RESUMO
The aim of the study was to develop and evaluate the effectiveness of personalized therapy forpatients with diabetes mellitus type 2 (DM) and obesity based on the study of rs5219 polymorphism of KCNJ11gene. The study involved 120 women with DM and obesity I-II degree. Genotyping was performed in patients using allele-specific amplification with the detection in real time. Depending on the genotype of KCNJ11 gene patients with DM and obesity received different treatment and were divided into 2 groups (40 patients in each): group A (C/T genotype) received standard low-calorie diet + metformin 2000 mg/day and group B (T/T genotype) received a personalized diet + vitamin-mineral complex (VMC) + metformin 2000 mg/day. Results of the study of rs5219 polymorphism of KCNJII gene in patients with,DM and obesity have shown that 49% of them were carriers of the mutated T allele in the heterozygous form and 37% - in the homozygous variant. It has been found that reducing of calories in a diet promoted weight loss in patients with DM and obesity mainly due to lean body mass in Group A and in Group B - mainly due to the fat component. A significant decrease in blood glucose under complex therapy was observed in both groups. However, after treatment in group B blood glucose levels were significantly lower than in group A. Thus, personalized therapy of patients with DM and obesity should be based on molecular genetic studies that will allow to improve the efficiency of therapeutic measures in these diseases.
Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Obesidade/dietoterapia , Obesidade/tratamento farmacológico , Polimorfismo Genético , Canais de Potássio Corretores do Fluxo de Internalização/genética , Medicina de Precisão , Adulto , Idoso , Restrição Calórica/métodos , Estudos de Casos e Controles , Terapia Combinada , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/genética , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Metformina/administração & dosagem , Metformina/uso terapêutico , Pessoa de Meia-Idade , Valor Nutritivo , Obesidade/complicações , Obesidade/genética , Resultado do Tratamento , Vitaminas/administração & dosagem , Vitaminas/uso terapêuticoRESUMO
Objective - To evaluate the effect of diet therapy with the inclusion of specialized food product with a modified carbohydrate profile (fruit jelly) on glycemic and metabolic parameters in patients with type 2 diabetes mellitus. The study included 45 patients (aged 35 to 69 years) with type 2 diabetes with concomitant obesity I-III degree. The study was conducted in two stages. The first phase evaluated the effect of jelly intake on postprandial glycemia with determination of blood glucose levels on an empty stomach and 30, 60, 120 and 180 minutes after consumption of fruit jelly with maltitol, pectin and sublimated raspberry juice and traditional marmalade with fructose (control), containing 25 g of digestible carbohydrates. In the second phase the effectiveness of combination therapy during 2 weeks of the inclusion of fruit jelly with a modified carbohydrate profile in a standard hypocaloric diet (1550 kcal/day) has been assessed. It has been shown that the dynamics of postprandial glycemia in patients with type 2 diabetes after the consumption of fruit jelly with a modified carbohydrate profile was comparable to the dynamics of blood glucose after eating traditional marmalade with fructose. Inclusion of fruit jelly with a modified carbohydrate profile in the standard diet therapy of patients with type 2 diabetes during 2 weeks was accompanied by positive dynamics of carbohydrate and lipid metabolism, as well as a decrease in the content of lipid peroxidation products in blood plasma: reducing the level of conjugated dienes and malondialdehyde averaged 15.2 and 17.4% from baseline (p<0.05), respectively, while content of lipid peroxidation products in blood plasma did not changed in patients from the control group.
Assuntos
Metabolismo dos Carboidratos/efeitos dos fármacos , Carboidratos da Dieta/administração & dosagem , Alimentos Especializados , Metabolismo dos Lipídeos/efeitos dos fármacos , Obesidade , Adulto , Idoso , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/dietoterapia , Obesidade/metabolismo , Obesidade/patologiaRESUMO
The influence of diet inclusion of vitamin and mineral complex (VMC), potassium and magnesium in the form of asparaginate on micronutrient status, body composition and biochemical parameters in patients with diabetes mellitus type 2 (DM2) has been investigated. 120 female patients with DM2 and obesity of I-III degree (mean age - 58 +/- 6 years) have been included in the study. The patients were divided into two groups: main group (n = 60) and control group (n = 60). For 3 weeks patients of both groups received a low-calorie diet (1600 kcal/day). Patients of the main group received VMC, providing an additional intake of vitamins C and E (100-120% RDA), beta-carotene (40% RDA), nicotinamide (38% RDA), pantothenic acid and biotin (60% RDA), vitamins B12, B2 and folic acid (75-83% RDA), vitamins B1 and B6 (160-300% RDA), zinc (100% RDA) and chromium (400% RDA), and also received magnesium (17.7% RDA) and potassium (9.4% RDA) in the form of asparaginate. Body composition, biochemical parameters and micronutrient status (blood serum level of vitamins C, D, B6, B12, folate, potassium, calcium, magnesium, zinc, phosphorus) were evaluated in all patients before and after the 3-week course of diet therapy. After the low-calorie diet therapy average body weight reduction was 4.2 +/- 0.2 kg in the main group, and 4.4 +/- 0.1 kg in the control group, without statistically significant differences between groups. Statistically significant decrease of total cholesterol, triglycerides, and glucose concentration in blood serum was registered in both groups. It should be noted that in the control group glycemia decreased on 1.2 +/- 0.1 mmol/l, while the main group showed a decrease on 1.8 +/- 0.1 (p < 0.05) to normal values (5.4 +/- 0.1 mmol/l). Initial assessment of vitamin and mineral status revealed that most patients were optimal supplied with vitamins and minerals. After the dietotherapy significant increase of vitamin C, 25-hydroxyvitamin D, vitamin B6, folate, vitamin B12, potassium, magnesium, calcium, zinc and phosphorus concentration in blood serum was observed in patients receiving VMC. While in the control group statistically significant decrease of vitamin C, magnesium, zinc and phosphorus concentration in blood serum after the treatment was revealed. The obtained data shows the necessity of addition of the vitamin-mineral complex to the diet of patients with DM2 and obesity.
Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Suplementos Nutricionais , Minerais/administração & dosagem , Vitaminas/administração & dosagem , Adulto , Glicemia/metabolismo , Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangueRESUMO
Nanostructured silica (SiO2) "Aerosil" with the size of the primary nanoparticles (NPs) of 5-30 nm, in the form of ultrasound treated water suspension was administered to rats of 80 ± 4 g initial body weight for the first 30 days by intragastric gavage and then for 62 days with diets consumed in doses of 0.1; 1.0; 10 and 100 mg/kg body weight per day. The control group received vehicle of nanomaterial (NM)--deionized water. There were measured in liver of ani- mals the content of total cytochromes P450 and b5 in the microsomal fraction of liver, activity (Vmax) of microsomal monooxygenases with the mixed func- tion of isoforms CYP1A1, 1A2 and 2B1 on their specific substrates, the activity of conjugating liver enzymes glutathione-S-transferase and UDP-glucuronosyl-transferase in microsomal fraction and cytosol, the total and non sedimentable activity of lysosomal hydrolases (ß-glucuronidase, ß-galactozydase, arylsulphatase A, B). The content of PUFA's diene conjugates and TBA-reactive substances in the blood plasma and the activity of antioxidative enzymes (glutathionperoxidase, superoxidedismutase, glutathionreductase, katalase) in erytrocytes were estimated. A set of standard biochemical parameters of blood serum was also examined (total protein, albumin, glucose, creatinine, urea, uric acid, activities of hepatic transaminases). The studies revealed changes of a number of molecu lar markers that could be interpreted as unfavorable. These include isoforms of CYP2B1 activity decrease at a dose HM 1-10 mg/kg of body weight, decrease in the serum content of total protein, albumin and glucose levels in a dose range of 0.1-10 mg/kg. These changes were absent at the maximum dose of NM, which did not allow to clearly establish the dose-response. The remaining studied fig ures resided in the normal range or experienced changes that could not be interpreted as toxic.