Advanced glycation end products (AGEs) in relation to atherosclerotic lipid profiles in middle-aged and elderly diabetic patients.

OBJECTIVES: To evaluate the association between AGEs and atherosclerotic lipid profiles among aging diabetic patients in Taiwan. DESIGN AND METHODS: After age and gender matching, we selected 207 diabetic subjects and 174 diabetic subjects with proteinuria. Lipid profiles, including total cholesterol (TC), triglycerides (TG), high density cholesterol-lipoprotein (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were measured using standard methods. AGEs were measured with the immunoassay method. RESULTS: In general, males were heavier; however, females had higher AGEs, fasting glucose (GLU), TC, HDL-C and LDL-C levels than males, and had higher TC/HDL-C, LDL-C/HDL-C, and TG/HDL-C ratios compared to males. AGEs were more strongly correlated with TG levels and TCL/LDL-C, LDL-C/HDL-C and TG/HDL-C ratios when compared to glucose or hemoglobin A1c. Subjects had higher AGEs levels (≧ 2.0 AU) with more adverse lipid profiles. CONCLUSION: AGEs seem to be a good biomarker to evaluate the association between diabetes and atherosclerotic disorders in aging diabetes.

BMI, body fat mass and plasma leptin level in relation to cardiovascular diseases risk factors among adolescents in Taitung.

BACKGROUND: To investigate the risk factors associated with cardiovascular diseases and its relation to BMI, body fat mass and plasma leptin level among adolescents in Taitung, Taiwan. METHODS: A cross-sectional Taitung Children Heart Study for 500 young adolescents between ages 13 and 15 was conducted. Gender-specific regression models were used to determine the associations between BMI, percentage of body fat mass, plasma leptin level and seven CVDs risk factors (systolic and diastolic blood pressure, mean arterial pressure, triglycerides, total cholesterol, HDL-cholesterol and LDL-cholesterol) before and after adjusting for weight status and age. RESULTS: After adjusting for weight status and age, BMI was positively associated with systolic BP, triglycerides, LDL-cholesterol levels but negatively associated with HDL-cholesterol level in boys while positively associated with systolic and diastolic BP, mean arterial pressure, and LDL-cholesterol level in girls. The percentage of body fat mass was positively associated with triglycerides, total cholesterol, and LDL-cholesterol in boys while positively associated with systolic BP, total cholesterol, and LDL-cholesterol in girls. Plasma leptin was positively associated with triglycerides, total cholesterol and LDL-cholesterol in boys but no statistically significant associations with CVDs risk factors in girls. A strong relationship between the percentage of body fat mass and plasma leptin appeared among all participants (r=0.59, p<0.01). CONCLUSIONS: BMI, body fat mass and plasma leptin level may be used to identify certain CVDs risk factors among Taitung adolescents. Future researches could consider measuring body fat mass in the relationship of CVDs risk factors instead of plasma leptin among young adolescents.

Assessment of the pharmacokinetics, removal rate of hemodialysis, and safety of lactulose in hemodialysis patients.

Lactulose is often used to treat hepatic encephalopathy or constipation, and also exhibits benefits to chronic renal insufficiency due to reduce nitrogen-related products in serum. The present study investigated the pharmacokinetics of lactulose, its removal rate through dialysis, and safety by administering lactulose 6.5 g (Lagnos Jelly Divided Pack 16.05 g) orally to six hemodialysis patients who resided in Taiwan. As a result, the means of maximum plasma concentrations (Cmax) and Time to reach Cmax (Tmax) were 3090 ± 970 ng/mL and 6.5 ± 2.3 hours, respectively. The mean plasma concentration was 2220 ± 986 ng/mL after administration for 24 hours. Sequentially, the mean plasma concentration reduced to 307 ± 117 ng/mL after the application of 4-hour dialysis. Area under the plasma concentration-time curve from zero to 24 h post-dose (AUC0-24h) were 56,200 ± 21,300 ng h/mL and the AUC0-28h was 61,200 ± 23,300 ng h/mL. The rate of lactulose removal by dialysis was 83.6±8.9%. In addition, the multiple doses of lactulose using a simulated model suggested that no plasma accumulation would be expected while coordinating with dialysis. Good tolerability was confirmed, while the mild adverse effect of diarrhea was observed in one case during the study period. No death or serious adverse effect was reported. Based on the present study, we demonstrated the pharmacokinetic transition with respect to plasma levels of lactulose in patients with impaired renal excretion treated with hemodialysis.

Prevalence and trend of dyslipidaemia from 1996 to 2006 among normal and overweight adolescents in Taiwan.

OBJECTIVES: To evaluate the trend of dyslipidaemia from 1996 to 2006 and examine its relationship with weight status among adolescents in Taiwan. DESIGN: 2 cross-sectional surveys were conducted in 1996 and 2006. SETTING: The junior high schools in Taipei. PARTICIPANTS: After multistage sampling, total of 1500 and 1283 junior high school students were chosen in 1996 and 2006. After excluding missing data, a total of 1353 (676 boys and 677 girls) and 1203 (585 boys and 618 girls) children were included in the final analyses in 1996 and 2006. OUTCOME MEASURES: Anthropometric measures as body height and weight were measured, and body mass index (BMI) was calculated. Blood lipid profiles as total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol were measured. RESULTS: From 1996 to 2006, the prevalence of dyslipidaemia and hypercholesterolaemia significantly increased from 13% (95% CI 11.3% to 15.0%) to 22.3% (95% CI 20.0% to 24.7%) and 6.2% (95% CI 5.0% to 7.6%) to 13.8% (95% CI 11.9% to 15.9%), respectively. The prevalence of hypertriglyceridaemia and low HDL-C dyslipidaemia increased from 3% (95% CI 1.8% to 4.5%) to 4.3% (95% CI 2.8% to 6.2%) and 6.5% (95% CI 4.8% to 8.6%) to 11.6% (95% CI 9.1% to 14.5%), with significance seen only in boys. When compared with normal weight participants, overweight boys and girls faced a 2-fold and 1.6-fold increased risk of dyslipidaemia, respectively, in the 2006 study. The increased risk of low HDL-C dyslipidaemia for overweight participants was 2.6-fold and 7.2-fold in boys and girls, respectively. In 2006, each unit increment of BMI was associated with 28%, 13% and 13% risk of hypertriglyceridaemia, low HDL-C and dyslipidaemia for boys, and 25% risk of low HDL-C dyslipidaemia in girls. CONCLUSIONS: The prevalence of dyslipidaemia had increased significantly for boys and girls in normal weight and overweight adolescents. Early screening of dyslipidaemia and weight intervention programmes in adolescents will be the key to prevent dyslipidaemia and cardiovascular-related comorbidities.