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1.
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
2.
Mymensingh Med J ; 29(1): 66-72, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915338

RESUMEN

Various forms of sexual dysfunction occur in men with diabetes mellitus (DM) including disorders of libido, ejaculatory problems, and erectile dysfunction (ED). This cross sectional study was conducted in a tertiary hospital of Bangladesh from December 2017 to May 2018 to find out the frequency and risk factors of ED in subjects with type 2 DM (T2DM). One hundred fifty (150) consecutive male patients with T2DM attending the Endocrinology outpatient department (OPD) of the hospital during the study period were evaluated for the presence of ED by using the International Index of Erectile Function-5 (IIEF-5) questionnaire; their socio-demographic, anthropometric, and clinical data were also recorded. Glycemic status was assessed by measurement of fasting plasma glucose (FPG) and HbA1c. Morning serum testosterone was measured in all. Among 150 subjects 68(45.3%) had ED; ED was mild in 14.7%, mild to moderate in 18.0%, moderate in 6.0% whereas severe ED was present in 6.7% of the subjects. The subjects with ED had higher mean age, longer duration of DM, higher body mass index (BMI), higher HbA1c, higher FPG, higher serum creatinine, and lower serum testosterone level than those without ED. Study subjects in the higher age group and higher duration of DM had higher frequencies of ED. IIEF-5 score showed significant negative correlation with age, duration of DM, HbA1c, fasting plasma glucose, serum creatinine and significant positive correlation with serum testosterone. In logistic regression analysis, duration of DM and serum testosterone were found be independent predictors of ED. Frequency of ED among Bangladeshi type 2 diabetic males is high; duration of DM and serum testosterone are independent predictors of ED in them.


Asunto(s)
Diabetes Mellitus Tipo 2/complicaciones , Disfunción Eréctil/epidemiología , Adulto , Distribución por Edad , Bangladesh/epidemiología , Glucemia/análisis , Índice de Masa Corporal , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Disfunción Eréctil/etiología , Hemoglobina A Glucada/análisis , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Prevalencia , Factores de Riesgo , Testosterona/sangre
3.
Mymensingh Med J ; 29(1): 183-186, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31915356

RESUMEN

Diabetes mellitus (DM) is the leading cause of death worldwide, responsible for one third of death, higher glycemic status and diabetes related complication are the most common cause. Low level of chromium (Cr) one of the major contributors higher glycemic status and increased the risk of diabetes related complication in type 2 diabetes mellitus. This study was aimed to find out the relationship between glycemic status and serum chromium level with type 2 diabetes mellitus. This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh from July 2014 to June 2015. Fifty type 2 diabetic subjects with age ranging from 40 to 55 years were study group and fifty ages, BMI matched healthy subjects were control group. Patients were selected from Bangladesh Institute of Research for Diabetic Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh. HbA1c, FSG levels were estimated in the laboratory of the Department of Biochemistry, BIRDEM General Hospital, Dhaka. Serum Cr level was estimated by flame atomic absorption spectrophotometry. For statistical analysis unpaired Student's 't' test was performed. In this study, mean serum chromium level was significantly (P<0.001) lower in diabetic patients than that of control group. On correlation analysis, serum Cr level showed significant negative correlation with FSG and HbA1C levels in type 2 diabetic patients. The study reflected that serum Cr level was reduced in DM which was higher with glycemic status of this disease. Categorization of patients with type 2 DM on the basis of low serum Cr level and high FSG and HbA1c level will be helpful for risk of diabetic complications.


Asunto(s)
Glucemia/análisis , Cromo/sangre , Diabetes Mellitus Tipo 2/sangre , Hemoglobina A Glucada/metabolismo , Adulto , Bangladesh , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Espectrofotometría Atómica
4.
Medicine (Baltimore) ; 99(2): e18679, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914062

RESUMEN

This study aimed to correlate hypoglycemic risk exposures (HREs) with low blood glucose value (BGV) in ambulatory patients to inform selection of a glucose critical action value (CAV).This was a retrospective study of ambulatory patients with at least 1 serum glucose ≤70 mg/dL obtained at 2 laboratories within the Johns Hopkins Health System over 3.8 years. Multivariable logistic regression was used to evaluate association of BGV cut-offs of <60, <54, <50, and <45 mg/dL with HREs. HREs were classified as "high hypoglycemic risk" (HHR), "moderate hypoglycemic risk" (MHR), "low hypoglycemic risk" (LHR), and "no hypoglycemic risk" (NHR).A total of 5404 patient samples of BG ≤70 mg/dL were analyzed, of which 30.3%, 23.2%, 28.5%, 18.0% occurred in NHR, LHR, MHR, and HHR groups, respectively. An inverse relationship was noted between BGV cut-offs and HHR, but no association was observed for LHR or MHR. After adjusting for age, sex, and race, there was an inverse association between BG thresholds and the odds of HHR. For classification of HHR, BGV cut-offs of <60, <54, <50, and <45 mg/dL correctly classified 71.2%, 69.8%, 68.8%, and 67.2% of BG samples, achieved false-positive rates of 13.6%, 4.7%, 1.7%, and 0.5% and positive likelihood ratios of 3.3, 6.0, 11.2, and 23.4, respectively.Nearly 70% of low BGVs occurred in patients with at least 1 HRE, but only ∼20% occurred in HHR patients. Given their high positive likelihood ratios, BGVs <54 or <50 mg/dL are reasonable candidates for CAVs that would allow sufficient clinician response time while minimizing false-positive alerts.


Asunto(s)
Instituciones de Atención Ambulatoria/estadística & datos numéricos , Glucemia/análisis , Hipoglucemia/epidemiología , Adulto , Anciano , Comorbilidad , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 1/epidemiología , Reacciones Falso Positivas , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Valores de Referencia , Estudios Retrospectivos , Factores de Riesgo
5.
Angiology ; 71(2): 167-174, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31749367

RESUMEN

Diabetes mellitus, and even prediabetes, has been shown to be independently associated with cardiovascular disease. Our study explored whether the combination of glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG) can better assess the severity of coronary heart disease (CHD) in elective percutaneous coronary intervention (PCI) patients. We consecutively enrolled 1006 prediabetic patients with HbA1c 5.7% to 6.4% who underwent elective PCI. Patients were divided into 2 groups: a normal fasting glucose (NFG) group (FBG <6.1 mmol/L) and an impaired fasting glucose (IFG) group (6.1 ≤FBG<7.0 mmol/L) with defined values. Baseline characteristics and angiography data of the 2 groups were compared. The prevalence of 3-vessel disease (P = .002), the GENSINI (the score is named after a professor) score (P = .002), and the SYNTAX (SYNergy between PCI with TAXUS™ and Cardiac Surgery) score (P = .002) of the IFG group was significantly higher compared to the NFG group. After multiple regression analysis, FBG was found to be independently associated with prevalence of 3-vessel disease (adjusted odds ratio: 1.62; 95% confidence interval: 1.21-2.36; P = .013), the GENSINI score (standardized ß = .138, P = .008), and the SYNTAX score (standardized ß = .145, P = .005). In addition, HbA1 c was independently associated with the prevalence of 3-vessel disease, the GENSINI, score, and the SYNTAX score (P < .05). Both FBG and HbA1c are independently correlated with the severity of CHD in prediabetic patients with HbA1c 5.7% to 6.4%.


Asunto(s)
Glucemia/análisis , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/cirugía , Hemoglobina A Glucada/análisis , Intervención Coronaria Percutánea , Enfermedad de la Arteria Coronaria/diagnóstico , Procedimientos Quirúrgicos Electivos , Ayuno , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
6.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 4-7, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31666312

RESUMEN

OBJECTIVE: There is a paucity of data about normal blood metabolite concentrations in healthy babies, in part because of a reluctance to undertake non-therapeutic invasive testing in newborns. The Glucose in Well Babies study (GLOW) sought to describe blood glucose, lactate and beta-hydroxybutyrate concentrations in healthy term babies over the first 5 postnatal days. We also sought to understand both parents' experience of participation in this invasive non-therapeutic study. DESIGN, SETTING, PATIENTS AND INTERVENTIONS: Eligible babies were healthy, term, appropriately grown singletons born in a birthing centre, hospital or home within the greater Hamilton area and then discharged home. Babies had subcutaneous continuous glucose monitoring placed soon after birth, up to 14 heel-prick blood samples, twice-daily home visits and parents were asked to record all feeds. At study completion, both parents were asked to independently complete a questionnaire about their experience. RESULTS: All eligible babies completed the study and every parent completed the questionnaire (65 fathers, 66 mothers). Parents reported they liked contributing to improving healthcare (126/131, 96%) and support from the GLOW team (119/131, 91%). Nearly all (127/131, 97%) would participate in GLOW again if they had another eligible baby, and all would recommend GLOW to family and friends. Two-thirds of parents (87/131, 66%) reported that participation had made them more likely to contribute to clinical research in the future. CONCLUSIONS: Non-therapeutic studies involving invasive procedures in healthy term babies are feasible, and parents were positive about their experience.


Asunto(s)
Ácido 3-Hidroxibutírico/sangre , Actitud Frente a la Salud , Glucemia/análisis , Ácido Láctico/sangre , Experimentación Humana no Terapéutica , Padres , Adulto , Recolección de Muestras de Sangre , Femenino , Cuidados de Enfermería en el Hogar , Humanos , Recién Nacido , Masculino , Monitoreo Fisiológico , Nueva Zelanda , Estudios Prospectivos , Valores de Referencia , Encuestas y Cuestionarios
7.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 45-49, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31079067

RESUMEN

OBJECTIVES: To determine the impact of incorporating dextrose gel in the treatment of neonatal hypoglycaemia (NH) and the role of feeding type in NH outcomes. STUDY DESIGN: We conducted a retrospective analysis of 2688 infants >35 weeks' gestation who were screened for NH before and after implementation of a clinical guideline for NH evaluation and treatment. We analysed the proportion of infants who required intravenous dextrose for NH before and after guideline implementation, the change in blood glucose concentrations with gel by feeding type and the odds of successful NH treatment with gel and feeding by feeding type. RESULTS: Following implementation of the guideline, a lower proportion of infants required intravenous dextrose for NH treatment (8.6% (60 infants) before guideline vs. 5.6% (112 infants) after guideline (p=0.007)). The median rise in blood glucose concentration with gel administration in the entire cohort was 0.61 mmol/L (11 mg/dL) (IQR 0.28-1.06 mmol/L (5-19 mg/dL)). Blood glucose concentration of formula-fed infants rose more in response to feeding and gel than breastfed infants (p≤0.0001). Formula feeding was associated with a lower odds of recurrent hypoglycaemia, as defined by requiring a second gel, in a fully adjusted model. Specifically, in infants with a pregel blood glucose of 2.00-2.17 mmol/L (36-39 mg/dL), formula feeding with gel was associated with a lower odds of recurrent hypoglycaemia. CONCLUSIONS: Dextrose gel is an effective tool in the treatment of NH. An infant's pregel blood glucose concentration may be helpful in guiding decisions around type of feeding provided.


Asunto(s)
Geles , Glucosa/administración & dosificación , Hipoglucemia/tratamiento farmacológico , Enfermedades del Recién Nacido/tratamiento farmacológico , Edulcorantes/administración & dosificación , Glucemia/análisis , Lactancia Materna , Femenino , Humanos , Fórmulas Infantiles , Recién Nacido , Masculino , Guías de Práctica Clínica como Asunto , Estudios Retrospectivos
8.
Einstein (Sao Paulo) ; 18: eAO4784, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31553356

RESUMEN

OBJECTIVE: To evaluate the effect of three types of muscular resistance training on adiposity, inflammation levels and insulin activity in Swiss mice with fat-rich diet-induced obesity. METHODS: Lean and obese male Swiss mice were selected and allocated to one of eight groups comprising eight mice each, as follows: standard diet + no training; standard diet + muscular resistance training; standard diet + hypertrophy training; standard diet + strength training; high-fat diet + no training; high-fat diet + muscular resistance training; high-fat diet + hypertrophy training; high-fat diet + strength training. The training protocol consisted of stair climbing for a 10-week period. Blood samples were collected for lactate analysis, glucose level measurement and insulin tolerance test. After euthanasia, adipose tissues were removed and weighed for adiposity index determination. Fragments of epididymal adipose tissue were then embedded for histological analysis or homogenized for tumor necrosis factor alpha level determination using the ELISA method. RESULTS: Ausency of differences in total training volume and blood lactate levels overall emphasize the similarity between the different resistance training protocols. Body weight loss, reduced adipocyte area and lower adiposity index were observed in trained obese mice, regardless of training modality. Different training protocols also improved insulin sensitivity and reduced inflammation levels. CONCLUSION: Resistance training protocols were equally effective in reducing body fat, inflammation levels and insulin resistance in obese mice.


Asunto(s)
Adiposidad/fisiología , Hipertrofia/fisiopatología , Inflamación/fisiopatología , Resistencia a la Insulina/fisiología , Ejercicios de Estiramiento Muscular/métodos , Obesidad/fisiopatología , Condicionamiento Físico Animal/fisiología , Tejido Adiposo Blanco/fisiopatología , Animales , Glucemia/análisis , Peso Corporal/fisiología , Dieta Alta en Grasa , Ensayo de Inmunoadsorción Enzimática , Masculino , Ratones , Ratones Obesos , Reproducibilidad de los Resultados , Entrenamiento de Resistencia/métodos , Factores de Tiempo , Factor de Necrosis Tumoral alfa/análisis
9.
Biochem Med (Zagreb) ; 30(1): 010704, 2020 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-31839724

RESUMEN

Introduction: Diabetes mellitus (DM) is one of the most prevalent diseases worldwide. The objective of this study was to find out under what preanalytical conditions routine and diagnostic glucose tests are performed across Spanish laboratories; and also what criteria are used for DM diagnosis. Materials and methods: An online survey was performed by the Commission on Quality Assurance in the Extra-Analytical Phase of the Spanish Society of Laboratory Medicine (SEQC-ML). Access to the questionnaire was available on the home page of the SEQC-ML website during the period April-July 2018. Data analysis was conducted with the IBM SPSS© Statistics (version 20.0) program. Results: A total of 96 valid surveys were obtained. Most laboratories were in public ownership, serving hospital and primary care patients, with high and medium workloads, and a predominance of mixed routine-urgent glucose testing. Serum tubes were the most used for routine glucose analysis (92%) and DM diagnosis (54%); followed by lithium-heparin plasma tubes (62%), intended primarily for urgent glucose testing; point-of-care testing devices were used by 37%; and plasma tubes with a glycolysis inhibitor, mainly sodium fluoride, by 19%. Laboratories used the cut-off values and criteria recognized worldwide for DM diagnosis in adults and glucose-impaired tolerance, but diverged in terms of fasting plasma glucose and gestational DM criteria. Conclusion: Preanalytical processing of routine and DM diagnostic glucose testing in Spain does not allow a significant, non-quantified influence of glycolysis on the results to be ruled out. Possible adverse consequences include a delay in diagnosis and possible under-treatment.


Asunto(s)
Glucemia/análisis , Recolección de Muestras de Sangre/métodos , Recolección de Muestras de Sangre/instrumentación , Diabetes Mellitus/diagnóstico , Humanos , Laboratorios de Hospital/normas , Fase Preanalítica , España , Encuestas y Cuestionarios
10.
Biochem Med (Zagreb) ; 30(1): 010802, 2020 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-31839727

RESUMEN

Introduction: Hypoglycaemia has been reported as an unusual complication of tramadol use and in a few cases of tramadol poisoning, but the exact mechanism is not known. Case description: An ambulance crew was dispatched to an unconscious 46-year old man. A glucometer point-of-care measurement revealed a profound hypoglycaemia (1.9 mmol/L). Treatment with intravenous glucose was started and the patient was transported to the hospital. The patient had several episodes of pulseless electrical activity requiring cardiopulmonary resuscitation in the ambulance and upon arrival in the hospital. Despite continuous glucose infusion the hypoglycaemia was difficult to correct during the next few hours and the patient developed hypokalaemia. Further investigation to identify the cause of hypoglycaemia revealed that insulin and C-peptide were inappropriately raised. A toxicological investigation revealed the presence of tramadol and its metabolites in lethal concentrations. Also acetaminophen, ibuprofen and lormetazepam were present. Ethanol screening was negative (< 0.1 g/L) and no sulfonylurea were detected. The patient developed multiple organ failure, but eventually recovered. What happened: The hypoglycaemia was caused by inappropriate stimulation of insulin secretion in a patient intoxicated with tramadol. The sudden hypokalaemia was caused by a massive intracellular shift of potassium in response to the hyperinsulinemia, triggered by the intravenous administration of glucose. Main lesson: To our knowledge, we are the first to document a significant rise in endogenous insulin production in a hypoglycaemic patient presenting with tramadol intoxication. Our observation suggests that hyperinsulinemia could be the cause of the hypoglycaemia associated with tramadol use.


Asunto(s)
Analgésicos Opioides/efectos adversos , Hipoglucemia/diagnóstico , Tramadol/efectos adversos , Analgésicos Opioides/uso terapéutico , Glucemia/análisis , Péptido C/sangre , Glucosa/administración & dosificación , Humanos , Hipoglucemia/inducido químicamente , Hipoglucemia/etiología , Insulina/sangre , Masculino , Persona de Mediana Edad , Dolor/tratamiento farmacológico , Tramadol/uso terapéutico
11.
Life Sci ; 242: 117212, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31884092

RESUMEN

AIMS: Oxidative stress is an important risk factor in development and progression of type 2 diabetes. Resveratrol (RSV), as a natural antioxidant, reduces intracellular reactive oxygen species (ROS) and oxidative stress. MATERIALS AND METHODS: The study investigated the effects of RSV treatment on high-fat diet (HFD)-fed mice and muscle, adipose, and hepatic cells of insulin resistance. HFD-fed mice were treated with RSV for 10 weeks. Blood glucose, plasma triglyceride (TG), body weight and glucose-lipid metabolism of skeletal muscle, fat and liver were examined. We further assessed the metabolic regulation of RSV in C2C12 myotubes, 3T3-L1 adipocytes and HepG2 cells of insulin resistance. KEY FINDINGS: We found that RSV reduced blood glucose, plasma TG and body weight, ameliorated insulin resistance in HFD-fed mice. RSV reduced lipid accumulation and increased glycogen storage in muscle and hepatic cells, promoted lipolysis in adipocytes. We further found RSV reduced ROS levels in muscle, adipose, and hepatic cells of insulin resistance, contributing to improvement of metabolic abnormalities in HFD-fed mice. SIGNIFICANCE: The study reveals that RSV ameliorates metabolic disorders and insulin resistance in HFD-fed mice, which provides further demonstration in RSV-treated type 2 diabetes.


Asunto(s)
Antioxidantes/farmacología , Dieta Alta en Grasa/efectos adversos , Resistencia a la Insulina , Enfermedades Metabólicas/tratamiento farmacológico , Resveratrol/farmacología , Tejido Adiposo/efectos de los fármacos , Tejido Adiposo/metabolismo , Animales , Glucemia/análisis , Células Hep G2/efectos de los fármacos , Humanos , Metabolismo de los Lípidos/efectos de los fármacos , Hígado/efectos de los fármacos , Hígado/metabolismo , Masculino , Enfermedades Metabólicas/etiología , Ratones , Ratones Endogámicos C57BL , Músculo Esquelético/efectos de los fármacos , Músculo Esquelético/metabolismo , Estrés Oxidativo/efectos de los fármacos , Triglicéridos/sangre
12.
Cell Physiol Biochem ; 53(6): 982-998, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31829530

RESUMEN

BACKGROUND/AIMS: Diabetic cardiomyopathy (DCM) is characterized by structural and functional alterations that can lead to heart failure. Several mechanisms are known to be involved in the pathogenesis of DCM, however, the molecular mechanism that links inflammation to DCM is incompletely understood. To learn about this mechanism, we investigated the role of inflammatory serine proteases (ISPs) during the development of DCM. METHODS: Eight weeks old mice with deletion of dipeptidyl peptidase I (DPPI), an enzyme involved in the maturation of major ISPs, and wild type (WT) mice controls were injected with streptozotocin (50 mg/kg for 5 days intraperitoneally) and studied after 4, 8, 16, and 20 week after induction of type 1 diabetes mellitus (T1DM). Induction of diabetes was followed by echocardiographic measurements, glycemic and hemoglobulin A1c profiling, immunoblot, qPCR, enzyme activity assays, and immunohistochemistry (IHC) analysis of DPPI, ISPs, and inflammatory markers. Fibrosis was determined from left ventricular heart by Serius Red staining and qPCR. Apoptosis was determined by TUNEL assay and immunoblot analysis. RESULTS: In the diabetic WT mice, DPPI expression increased along with ISP activation, and DPPI accumulated abundantly in the left ventricle mainly from infiltrating neutrophils. In diabetic DPPI-knockout (DPPI-KO) mice, significantly decreased activation of ISPs, myocyte apoptosis, fibrosis, and cardiac function was improved compared to diabetic WT mice. In addition, DPPI-KO mice showed a decrease in overall inflammatory status mediated by diabetes induction which was manifested by decreased production of pro-inflammatory cytokines like TNF-α, IL-1ß and IL-6. CONCLUSION: This study elucidates a novel role of ISPs in potentiating the immunological responses that lead to the pathogenesis of DCM in T1DM. To the best of our knowledge, this is the first study to report that DPPI expression and activation promotes the inflammation that enhances myocyte apoptosis and contributes to the adverse cardiac remodeling that subsequently leads to DCM.


Asunto(s)
Catepsina C/metabolismo , Cardiomiopatías Diabéticas/patología , Serina Proteasas/metabolismo , Animales , Apoptosis , Glucemia/análisis , Catepsina C/genética , Diabetes Mellitus Experimental/inducido químicamente , Diabetes Mellitus Experimental/complicaciones , Diabetes Mellitus Experimental/patología , Cardiomiopatías Diabéticas/etiología , Regulación hacia Abajo , Fibrosis , Corazón/fisiología , Ventrículos Cardíacos/metabolismo , Interleucina-1beta/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Neutrófilos/citología , Neutrófilos/inmunología , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Proteína X Asociada a bcl-2/metabolismo
14.
Medicine (Baltimore) ; 98(50): e18346, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852132

RESUMEN

BACKGROUND: Type 2 diabetes (T2D) is a significant health concern worldwide, and good glycemic control is the basis of avoiding disease progression. Herbal tea, as a convenient and effective medication method, has gained popularity among many diabetic patients. However, there are no systematic reviews or meta-analyses to evaluate the clinical efficacy of herbal tea on T2D. METHODS: Four English electronic databases and 4 Chinese electronic databases were searched for randomized controlled trials (RCTs) meeting inclusion criteria; Clinical trials were searched to explore the relevant unpublished data. Fasting blood glucose and glycated hemoglobin will be measured as primary outcomes. Secondary outcomes include 2-hour postprandial blood glucose, fasting insulin, and homeostasis model assessment-insulin resistance. The heterogeneity of data will be investigated by Chi-square and I test; subgroup analysis and sensitivity analysis will be conducted to explore the sources of heterogeneity; funnel plot will be used to evaluate publication bias; finally, we will use grading of recommendations assessment, development, and evaluate system method to evaluate the quality of evidence. Merging analysis of data will be performed using Rev Man 5.3 software. RESULTS: The results will be published in a peer-reviewed journal. CONCLUSIONS: The systematic review will confirm whether herbal tea consumption is benefit to the glycemic control in patients with T2D. PROSPERO REGISTRATION NUMBER: CRD42019129863.


Asunto(s)
Glucemia/análisis , Diabetes Mellitus Tipo 2/sangre , Índice Glucémico , Tés de Hierbas , Diabetes Mellitus Tipo 2/dietoterapia , Ayuno , Hemoglobina A Glucada/análisis , Humanos , Insulina/sangre , Resistencia a la Insulina , Metaanálisis como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
15.
Medicine (Baltimore) ; 98(51): e18354, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31860991

RESUMEN

Many cancer patients develop diabetes, which may result in reduction of chemotherapy effectiveness and increased infection risk and cardiovascular mortality. Diabetes may also increase the risks of chemotherapy-related toxicity and post-operative mortality, or represent an obstacle to optimal cancer treatment. However, the clinical predictors of diabetes in cancer patients remain largely unknown. Therefore, the aim of our study was to evaluate the risk factors for developing diabetes and construct a nomogram to predict diabetes in cancer patients.We investigated patients from a national sample cohort obtained from the Korea National Health Insurance Service (KNHIS), which included 2% of the Korean population. Patients who had undergone routine medical evaluation by the KNHIS between 2004 and 2008 and been hospitalized due to cancer (ICD-10 codes C00-97) during the past 3 years were included. After excluding patients with type 2 diabetes and missing data, 10,899 patients were enrolled and followed-up until 2013. A total of 7630 (70%) patients were assigned as the training cohort and used to construct the nomogram which was based on a multivariable logistic regression model. The remaining patients (n = 3269) were used as the validation cohort.The incidence rate of diabetes was 12.1 per 1000 person-years over a mean follow-up of 6.6 ±â€Š1.8 years. Significant risk factors for developing diabetes were age, sex, obesity, fasting plasma glucose, hypertension, and hypercholesterolmia. A nomogram was constructed using these variables and internally validated. The area under the curve was 0.70 (95% confidence interval, .666-.730, P < .0001) and the calibration plot showed agreement between the actual and nomogram-predicted diabetes probabilities.The nomogram developed in this study is easy to use and convenient for identifying cancer patients at high-risk for type 2 diabetes, enabling early type 2 diabetes screening and management.


Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Neoplasias/epidemiología , Medición de Riesgo , Factores de Edad , Anciano , Glucemia/análisis , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Incidencia , Masculino , Nomogramas , Obesidad/epidemiología , República de Corea/epidemiología , Factores de Riesgo , Distribución por Sexo , Factores Sexuales
16.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(10): 647-653, dic. 2019. tab, graf
Artículo en Inglés | IBECS | ID: ibc-184792

RESUMEN

Introduction: Several sweeteners are introduced to replace sucrose in the human diet. However, they had their own limitations and concerns, particularly in terms of their taste and their long-term health consequences. This study examined the effect of a new mixture of sugars and sugar alcohol on the postprandial blood glucose levels and its possible gastrointestinal (GI) adverse reactions in human adults. Methods: In this double-blind three-way randomized clinical trial, adults (21 with type 2 diabetes and 20 healthy) received 300 ml of three beverages containing 50 g glucose, sucrose, and lacritose (a mixture of lactose, fructose, sucrose, and erythritol) when they were in the fasted state in a random order. Postprandial serum glucose was checked every 30min up to 2 h and the gastrointestinal reactions were collected. Results: The mean serum glucose was significantly lower in all time points after ingestion of the lacritose for participants with type 2 diabetes compared to glucose and sucrose (P < 0.05). The blood glucose levels were significantly lower in the 30th and 60th min for healthy subjects (P < 0.05). Adverse GI reactions were not significant between the test beverages. Conclusions: The ingestion of a 50 g dose of lacritose containing lactose, fructose, sucrose, and erythritol, led to an improved blood glucose levels without any significant adverse effect compared to the same amount of glucose and sucrose. Studying the long-term effects of lacritose on appetite, metabolic markers and adverse reactions is recommended. The trial was registered in Iranian registry of clinical trials: IRCT2015050912571N2


Introducción: Se han utilizado varios edulcorantes para sustituir a la sacarosa en la dieta humana. Sin embargo, tenían sus propias limitaciones y problemas, sobre todo por su sabor y sus consecuencias a largo plazo para la salud. En este estudio se explora el efecto de una nueva muestra de azúcares y alcohol de azúcar en los niveles de glucemia posprandial y las posibles reacciones adversas digestivas a ella en adultos humanos. Métodos: En este ensayo clínico doble ciego aleatorizado de tres vías, adultos (21 con diabetes tipo 2 y 20 sanos) recibieron 300ml de tres bebidas que contenían 50 g de glucosa, sacarosa y lacritosa (una mezcla de lactosa, fructosa, sacarosa y eritritol) en orden aleatorio en ayunas. Se comprobó la glucose sérica posprandial cada 30 minutos hasta las dos horas y se recogieron las reacciones digestivas. Resultados: Los valores medios de glucosa en suero eran significativamente menores en todos los puntos temporales tras la ingesta de lacritosa que tras la de glucosa y sacarosa en los participantes con diabetes tipo 2 (P < 0,05). Los niveles de glucemia eran significativamente menores a los 30 y 60 minutos en los sujetos sanos (P < 0,05). No había diferencias significativas en las reacciones digestivas adversas entre las bebidas estudiadas. Conclusiones: La ingesta de una dosis de 50 g de lacritosa que contiene lactosa, fructosa, sacarosa y eritritol, mejoró los niveles de glucemia sin efectos adversos importantes comparada con la misma cantidad de glucosa y sacarosa. Se recomienda estudiar los efectos a largo plazo de la lacritosa en el apetito, los marcadores metabólicos y las reacciones adversas. El ensayo se inscribió en el registro de ensayos clínicos de Irán: IRCT2015050912571N2


Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Glucemia/análisis , Sacarosa/sangre , Hiperglucemia/sangre , Hiperglucemia/inducido químicamente , Alcoholes del Azúcar/análisis , Sacarosa/efectos adversos , Índice Glucémico , Hiperglucemia/complicaciones , Método Doble Ciego , Alcoholes del Azúcar/efectos adversos , Alcoholes del Azúcar/sangre , Antropometría
17.
Zhonghua Fu Chan Ke Za Zhi ; 54(11): 741-746, 2019 Nov 25.
Artículo en Chino | MEDLINE | ID: mdl-31752456

RESUMEN

Objective: To explore the characteristics of maternal glucose and lipid metabolism in twin pregnancies complicated by gestational diabetes mellitus (GDM). Methods: The clinical features of twin and singleton pregnancies complicated by GDM, which delivered in Peking University First Hospital from January 1st, 2012 to December 31st, 2017 were retrospectively analyzed. A total of 286 twin pregnancies with GDM (GDM-T group) were collected, and 572 singleton pregnancies complicated by GDM (GDM-S group) which were matched by delivery time in a ratio of 1∶2 among all singleton pregnancies with GDM. The characteristics of maternal glucolipid metabolism in the second trimesters of pregnancy was compared between two groups. Results: (1) Compared with GDM-S group, the maternal delivery age were lower [(32±4), (33±4) years] and prepregnancy body mass index (BMI) were higher [(24±4), (23±4) kg/m(2)] in GDM-T group, the differences were statistically significant (all P<0.05). The incidence of chronic hypertension was found no significant difference (P=0.581). (2) The 3 points of glucose values in 75 g oral glucose tolerance test (OGTT) and OGTT-area under curve (AUC) had no significant difference between GDM-T and GDM-S group.When compared with GDM-S group, the maternal glycosylated hemoglobin levels [(5.41±0.35)%, (5.32±0.28)%], the insulin resistance index (4.07±0.77, 2.63±1.50) and the proportion of insulin use (7.7%, 4.4%) were all significantly higher in GDM-T group (all P<0.05). The values of triglyceride [(3.4±1.4), (2.6±1.2) mmol/L], total cholesterol [(6.3±1.1), (6.0±1.0) mmol/L], low density lipoprotein cholesterol [(3.3±0.9), (3.1±0.8) mmol/L] were significantly higher and values of high density lipoprotein cholesterol [(1.7±0.4), (2.0±0.5) mmol/L] were significantly lower in GDM-T group than GDM-S group (all P<0.05). (3) There was no significant difference in the incidence of gestational hypertension between the two groups (P>0.05). When compared with GDM-S group, the incidences of preeclampsia and small for gestational age were both significantly higher (13.3% vs 2.4%; 28.7% vs 1.7%) and the incidence of large for gestational age was significantly lower in GDM-T group (4.5% vs 15.2%; all P<0.05). Conclusions: The insulin resistance is aggravated in twin pregnancies and the characteristics of lipid metabolism are different between singleton and twin pregnant women complicated by GDM, and there are more complications in twin GDM pregnancies.


Asunto(s)
Diabetes Gestacional/etiología , Hipertensión Inducida en el Embarazo/etiología , Embarazo Gemelar , Glucemia/análisis , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Embarazo , Estudios Retrospectivos
18.
Vet Parasitol ; 276: 108964, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31698093

RESUMEN

Parasites induce behavioral changes in the host and obesity is a health problem affecting different animal species. Cysticercosis caused by Taenia pisiformis affects some behavior of rabbits and reproductive behavior of does. Rabbits do not escape from metabolic disorders, being long-live animals useful in breeding, research and companion animals. Here, we addressed the interaction between parasitosis and obesity, and studied how these conditions or the comorbidity affect behavioral and productive parameters in bucks infected with 3000 T. pisiformis eggs. We found that the chronic infection reduced locomotor activity by 28.5% in obese, 18.5% in infected and 47% in obese-infected group (comorbid). The exploratory activity reduced by 42% in obese, 48% in infected and 68% in comorbid rabbits (P ≤ 0.001). Chinning was not affected by obesity, while infection decreased it by 25%. Behavioral reproductive parameters like response time, the mount latency and number of ejaculates were affected by infection and obesity. Furthermore, obesity seems to increase the parasite load promoting the formation of liver granulomas (16% granulomas compared with normal weight), with a higher number of cysticerci in obese animals (86% more than normal weight). Infection decreases body weight, body mass index and the zoometric index BW/LV in obese and normal weight rabbits. In conclusion, infection with T. pisiformis altered behavioral and productive parameters, and obesity magnifies the impact caused by the infection. Also, obesity leads to major susceptibility to infection with T. pisiformis.


Asunto(s)
Cisticercosis/complicaciones , Obesidad/complicaciones , Animales , Conducta Animal , Glucemia/análisis , Índice de Masa Corporal , Peso Corporal , Cisticercosis/fisiopatología , Conducta Exploratoria , Locomoción , Masculino , Obesidad/fisiopatología , Carga de Parásitos , Conejos , Distribución Aleatoria , Semen , Conducta Sexual Animal
19.
J Photochem Photobiol B ; 201: 111643, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31698218

RESUMEN

Diabetes is a major emerging health consequence across the world which directly associated with the obesity. Contemporary anti-diabetic drugs have numeral limitations, and investigation of herbal remedies for diabetes give novel guide for the expansion of new drugs that can be used as harmonizing to present anti-diabetic allopathic medications. Gold nanoparticles (AuNPs) of 21 nm have been formerly well portrayed in vitro for their capability to intend active uptake in cell. Our present study was dealing with the synthesis of gold nanoparticles by means of Smilax glabra rhizome amend the anti-obesity constraints in high-fat diet by streptozotocin provoked obese diabetes in rat model. Characterization studies like UV -Spectroscopy, XRD analysis, SEM, TEM microscopy, Energy Dispersive X-Ray Spectroscopy, and FT-IR investigation confirms the availability of dimension, shape and size. Biochemical parameters like blood glucose and insulin sufferance and its release, lipid profile, aterogenic & coronary index, liver markers, inflammatory markers, hormones like leptin, resistin, adiponectin indicates the therapeutic effect of gold nanoparticles harvested from Smilax glabra on obese and diabetic rats. Histopathological examinations displayed the disturbed internal structures of obese and diabetic rats liver and heart tissues. Whereas, treatment with gold nanoparticles synthesized from Smilax glabra restored the internal membrane, nuclei and cytoplasm. All these findings confirmed the anti-obesity and anti-diabetic effect of synthesized gold nanoparticles from Smilax glabra.


Asunto(s)
Diabetes Mellitus Experimental/patología , Dieta Alta en Grasa , Oro/química , Nanopartículas del Metal/química , Smilax/química , Animales , Glucemia/análisis , Diabetes Mellitus Experimental/inducido químicamente , Diabetes Mellitus Experimental/tratamiento farmacológico , Corazón/efectos de los fármacos , Hígado/efectos de los fármacos , Hígado/metabolismo , Hígado/patología , Masculino , Nanopartículas del Metal/uso terapéutico , Nanopartículas del Metal/toxicidad , Miocardio/metabolismo , Miocardio/patología , Extractos Vegetales/química , Ratas , Ratas Wistar , Rizoma/química , Rizoma/metabolismo , Smilax/metabolismo , Estreptozocina/toxicidad
20.
BMJ ; 367: l5887, 2019 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-31690574

RESUMEN

Diabetes is a major and costly health concern worldwide, with high morbidity, disability, mortality, and impaired quality of life. The vast majority of people living with diabetes have type 2 diabetes. Historically, the main strategy to reduce complications of type 2 diabetes has been intensive glycemic control. However, the body of evidence shows no meaningful benefit of intensive (compared with moderate) glycemic control for microvascular and macrovascular outcomes important to patients, with the exception of reduced rates of non-fatal myocardial infarction. Intensive glycemic control does, however, increase the risk of severe hypoglycemia and incurs additional burden by way of polypharmacy, side effects, and cost. Additionally, data from cardiovascular outcomes trials showed that cardiovascular, kidney, and mortality outcomes may be improved with use of specific classes of glucose lowering drugs largely independently of their glycemic effects. Therefore, delivering evidence based, patient centered care to people with type 2 diabetes requires a paradigm shift and departure from the predominantly glucocentric view of diabetes management. Instead of prioritizing intensive glycemic control, the focus needs to be on ensuring access to adequate diabetes care, aligning glycemic targets to patients' goals and situations, minimizing short term and long term complications, reducing the burden of treatment, and improving quality of life.


Asunto(s)
Complicaciones de la Diabetes/prevención & control , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Hipoglucemia/epidemiología , Hipoglucemiantes/administración & dosificación , Calidad de Vida , Glucemia/análisis , Glucemia/efectos de los fármacos , Complicaciones de la Diabetes/sangre , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Medicina Basada en la Evidencia/métodos , Medicina Basada en la Evidencia/normas , Humanos , Hiperglucemia/sangre , Hiperglucemia/tratamiento farmacológico , Hipoglucemia/inducido químicamente , Hipoglucemiantes/efectos adversos , Incidencia , Metaanálisis como Asunto , Atención Dirigida al Paciente/métodos , Atención Dirigida al Paciente/normas , Guías de Práctica Clínica como Asunto , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
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