Canagliflozin regulates metabolic reprogramming in diabetic kidney disease by inducing fasting-like and aestivation-like metabolic patterns.

AIMS/HYPOTHESIS: Sodium-glucose co-transporter 2 (SGLT2) inhibitors (SGLT2i) are antihyperglycaemic drugs that protect the kidneys of individuals with type 2 diabetes mellitus. However, the underlying mechanisms mediating the renal benefits of SGLT2i are not fully understood. Considering the fuel switches that occur during therapeutic SGLT2 inhibition, we hypothesised that SGLT2i induce fasting-like and aestivation-like metabolic patterns, both of which contribute to the regulation of metabolic reprogramming in diabetic kidney disease (DKD). METHODS: Untargeted and targeted metabolomics assays were performed on plasma samples from participants with type 2 diabetes and kidney disease (n=35, 11 women) receiving canagliflozin (CANA) 100 mg/day at baseline and 12 week follow-up. Next, a systematic snapshot of the effect of CANA on key metabolites and pathways in the kidney was obtained using db/db mice. Moreover, the effects of glycine supplementation in db/db mice and human proximal tubular epithelial cells (human kidney-2 [HK-2]) cells were studied. RESULTS: Treatment of DKD patients with CANA for 12 weeks significantly reduced HbA1c from a median (interquartile range 25-75%) of 49.0 (44.0-57.0) mmol/mol (7.9%, [7.10-9.20%]) to 42.2 (39.7-47.7) mmol/mol (6.8%, [6.40-7.70%]), and reduced urinary albumin/creatinine ratio from 67.8 (45.9-159.0) mg/mmol to 47.0 (26.0-93.6) mg/mmol. The untargeted metabolomics assay showed downregulated glycolysis and upregulated fatty acid oxidation. The targeted metabolomics assay revealed significant upregulation of glycine. The kidneys of db/db mice undergo significant metabolic reprogramming, with changes in sugar, lipid and amino acid metabolism; CANA regulated the metabolic reprogramming in the kidneys of db/db mice. In particular, the pathways for glycine, serine and threonine metabolism, as well as the metabolite of glycine, were significantly upregulated in CANA-treated kidneys. Glycine supplementation ameliorated renal lesions in db/db mice by inhibiting food intake, improving insulin sensitivity and reducing blood glucose levels. Glycine supplementation improved apoptosis of human proximal tubule cells via the AMP-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) pathway. CONCLUSIONS/INTERPRETATION: In conclusion, our study shows that CANA ameliorates DKD by inducing fasting-like and aestivation-like metabolic patterns. Furthermore, DKD was ameliorated by glycine supplementation, and the beneficial effects of glycine were probably due to the activation of the AMPK/mTOR pathway.

Glucose promotes cell growth and casein synthesis via ATF4/Nrf2-Sestrin2- AMPK-mTORC1 pathway in dairy cow mammary epithelial cells.

In the dairy industry, glucose (Glu) is used as bioactive substance to increase milk yield. However, the molecular regulation underneath needs further clarification. Here, the regulation and its molecular mechanism of Glu on cell growth and casein synthesis of dairy cow mammary epithelial cells (DCMECs) were investigated. When Glu was added from DCMECs, both cell growth, ß-casein expression and the mechanistic target of rapamycin complex 1 (mTORC1) pathway were increased. Overexpression and silencing of mTOR revealed that Glu promoted cell growth and ß-casein expression through the mTORC1 pathway. When Glu was added from DCMECs, both Adenosine 5'-monophosphate-activated protein kinase α (AMPKα) and Sestrin2 (SESN2) expression were decreased. Overexpression and silencing of AMPKα or SESN2 uncovered that AMPKα suppressed cell growth and ß-casein synthesis through inhibiting mTORC1 pathway, and SESN2 suppressed cell growth and ß-casein synthesis through activating AMPK pathway. When Glu was depleted from DCMECs, both activating transcription factor 4 (ATF4) and nuclear factor (erythroid-derived 2)-like 2 (Nrf2) expression were increased. Overexpression or silencing of ATF4 or Nrf2 demonstrated that Glu depletion promoted SESN2 expression through ATF4 and Nrf2. Together, these results indicate that in DCMECs, Glu promoted cell growth and casein synthesis via ATF4/Nrf2-SESN2-AMPK-mTORC1 pathway.

Involvement of miR-27a-3p in diabetic nephropathy via affecting renal fibrosis, mitochondrial dysfunction, and endoplasmic reticulum stress.

Diabetic nephropathy (DN) is acknowledged as a serious chronic complication of diabetes mellitus. Nevertheless, its pathogenesis is complicated and unclear. Thus, in this study, the role of miR-27a-3p-prohibitin/TMBIM6 signaling axis in the progression of DN was elucidated. Type 2 diabetic db/db mice and high glucose (HG)-challenged HK-2 cells were used as in vivo and in vitro models. Our results showed that miR-27a-3p was upregulated and prohibitin or transmembrane BAX inhibitor motif containing 6 (TMBIM6) was downregulated in the kidney tissues of db/db mice and HG-treated HK-2 cells. Silencing miR-27a-3p enhanced the expression of prohibitin and TMBIM6 in the kidney tissues and HK-2 cells. Inhibition of miR-27a-3p improved functional injury, as evidenced by decreased blood glucose, urinary albumin, serum creatinine, and blood urea nitrogen levels. MiR-27a-3p silencing ameliorated renal fibrosis, reflected by reduced profibrogenic genes (e.g., transforming growth factor ß1, fibronectin, collagen I and III, and α-smooth muscle actin). Furthermore, inhibition of miR-27a-3p relieved mitochondrial dysfunction in the kidney of db/db mice, including upregulation of mitochondrial membrane potential, complex I and III activities, adenosine triphosphate, and mitochondrial cytochrome C, as well as suppressing reactive oxygen species production. In addition, miR-27a-3p silencing attenuated endoplasmic reticulum (ER) stress, reflected by reduced expression of p-IRE1α, p-eIF2α, XBP1s, and CHOP. Mechanically, we identified prohibitin and TMBIM6 as direct targets of miR-27a-3p. Inhibition of miR-27a-3p protected HG-treated HK-2 cells from apoptosis, extracellular matrix accumulation, mitochondrial dysfunction, and ER stress by regulating prohibitin or TMBIM6. Taken together, we reveal that miR-27a-3p-prohibitin/TMBIM6 signaling axis regulates the progression of DN, which can be a potential therapeutic target.

LDOC1 is differentially expressed in thyroid cancer and display tumor-suppressive function in papillary thyroid carcinoma.

The leucine zipper downregulated in cancer 1 (LDOC1) has been proposed as a regulator of transcription and cell signaling. We have previously demonstrated that LDOC1 is differentially expressed in papillary thyroid carcinoma (PTC), this study was designed to characterize LDOC1 expression in thyroid follicle originated cancer tissues and to specifically evaluate its function in thyroid carcinogenesis. LDOC1 expression was performed in human normal thyroid and thyroid cancer. LDOC1 function was characterized, in two PTC cell lines (TPC1 and BCPAP), through the analysis of in vitro cell proliferation, apoptosis, migration, and invasion along with in vivo tumor xenograft growth. Transduced BCPAP cells were stimulated with tumor necrosis factor α, and the levels of nuclear P65, Bax, Bcl-2, c-Myc, and XIAP were assessed. A luciferase reporter assay was used to measure nuclear factor-κB (NF-κB) activity, and the functional connection between LDOC1 effect and NF-κB activity was determined using a specific NF-κB inhibitor. Our results revealed that LDOC1 was translocated from the nucleus to the cytoplasm in human thyroid cancer, and was significantly downregulated in PTC compared with normal thyroid. LDOC1 overexpression in TPC1 resulted in a significant suppression of the malignant phenotype, whereas LDOC1 ablation in BCPAP promoted this phenotype. Additional studies demonstrated that LDOC1 ablation facilitated nuclear P65 expression and NF-κB activity. NF-κB inhibition reversed the effects of LDOC1 ablation on proliferation, apoptosis, migration, and invasion. Our findings confirmed that LDOC1 is a novel therapeutic target in PTC and provides new insight into the role of LDOC1 in PTC progression, through NF-κΒ signaling suppression.

Otoprotective effects of mouse nerve growth factor in DBA/2J mice with early-onset progressive hearing loss.

As it displays progressive hair-cell loss and degeneration of spiral ganglion neurons (SGNs) characterized by early-onset progressive hearing loss (ePHL), DBA/2J is an inbred mouse strain widely used in hearing research. Mouse nerve growth factor (mNGF), as a common exogenous nerve growth factor (NGF), has been studied extensively for its ability to promote neuronal survival and growth. To determine whether mNGF can ameliorate progressive hearing loss (PHL) in DBA/2J mice, saline or mNGF was given to DBA/2J mice of either sex by daily intramuscular injection from the 1st to the 9th week after birth. At 5, 7, and 9 weeks of age, in comparison with vehicle groups, mNGF groups experienced decreased auditory-evoked brainstem response (ABR) thresholds and increased distortion product otoacoustic emission (DPOAE) amplitudes, the prevention of hair cell loss, and the inhibition of apoptosis of SGNs. Downregulation of Bak/Bax and Caspase genes and proteins in cochleae of mice receiving the mNGF treatment was detected by real-time PCR, Western blot, and immunohistochemistry. This suggests that the Bak-dependent mitochondrial apoptosis pathway may be involved in the otoprotective mechanism of mNGF in progressive hearing loss of DBA/2J mice. Our results demonstrate that mNGF can act as an otoprotectant in the DBA/2J mice for the early intervention of PHL and, thus, could become of great value in clinical applications. © 2017 Wiley Periodicals, Inc.

The role of FoxO1 in interleukin-1ß-induced autostimulation in retina endothelial cells and retinas of diabetic rats.

Diabetic retinopathy is a chronic, low-grade inflammatory disease. The present study aimed to investigate the effect of forkhead transcription factor O1 (FoxO1) expression on interleukin-1ß (IL-1ß)-induced autostimulation, both in vitro in human retina microvascular endothelial cells (HRMECs), and in vivo in retinas isolated from streptozotocin-induced diabetic rats. High-glucose (HG) and recombinant IL-1ß treatment were both shown to increase the expression of FoxO1 and IL-1ß in HRMECs in a dose-dependent manner. IL-1 receptor antagonist (IL-1RA) and mitogen-activated protein kinase (MAPK) inhibitors reduced IL-1ß-induced expression of FoxO1 in HRMECs. Moreover, the increased expressions of FoxO1 and IL-1ß in the retinas of diabetic rats were significantly decreased by intravitreal injection of lentiviral vector-mediated FoxO1 small-interfering RNA. Together, these results suggest that HG triggers IL-1ß synthesis in HRMECs. The produced IL-1ß induces increased FoxO1 expression, as well as interacts with the IL-1 receptor to activate MAPK signaling and thereby induces IL-1ß autostimulation. The IL-1ß-induced autostimulation can be inhibited by downregulation of FoxO1, accompanied by a reduction of inflammation. Together, these findings identify novel functions for FoxO1 and IL-1ß in diabetic retinopathy.

Lentiviral Vector-Mediated FoxO1 Overexpression Inhibits Extracellular Matrix Protein Secretion Under High Glucose Conditions in Mesangial Cells.

Diabetic nephropathy is characterized by inordinate secretion of extracellular matrix (ECM) proteins from mesangial cells (MCs), which is tightly associated with excessive activation of TGF-ß signaling. The forkhead transcription factor O1 (FoxO1) protects mesangial cells from hyperglycemia-induced oxidative stress, which may be involved in ameliorating the redundant secretion of ECM proteins under high glucose conditions. Here, we reported that high glucose elevated the level of p-Akt to attenuate endogenous FoxO1 bioactivities in MCs, accompanied with decreases in the mRNA expressions of catalase (CAT) and superoxide dismutase 2 (SOD2). Meanwhile, the expressions of major ECM proteins-FN and Col I-increased under high glucose conditions, in consistent with the activation of TGF-ß/Smad signaling. By contrast, overexpression of nucleus-localized FoxO1 (insensitive to Akt phosphorylation) directly up-regulated the expressions of anti-oxidative enzymes, accompanied with inactivation of TGF-ß/Smad3 pathway, as well as decreases of extracellular matrix proteins. Moreover, similar to those MCs overexpressed of nucleus-localized FoxO1 in high glucose conditions, MCs with down-regulation of FoxO1 by small interference-RNA under normal glucose conditions showed increased FN level and activated TGF-ß/Smad3 pathway. Our findings link the anti-oxidative activity of FoxO1 and the TGF-ß-induced secretion of ECM proteins, indicating the novel role of FoxO1 in protecting MCs under high glucose conditions.

Overexpression of FOXO1 ameliorates the podocyte epithelial-mesenchymal transition induced by high glucose in vitro and in vivo.

Accumulating evidence has suggested that the epithelial-mesenchymal transition (EMT) is a pathway that potentially leads to podocyte depletion and proteinuria in diabetic nephropathy (DN). Therefore, this study was designed to investigate the protective effects of forkhead transcription factor O1 (FOXO1) on podocyte EMT, under high-glucose (HG) conditions in vitro and under diabetic conditions in vivo. The results showed that HG-induced podocyte EMT was associated with FOXO1 inactivation, which was accompanied by activation of the transforming growth factor (TGF)-ß1/SMAD3/integrin-linked kinase (ILK) pathway. Accordingly, constitutive FOXO1 activation suppressed the TGF-ß1/Smad3/ILK pathway and partially reversed EMT, similar to the effects observed after treatment with SIS3 or QLT0267, which are selective inhibitors of TGF-ß1-dependent SMAD3 phosphorylation and ILK, respectively. In addition, lentiviral-mediated FOXO1 overexpression in the kidneys of diabetic mice considerably increased FOXO1 expression and activation, while decreasing proteinuria and renal pathological injury. These data suggested that forced FOXO1 activation inhibited HG-induced podocyte EMT and ameliorated proteinuria and renal injury in diabetic mice. Our findings further highlighted that FOXO1 played a protective role against diabetes in mice and may potentially be used as a novel therapeutic target for treating diabetic nephropathy.

Effects of overexpressing FoxO1 on apoptosis in glomeruli of diabetic mice and in podocytes cultured in high glucose medium.

Podocyte apoptosis induced by high levels of glucose is a key event in the development and prognosis of diabetic nephropathy (DN). Forkhead transcription factor O1 (FoxO1) has been defined as a critical mediator of oxidative stress in animal models of diabetes and is involved in mitophagy. To test the role of FoxO1 in regulating podocyte apoptosis both in vivo and in vitro, we generated FoxO1 overexpression models. High-glucose (HG) induced podocyte apoptosis with decreased mitophagy. These changes were accompanied by mitochondrial dysfunction and more severe podocyte loss in mouse kidney. FoxO1 overexpression prevented the apoptosis induced by HG. Reduction of cell apoptosis and renal damage depended upon the expression of PTEN-induced putative kinase 1 (PINK1). These findings suggest that specific overexpression of renal FoxO1 decreases podocyte apoptosis, which may be explained in part by its regulation of PINK1, and that targeting FoxO1 may represent a novel therapeutic approach for DN.

Valsartan inhibits amylin-induced podocyte damage.

Previous studies have described the deposition of amylin in the kidney of patients with type 2 diabetes mellitus (T2DM). These deposits play a critical role in the pathogenesis of diabetic nephropathy (DN), although the mechanism underlying this effect is unknown. Thus, this study was undertaken to investigate whether amylin aggregation stimulates the local angiotensin II type 1 receptor (AT1R) in podocytes, and to examine its role in podocyte apoptosis. Amylin-induced apoptosis was investigated in vitro in differentiated, conditionally immortalized mouse podocytes and in vivo in KM mice. Expression of genes including nephrin, podocin, AT1R and desmin was measured through quantitative real time PCR, western blot and immunohistochemistry. Apoptosis was determined by flow cytometry, while the cellular distribution of podocin and nephrin was investigated by immunofluorescence. The ultra-structure of glomeruli was examined by transmission electron microscopy (TEM). Amylin enhanced apoptosis in a dose-dependent manner in vitro. The peptide also suppressed podocin and nephrin expression, but enhanced that of AT1R and desmin. Both effects were significantly blocked by valsartan, which inhibits angiotensin II type 1 receptor. These findings suggest that amylin activates a local intracellular RAS in podocytes and induces damage and apoptosis.

FoxP3 in papillary thyroid carcinoma induces NIS repression through activation of the TGF-ß1/Smad signaling pathway.

Forkhead box P3 (FoxP3) expression in papillary thyroid carcinoma (PTC) is associated with resistance to radioiodine treatment. The sodium iodine symporter (NIS) is a plasma membrane glycoprotein, the repression of which may render the tumor refractive to radioiodine therapy. In this study, samples from 90 PTCs as well as 40 normal thyroid tissues were examined for FoxP3 and NIS by immunohistochemistry and real-time PCR. We found that FoxP3 was associated with decreased NIS expression. Lentiviral-mediated FoxP3-overexpressing cells were constructed and real-time PCR and western blotting were performed to evaluate the expression of NIS. Meanwhile, key members of the transforming growth factor-ß1 (TGF-ß1) pathway were explored by ELISA and immunofluorescence and a neutralizing TGF-ß1 antibody was used to block activity. In vitro, FoxP3 overexpression significantly reduced NIS transcript and protein levels and the TGF-ß1 pathway was activated. However, treatment with neutralizing TGF-ß1 antibody partially abrogated FoxP3-induced NIS repression. These findings suggest that FoxP3 could compromise NIS expression by inducing TGF-ß1.

Simultaneous encryption and compression of medical images based on optimized tensor compressed sensing with 3D Lorenz.

BACKGROUND: The existing techniques for simultaneous encryption and compression of images refer lossy compression. Their reconstruction performances did not meet the accuracy of medical images because most of them have not been applicable to three-dimensional (3D) medical image volumes intrinsically represented by tensors. METHODS: We propose a tensor-based algorithm using tensor compressive sensing (TCS) to address these issues. Alternating least squares is further used to optimize the TCS with measurement matrices encrypted by discrete 3D Lorenz. RESULTS: The proposed method preserves the intrinsic structure of tensor-based 3D images and achieves a better balance of compression ratio, decryption accuracy, and security. Furthermore, the characteristic of the tensor product can be used as additional keys to make unauthorized decryption harder. CONCLUSIONS: Numerical simulation results verify the validity and the reliability of this scheme.

HOSVD-Based 3D Active Appearance Model: Segmentation of Lung Fields in CT Images.

An Active Appearance Model (AAM) is a computer vision model which can be used to effectively segment lung fields in CT images. However, the fitting result is often inadequate when the lungs are affected by high-density pathologies. To overcome this problem, we propose a Higher-order Singular Value Decomposition (HOSVD)-based Three-dimensional (3D) AAM. An evaluation was performed on 310 diseased lungs form the Lung Image Database Consortium Image Collection. Other contemporary AAMs operate directly on patterns represented by vectors, i.e., before applying the AAM to a 3D lung volume,it has to be vectorized first into a vector pattern by some technique like concatenation. However, some implicit structural or local contextual information may be lost in this transformation. According to the nature of the 3D lung volume, HOSVD is introduced to represent and process the lung in tensor space. Our method can not only directly operate on the original 3D tensor patterns, but also efficiently reduce the computer memory usage. The evaluation resulted in an average Dice coefficient of 97.0 % ± 0.59 %, a mean absolute surface distance error of 1.0403 ± 0.5716 mm, a mean border positioning errors of 0.9187 ± 0.5381 pixel, and a Hausdorff Distance of 20.4064 ± 4.3855, respectively. Experimental results showed that our methods delivered significant and better segmentation results, compared with the three other model-based lung segmentation approaches, namely 3D Snake, 3D ASM and 3D AAM.

Effects of FoxO1 on podocyte injury in diabetic rats.

OBJECTIVE: This study was designed to investigate the protective effect of forkhead transcription factor O1 (FoxO1) on podocyte injury in rats with diabetic nephropathy. METHODS: Streptozotocin-induced diabetic rats were served as DM group, while DM rats transfected with blank lentiviral vectors (LV-pSC-GFP) or lentiviral vectors carrying constitutively active FoxO1 (LV-CA-FoxO1) were served as LV-NC group or LV-CA group, respectively. The control group (NG) consisted of uninduced rats that received an injection of diluent buffer. At 2, 4, and 8 weeks after transfection, the levels of urine albumin, blood glucose, blood urea nitrogen, serum creatinine and urine podocalyxin were measured. Real-time PCR and western blotting were performed to measure mRNA and protein levels of FoxO1, podocalyxin, nephrin, and desmin in renal cortex. In addition, light and electron microscopy were used to detect structural changes in the glomerulus and podocytes. RESULTS: Compared with the rats in LV-NC and DM groups, LV-CA rats showed a significant increase in FoxO1 mRNA and protein levels and a distinct decrease in urine albumin, blood urea nitrogen, and serum creatinine (except at the two-week time point) levels (p < 0.05). Podocalyxin and nephrin mRNA and protein levels increased (p < 0.05), whereas desmin mRNA and protein levels decreased (p < 0.05). Pathological changes in glomerulus were also ameliorated in LV-CA group. CONCLUSIONS: Upregulating expression of FoxO1 by transduction with recombinant lentivirus ameliorates podocyte injury in diabetic rats.

Nesfatin-1 correlates with hypertension in overweight or obese Han Chinese population.

We investigated blood nesfatin-1 levels in hypertension patients. We found that fasting plasma nesfatin-1 levels were significantly higher in hypertension patients than in control groups, especially in overweight/obese hypertension patients (4.5 ± 2.1 versus 3.3 ± 1.1 ng/ml, p < 0.01). Body mass index, systolic blood pressure and diastolic blood pressure were indeed positively correlated with fasting plasma nesfatin-1 levels (r = 0.234, p < 0.05; r = 0.304, p < 0.01; r = 0.251, p < 0.05; r = 0.461, p < 0.01; respectively). Logistic regression analysis revealed that the plasma level of nesfatin-1 could be independent of risk prediction over standard measures (OR = 1.547, 95% CI: 1.153-6.273, p = 0.026). Nesfatin-1 has the incremental contribution to hypertension risk prediction (IDI: 0.014, p = 0.018; NRI: 0.050, p = 0.043). The plasma nesfatin-1 level in hypertension patients with microalbuminuria are significantly higher than those without microalbuminuria patients (6.4 ± 2.1 ng/ml versus 3.9 ± 1.8 ng/ml, p < 0.01). Nesfatin-1 might play an important role in obesity hypertension, and its increase could be a risk factor for obesity-associated hypertension.

Three-dimensional SVM with latent variable: application for detection of lung lesions in CT images.

The study aims to improve the performance of current computer-aided schemes for the detection of lung lesions, especially the low-contrast in gray density or irregular in shape. The relative position between suspected lesion and whole lung is, for the first time, added as a latent feature to enrich current Three-dimensional (3D) features such as shape, texture. Subsequently, 3D matrix patterns-based Support Vector Machine (SVM) with the latent variable, referred to as L-SVM3Dmatrix, was constructed accordingly. A CT image database containing 750 abnormal cases with 1050 lesions was used to train and evaluate several similar computer-aided detection (CAD) schemes: traditional features-based SVM (SVMfeature), 3D matrix patterns-based SVM (SVM3Dmatrix) and L-SVM3Dmatrix. The classifier performances were evaluated by computing the area under the ROC curve (AUC), using a 5-fold cross-validation. The L-SVM3Dmatrix sensitivity was 93.0 with 1.23% percentage of False Positive (FP), the SVM3Dmatrix sensitivity was 88.4 with 1.49% percentage of FP, and the SVMfeature sensitivity was 87.2 with 1.78% percentage of FP. The L-SVM3Dmatrix outperformed other current lung CAD schemes, especially regarding the difficult lesions.

[Predictive value of liver enzymes and alcohol consumption for risk of type 2 diabetes].

OBJECTIVE: To compare the predictive value of liver enzymes and alcohol consumption for determining risk of type 2 diabetes (T2DM). METHODS: A cross-sectional study was conducted in Zhengzhou with a total of 2, 693 men.Participants' height, weight, and histories of smoking and drinking were recorded. Levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT) and blood glucose, as well as related metabolic indexes were detected. RESULTS: Moderate daily alcohol consumption (more than 35 g ethanol/week and less than 140 g ethanol/week) decreased the risk of type 2 diabetes (OR =0.376, 95% CI:0.306 -0.463, P less than 0.05) but increased risk for higher levels of GGT and ALT (OR GGT =3.012, 95% CI:2.357-3.849, Pless than 0.01; ORALT =1.473, 95% CI:1.043-2.081, Pless than 0.05). In joint analyses of alcohol consumption and liver enzymes, the group of nondrinkers/light drinkers (less than or equal to 35 g ethanol/week) in the fourth quartile of GGT levels had the highest risk for type 2 diabetes (OR =12.219, 95% CI:6.217-24.016, P less than 0.01). The relationship of ALT and daily alcohol consumption with the risk of type 2 diabetes was almost the same as that of GGT (nondrinkers/light drinkers in the fourth quartile of ALT levels (OR =5.357, 95% CI:3.070-9.350, P less than 0.0 1). CONCLUSION: GGT, ALT and daily alcohol consumption were independently associated with risk of type 2 diabetes. Nondrinkers/light drinkers with the highest levels ofGGT orALT were at high risk of type 2 diabetes.

The effect of FoxO1 on the proliferation of rat mesangial cells under high glucose conditions.

BACKGROUND: Hyperproliferation of glomerular mesangial cells (MCs) is a major pathological characteristic in the early stage of diabetic nephropathy (DN). We have previously confirmed that forkhead transcription factor O1 (FoxO1) was significantly downregulated in both the renal cortex of DN rats and MCs cultured under high-glucose (HG) conditions, but the effects and mechanisms of FoxO1 involved in the hyperproliferation of MCs are still unclear. This study aims to investigate whether FoxO1 regulates the hyperproliferation of MCs induced under high-glucose conditions, through modulating the cyclin-dependent kinase inhibitor (CKI), p27. METHODS: Lentiviral vectors of LV-constitutively active FoxO1 (CA-FoxO1) and LV-small interfering RNA (siRNA)-FoxO1 were constructed to up- and downregulate FoxO1. Similarly, LV-NC-FoxO1 was used as negative control (NC). Rat MCs were cultured in normal glucose (5.6 mM) medium, HG (30 mM) medium, HG with LV-NC-FoxO1, HG with LV-CA-FoxO1 and HG with LV-siRNA-FoxO1 for 72 h. Cell proliferation, cell cycle progression, messenger RNA and protein expression of FoxO1, p27, cyclin D1 and CDK4 were detected by methyl thiazolyl tetrazolium assay, flow cytometry, quantitative real-time polymerase chain reaction and western blotting, respectively. RESULTS: MCs exposed to HG medium triggered hyperproliferation of MCs. Nevertheless, overexpression of FoxO1 caused by LV-CA-FoxO1 promoted cell cycle arrest at the G0/G1 phase and attenuated proliferation, which was associated with upregulation of p27 and downregulation of cyclin D1 and CDK4. Moreover, specific degradation of FoxO1 by LV-siRNA-FoxO1 caused a decrease of p27, increase of cyclin D1 and CDK4, overrode the limited cell cycle and stimulated proliferation of MCs. CONCLUSIONS: Overexpression of FoxO1 caused upregulation of p27, which promoted cell cycle arrest and inhibited hyperproliferation of MCs induced by HG. Degradation of FoxO1 caused an increase in p27 and stimulated MC proliferation. These findings unveil part of the molecular mechanism of FoxO1 regulation of MC hyperproliferation induced by HG.

Differences in facial profile and dental esthetic perceptions between young adults and orthodontists.

INTRODUCTION: The principal aim of this study was to investigate differences in perception of soft-tissue facial profiles and dental esthetics between young Chinese adults and orthodontists. METHODS: Eight hundred ninety-two subjects (444 male, 448 female), ages 16 to 24 years, chose 1 image from among 5 profile silhouettes and from among 10 ranked color photographs of the aesthetic component (AC) of the index of orthodontic treatment need that most closely resembled their own profile and dental esthetic appearance, respectively. A panel of 20 orthodontists then independently repeated the same image selection process. Each subject also completed the Eysenck personality questionnaire for psychoticism. We used the Mann-Whitney U test and the Spearman rank correlation test, with statistical significance set at α = 0.05. RESULTS: Only 37.0% of subjects had straight profiles by objective orthodontic assessment, but 85.0% chose straight profiles by subjective self-perception. About 17.5%, mainly females, chose the mild convex as the ideal profile. Only 2.5% of the subjects were ranked 1 on the AC by orthodontists, but 43.6% chose 1, or ideal, by self-perception. Male subjects scored significantly higher than did female subjects for self-perceived facial profiles (more protruded chins) and for the AC (more attractive dental appearance). Subjects with high psychoticism T scores (>50) scored significantly lower for self-perceived facial profiles (more retruded chins) and on the AC (less attractive dental appearance). CONCLUSIONS: Young Chinese adults perceived their facial profiles and dental appearances to be significantly more straight and attractive, respectively, than did the orthodontists. A significant proportion of the young adults, mainly women, preferred a mild convex facial profile. High psychoticism scores might significantly affect the self-perception of orthodontic treatment needs.

[A pedigree study of a patient with primary pigmented nodular adrenocortical disease and familial gene mutation].

OBJECTIVE: To clarify the clinical features and genetic background of a kindred of primary pigmented nodular adrenocortical disease (PPNAD). METHODS: Detailed clinical characteristics and laboratory test results from a ten-year old girl diagnosed as PPNAD were collected. Seven members of her family were screened for Cushing syndrome and Carney complex, and their blood DNA was extracted and sequenced for PRKAR1A, PDE11A, PDE8B and CTNNB1 mutations with ABI3730. RESULTS: The girl presented with symptoms and signs of hypercortisolism, while no features of Carney complex were observed. Hypercortisolemia, suppressed corticotrophin and high urinary free cortisol level were revealed. Cortisol level could not be suppressed both in high and low dose dexamethasone suppression test. The diagnosis of adrenocorticotrophic hormone (ACTH)-independent Cushing syndrome was established. Image and pathology of adrenal glands were in accordance with PPNAD. Other family members showed no evidence of Cushing syndrome or Carney complex. DNA sequencing showed that the patient harbored a missense mutation, C18G. Her father and younger sister were proved to be carriers of this mutation. CONCLUSION: A Chinese PPNAD family was identified clinically and genetically, and a novel missense mutation of PRKAR1A was found.