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1.
Diabetes Obes Metab ; 23(2): 391-403, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33051976

RESUMEN

AIM: To assess the relationship between body mass index (BMI) classes and early COVID-19 prognosis in inpatients with type 2 diabetes (T2D). METHODS: From the CORONAvirus-SARS-CoV-2 and Diabetes Outcomes (CORONADO) study, we conducted an analysis in patients with T2D categorized by four BMI subgroups according to the World Health Organization classification. Clinical characteristics and COVID-19-related outcomes (i.e. intubation for mechanical ventilation [IMV], death and discharge by day 7 [D7]) were analysed according to BMI status. RESULTS: Among 1965 patients with T2D, 434 (22.1%) normal weight (18.5-24.9 kg/m2 , reference group), 726 (36.9%) overweight (25-29.9 kg/m2 ) and 805 (41.0%) obese subjects were analysed, including 491 (25.0%) with class I obesity (30-34.9 kg/m2 ) and 314 (16.0%) with class II/III obesity (≥35 kg/m2 ). In a multivariable-adjusted model, the primary outcome (i.e. IMV and/or death by D7) was significantly associated with overweight (OR 1.65 [1.05-2.59]), class I (OR 1.93 [1.19-3.14]) and class II/III obesity (OR 1.98 [1.11-3.52]). After multivariable adjustment, primary outcome by D7 was significantly associated with obesity in patients aged younger than 75 years, while such an association was no longer found in those aged older than 75 years. CONCLUSIONS: Overweight and obesity are associated with poor early prognosis in patients with T2D hospitalized for COVID-19. Importantly, the deleterious impact of obesity on COVID-19 prognosis was no longer observed in the elderly, highlighting the need for specific management in this population.


Asunto(s)
Índice de Masa Corporal , Diabetes Mellitus Tipo 2/virología , Obesidad/virología , Anciano , /virología , Diabetes Mellitus Tipo 2/mortalidad , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Humanos , Pacientes Internos/estadística & datos numéricos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Obesidad/mortalidad , Obesidad/fisiopatología , Alta del Paciente/estadística & datos numéricos , Pronóstico , Respiración Artificial/estadística & datos numéricos , Estudios Retrospectivos
2.
Physiol Rep ; 8(24): e14644, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33340273

RESUMEN

This review examines the stress hormone cortisol which plays an important role in regulating and supporting different bodily functions. Disruption in cortisol production has an impact on health and this review looks at a wide range of papers where cortisol has been indicated as a factor in numerous chronic conditions-especially those which are classed as "noncommunicable diseases" (NCDs). Timely detection, screening, and treatment for NCDs are vital to address the growing problem of NCDs worldwide-this would have health and socioeconomic benefits. Interestingly, many of the papers highlight the pro-inflammatory consequences of cortisol dysregulation and its deleterious effects on the body. This is particularly relevant given the recent findings concerning COVID-19 where pro-inflammatory cytokines have been implicated in severe inflammation.


Asunto(s)
/sangre , Enfermedades Cardiovasculares/sangre , Ritmo Circadiano , Diabetes Mellitus Tipo 2/sangre , Hidrocortisona/sangre , Sistema Hipotálamo-Hipofisario/metabolismo , Inflamación/sangre , Estrés Fisiológico , Animales , Biomarcadores/sangre , /fisiopatología , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/fisiopatología , Citocinas/sangre , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/fisiopatología , Humanos , Sistema Hipotálamo-Hipofisario/fisiopatología , Inflamación/epidemiología , Inflamación/fisiopatología , Mediadores de Inflamación/sangre
3.
PLoS One ; 15(11): e0241432, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33137150

RESUMEN

BACKGROUND: The prevalence of metabolic syndrome is rising at an alarming rate and more common among Type 2 Diabetes Mellitus patients in the world. The risk for cardiovascular disease is greater among individuals who have a combination of Type 2 Diabetes Mellitus and metabolic syndrome compared to those who have either alone. OBJECTIVE: To assess the proportion of metabolic syndrome and lifestyle factors among Type 2 Diabetes Mellitus Patients in Dessie Referral Hospital, Amhara Region, Ethiopia. METHODS: A hospital-based cross-sectional study was conducted from February to March 2017 among 343 randomly selected Type 2 Diabetes Mellitus patients. Three definitions of Metabolic syndrome were considered. Multivariable logistic regression analysis was conducted to identify factors associated with metabolic syndrome. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) were reported to show the strength of association. Statistical significance was declared at P-value < 0.05. RESULT: The proportion of metabolic syndrome was 50.3%, 59.4% and 64.5% according to 2005 International Diabetes Federation, revised ATP III and 2009 harmonized criteria, respectively. Being female (AOR = 2.43; 95% CI = 1.40, 4.21), consumption of red meat (AOR = 2.61; 95% CI = 1.28, 5.33), sedentary leisure time activity (AOR = 2.65; 95% CI = 1.47, 4.78), coffee intake (AOR = 0.43; 95% CI = 0.21, 0.86), BMI ≥ 25 kg/m2 (AOR = 9.59; 95% CI = 4.98, 18.47), 40-49 years of age (AOR = 2.74, 95% CI = (1.02, 7.37), 50-59 years of age (AOR = 4.22; 95% CI = 1.60, 11.11) and ≥70 years of age (AOR = 4.51, 95% CI = 1.44, 14.15) were significantly associated with metabolic syndrome. CONCLUSION AND RECOMMENDATION: The proportion of metabolic syndrome was high among Type 2 Diabetes Mellitus patients. Overweight and obesity, being female, age of respondent, intake of coffee, regular red meat consumption, and sedentary leisure-time activity were factors associated with metabolic syndrome. Counseling of Type 2 Diabetes Mellitus patients on the need for spending leisure time with activities, intake of coffee, control of body weight, and avoidance of regular red meat consumption is recommended.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Síndrome Metabólico/epidemiología , Obesidad/epidemiología , Adulto , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/fisiopatología , Etiopía/epidemiología , Femenino , Hospitales , Humanos , Estilo de Vida , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/fisiopatología , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/fisiopatología , Sobrepeso , Factores de Riesgo
4.
J Vis Exp ; (164)2020 10 23.
Artículo en Inglés | MEDLINE | ID: mdl-33165321

RESUMEN

The optomotor response and the Y-maze are behavioral tests useful for assessing visual and cognitive function, respectively. The optomotor response is a valuable tool to track changes in spatial frequency (SF) and contrast sensitivity (CS) thresholds over time in a number of retinal disease models, including diabetic retinopathy. Similarly, the Y-maze can be used to monitor spatial cognition (as measured by spontaneous alternation) and exploratory behavior (as measured by a number of entries) in a number of disease models that affect the central nervous system. Advantages of the optomotor response and the Y-maze include sensitivity, speed of testing, the use of innate responses (training is not needed), and the ability to be performed on awake (non-anesthetized) animals. Here, protocols are described for both the optomotor response and the Y-maze and examples of their use shown in models of Type I and Type II diabetes. Methods include preparation of rodents and equipment, performance of the optomotor response and the Y-maze, and post-test data analysis.


Asunto(s)
Cognición , Diabetes Mellitus Experimental/fisiopatología , Diabetes Mellitus Tipo 1/fisiopatología , Diabetes Mellitus Tipo 2/fisiopatología , Aprendizaje por Laberinto/fisiología , Visión Ocular/fisiología , Animales , Conducta Animal , Masculino , Ratas
5.
Medicine (Baltimore) ; 99(46): e23211, 2020 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-33181703

RESUMEN

Dietary intake influences gut microbiota activity. Nevertheless, there is a lack of evidence available that illustrates the acute effects of high glucose meal on metabolic endotoxemia. The present study assessed the acute impact of high glucose meal on endotoxemia and other clinical parameters in Saudi females with varying degrees of glycemia.The subjects were 64 consenting pre-menopausal women, grouped into 3: control [n = 14 lean, non-T2DM, BMI = 22.2 ±â€Š2.2 kg/m]; overweight [n = 16, non-T2DM, BMI = 28.5 ±â€Š1.5 kg/m] and T2DM [n = 34, BMI = 35.2 ±â€Š7.7 kg/m]. After an overnight fast, all subjects were given a standardized high-glucose (75 g) meal. Anthropometrics were taken and blood samples were withdrawn at baseline and postprandial (0, 2 and 4-hours), serum glucose, endotoxin and lipid profile were quantified.At baseline, total cholesterol, LDL-cholesterol, triglycerides and serum glucose levels were significantly higher (P values <.01) whereas significantly lower HDL-cholesterol levels (P < .01) were observed in T2DM subjects compared to other groups. Baseline endotoxin levels were highest in the overweight group (3.2 ±â€Š1.1 mmol/L) as compared to control (2.0 ±â€Š0.5 mmol/L) and T2DM (2.7 ±â€Š1.2 mmol/L) (P = .046). HDL-cholesterol, LDL-cholesterol and triglycerides, significantly decreased in the T2DM group after 2 hours (P values <.05), whereas unremarkable changes observed in other groups. Lastly, endotoxin levels significantly increased only in the overweight group (3.2 ±â€Š1.1 vs 4.2 ±â€Š1.4 mmol/L; P < .05), 4 hours postprandial.High glucose meal elevates endotoxemia only among overweight subjects and impairs dysbiosis.


Asunto(s)
Endotoxemia/complicaciones , Glucosa/análisis , Obesidad/complicaciones , Administración Oral , Adulto , Árabes/clasificación , Árabes/estadística & datos numéricos , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Endotoxemia/fisiopatología , Ayuno/sangre , Ayuno/metabolismo , Femenino , Humanos , Lípidos/análisis , Lípidos/sangre , Persona de Mediana Edad , Obesidad/fisiopatología , Prevalencia , Arabia Saudita
6.
PLoS One ; 15(11): e0242199, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33180801

RESUMEN

BACKGROUND: Recent evidence of significant sex-based differences in the presentation of Type 2 Diabetes Mellitus (DM) and its complications has been found in humans, which may contribute to sex-based differences in reduced functionality and quality of life. Some functionality, such as tactile function of the hands, has significant direct impact on quality of life. The purpose of the current study was to explore the impact of DM and sex on tactile function, with consideration of variability in health state measures. RESEARCH DESIGN AND METHODS: A case-control single time point observational study from 2012-2020 in an ethnically diverse population-based community setting. The sample consists of 132 adult individuals: 70 independent community dwelling persons with DM (PwDM) and 62 age- and sex-matched controls (42 males and 90 females in total). The Semmes-Weinstein monofilament test was used to evaluate tactile sensation of the hands. RESULTS: Tactile sensation thresholds were adversely impacted by sex, age, degree of handedness, high A1c, diagnosis of DM, and neuropathy. Overall, strongly right-handed older adult males with poorly controlled DM and neuropathy possessed the poorest tactile discrimination thresholds. When self-identified minority status was included in a secondary analysis, DM diagnosis was no longer significant; negative impacts of age, neuropathy, degree of handedness, and high A1c remained significant. CONCLUSIONS: The data indicate significant impacts of male sex, age, degree of handedness, self-identified minority status, and metabolic health on the development of poor tactile sensation. This combination of modifiable and non-modifiable factors are important considerations in the monitoring and treatment of DM complications.


Asunto(s)
Envejecimiento/fisiología , Diabetes Mellitus Tipo 2/fisiopatología , Percepción del Tacto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Umbral Sensorial , Factores Sexuales
8.
PLoS One ; 15(10): e0240983, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33091029

RESUMEN

Diabetic retinopathy is a microvascular complication of hyperglycaemia. Little is known about the association of glucose metabolism and retinopathy signs in the non-diabetic middle-aged population. We studied prevalence of retinopathy in a subsample of Northern Finland Birth Cohort study (NFBC1966) of 1809 subjects, at 47 years of age, without previously diagnosed type 2 diabetes and/or blood pressure-lowering medication. All participants underwent clinical evaluations including an oral glucose tolerance test (glucose and insulin values measured at 0, 30, 60 and 120 min) and HbA1c. The retinopathy signs were diagnosed by fundus photographs and classified according to the Eurodiab classification scheme. The overall prevalence of newly diagnosed retinopathy was 1.4%. The retinopathy signs were significantly associated with increased 30 min, 1-h and 2-h glucose levels and 2-h insulin level in an OGTT. After adjustment with systolic blood pressure, only 30 min glucose, 1-h glucose and 2-h insulin levels were associated with retinopathy signs. Our findings show the potential role of 30 min and 1-h post-load glucose and 2-h insulin levels as risk factors for retinopathy lesions among the participants without previously diagnosed diabetes or hypertensive medication.


Asunto(s)
Glucosa/metabolismo , Enfermedades de la Retina/etiología , Enfermedades de la Retina/metabolismo , Glucemia/metabolismo , Presión Sanguínea/fisiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Finlandia , Intolerancia a la Glucosa/metabolismo , Intolerancia a la Glucosa/fisiopatología , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/metabolismo , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Enfermedades de la Retina/fisiopatología , Factores de Riesgo
9.
PLoS One ; 15(10): e0240588, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33064756

RESUMEN

INTRODUCTION: Diabetes-related lower extremity amputation has a major psycho-social and economic cost on the patient as well as a direct impact on financial expenditure within health facilities. AIM: This study aimed to determine the incidence and patient-related factors related to diabetes-related amputations amongst patients that were referred to the quaternary hospital between 1 January 2014 and 31 December 2015. METHODS: A retrospective cohort study. Data were retrieved from the medical record for each diabetes patient that was managed at IALCH during the study period. The following variables were collected: sociodemographic parameters (age, gender, and ethnicity) and diabetes-related parameters (type of diabetes) and additional complications. RESULTS: Ninety-nine patients (0, 73%) of all diabetes patients managed were new diabetes-related lower-extremity amputations. There were statistically significant increased odds of female patients (OR: 1, 7) and patients with non-insulin dependent diabetes (OR: 1, 64) to have new diabetes-related amputations. Patients older than 60 years (OR: 1, 31); African patients (OR: 1, 35) patients with cardiovascular complications (OR: 1, 04) and patients with retinopathy (OR: 1, 48) were more likely to have diabetes-related amputations but not statistically significant. CONCLUSIONS: A combination of primary preventive strategies, early detection and appropriate management of patients with diabetes and specific guidelines on the frequency, clinical and laboratory tests required for early diagnosis and referrals with early signs of diabetes-related complicationsat primary care level will assist in reducing the long term adverse outcomes including amputations.


Asunto(s)
Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Pie Diabético/cirugía , Sistema Musculoesquelético/cirugía , Adulto , Anciano , Amputación , Complicaciones de la Diabetes/fisiopatología , Complicaciones de la Diabetes/cirugía , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/fisiopatología , Diabetes Mellitus Tipo 2/cirugía , Pie Diabético/patología , Femenino , Hospitales , Humanos , Extremidad Inferior/fisiopatología , Extremidad Inferior/cirugía , Masculino , Persona de Mediana Edad , Sistema Musculoesquelético/fisiopatología , Factores de Riesgo , Sudáfrica
10.
Sci Rep ; 10(1): 16368, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-33004912

RESUMEN

Hippocampal neurogenesis plays an important role in learning and memory function throughout life. Declines in this process have been observed in both aging and Alzheimer's disease (AD). Type 2 Diabetes mellitus (T2DM) is a disorder characterized by insulin resistance and impaired glucose metabolism. T2DM often results in cognitive decline in adults, and significantly increases the risk of AD development. The pathways underlying T2DM-induced cognitive deficits are not known. Some studies suggest that alterations in hippocampal neurogenesis may contribute to cognitive deterioration, however, the fate of neurogenesis in these studies is highly controversial. To address this problem, we utilized two models of T2DM: (1) obesity-independent MKR transgenic mice expressing a mutated form of the human insulin-like growth factor 1 receptor (IGF-1R) in skeletal muscle, and (2) Obesity-dependent db/db mice harboring a mutation in the leptin receptor. Our results show that both models of T2DM display compromised hippocampal neurogenesis. We show that the number of new neurons in the hippocampus of these mice is reduced. Clone formation capacity of neural progenitor cells isolated from the db/db mice is deficient. Expression of insulin receptor and epidermal growth factor receptor was reduced in hippocampal neurospheres isolated from db/db mice. Results from this study warrant further investigation into the mechanisms underlying decreased neurogenesis in T2DM and its link to the cognitive decline observed in this disorder.


Asunto(s)
Diabetes Mellitus Tipo 2/fisiopatología , Hipocampo/fisiopatología , Neurogénesis/fisiología , Neuronas/fisiología , Obesidad/fisiopatología , Animales , Proliferación Celular/fisiología , Disfunción Cognitiva/genética , Disfunción Cognitiva/fisiopatología , Diabetes Mellitus Tipo 2/genética , Ratones , Ratones Transgénicos , Células-Madre Neurales/fisiología , Obesidad/genética , Receptor IGF Tipo 1/genética , Receptores de Leptina/genética
11.
Sci Rep ; 10(1): 17056, 2020 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-33051498

RESUMEN

To investigate the relationship between diabetic foot complications (DFCs) and clinical characteristics, especially the number and types of first-degree family members with diabetes. A total of 8909 type 2 diabetes patients were enrolled. The clinical characteristics of these patients, including DFCs and family history of diabetes (FHD), were collected from medical records. Multiple regression was used to investigate the association between FHD and DFCs after adjusting for confounding factors. The patients with one and more than one first-degree family member with diabetes accounted for 18.7% and 12.8%, respectively. The proportions of the participants with a father with diabetes, a mother with diabetes, both parents with diabetes, siblings with diabetes, father and siblings with diabetes, mother and siblings with diabetes, and both parents and siblings with diabetes were 3.5%, 6.2%, 1.1%, 14.4%, 1.5%, 4%, and 0.7%, respectively. The multiple regression analysis showed that the number of family members with diabetes was positively associated with DFCs. However, among the different types of FHD, only the patients with a mother with diabetes showed a statistical association with DFCs. In addition to FHD, other factors, including gender, body mass index, platelet count, hemoglobin levels, albumin levels, high-density cholesterol levels, diabetic peripheral neuropathy, and the use of lipid-lowering agents, oral hypoglycemic agents, and insulin, were also associated with DFCs. DFCs were associated with different numbers of family members with diabetes and types of FHD. This association reveals the importance of genetic and environmental factors in DFCs and highlights the importance of adding FHD to public health strategies targeting detecting and preventing the disease.


Asunto(s)
Diabetes Mellitus Tipo 2/fisiopatología , Pie Diabético/epidemiología , Anamnesis/estadística & datos numéricos , Adulto , Anciano , Glucemia/análisis , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/genética , Pie Diabético/fisiopatología , Femenino , Humanos , Insulina/metabolismo , Resistencia a la Insulina/fisiología , Masculino , Persona de Mediana Edad , Análisis de Regresión , Factores de Riesgo , Circunferencia de la Cintura
13.
BMC Geriatr ; 20(1): 399, 2020 10 12.
Artículo en Inglés | MEDLINE | ID: mdl-33046005

RESUMEN

BACKGROUND: There is a link between hyperglycemia and mechanical functions of muscle. However, existing evidence of the association between hyperglycemia and weaker muscle strength is limited and inconsistent. We examined whether glycemic status was associated with relative grip strength (RGS) in older Chinese. METHODS: In 2008-2012, 9180 participants (2516 men and 6664 women) from the Guangzhou Biobank Cohort Study had fasting and 2-h post-load glucose measured. Glycemic status was categorized as normoglycaemia, prediabetes (i.e., impaired fasting glucose and/or impaired glucose tolerance) and diabetes. RGS was assessed using a Jamar Hydraulic Hand Dynamometer divided by body mass index. General linear model was used to assess the association of glycemic status with RGS. RESULTS: After adjusting for age, smoking status, alcohol use, physical activity, health status, body fat percentage and waist circumference, in men, hyperglycemia was associated with a lower RGS, with the RGS being 1.38 (95% confidence interval (CI) = 1.34, 1.42) in normoglycaemia, 1.35 (95% CI = 1.30, 1.39) in prediabetes, 1.33 (95% CI = 1.29, 1.38) in newly diagnosed diabetes and 1.32 (95% CI = 1.27, 1.37) in known diabetes (P for trend < 0.001). The association of glycemic status with RGS was non-significant in women. Among the normoglycaemic group, no association was found between fasting glucose and RGS in men, whereas a significantly inverse association was found in women, with adjusted ß for RGS per mmol/l increase in fasting glucose being - 0.05 to - 0.04 (P values from 0.002 to 0.03). CONCLUSIONS: Higher fasting glucose was associated with reduced grip strength in a dose-response manner, and the association was significant even in women with normoglycaemia. Our findings suggest that lowering glucose across the whole range might be important in preserving muscle strength, especially in aging women.


Asunto(s)
Envejecimiento/fisiología , Diabetes Mellitus Tipo 2/fisiopatología , Fuerza de la Mano/fisiología , Hiperglucemia/fisiopatología , Anciano , Bancos de Muestras Biológicas , Glucemia/análisis , Estudios de Cohortes , Diabetes Mellitus Tipo 2/diagnóstico , Femenino , Humanos , Hiperglucemia/diagnóstico , Masculino
14.
Medicine (Baltimore) ; 99(43): e22215, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33120730

RESUMEN

The Increasing prevalence of type 2 diabetes mellitus (T2DM) has been observed in younger adults. Insulin resistance [IR], decreased first-, second-phase insulin secretion, and glucose effectiveness (GE) (IR, first phase insulin secretion [FPIS], second phase insulin secretion [SPIS], and GE), denoted as diabetes factors (DF), are core for developing T2DM. A body of evidence has shown that inflammation contributes to the development of diabetes. In the present study, our goals were first, evaluate the relationships between white blood cell (WBC) count and, second, examine the relative tightness between the 4 DFs to WBC count. Thus, the pathophysiology of T2DM in Chinese young men could be more understood.21112 non-obese males between 18 to 27 years old were recruited (mean age: 24.3 ±â€Š0.017), including 1745 subjects with metabolic syndrome. DFs were calculated by the published equations by our groups as follows:The association between DFs and WBC count was analyzed using a simple correlation. The r-values of the simple correlation are regarded as the tightness of the relationships.Higher WBC, FPIS, SPIS, IR, age, BMI, blood pressure, FPG, TG, Cholesterol, low-density lipoprotein cholesterol and lower HDL-C and GE were observed in subjects with metabolic syndrome. A similar trend was seen across the quartiles of WBC levels. Among the 4 DFs, GE has the highest r-value (r = -0.093, P < .001), followed by IR (r = 0.067, P < .001), SPIS (r = 0.029, P < .001) and FPIS (r = 0.027, P < .001).Elevated WBC count is significantly associated with all the 4 DFs and the relative order of the tightness, from the highest to the lowest, are GE, IR, SPIS, and FPIS in Chinese young men.


Asunto(s)
Glucemia/análisis , Resistencia a la Insulina/fisiología , Secreción de Insulina/fisiología , Recuento de Leucocitos , Síndrome Metabólico/sangre , Adolescente , Adulto , Grupo de Ascendencia Continental Asiática , Presión Sanguínea , Índice de Masa Corporal , Colesterol/sangre , HDL-Colesterol , LDL-Colesterol , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Ayuno , Humanos , Masculino , Síndrome Metabólico/fisiopatología , Taiwán , Adulto Joven
15.
Am J Physiol Heart Circ Physiol ; 319(6): H1387-H1397, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33035443

RESUMEN

Perivascular adipose tissue (PVAT) depots are metabolically active and play a major vasodilator role in healthy lean individuals. In obesity, they become inflamed and eosinophil-depleted and the anticontractile function is lost with the development of diabetes and hypertension. Moreover, eosinophil-deficient ΔdblGATA-1 mice lack PVAT anticontractile function and exhibit hypertension. Here, we have investigated the effects of inducing eosinophilia on PVAT function in health and obesity. Control, obese, and ΔdblGATA-1 mice were administered intraperitoneal injections of interleukin-33 (IL-33) for 5 days. Conscious restrained blood pressure was measured, and blood was collected for glucose and plasma measurements. Wire myography was used to assess the contractility of mesenteric resistance arteries. IL-33 injections induced a hypereosinophilic phenotype. Obese animals had significant elevations in blood pressure, blood glucose, and plasma insulin, which were normalized with IL-33. Blood glucose and insulin levels were also lowered in lean treated mice. In arteries from control mice, PVAT exerted an anticontractile effect on the vessels, which was enhanced with IL-33 treatment. In obese mice, loss of PVAT anticontractile function was rescued by IL-33. Exogenous application of IL-33 to isolated arteries induced a rapidly decaying endothelium-dependent vasodilation. The therapeutic effects were not seen in IL-33-treated ΔdblGATA-1 mice, thereby confirming that the eosinophil is crucial. In conclusion, IL-33 treatment restored PVAT anticontractile function in obesity and reversed development of hypertension, hyperglycemia, and hyperinsulinemia. These data suggest that targeting eosinophil numbers in PVAT offers a novel approach to the treatment of hypertension and type 2 diabetes in obesity.NEW & NOTEWORTHY In this study, we have shown that administering IL-33 to obese mice will restore PVAT anticontractile function, and this is accompanied by normalized blood pressure, blood glucose, and plasma insulin. Moreover, the PVAT effect is enhanced in control mice given IL-33. IL-33 induced a hypereosinophilic phenotype in our mice, and the effects of IL-33 on PVAT function, blood pressure, and blood glucose are absent in eosinophil-deficient mice, suggesting that the effects of IL-33 are mediated via eosinophils.


Asunto(s)
Tejido Adiposo/efectos de los fármacos , Hipertensión/prevención & control , Interleucina-33/farmacología , Arterias Mesentéricas/efectos de los fármacos , Obesidad/tratamiento farmacológico , Vasodilatación/efectos de los fármacos , Vasodilatadores/farmacología , Tejido Adiposo/metabolismo , Tejido Adiposo/fisiopatología , Animales , Presión Arterial/efectos de los fármacos , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatología , Diabetes Mellitus Tipo 2/prevención & control , Modelos Animales de Enfermedad , Eosinófilos/efectos de los fármacos , Eosinófilos/metabolismo , Factor de Transcripción GATA1/genética , Factor de Transcripción GATA1/metabolismo , Hipertensión/metabolismo , Hipertensión/fisiopatología , Hipoglucemiantes/farmacología , Masculino , Arterias Mesentéricas/metabolismo , Arterias Mesentéricas/fisiopatología , Ratones Endogámicos C57BL , Ratones Noqueados , Óxido Nítrico Sintasa de Tipo III/genética , Óxido Nítrico Sintasa de Tipo III/metabolismo , Obesidad/metabolismo , Obesidad/fisiopatología
16.
Intern Med ; 59(18): 2229-2235, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32938850

RESUMEN

Objective The measurement of C-peptide immunoreactivity (CPR) is essential for evaluating the pancreatic ß-cell function and selecting appropriate therapeutic agents in patients with diabetes mellitus. The meal tolerance test (MTT) is simple to administer physiological insulin-stimulating test. Previous studies have reported that several CPR-related indices are useful markers for predicting insulin requirement in type 2 diabetes. In the present study, we investigated the serum CPR response during the MTT in hospitalized patients with type 2 diabetes mellitus in order to clarify the clinical utility of the MTT. Methods We performed the MTT using a test meal with timed measurements of the serum CPR level based on the oral glucose tolerance test over 180 minutes and tested the correlation of various CPR-related indices and clinical factors in patients with type 2 diabetes mellitus. Patients The subjects were patients with type 2 diabetes mellitus who had been admitted to our hospital for diabetes management and education. The final study population consisted of 68 patients. Results The fasting CPR level was correlated with the 24-hour urinary CPR excretion and body mass index. The serum CPR level at 120 minutes in the MTT was strongly correlated with the area under the curve of CPR during the MTT. The patients who needed insulin therapy at 6 months after hospitalization showed a significant lower incremental CPR value from 0 to 120 minutes in the MTT than those who did not need insulin therapy. Conclusion The plasma C-peptide levels at 0 and 120 minutes in the MTT provide essential information for the clinical management of patients with type 2 diabetes mellitus.


Asunto(s)
Péptido C/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Técnicas de Diagnóstico Endocrino , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Adulto , Biomarcadores/sangre , Glucemia/metabolismo , Índice de Masa Corporal , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Insulina/sangre , Células Secretoras de Insulina/fisiología , Masculino , Comidas , Carne , Persona de Mediana Edad , Periodo Posprandial
17.
Niger J Clin Pract ; 23(9): 1194-1200, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32913156

RESUMEN

Aim: This retrospective analysis aims to evaluate the correlation between blood glucose fluctuation (BGF) and heart rate variability (HRV) in patients with coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM). Subjects and Methods: In total, 210 patients with CHD and T2DM from January 2014 to January 2019 admitted to Wenling Hospital of Traditional Chinese Medicine were enrolled in this study. Based on whether BGF existed, patients were allocated to BG control group and BG fluctuation group. The HRV parameters, frequency of adverse events, and Gensini score between groups were recorded and Pearson analysis was performed. Results: Results displayed that no significant differences in age, gender, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), alcohol consumption history, drinking history, or serum lipid were found between groups (P > 0.05 for all items). However, the BGF parameters were significantly higher while the HRV parameters were significantly lower in BG fluctuation group, compared with BG control group (P < 0.05 for all items). Pearson analysis showed that despite mean blood glucose (MBG) and mean amplitude of glycemic excursions (MAGE) both correlated with a standard deviation of NN intervals (SDNN) level, the correlation coefficient of MAGE-SDNN was much higher (-0.705 vs -0.185). Additionally, the frequencies of adverse events and Gensini scores were also significantly higher in the BG fluctuation group than the BG control group. Conclusions: It suggests that BGF strongly correlated with HRV in patients with CHD and T2DM. It also provides experimental instructions for clinical practice.


Asunto(s)
Glucemia/análisis , Enfermedad Coronaria/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Glucosa/metabolismo , Frecuencia Cardíaca/fisiología , Adulto , Anciano , Índice de Masa Corporal , Enfermedad Coronaria/sangre , Enfermedad Coronaria/fisiopatología , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
18.
High Blood Press Cardiovasc Prev ; 27(6): 515-526, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32964344

RESUMEN

Epidemiological studies have documented a high incidence of diabetes in hypertensive patients.Insulin resistance is defined as a less than expected biologic response to a given concentration of the hormone and plays a pivotal role in the pathogenesis of diabetes. However, over the last decades, it became evident that insulin resistance is not merely a metabolic abnormality, but is a complex and multifaceted syndrome that can also affect blood pressure homeostasis. The dysregulation of neuro-humoral and neuro-immune systems is involved in the pathophysiology of both insulin resistance and hypertension. These mechanisms induce a chronic low grade of inflammation that interferes with insulin signalling transduction. Molecular abnormalities associated with insulin resistance include the defects of insulin receptor structure, number, binding affinity, and/or signalling capacity. For instance, hyperglycaemia impairs insulin signalling through the generation of reactive oxygen species, which abrogate insulin-induced tyrosine autophosphorylation of the insulin receptor. Additional mechanisms have been described as responsible for the inhibition of insulin signalling, including proteasome-mediated degradation of insulin receptor substrate 1/2, phosphatase-mediated dephosphorylation and kinase-mediated serine/threonine phosphorylation of both insulin receptor and insulin receptor substrates. Insulin resistance plays a key role also in the pathogenesis and progression of hypertension-induced target organ damage, like left ventricular hypertrophy, atherosclerosis and chronic kidney disease. Altogether these abnormalities significantly contribute to the increase the risk of developing type 2 diabetes.


Asunto(s)
Presión Sanguínea , Diabetes Mellitus Tipo 2/fisiopatología , Hipertensión Esencial/fisiopatología , Resistencia a la Insulina , Animales , Biomarcadores/sangre , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/epidemiología , Hipertensión Esencial/sangre , Hipertensión Esencial/epidemiología , Humanos , Incidencia , Insulina/sangre , Pronóstico , Factores de Riesgo , Transducción de Señal
19.
Am J Physiol Endocrinol Metab ; 319(5): E835-E851, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-32865011

RESUMEN

Cardiac autonomic neuropathy (CAN) is an early cardiovascular manifestation of type 2 diabetes (T2D) that constitutes an independent risk factor for cardiovascular mortality and morbidity. Nevertheless, its underlying pathophysiology remains poorly understood. We recently showed that localized perivascular adipose tissue (PVAT) inflammation underlies the incidence of parasympathetic CAN in prediabetes. Here, we extend our investigation to provide a mechanistic framework for the evolution of autonomic impairment as the metabolic insult worsens. Early metabolic dysfunction was induced in rats fed a mild hypercaloric diet. Two low-dose streptozotocin injections were used to evoke a state of late decompensated T2D. Cardiac autonomic function was assessed by invasive measurement of baroreflex sensitivity using the vasoactive method. Progression into T2D was associated with aggravation of CAN to include both sympathetic and parasympathetic arms. Unlike prediabetic rats, T2D rats showed markers of brainstem neuronal injury and inflammation as well as increased serum levels of IL-1ß. Experiments on PC12 cells differentiated into sympathetic-like neurons demonstrated that brainstem injury observed in T2D rats resulted from exposure to possible proinflammatory mediators in rat serum rather than a direct effect of the altered metabolic profile. CAN and the associated cardiovascular damage in T2D only responded to combined treatment with insulin to manage hyperglycemia in addition to a nonhypoglycemic dose of metformin or pioglitazone providing an anti-inflammatory effect, coincident with the effect of these combinations on serum IL-1ß. Our present results indicate that CAN worsening upon progression to T2D involves brainstem inflammatory changes likely triggered by systemic inflammation.


Asunto(s)
Barorreflejo/fisiología , Diabetes Mellitus Experimental/fisiopatología , Diabetes Mellitus Tipo 2/fisiopatología , Neuropatías Diabéticas/fisiopatología , Hipoglucemiantes/uso terapéutico , Inflamación/fisiopatología , Animales , Barorreflejo/efectos de los fármacos , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Neuropatías Diabéticas/sangre , Neuropatías Diabéticas/tratamiento farmacológico , Progresión de la Enfermedad , Hemodinámica/efectos de los fármacos , Hemodinámica/fisiología , Hipoglucemiantes/administración & dosificación , Inflamación/sangre , Inflamación/tratamiento farmacológico , Insulina/administración & dosificación , Insulina/uso terapéutico , Interleucina-1beta/sangre , Masculino , Pioglitazona/administración & dosificación , Pioglitazona/uso terapéutico , Ratas , Ratas Sprague-Dawley
20.
Vasc Health Risk Manag ; 16: 343-352, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32943869

RESUMEN

Purpose: The impact of glycemic control on macrovascular complications and arterial stiffness in type II diabetes (T2D), as well as the extent of additive effect of hypertension, is unclear. The aims of this study were to investigate the impact of glycemic control on the cardio-ankle vascular index (CAVI), an indicator of arterial stiffness, and to determine the relative risk of concomitant diabetes and hypertension with arterial stiffness. Methods: One hundred and nine participants were enrolled and classified as non-diabetes (n= 37) and diabetes (n=72); the diabetic group was further identified as controllable and uncontrollable T2D depending on their hemoglobin A1c (HbA1c) levels. Univariate and multiple regression analyses were used to assess the association between CAVI and glycemic control status and hypertension. Relative risk analysis for abnormal CAVI with exposure to diabetes and hypertension was investigated. Results: In all participants, age, systolic blood pressure, body mass index, and fasting blood sugar were independent predictors of CAVI. In diabetic participants, glycemic control status or HbA1c levels did not significantly correlate with CAVI. Systolic blood pressure was an independent predictor for CAVI with ß = 0.26. In addition, the coexistence of diabetes together with hypertension was significantly associated with a 2.4-fold increase in the risk of abnormal CAVI (95% CI, 1.410-4.184; p <0.001). Conclusion: This study demonstrates that HbA1c as well as fasting blood sugar levels in diabetic participants do not correlate with arterial stiffness. Concomitant diabetes and hypertension significantly increase the risk of arterial stiffness.


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Hemoglobina A Glucada/metabolismo , Hipertensión/fisiopatología , Rigidez Vascular , Adulto , Anciano , Biomarcadores/sangre , Glucemia/efectos de los fármacos , Índice Vascular Cardio-Tobillo , Estudios de Casos y Controles , Estudios Transversales , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Humanos , Hipertensión/diagnóstico , Hipoglucemiantes/uso terapéutico , Masculino , Persona de Mediana Edad , Factores de Riesgo
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