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1.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(3): 251-256, 2020 Mar.
Artículo en Chino | MEDLINE | ID: mdl-32204762

RESUMEN

OBJECTIVE: To study the association between CD40-CD40L system and obesity in children. METHODS: A total of 76 obese children were enrolled as the obese group, and 74 healthy children with normal body mass index (BMI) were enrolled as the control group. The two groups were compared in terms of morphological indices, biochemical parameters, and serum levels of CD40 and CD40L. Partial correlation analysis and multivariate linear regression analysis were performed to investigate the correlation of CD40 and CD40L with other clinical indices. RESULTS: Compared with the control group, the obese group had significantly higher BMI, waist circumference/height ratio, systolic pressure, diastolic pressure, alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid, triglyceride, apolipoprotein B, fasting blood glucose, fasting insulin, glycosylated hemoglobin, platelet count, CD40L, and mean carotid intima-media thickness (P<0.05), but significantly lower high-density lipoprotein cholesterol and apolipoprotein A1 (P<0.05). With age and sex as the control factors, the partial correlation analysis showed that CD40L was positively correlated with height, weight, BMI, diastolic pressure, bile acid, triglyceride, total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, and platelet count (P<0.05). CD40 was positively correlated with waist circumference/height ratio and platelet count (P<0.05). The multivariate linear regression analysis showed that ALT, AST, total cholesterol, and platelet count were the dependent factors influencing the level of CD40L (R2=0.266, P<0.05). CONCLUSIONS: CD40-CD40L system is closely associated with obesity and related hyperlipidemia and hypertension. CD40 and CD40L may be used as new indicators for early warning of metabolic syndrome and provide new ideas for the prevention and treatment of related chronic diseases.


Asunto(s)
Obesidad Pediátrica , Glucemia , Índice de Masa Corporal , Antígenos CD40 , Ligando de CD40 , Grosor Intima-Media Carotídeo , Niño , Humanos , Triglicéridos
2.
Rev Med Suisse ; 16(687): 582-585, 2020 Mar 25.
Artículo en Francés | MEDLINE | ID: mdl-32216181

RESUMEN

Metabolic surgery is becoming increasingly important in the treatment of obese and diabetic patients. Its impact is major on immediate post-operative glycemic control and adaptation of anti-diabetic treatments is necessary. Over time, a recurrence of diabetes may be observed and the choice of treatments to be reintroduced must take into account the surgery performed. By discussing pharmacological options during the preoperative, peri-operative and post-operative periods, this article provides a review of the literature on a subject for which few guidelines are currently proposed.


Asunto(s)
Cirugía Bariátrica , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/terapia , Obesidad/complicaciones , Obesidad/cirugía , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Humanos , Obesidad/sangre
3.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(2): 146-150, 2020 Mar.
Artículo en Chino | MEDLINE | ID: mdl-32220179

RESUMEN

Based on the higher mortality and the higher proportion of critically ill adults in coronavirus disease 2019 (COVID-19) patients with diabetes, good inpatient glycemic control is particularly important in the comprehensive treatment of COVID-19. Individualized blood glucose target goals and treatment strategies should be made according to specific circumstances of COVID-19 inpatients with diabetes. For mild patients, a strict glycemic control target (fasting plasma glucose (FPG) 4.4-6.1 mmol/L, 2-hour postprandial plasma glucose (2 h PG) 6.1-7.8 mmol/L) are recommended; a target for the glycemic control of common type patients (FPG 6.1-7.8 mmol/L, 2 h PG 7.8-10.0 mmol/L) and subcutaneous insulin deliver therapy are recommended; a target nonfasting blood glucose range of 10.0 mmol or less per liter for severe-type COVID-19 patients, a relatively Less stringent blood glucose control target (FPG 7.8-10.0 mmol/L, 2 h PG 7.8-13.9 mmol/L) for critically ill patients and intravenous insulin infusion therapy are recommended. Due to the rapid changes in the condition of some patients, the risk of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar status (HHS) maybe occur during the treatment. Blood glucose monitoring, dynamic evaluation and timely adjustment of strategies should be strengthened to ensure patient safety and promote early recovery of patients.


Asunto(s)
Betacoronavirus , Glucemia , Infecciones por Coronavirus/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemiantes/uso terapéutico , Insulina/uso terapéutico , Neumonía Viral/complicaciones , Adulto , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/complicaciones , Cetoacidosis Diabética/etiología , Cetoacidosis Diabética/prevención & control , Humanos , Hiperglucemia/tratamiento farmacológico , Coma Hiperglucémico Hiperosmolar no Cetósico/etiología , Coma Hiperglucémico Hiperosmolar no Cetósico/prevención & control , Pandemias
4.
Isr Med Assoc J ; 22(3): 137-141, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32147976

RESUMEN

BACKGROUND: Pregestational diabetes mellitus (PGDM) carries a significantly elevated risk of adverse maternal and fetal outcomes. There is evidence that certain interventions reduce the risk for adverse outcomes. Studies have shown that a multi-disciplinary approach improves pregnancy outcomes in women with PGDM. OBJECTIVES: To determine pregnancy outcomes in women with PGDM using a multi-disciplinary approach. METHODS: We retrospectively reviewed consecutive women with pregestational type 1 and type 2 diabetes who were monitored at a high-risk pregnancy clinic at the Sheba Medical Center. Clinical data were obtained from the medical records. All data related to maternal glucose control and insulin pump function were prospectively recorded on Medtronic CareLink® pro software (Medtronic MiniMed, Northridge, CA). RESULTS: This study comprised 121 neonates from 116 pregnancies of 94 women. In 83% of the pregnancies continuous glucose monitoring (CGM) sensors were applied during a part or all of the pregnancy. Pregnancy outcomes among women who were followed by a multi-disciplinary team before and during pregnancy, and during labor and puerperium resulted in better glucose control (hemoglobin A1c 6.4% vs. 7.8%), lower risk for pregnancy induced hypertension/preeclampsia (7.7% vs. 15.6%), lower birth weight (3212 g vs. 3684 g), and lower rate of large size for gestational age and macrosomia (23.1% vs. 54.2% and 3.3% vs. 28.4%, respectively), compared to data from European cohorts. CONCLUSIONS: The multi-disciplinary approach for treating women with PGDM practiced in the high-risk pregnancy clinic at the Sheba Medical Center resulted in lower rates of macrosomia, LGA, and pregnancy induced hypertension compared to rates reported in the literature.


Asunto(s)
Diabetes Mellitus/terapia , Complicaciones del Embarazo/terapia , Atención Prenatal/métodos , Adulto , Glucemia , Femenino , Macrosomía Fetal/prevención & control , Humanos , Hipertensión/prevención & control , Recién Nacido de Bajo Peso , Recién Nacido , Insulina/uso terapéutico , Israel , Preeclampsia/prevención & control , Embarazo , Estudios Prospectivos , Estudios Retrospectivos
6.
Zhonghua Yi Xue Za Zhi ; 100(6): 419-423, 2020 Feb 18.
Artículo en Chino | MEDLINE | ID: mdl-32146763

RESUMEN

Objective: To investigate related factors for microalbuminuria in adult type 1 diabetes (T1D) patients of short disease duration (less than 5 years), and provide evidence for prevention of early diabetic kidney disease in this population. Methods: All adult patients enrolled in the Guangdong T1D translational medicine study between 2011 and 2017 with a disease duration of less than 5 years were included in this analysis. At enrollment, patients' demographic and clinical data were documented, and blood and urine samples were collected for the measurements of blood lipids, glycated hemoglobin A1c and urine albuminuria. Insulin resistance was evaluated by estimated glucose disposal rate (eGDR). Patients were categorized into groups based on urine albumin creatitine ratio (UACR): normoalbuminuric group (UACR<30 mg/g) and microalbuminuric group (UACR≥30 mg/g). Stepwise multivariate linear regression analysis was used to analyze risk factors for microalbuminuria in adult T1D patients of short disease duration. Results: A total of 384 patients were included in this analysis, and 51.3% (197/384) of which was female. The onset age of patients was (24.6±12.5) years, with a disease duration of 2.1(0.6, 3.5) years, body mass index of (19.8±3.2) kg/m(2), waist hip ratio of 0.85±0.21, and glycated hemoglobin A1c of (9.8±3.3)% at enrollment. Microalbuminuria occurred in 62 patients (16.1%). Multivariate linear analysis showed that higher glycated hemoglobin A1c, higher systolic blood pressure and more severe insulin resistance were related factors for microalbuminuria (t=2.322, 2.868 and -2.373, respectively, all P<0.05). Conclusions: Microalbuminuria was not rare in adult T1D patients of short disease duration. Inadequate glycemic control and insulin resistance were independent related factors for microalbuminuria in this population.


Asunto(s)
Diabetes Mellitus Tipo 1 , Nefropatías Diabéticas , Adulto , Albuminuria , Glucemia , Presión Sanguínea , Femenino , Hemoglobina A Glucada , Humanos
7.
Bratisl Lek Listy ; 121(3): 235-241, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32115983

RESUMEN

AIM: Hyperglycemia, oxidative stress and hyperlipidemia are features of diabetes mellitus. Thiamine has beneficial effects on carbohydrate metabolism and it was proposed that this vitamin has antihyperlipidemic and antioxidant effects. Our aim was to investigate the effects of thiamine on oxidative stress and metabolic changes in streptozotocin (STZ) induced diabetic rats. METHOD: Diabetes was induced by a single intraperitoneal injection of STZ. Thiamine (6 mg/kg) was added to drinking water for five weeks. The rats were divided into four groups: control rats; thiamine treated control rats; diabetic rats; thiamine treated diabetic rats. Plasma and tissue malondialdehyde (MDA) levels were measured by high-performance liquid chromatography and spectrophotometry, respectively. Paraoxonase (PON) and arylesterase (AE) activities were measured with spectrophotometric methods, and erythrocyte superoxide dismutase (SOD) and blood glutathione peroxidase (GSH-Px) activities were determined using commercial kits. RESULTS: Thiamine treatment reduced plasma and tissue MDA levels, serum glucose, total cholesterol and triglyceride levels, and increased serum high density lipoprotein- cholesterol and insulin levels, serum PON and AE, erythrocyte SOD and blood GSH-Px activities. CONCLUSION: Thiamine significantly improves oxidative stress and has hyperinsulinemic and antihyperlipidemic effects so we suggest that thiamine might be used as a supportive therapeutic agent in diabetes (Tab. 2, Fig. 3, Ref. 53).


Asunto(s)
Antioxidantes , Diabetes Mellitus Experimental , Estrés Oxidativo , Tiamina , Animales , Antioxidantes/farmacología , Glucemia , Malondialdehído , Estrés Oxidativo/efectos de los fármacos , Ratas , Ratas Wistar , Superóxido Dismutasa , Tiamina/farmacología
8.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(1): 62-66, 2020 Feb 28.
Artículo en Chino | MEDLINE | ID: mdl-32131941

RESUMEN

Objective To analyze the risk factors for postoperative recurrence of chronic suppurative otitis media(CSOM) and explore the intervention measures to prevent postoperative recurrence of CSOM. Methods A total of 1066 patients with CSOM who underwent concurrent surgical treatment and achieved clinical cure in our hospital from January 2012 to December 2018 were enrolled.The clinical data and laboratory findings were reviewed by using an electronic medical record system and the patients were followed up for 1 year.The patients were divided into the non-recurrent group and the recurrent group.Chi-square test and multivariate logistic regression were used to compare the factors may contribute to the postoperative recurrence. Results The recurrence rate of CSOM was 6.38%.Multi-drug-resistant(MDR) infection before surgery(χ 2=16.338,P=0.000),aged ≥60 years(χ 2=5.182,P=0.023),frequency of occurrence ≥3 times/year(χ 2=4.388,P=0.036),duration of active period>7 d(χ 2=4.729,P=0.030),repeated upper respiratory tract infection>3 times/year(χ 2=11.913,P=0.001),accompanied by chronic sinusitis(χ 2=11.077,P=0.001),blood glucose>6.11 mmol/L(χ 2=15.327,P=0.000),postoperative serum procalcitonin(PCT)>0.5 µg/L(χ 2=8.337,P=0.004) were the risk factors for postoperative recurrence.The use of snorkel was a protective factor for postoperative recurrence(χ 2=5.308,P=0.021).Multivariate analysis showed that MDR infection(OR=3.373,95%CI:1.825-6.234,P=0.000),repeated upper respiratory tract infection>3 times/year(OR=2.727,95%CI:1.479-5.030,P=0.001),accompanied by chronic sinusitis(OR=2.980,95%CI:1.654-5.369,P=0.000),blood glucose>6.11 mmol/L(OR=3.219,95%CI:1.741-5.953,P=0.000),and postoperative serum PCT>0.5 µg/L(OR=2.085,95%CI:1.106-3.931,P=0.023) were independent risk factors for postoperative recurrence in CSOM patients. Conclusions Effective prevention and control of MDR infection,control of blood sugar,prevention of upper respiratory tract infection,and lowering the recurrence of chronic sinusitis are the main measures to reduce postoperative recurrence of CSOM.Monitoring of the infection marker PCT can help to achieve early intervention.


Asunto(s)
Otitis Media Supurativa/diagnóstico , Otitis Media Supurativa/cirugía , Glucemia , Enfermedad Crónica , Humanos , Persona de Mediana Edad , Periodo Posoperatorio , Polipéptido alfa Relacionado con Calcitonina/sangre , Recurrencia , Factores de Riesgo
9.
Medicine (Baltimore) ; 99(11): e19501, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176092

RESUMEN

BACKGROUND: Clinical and basic research supports that blood glucose fluctuation is an important predictor of diabetic vascular disease and an etiology of lower extremity atherosclerosis, which is an important pathological basis for lower extremity vascular diseases. Previous Chinese National Natural Science Foundation trials (No. 81503566) have reported that the traditional Chinese medicine Shenqi compound can reduce blood glucose fluctuation and low-grade inflammation, and protect blood vessels; however, there are no high-quality clinical evidences available to support the same. This multicenter randomized controlled trial aims to obtain more clinical evidence to confirm the efficacy and safety of Shenqi compound in type 2 diabetes with lower extremity atherosclerosis. METHODS: A multicenter RCT will be implemented in this study for a 32-week study period (8 weeks for intervention and 24 weeks for follow-up). Participants will be recruited from the Teaching Hospital of Chengdu University of TCM, Mianyang Hospital of TCM, and Shuangliu Hospital of TCM. Sixty participants will be randomly divided into a treatment group (basic treatment combined with traditional Chinese medicine Shenqi Compound) or a control group (basic treatment combined with Chinese medicine placebo) with 30 participants in each group. Patients will be selected considering the following inclusion criteria: age between 35 and 65 years, and a positive diagnosis for type 2 diabetes with lower extremity atherosclerosis and TCM syndromes. Primary outcome indicator is an arterial color Doppler ultrasound. Secondary outcome indicators include: blood glucose fluctuation indicators (MBG, SDBG, LAGE), islet ß-cell function evaluation indicators (Homa-IR, Homa-islet, SG, SCP), inflammation indicators (NLR, CRP, IL-6), blood lipids, and HbA1c. Safety index includes vital signs (T, P, R, BP), blood, urine, stool routine, liver and renal function, electrocardiogram, and adverse event records. The endpoint event is defined as the presence of gangrene in the lower limbs. DISCUSSION: Explore the clinical effect of traditional Chinese medicine "Shenqi Compound" to reduce blood glucose fluctuation and use HOMA-IR, the area under the glucose curve, and the area under the C-peptide curve to evaluate the effect of protecting islet ß cell function. TRIAL REGISTRATION: Chinese clinical trial registry (ChiCTR-1900027693). Registered on November 23, 2019. http://www.chictr.org.cn.


Asunto(s)
Aterosclerosis/tratamiento farmacológico , Diabetes Mellitus Tipo 2 , Angiopatías Diabéticas/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Hipoglucemiantes/uso terapéutico , Extremidad Inferior/irrigación sanguínea , Medicina China Tradicional , Aterosclerosis/sangre , Aterosclerosis/fisiopatología , Glucemia , China , Angiopatías Diabéticas/sangre , Angiopatías Diabéticas/fisiopatología , Medicamentos Herbarios Chinos/administración & dosificación , Humanos , Hipoglucemiantes/administración & dosificación , Fitoterapia , Flujo Pulsátil , Ensayos Clínicos Controlados Aleatorios como Asunto , Flujo Sanguíneo Regional , Proyectos de Investigación
10.
Medicine (Baltimore) ; 99(11): e19284, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176052

RESUMEN

High levels of albuminuria have been demonstrated to associate with hearing loss in non-diabetic people, while the clinical impact of low-grade albuminuria has attracted less attention. This cross-sectional population-based study aimed to examine whether hearing loss in non-diabetic United States (US) adults is independently associated with low-grade albuminuria or reduced estimated glomeruli filtration rate (eGFR).A total of 2518 participants aged 20 to 69 years were selected from the US National Health and Nutritional Examination Survey database. Participants with diabetes or high-grade albuminuria were excluded. Hearing loss was assessed using low-frequency pure-tone average (LFPTA) thresholds (0.5, 1.0, 2.0 kHz) and high-frequency pure-tone average (HFPTA) thresholds (3.0, 4.0, 6.0, 8.0 kHz). Logistic and linear regression analyses were used to evaluate associations between renal function indicators and hearing loss.The median age of included participants was 37.4 years, and 55% of them were female. Multivariate analysis revealed that participants with urinary albumin-to-creatinine ratio (UACR) in the highest tertile had a significantly higher risk of hearing loss (OR, 1.79; 95% CI, 1.01-3.19) and higher HFPTA thresholds (ß: 2.23; SE: 0.77). Participants with eGFR <60 mL/min/1.73 m had higher LFPTA thresholds (ß: 4.31; SE: 1.79). After stratification by sex, a significant risk remained only for males in the highest UACR tertile, with 2.18 times the risk of hearing loss (95% CI, 1.06-4.48).Non-diabetic US males with low-grade albuminuria are at increased risk of hearing loss, independent of eGFR.


Asunto(s)
Albuminuria/complicaciones , Albuminuria/diagnóstico , Comorbilidad , Pérdida Auditiva/epidemiología , Pérdida Auditiva/etiología , Adulto , Distribución por Edad , Anciano , Audiometría/métodos , Glucemia/análisis , Estudios Transversales , Diabetes Mellitus , Tasa de Filtración Glomerular , Pérdida Auditiva/diagnóstico , Humanos , Incidencia , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Encuestas Nutricionales , Valores de Referencia , Medición de Riesgo , Índice de Severidad de la Enfermedad , Estados Unidos , Urinálisis/métodos
11.
Medicine (Baltimore) ; 99(5): e19023, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32000447

RESUMEN

In the present study, the performance of anthropometric parameters, lipid and glucose indexes, and the combination of anthropometric parameters with the TyG (triglycerides × fasting plasma glucose) metabolic index, was compared in detecting insulin resistance (IR) to evaluate the optimal cut-off points in nondiabetic Chinese individuals. A total of 1067 nondiabetics underwent oral glucose tolerance test, blood lipid, and fasting insulin measurements. The clinical usefulness of various parameters- body mass index (BMI), waist circumference (WC), TyG, triglycerides/ high density lipoprotein cholesterol ratio, and TyG with adiposity status (TyG-BMI [TyG × BMI] and TyG-WC)-was analyzed to identify IR. Spearman correlation and receiver-operating characteristic curve analyses were used to compare the predictive efficacy of different indicators. All indicators showed a positive correlation with IR in both normal glucose and all subjects. However, the correlation between BMI and homeostasis model assessment of IR index was higher than other indicators as assessed by Spearman correlation test (P < .05). Furthermore, BMI and TyG-BMI were better indicators than others as determined by comparing the area under the receiver-operating characteristics curves (P < .05) in detecting IR. BMI is a simple and accurate measure for detecting IR in Chinese subjects. The 27 kg/m threshold was the optimal BMI cut-off point for detecting IR in both normal glucose and all glucose categories subjects.


Asunto(s)
Resistencia a la Insulina , Antropometría , Glucemia/análisis , China , Estudios Transversales , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Lípidos/sangre , Masculino , Persona de Mediana Edad
12.
Medicine (Baltimore) ; 99(3): e18713, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011447

RESUMEN

BACKGROUND: Lower extremity artery disease (LEAD) is greatly harmful to Type 2 Diabetes Mellitus patients. Traditional Chinese Medicine (TCM) is an alternative therapy to delay the development of macrovascular diseases, but the existing evidence of its efficacy, safety and mechanism of action is insufficient. We report a study protocol of a multi-center, randomized, double-blind, placebo-controlled trial that aims to use well-designed clinical trial to evaluate the efficacy and safety of Chinese herbal medicine (CHM) Shen-Qi Hua-Yu formula, and to explore efficacy mechanism of the TCM granules and the biomarkers of TCM syndrome. METHODS: This is a multi-center, double-blind, randomized, and placebo-controlled study that randomized 120 participants into 2 groups. The treatment group will receive TCM granules and conventional medicine, while the control group will receive placebo in addition to conventional medicine. Two groups will receive 12-week treatment and 48-week follow-up, with a total of 13 visits. Primary efficacy outcomes included ankle brachial index. Secondary efficacy outcomes included fasting plasma glucose, blood lipid, hemorheology indexes, advanced glycation end products, the inner diameter, peak systolic velocity, end diastolic velocity and mean average velocity of the anterior tibial artery, posterior tibial artery and dorsalis pedis artery, and TCM syndrome score. The safety and endpoint outcomes will be evaluated in this trial. The study will explain the biological therapeutic mechanism of Shen-Qi Hua-Yu formula for diabetic LEAD, and try to use Isobaric tags for Relative and Absolute Quantitation (iTRAQ) and Western blot to screen biomarkers of characteristic diagnosis and clinical efficiency evaluation of the TCM syndrome. DISCUSSION: This study is a multi-center, randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of CHM in patients with diabetic LEAD, and to interpret the therapeutic mechanism of Shen-Qi Hua-Yu formula in treatment of diabetic LEAD through proteomics technology, and to screen biomarkers with characteristics of TCM diagnosis and clinical efficacy evaluation. On the other hand, to our knowledge, this study may be the first trial of CHM formulas to observe cardiovascular outcomes through long-term follow-up for the treatment of diabetic LEAD, which is of great value. TRIAL REGISTRATION: This study is registered on the Chinese Clinical Trial Registry: ChiCTR1900026372.


Asunto(s)
Angiopatías Diabéticas/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Adulto , Anciano , Índice Tobillo Braquial , Biomarcadores , Glucemia , Diabetes Mellitus Tipo 2/complicaciones , Método Doble Ciego , Femenino , Humanos , Lípidos/sangre , Extremidad Inferior , Masculino , Persona de Mediana Edad , Qi , Proyectos de Investigación , Arterias Tibiales
13.
Clín. investig. arterioscler. (Ed. impr.) ; 32(1): 8-14, ene.-feb. 2020. graf, ilus
Artículo en Español | IBECS | ID: ibc-187002

RESUMEN

Introducción: El incremento de grasa miocárdica ha sido propuesto como uno de los principales precursores de la disfunción miocárdica de etiología diabética independiente de la enfermedad arterial coronaria. Sin embargo, actualmente se carece de biomarcadores que reflejen el contenido de grasa miocárdica para la detección clínica de esta patología. Métodos: Las correlaciones entre el contenido de triglicéridos cardíacos y los niveles plasmáticos de las principales moléculas alteradas durante la diabetes y los niveles cardíacos de ARNm de genes implicados en el metabolismo cardíaco (Cd36 y Pdk4) han sido exploradas en un modelo murino de resistencia a la insulina inducida por una dieta con alto contenido en grasas. Resultados: En ratones resistentes a la insulina, la dieta grasa aumentó los niveles de triglicéridos del miocardio, en comparación con animales controles alimentados con una dieta estándar. El contenido de triglicéridos cardíacos se encontró directamente asociado con los niveles plasmáticos de glucosa, triglicéridos, VLDL, resistina y leptina. Además, se observó una correlación inversa entre el contenido de triglicéridos y los niveles cardíacos de ARNm de Cd36 y Pdk4. Conclusiones: Nuestros datos revelan que el contenido cardíaco de triglicéridos se encuentra asociado con un perfil bioquímico plasmático alterado y con una reprogramación de la expresión de genes dirigida a atenuar el impacto de la acumulación ectópica de lípidos en miocardio


Introduction: The increase in myocardial fat has been proposed as one of the main precursors of myocardial dysfunction due to diabetic aetiology, independently of coronary artery disease. However, biomarkers reflecting the myocardial fat content for the clinical detection of this pathology are currently lacking. Methods: Correlations between 4cardiac triglyceride content and plasma levels of major altered molecules during diabetes and cardiac mRNA levels of genes involved in cardiac metabolism (Cd36 and Pdk4) have been explored in a murine model of insulin resistance induced by a high-fat diet. Results: In insulin-resistant mice, the fatty diet increased myocardial triglyceride levels, compared to control animals fed with a standard diet. The content of cardiac triglycerides was directly associated with plasma levels of glucose, triglycerides, VLDL, resistin and leptin. In addition, an inverse correlation was observed between the content of cardiac triglycerides and the cardiac mRNA levels of Cd36 and Pdk4. Conclusions: Our data reveal that the cardiac triglyceride content is associated with altered plasma biochemical profile and reprogramming of gene expression aimed to mitigate the impact of ectopic lipid accumulation in the myocardium


Asunto(s)
Animales , Ratones , Cardiomiopatías/veterinaria , Resistencia a la Insulina , Grasas de la Dieta , Triglicéridos/análisis , Biomarcadores/sangre , Metabolismo de los Lípidos , Ácidos Grasos/metabolismo , Cardiomiopatías/etiología , Triglicéridos/metabolismo , Glucemia/metabolismo , Lipoproteínas VLDL/metabolismo , Leptina/metabolismo , Resistina/metabolismo , Miocardio/patología , ARN/metabolismo , Ácidos Grasos/sangre
14.
Zhongguo Zhen Jiu ; 40(2): 129-34, 2020 Feb 12.
Artículo en Chino | MEDLINE | ID: mdl-32100496

RESUMEN

OBJECTIVE: To observe the effect of electroacupuncture (EA) combined with lifestyle control on hepatic fat status, hepatic enzymology, glycolipid metabolism and anthropological parameters in patients with obese nonalcoholic fatty liver disease(NAFLD). METHODS: A total of 90 patients with obese NAFLD were randomized into an observation group (45 cases, 4 cases dropped off) and a control group (45 cases, 1 case dropped off). Lifestyle control was implemented in the control group. On the basis of the treatment in the control group, acupuncture was applied at Zhongwan (CV 12), Quchi (LI 11), Shuifen (CV 9), Huaroumen (ST 24), Daheng (SP 15), Guanyuan (CV 4), Qihai (CV 6), etc. EA was provided at Huaroumen (ST 24) and Daheng (SP 15) with dilatational wave, 2 Hz/100 Hz in frequency, 30 min each time, once every other day, 3 times a week. The treatment for 12 weeks was required in both of the two groups. Hepatic fat status [controlled attenuation parameter (CAP) and liver stiffness measurement (LSM)], hepatic enzymology [alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT)], glycolipid metabolism and insulin sensitivity [fasting plasma glucose (FPG), fasting serum lisulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C)] and anthropological parameters [body weight (BW), body mass index (BMI), fat percentage (FP), waist circumference (WC), hip circumference (HC) and waist-to-hip ratio (WHR)] in the two groups were observed before and after treatment. RESULTS: ①Compared before treatment, hepatic CAP, LSM, serum ALT, AST and GGT after treatment were obviously reduced in the two groups (P<0.05, P<0.01). After treatment, CAP and ALT in the observation group were lower than the control group (P<0.05). ②Compared before treatment, FINS, HOMA-IR, LDL-C, TC and TG after treatment were obviously reduced in the two groups (P<0.05, P<0.01),while the levels of HDL-C were increased (P<0.05). Compared before treatment, FPG after treatment in the observation group was reduced (P<0.05). Compared with the control group, FINS, HOMA-IR, TC and TG in the observation group were lower than those in the control group after treatment (P<0.05). ③Compared before treatment, BW BMI, FP, WC, HC, WHR after treatment were obviously reduced in the two groups (P<0.01). After treatment, WC and WHR in the observation group were lower than the control group (P<0.05). CONCLUSION: Electroacupuncture combined with lifestyle control can effectively treat obese nonalcoholic fatty liver disease, and present better therapeutic effect on hepatic fat status, glycolipid metabolism, insulin resistance, WC and WHR.


Asunto(s)
Electroacupuntura , Estilo de Vida , Enfermedad del Hígado Graso no Alcohólico/terapia , Glucemia , Humanos , Resistencia a la Insulina , Metabolismo de los Lípidos , Lípidos/sangre , Hígado/enzimología , Obesidad/complicaciones
15.
Medicine (Baltimore) ; 99(8): e19034, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080077

RESUMEN

BACKGROUND: Previous studies showed conflicting results for associations between vitamin D and prediabetes. The study aimed to make a systematic review and meta-analysis for the association between vitamin D and prediabetes. METHODS: We searched for articles identifying associations between vitamin D and prediabetes published in English until July 2019 in following databases (PubMed, Web of Science, EMBASE, Medline, Google Scholar, and Cochrane databases). Finally, we conducted these analyses (heterogeneities examination, meta-regression analyses, sensitivity analysis, and publication bias examination) using STATA 12.0 software (Stata Corporation, College Station, TX, USA). Q test and I were applied to examine heterogeneities between studies. RESULTS: Twelve studies were finally included in the present study. The study included 4 studies to explore the association between serum levels of 25-hydroxy (OH) vitamin D and risks of prediabetes (including 3094 participants). Additionally, the present study included 8 studies (including 865 individuals with prediabetes treated with vitamin D supplementation and 715 patients treated with placebo) to assess differences in therapeutic effects between individuals with prediabetes treated with vitamin D supplementation and those treated with placebo. The present study showed no significant associations between low serum levels of 25(OH) vitamin D and high risk of prediabetes. Additionally, the study showed no significant differences in changes of hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and homeostatic model assessment of insulin resistance (HOMA-IR) between individuals with prediabetes treated with vitamin D and those patients given placebo, whereas meta-analysis showed significantly greater changes in 2-hour oral glucose tolerance test (2HPG) in individuals with prediabetes treated with vitamin D, compared with individuals with prediabetes treated with placebo. CONCLUSION: The study supported that low serum levels of 25(OH) vitamin D increased the risk of prediabetes. In addition, vitamin D supplementation improves impaired glucose tolerance in prediabetes. However, more large-scale clinical trials are essential to explore the association between vitamin D and prediabetes.


Asunto(s)
Estado Prediabético/sangre , Estado Prediabético/tratamiento farmacológico , Vitamina D/sangre , Vitaminas/sangre , Glucemia/efectos de los fármacos , Ayuno/sangre , Intolerancia a la Glucosa/tratamiento farmacológico , Prueba de Tolerancia a la Glucosa/métodos , Hemoglobina A Glucada/análisis , Humanos , Resistencia a la Insulina/fisiología , Placebos/administración & dosificación , Factores de Riesgo , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico
16.
Diab Vasc Dis Res ; 17(1): 1479164119896978, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32000522

RESUMEN

OBJECTIVE: To investigate the relationship of 1-h postload plasma glucose during the oral glucose tolerance test with the severity of coronary artery lesions and risk of 1-year re-admission in coronary heart disease patients with normal glucose tolerance. METHODS: A total of 266 consecutive coronary heart disease patients who underwent coronary angiography and had normal glucose tolerance confirmed by oral glucose tolerance test during hospitalization were prospectively enrolled and followed in two groups according to the 1-h postload plasma glucose cut-off point (1-h postload plasma glucose <155 mg/dL, n = 149 and 1-h postload plasma glucose ⩾155 mg/dL, n = 117). Angiographic severity was assessed by number of diseased vessels, lesion morphology and Gensini score. The risk of 1-year re-admission with adverse cardiovascular events after discharge was analysed. RESULTS: Subjects with a 1-h postload plasma glucose ⩾155 mg/dL had higher incidence of multivessel disease and complex lesions, Gensini score and risk of 1-year re-admission than subjects with a 1-h postload plasma glucose <155 mg/dL (all p < 0.05). In the stepwise multivariate regression analysis, 1-h postload plasma glucose was the major determinant of the Gensini score. Subgroup analyses by sex showed that men with a 1-h postload plasma glucose ⩾155 mg/dL had higher incidence of complex lesions and risk of 1-year re-admission than men with a 1-h postload plasma glucose <155 mg/dL (all p < 0.05). CONCLUSION: Coronary heart disease patients with normal glucose tolerance and elevated 1-h postload plasma glucose levels had a greater severity of coronary artery lesions and an increased risk of re-admission with adverse cardiovascular events, particularly in men.


Asunto(s)
Glucemia/metabolismo , Enfermedad de la Arteria Coronaria/sangre , Readmisión del Paciente , Anciano , Biomarcadores/sangre , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/terapia , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Factores de Tiempo , Regulación hacia Arriba
17.
J Assoc Physicians India ; 68(2): 27-30, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32009358

RESUMEN

Aims and Objectives: To evaluate the adequacy of glycaemic, lipid and blood pressure (BP) goals of diabetic patients, To evaluate the differences in goal attainment rates between various parameters like age, sex, body mass index, complications, medications and compliance. Materials and Methods: A total of 250 diabetic patients coming to HIMS, Hassan were studied and evaluated for BP, fasting blood sugar (FBS) , post prandial blood sugar (PPBS), glycosylated haemoglobin (HbA1c), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides (TG). Patients were evaluated and reviewed past medical records for complications. All diabetics on treatment were included in the study; newly diagnosed, type-1 diabetes, seriously ill, pregnant and those who don't want to be the part of study were excluded. Study Design: Case series study. Results: Out of 250 patients, 55.6% were males, 44.4% were females. BP, FBS and PPBS were tested in all patients. HbA1C was tested in 72%. Lipid parameters like LDL, HDL, and TG were tested in 42%, 37.6% and 52.4% respectively. FBS, PPBS and HBA1C target goals were achieved in 43.89%, 63.89% and 11.67% respectively in patients with complications and 77%, 88.50% and 68.5% respectively in those without complications. LDL, HDL and TG target goals were achieved in 37.78%, 47.22% and 41.11% respectively in patients with complications and 67.1%, 67.20% and 71.4% respectively in those without complications. BP goal was achieved in 53.89% and 78.55% in patients with and without complications respectively.


Asunto(s)
Glucemia , Diabetes Mellitus Tipo 2 , Presión Sanguínea , Femenino , Hemoglobina A Glucada , Metas , Humanos , Lípidos , Masculino
18.
Rev Med Suisse ; 16(680): 264-267, 2020 Feb 05.
Artículo en Francés | MEDLINE | ID: mdl-32022491

RESUMEN

Considering the progressive nature of type 2 diabetes, glycated hemoglobin (HbA1c) goals and treatment plans should be regularly tailored to the patient's need to prevent hypoglycemia. There are individual HbA1c target levels that take into account factors such as age, comorbidity, and risks of treatment. The emergence of new therapeutic classes reducing hypoglycemia has changed ongoing practices. This article presents a potentially preventable case of a patient with hypoglycemia and reflects on the latest European and American recommendations for antidiabetic treatment in elderly patients.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemia/inducido químicamente , Hipoglucemia/prevención & control , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/uso terapéutico , Administración Oral , Anciano , Glucemia/efectos de los fármacos , Hemoglobina A Glucada/análisis , Humanos
19.
Zhonghua Zhong Liu Za Zhi ; 42(1): 65-69, 2020 Jan 23.
Artículo en Chino | MEDLINE | ID: mdl-32023772

RESUMEN

Objective: To evaluate the risk factors of perineal incision complications after abdominal abdominoperineal resection (APR) in elderly patients with rectal cancer. Methods: From January 2007 to September 2018, the clinical data of 72 elderly rectal cancer patients (age≥80 years) underwent abdominoperineal resection at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were collected and retrospectively analyzed. Univariate and multivariate analyses were performed to determine the risk factors of perineal incision complications in elderly patients with rectal cancer after APR. Results: Of the 76 patients, 47 were male and 25 were female, with an average age of (81.8±1.8) years. The incidence of postoperative perineal incision complications was 23.6% (17/72), including 5 cases of wound infection, 4 cases of incision fat liquefaction, and 8 cases of delayed wound healing. All of the patients were well recovered and discharged without death. The result of univariate analysis showed that, the occurrence of perineal incision complications was associated with serum albumin level < 35g/L (χ(2)=4.860, P=0.027), intraperitoneal chemotherapy with fluorouracil sustained release/lobaplatin rinse (χ(2)=8.827, P=0.003), pelvic restoration (χ(2)=9.062, P=0.003), diabetes (χ(2)=6.387, P=0.011) and coronary heart disease (χ(2)=7.688, P=0.006). Multivariable logistic regression analysis showed that the intraoperative pelvic restoration (OR=0.17, 95% CI: 0.04~0.82, P=0.027) and diabetes (OR=4.32, 95% CI: 1.05~17.81, P=0.043) were independent risk factors for perineal incision complications. Conclusions: Elderly patients with rectal cancer who undergo APR should preserve and restore the pelvic peritoneum as much as possible. Moreover, perioperative blood glucose monitoring is a powerful guarantee for preventing complications of perineal incision.


Asunto(s)
Perineo , Neoplasias del Recto , Anciano , Anciano de 80 o más Años , Glucemia , Análisis Factorial , Femenino , Humanos , Masculino , Perineo/cirugía , Complicaciones Posoperatorias , Neoplasias del Recto/cirugía , Estudios Retrospectivos , Factores de Riesgo
20.
Endocr Pract ; 26(1): 107-139, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32022600

RESUMEN

Abbreviations: A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ABCD = adiposity-based chronic disease; ACCORD = Action to Control Cardiovascular Risk in Diabetes; ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure; ACE = American College of Endocrinology; ACEI = angiotensin-converting enzyme inhibitor; AGI = alpha-glucosidase inhibitor; apo B = apolipoprotein B; ARB = angiotensin II receptor blocker; ASCVD = atherosclerotic cardiovascular disease; BAS = bile acid sequestrant; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CGM = continuous glucose monitoring; CHD = coronary heart disease; CKD = chronic kidney disease; DKA = diabetic ketoacidosis; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; EPA = eicosapentaenoic acid; ER = extended release; FDA = Food and Drug Administration; GLP1 = glucagon-like peptide 1; HDL-C = high-density-lipoprotein cholesterol; HeFH = heterozygous familial hypercholesterolemia; LDL-C = low-density-lipoprotein cholesterol; LDL-P = low-density-lipoprotein particle; Look AHEAD = Look Action for Health in Diabetes; NPH = neutral protamine Hagedorn; OSA = obstructive sleep apnea; PCSK9 = proprotein convertase subtilisin-kexin type 9 serine protease; RCT = randomized controlled trial; SU = sulfonylurea; SGLT2 = sodium-glucose cotransporter 2; SMBG = self-monitoring of blood glucose; T2D = type 2 diabetes; TZD = thiazolidinedione.


Asunto(s)
Diabetes Mellitus Tipo 2 , Endocrinólogos , Algoritmos , Glucemia , Automonitorización de la Glucosa Sanguínea , Consenso , Humanos , Proproteína Convertasa 9 , Estados Unidos
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