CONCLUSION These results support the concern that hypothyroidism might be overly and incorrectly diagnosed in first opinion practice, and that thyroid function testing should be performed only in those dogs with a high pretest probability of the disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Valerie Lamb
- Southern Counties Veterinary SpecialistsHampshireUK
| | | | - Darren Kelly
- Southern Counties Veterinary SpecialistsHampshireUK
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Schill F, Engström G, Melander O, Timpka S, Enhörning S. The possible role of the vasopressin system in hematopoiesis. Sci Rep 2024; 14:5085. [PMID: 38429469 PMCID: PMC10907562 DOI: 10.1038/s41598-024-55772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 11/23/2023] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
Vasopressin is a pleiotropic hormone that controls body fluid homeostasis. Vasopressin has also been proposed to be involved in erythropoiesis, thrombocyte activity and inflammation. However, whether increasing vasopressin is associated with changes in hematopoietic markers is not known. To evaluate this gap of knowledge we measured the vasopressin marker copeptin and markers of erythropoiesis (erythrocyte count, hemoglobin (Hb), red blood cell distribution width (RDW), mean corpuscular volume (MCV), erythrocyte volume fraction (EVF)), leukocyte count (total count, lymphocytes, neutrophils) and thrombocyte count in 5312 participants from the Swedish CArdioPulmonary bioImage Study (SCAPIS). The associations between increasing copeptin tertile and the hematopoietic markers were analyzed in multivariate linear regression analyses. We found that increasing copeptin tertile was significantly (p < 0.001) associated with increasing erythrocytes, RDW, EVF, Hb, leukocytes and neutrophils after adjustment for age, sex, current smoking, prevalent diabetes, hypertension, creatinine, body mass index and physical activity. Increasing copeptin tertile was, however, not associated with change in MCV, lymphocyte or thrombocyte count. In conclusion, we found that increasing copeptin levels are positively associated with markers of erythropoiesis and leukocyte count in the general population. These results warrant further research on possible mechanistic effects of vasopressin on hematopoiesis.
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Affiliation(s)
- Fredrika Schill
- Department of Cardiology, Skåne University Hospital, Carl-Bertil Laurells Gata 9, 214 28, Malmö, Sweden.
- Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden.
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Jan Waldenströms Gata 11 A, 214 28, Malmö, Sweden
| | - Simon Timpka
- Perinatal and Cardiovascular Epidemiology, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, 214 28, Malmö, Sweden
- Department of Obstetrics and Gynecology, Skåne University Hospital, Jan Waldenströms gata 47, 214 28, Malmö, Sweden
| | - Sofia Enhörning
- Department of Clinical Sciences, Lund University, Jan Waldenströms Gata 35, 214 28, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Jan Waldenströms Gata 11 A, 214 28, Malmö, Sweden
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Rastogi S, Verma N, Raghuwanshi G, Kumar Verma D, Atam V. Chronomedicine Insights: Evaluating the Impact of Time-Restricted Meal Intake on Lipid Profile Parameters Among Individuals With Type 2 Diabetes in Northern India. Cureus 2024; 16:e56902. [PMID: 38659523 PMCID: PMC11042785 DOI: 10.7759/cureus.56902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Time-restricted meal intake (TRM) has shown potential benefits such as enhanced insulin sensitivity, lowered blood sugar levels, and possible weight loss in individuals with type 2 diabetes mellitus (T2DM). Our study aimed to investigate the impact of TRM on lipid profile parameters such as total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) in fasting conditions in T2DM patients. METHODS In total, 400 patients from the endocrinology department at King George's Medical University (KGMU), Lucknow were enrolled in this study, adhering to the guidelines of the American Diabetes Association (ADA). Male and female patients with recently diagnosed T2DM (in the past five years), aged between 25 to 60 years, on oral anti-diabetic therapy excluding insulin, expressing willingness to provide written consent and to adhere to TRM were included in the TRM group. It was a longitudinal study as diabetic dyslipidemia is primarily caused by insulin resistance and nutritional reasons and we wanted to assess the effect of TRM on lipid profile in T2DM patients. Patients were enrolled via simple random sampling using the random number table method (computerized). The TRM group had an early dinner at 7 pm whereas the control group was of non-TRM/late-night eaters. TRM group was given comprehensive guidance including strategies to manage hunger, permissible beverage options (water and prescribed medication) during the fasting period, and daily maintenance of a diary documenting their timing, type, and quantity of food intake which they were requested to bring fortnightly. Emphasis was placed on recording even minor dietary items consumed throughout the day. The TRM group consumed food ad libitum during a 12-hour eating window from breakfast at 7 am to dinner at 7 pm. Data distribution was non-parametric. Mann-Whitney U test compared TRM and control group using mean values at baseline and follow-ups. Analysis used GraphPad Prism 9.2.0 software (GraphPad Inc., La Jolla, CA). A p-value less than 0.05 (p < 0.05) was considered statistically significant. RESULTS A total of 127 patients were lost to follow-up, resulting in 273 patients who completed the study. The mean value of TC in the TRM and non-TRM groups using the Mann-Whitney U test registered a highly significant p-value <0.0001 at 18 months, with a decrease of 14.17% from baseline in the TRM group and a decrease of 1.53% from baseline in the non-TRM group. The TRM group had a decrease of 24.75% in TG from a baseline value of 145.4±41.9, whereas the non-TRM group showed a decrease of 2.2% from a baseline value of 154.7±37.30 (p-value <0.0001). The TRM group showed an increase of 9.25% in HDL from a baseline value of 50.14±8.58; the non-TRM group showed an increase of 0.82% from a baseline value of 48.62±9.31 (p-value <0.0001). TRM group showed a decrease of 8.62% in LDL from a baseline value of 68.20±16.2 while the non-TRM group showed an increase of 1.54% from a baseline value of 65.38±19.3 (p-value <0.0002). The TRM group showed a decrease of 13.97% in VLDL from a baseline value of 32.20±18.7; the non-TRM group showed an increase of 4% from a baseline value of 30.16±24.2 (p-value <0.0001). CONCLUSION Our study's promising results underscore the potential of TRM as an effective strategy for managing dyslipidemia in individuals with T2DM, even over prolonged periods.
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Affiliation(s)
- Smriti Rastogi
- Physiology, King George's Medical University, Lucknow, IND
| | - Narsingh Verma
- Physiology, King George's Medical University, Lucknow, IND
| | - Gourav Raghuwanshi
- Physiology, People's College of Medical Sciences and Research Centre, Bhopal, IND
| | | | - Virendra Atam
- Internal Medicine, King George's Medical University, Lucknow, IND
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Kemp KL, Skinner JE, Bertin F. Effect of phenylbutazone on insulin secretion in horses with insulin dysregulation. J Vet Intern Med 2024; 38:1177-1184. [PMID: 38363029 PMCID: PMC10937495 DOI: 10.1111/jvim.17013] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 11/01/2023] [Accepted: 01/26/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Phenylbutazone is often prescribed to manage pain caused by hyperinsulinemia-associated laminitis, but in diabetic people nonsteroidal anti-inflammatory drugs increase insulin secretion and pancreatic activity. HYPOTHESIS/OBJECTIVES Investigate the effect of phenylbutazone administration on insulin secretion in horses. It was hypothesized that phenylbutazone will increase insulin secretion in horses with insulin dysregulation (ID). ANIMALS Sixteen light breed horses, including 7 with ID. METHODS Randomized cross-over study design. Horses underwent an oral glucose test (OGT) after 9 days of treatment with phenylbutazone (4.4 mg/kg IV q24h) or placebo (5 mL 0.9% saline). After a 10-day washout period, horses received the alternative treatment, and a second OGT was performed. Insulin and glucose responses were compared between groups (ID or controls) and treatments using paired t test and analyses of variance with P < .05 considered significant. RESULTS In horses with ID, phenylbutazone treatment significantly decreased glucose concentration (P = .02), glucose area under the curve (2429 ± 501.5 vs 2847 ± 486.1 mmol/L × min, P = .02), insulin concentration (P = .03) and insulin area under the curve (17 710 ± 6676 vs 22 930 ± 8788 μIU/mL × min, P = .03) in response to an OGT. No significant effect was detected in control horses. CONCLUSION AND CLINICAL IMPORTANCE Phenylbutazone administration in horses with ID decreases glucose and insulin concentrations in response to an OGT warranting further investigation of a therapeutic potential of phenylbutazone in the management of hyperinsulinemia-associated laminitis beyond analgesia.
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Affiliation(s)
- Kate L. Kemp
- School of Veterinary ScienceThe University of QueenslandGatton, QueenslandAustralia
| | - Jazmine E. Skinner
- School of Agriculture and Environmental ScienceUniversity of Southern QueenslandDarling Heights, QueenslandAustralia
| | - François‐René Bertin
- School of Veterinary ScienceThe University of QueenslandGatton, QueenslandAustralia
- College of Veterinary MedicinePurdue UniversityWest‐LafayetteIndianaUSA
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45
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Ma L, Dong Y, Li Z, Meng J, Zhao B, Wang Q. Relationship between circulating metabolites and diabetic retinopathy: a two-sample Mendelian randomization analysis. Sci Rep 2024; 14:4964. [PMID: 38424453 PMCID: PMC10904376 DOI: 10.1038/s41598-024-55704-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 11/21/2023] [Accepted: 02/27/2024] [Indexed: 03/02/2024] Open
Abstract
Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes mellitus, however, its underlying biological mechanisms remain poorly understood. We examined single nucleotide polymorphisms linked to 486 blood metabolites through extensive genome-wide association studies conducted on individuals of European ancestry. The FinnGen Biobank database served as a reference to define DR. Two-sample MR analysis was conducted to reveal the association between the levels of genetically predicted circulating metabolites and the susceptibility to DR. To validate the robustness of the obtained findings, sensitivity analyses with weighted median, weighted mode, and MR-Egger were conducted. 1-oleoylglycerophosphoethanolamine (odds ratio [OR] (OR per one standard deviation [SD] increase) = 0.414; 95% confidence interval [CI] 0.292-0.587; P = 7.613E-07, PFDR = 6.849E-06), pyroglutamine (OR per one SD increase = 0.414; 95% confidence interval [CI] 0.292-0.587; P = 8.31E-04, PFDR = 0.007), phenyllactate (PLA) (OR per one SD increase = 0.591; 95% confidence interval [CI] 0.418-0.836; P = 0.003, PFDR = 0.026), metoprolol acid metabolite (OR per one SD increase = 0.978; 95% confidence interval [CI] 0.962-0.993; P = 0.005, PFDR = 0.042), 10-undecenoate (OR per one SD increase = 0.788; 95% confidence interval [CI] 0.667-0.932; P = 0.005, PFDR = 0.049), erythritol (OR per one SD increase = 0.691; 95% confidence interval [CI] 0.513-0.932; P = 0.015, PFDR = 0.034), 1-stearoylglycerophosphoethanolamine (OR per one SD increase = 0.636; 95% confidence interval [CI] 0.431-0.937; P = 0.022, PFDR = 0.099), 1-arachidonoylglycerophosphoethanolamine (OR per one SD increase = 0.636; 95% confidence interval [CI] 0.431-0.937; P = 0.030, PFDR = 0.099) showed a significant causal relationship with DR and could have protective effects. stachydrine (OR per one SD increase = 1.146; 95% confidence interval [CI] 1.066-1.233; P = 2.270E-04, PFDR = 0.002), butyrylcarnitine (OR per one SD increase = 1.117; 95% confidence interval [CI] 1.023-1.219; P = 0.014, PFDR = 0.062), 5-oxoproline (OR per one SD increase = 1.569; 95% confidence interval [CI] 1.056-2.335; P = 0.026, PFDR = 0.082), and kynurenine (OR = 1.623; 95% CI 1.042-2.526; P = 0.041, PFDR = 0.097) were significantly associated with an increased risk of DR. This study identified metabolites have the potential to be considered prospective compounds for investigating the underlying mechanisms of DR and for selecting appropriate drug targets.
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Affiliation(s)
- Lingli Ma
- Department of Endocrinology and Metabolism, China-Japan Union Hospital of Jilin University, 126 Sendai Avenue, Changchun City, Jilin Province, China
| | - Ying Dong
- Department of Radiotherapy, Jilin Cancer Hospital, Changchun, China
| | - Zimeng Li
- Department of Endocrinology and Metabolism, China-Japan Union Hospital of Jilin University, 126 Sendai Avenue, Changchun City, Jilin Province, China
| | - Jian Meng
- Department of Endocrinology and Metabolism, China-Japan Union Hospital of Jilin University, 126 Sendai Avenue, Changchun City, Jilin Province, China
| | - Bingqi Zhao
- Department of Endocrinology and Metabolism, China-Japan Union Hospital of Jilin University, 126 Sendai Avenue, Changchun City, Jilin Province, China
| | - Qing Wang
- Department of Endocrinology and Metabolism, China-Japan Union Hospital of Jilin University, 126 Sendai Avenue, Changchun City, Jilin Province, China.
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Zhang YN, Wu Q, Deng YH. Phenotypic characterisation of regulatory T cells in patients with gestational diabetes mellitus. Sci Rep 2024; 14:4881. [PMID: 38418860 PMCID: PMC10902321 DOI: 10.1038/s41598-023-47638-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 09/10/2023] [Accepted: 11/16/2023] [Indexed: 03/02/2024] Open
Abstract
Gestational diabetes mellitus (GDM) is a common complication that occurs during pregnancy. Emerging evidence suggests that immune abnormalities play a pivotal role in the development of GDM. Specifically, regulatory T cells (Tregs) are considered a critical factor in controlling maternal-fetal immune tolerance. However, the specific characteristics and alterations of Tregs during the pathogenesis of GDM remain poorly elucidated. Therefore, this study aimed to investigate the changes in Tregs among pregnant women diagnosed with GDM compared to healthy pregnant women. A prospective study was conducted, enrolling 23 healthy pregnant women in the third trimester and 21 third-trimester women diagnosed with GDM. Participants were followed up until the postpartum period. The proportions of various Treg, including Tregs, mTregs, and nTregs, were detected in the peripheral blood of pregnant women from both groups. Additionally, the expression levels of PD-1, HLA-G, and HLA-DR on these Tregs were examined. The results revealed no significant differences in the proportions of Tregs, mTregs, and nTregs between the two groups during the third trimester and postpartum period. However, GDM patients exhibited significantly reduced levels of PD-1+ Tregs (P < 0.01) and HLA-G+ Tregs (P < 0.05) in the third trimester compared to healthy pregnant women in the third trimester. Furthermore, GDM patients demonstrated significantly lower levels of PD-1+ mTregs (P < 0.01) and HLA-G+ (P < 0.05) mTregs compared to healthy pregnant women in the third trimester. Overall, the proportion of Tregs did not exhibit significant changes during the third trimester in GDM patients compared to healthy pregnant women. Nevertheless, the observed dysregulation of immune regulation function in Tregs and mTregs may be associated with the development of GDM in pregnant women.
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Affiliation(s)
- Ya-Nan Zhang
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Hunan, 410208, China
| | - Qin Wu
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Hunan, 410208, China
| | - Yi-Hui Deng
- School of Chinese Medicine, Hunan University of Chinese Medicine, Hunan, 410208, China.
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Pears G, Mahajan A, Olsson-Brown A, Sacco J. A case of immunotherapy-induced thyroiditis. Explor Target Antitumor Ther 2024; 5:225-231. [PMID: 38464389 PMCID: PMC10918230 DOI: 10.37349/etat.2024.00214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 12/21/2023] [Indexed: 03/12/2024] Open
Abstract
Immunotherapy treatments for cancer are known to cause adverse thyroid events which present a diagnostic challenge to clinicians and radiologists. This case report highlights the importance of a high clinical index of suspicion and careful assessment of the thyroid on serial imaging studies to make the diagnosis. The case involves a 65-year-old male with malignant melanoma who was started on immunotherapy as part of a clinical trial. He developed thyroid dysfunction followed by an attack of acute neck pain. Ultrasound of his thyroid was performed which showed significant atrophy. A review of previous imaging was undertaken which confirmed the patient had suffered from thyroiditis and subsequent atrophy. Following this, the diagnosis of immunotherapy-induced thyroid dysfunction was made. Thyroxine supplementation and steroid dose were then adjusted causing his thyroid function and symptoms to improve. Immunotherapy agents for cancers are becoming more and more common. As the case report shows, physicians and radiologists will need to be vigilant to diagnose and treat any adverse events.
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Affiliation(s)
- George Pears
- Department of Imaging, The Clatterbridge Cancer Centre NHS Foundation Trust, L7 8YA Liverpool, UK
| | - Abhishek Mahajan
- Department of Imaging, The Clatterbridge Cancer Centre NHS Foundation Trust, L7 8YA Liverpool, UK
- Faculty of Health and Life Sciences, University of Liverpool, L7 8TX Liverpool, UK
| | - Anna Olsson-Brown
- Oncology, The Clatterbridge Cancer Centre NHS Foundation Trust, L7 8YA Liverpool, UK
| | - Joseph Sacco
- Oncology, The Clatterbridge Cancer Centre NHS Foundation Trust, L7 8YA Liverpool, UK
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Zhou J, Zhang M, Ju X, Wang H, Xiao H, Zhai Z, Zhong X, Hong J. Increased monocytic myeloid-derived suppressor cells in type 2 diabetes correlate with hyperglycemic and was a risk factor of infection and tumor occurrence. Sci Rep 2024; 14:4384. [PMID: 38388535 PMCID: PMC10883972 DOI: 10.1038/s41598-024-54496-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 08/30/2023] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
To investigate the frequency of monocytic myeloid-derived suppressor cells (M-MDSCs) in type 2 diabetes mellitus (T2DM) patients and explore the potential associations between M-MDSCs, glycemic control, and the occurrence of infections and tumor. 102 healthy and 77 T2DM individuals were enrolled. We assessed the M-MDSCs frequency, levels of fasting plasma glucose (FPG), haemoglobin A1c (HbA1c), and other relevant indicators. Each patient underwent a follow-up of at least 6 months after M-MDSCs detection. The M-MDSCs frequency was significantly higher in patients with poor glycemic control (PGC) compared to the healthy population (P < 0.001), whereas there was no significant difference between patients with good glycemic control and the healthy (P > 0.05). There was a positive correlation between the M-MDSCs frequency and FPG, HbA1c (R = 0.517 and 0.315, P < 0.001, respectively). T2DM patients with abnormally increased M-MDSCs have a higher incidence of infection and tumor (48.57% and 11.43% respectively). Our results shed new light on the pathogenesis of T2DM, help to understand why T2DM patients are susceptible to infection and tumor and providing novel insights for future prevention and treatment of T2DM.
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Affiliation(s)
- Ji Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
- School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Mengjie Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui, China
- Department of Endocrinology, Fuyang People's Hospital, Fuyang, 236000, Anhui, China
| | - Xiaodi Ju
- School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Huiping Wang
- Hematologic Department/Hematologic Disease Research Center, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Hao Xiao
- Hematologic Department/Hematologic Disease Research Center, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Zhimin Zhai
- Hematologic Department/Hematologic Disease Research Center, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Xing Zhong
- Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui, China.
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China.
- Nursing International Collaboration Research Center of Anhui Province, Hefei, 230601, Anhui, China.
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Wang Z, Zhang G, Fu J, Li G, Zhao Z, Choe H, Ding K, Ma J, Wei J, Shang D, Zhang L. Mechanism exploration and biomarker identification of glycemic deterioration in patients with diseases of the exocrine pancreas. Sci Rep 2024; 14:4374. [PMID: 38388766 PMCID: PMC10883946 DOI: 10.1038/s41598-024-52956-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 05/29/2023] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
The damage to the endocrine pancreas among patients with diseases of the exocrine pancreas (DP) leads to reduced glycemic deterioration, ultimately resulting in diabetes of the exocrine pancreas (DEP). The present research aims to investigate the mechanism responsible for glycemic deterioration in DP patients, and to identify useful biomarkers, with the ultimate goal of enhancing clinical practice awareness. Gene expression profiles of patients with DP in this study were acquired from the Gene Expression Omnibus database. The original study defines DP patients to belong in one of three categories: non-diabetic (ND), impaired glucose tolerance (IGT) and DEP, which correspond to normoglycemia, early and late glycemic deterioration, respectively. After ensuring quality control, the discovery cohort included 8 ND, 20 IGT, and 12 DEP, while the validation cohort included 27 ND, 15 IGT, and 20 DEP. Gene set enrichment analysis (GSEA) employed differentially expressed genes (DEGs), while immunocyte infiltration was determined using single sample gene set enrichment analysis (ssGSEA). Additionally, correlation analysis was conducted to establish the link between clinical characteristics and immunocyte infiltration. The least absolute shrinkage and selection operator regression and random forest combined to identify biomarkers indicating glycemic deterioration in DP patients. These biomarkers were further validated through independent cohorts and animal experiments. With glycemic deterioration, biological processes in the pancreatic islets such as nutrient metabolism and complex immune responses are disrupted in DP patients. The expression of ACOT4, B2M, and ACKR2 was upregulated, whereas the expression of CACNA1F was downregulated. Immunocyte infiltration in the islet microenvironment showed a significant positive correlation with the age, body mass index (BMI), HbA1c and glycemia at the 2-h of patients. It was a crucial factor in glycemic deterioration. Additionally, B2M demonstrated a significant positive correlation with immunocyte infiltration and clinical features. Quantitative real-time PCR (qRT-PCR) and western blotting confirmed the upregulation in B2M. Immunofluorescent staining suggested the alteration of B2M was mainly in the alpha cells and beta cells. Overall, the study showed that gradually increased immunocyte infiltration was a significant contributor to glycemic deterioration in patients with DP, and it also highlighted B2M as a biomarker.
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Affiliation(s)
- Zhen Wang
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, 116000, China
| | - Guolin Zhang
- Department of Cardiology II, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China
| | - Jixian Fu
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, 110001, China
| | - Guangxing Li
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
| | - Zhihao Zhao
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
| | - HyokChol Choe
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
- Department of Clinical Medicine, Sinuiju Medical University, Sinuiju, Republic of Korea
| | - Kaiyue Ding
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
| | - Junnan Ma
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
| | - Jing Wei
- Department of Immunology, College of Basic Medical Science, Dalian Medical University, Dalian, 116044, China.
| | - Dong Shang
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, 116000, China.
| | - Lin Zhang
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China.
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Seabrook A, Vasudevan A, Neville K, Gerstl B, Benn D, Smith J, Kirk J, Gill A, Clifton-Bligh R, Tucker K. Genotype-phenotype correlations in paediatric and adolescent phaeochromocytoma and paraganglioma: a cross-sectional study. Arch Dis Child 2024; 109:201-208. [PMID: 38071512 DOI: 10.1136/archdischild-2023-325419] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 04/04/2023] [Accepted: 10/16/2023] [Indexed: 02/21/2024]
Abstract
Phaeochromocytoma (PC) and paraganglioma (PGL) syndromes associated with germline pathogenic variants are associated with high morbidity and mortality. Establishing genotype-phenotype correlations within a young population is challenging due to their rare occurrence. OBJECTIVE To describe genotype-phenotype correlations in paediatric and adolescent patients diagnosed with PC/PGL. To establish the incidence of PC/PGL in a young population and prevalence of germline pathogenic variants within this group. STUDY DESIGN We conducted a cross-sectional study of patients diagnosed with a PC/PGL aged 0-21 years old who were reviewed within Familial Cancer Services within New South Wales and the Australian Capital Territory, Australia. RESULTS A germline pathogenic variant was detected in 80% (24/30) of patients; SDHB: n=12, VHL: n=11, and MAX: n=1. Only patients harbouring a germline pathogenic variant reported a family history of syndromic tumours, those with apparently sporadic disease did not (62.5% versus 0%, p=0.02). All patients with VHL presented with an adrenal tumour compared with 25% of those with SDHB (100% versus 25%, p=0.01). Occurrence of multiple primary PC/PGL was seen in patients with VHL however was absent in patients with SDHB (36% versus 0%, p=0.03). Incidence rate of paediatric PC/PGL was 0.45 cases per million person years. CONCLUSIONS PC/PGL diagnosed in children and adolescents were strongly associated with germline pathogenic variants in VHL or SDHB. These patients should be referred to specialist services for family counselling and genetic testing along followed by investigations for the detection of bilateral, multifocal or metastatic disease, and lifelong surveillance for recurrent disease.
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Affiliation(s)
- Amanda Seabrook
- Cancer Genetics Diagnostic Laboratory, Kolling Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Anand Vasudevan
- Deaprtment of Clinical Genetics, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Kristen Neville
- Department of Endocrinology, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
- Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Brigitte Gerstl
- The Kids Cancer Centre, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Diana Benn
- Cancer Genetics Diagnostic Laboratory, Kolling Institute of Medical Research, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Janine Smith
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Clinical Genetics, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Judy Kirk
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Familial Cancer Service, Westmead Hospital, Westmead, New South Wales, Australia
| | - Anthony Gill
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Roderick Clifton-Bligh
- Cancer Genetics Diagnostic Laboratory, Kolling Institute of Medical Research, Sydney, New South Wales, Australia
- Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Katherine Tucker
- Hereditary Cancer Service, Prince of Wales Hospital Nelune Comprehensive Cancer Centre, Randwick, New South Wales, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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