Effect of high doses of vitamin D on arterial properties, adiponectin, leptin and glucose homeostasis in type 2 diabetic patients.

BACKGROUND & AIMS: Vitamin D supplementation has the potential to alleviate the cardiovascular damage in diabetic patients. The present study was designed to evaluate long term impact of high doses of vitamin D on arterial properties, glucose homeostasis, adiponectin and leptin in patients with type 2 diabetes mellitus. METHODS AND RESULTS: In randomized, placebo-controlled study 47 diabetic patients were assigned into two groups: Group 1 received oral daily supplementation with vitamin D at a dose of 1000 U/day for 12 months. Group 2 received matching placebo capsules. Blood sampling for metabolic parameters, including fasting glucose, lipid profile, HbA1C, insulin, hs-CRP, 25 OH Vit D, adiponectin and leptin was performed at baseline and at the end of the study. Insulin resistance was assessed by homeostasis model assessment (HOMA-IR). Central aortic augmentation index (AI) was evaluated using SphygmoCor. RESULTS: The two groups were similar at baseline in terms of hemodynamic parameters. After 12 months, AI decreased significantly during the treatment period in patients received vitamin D (p < 0.0001) and did not change in placebo group. Glucose homeostasis parameters, leptin as well as leptin adiponectin ratio did not change in both groups. 25 OH Vit D level significantly increased (p = 0.022) and circulating adiponectin marginally increased (p = 0.065) during 12 month treatment period in active treatment and did not change in placebo group. CONCLUSIONS: High doses of vitamin D supplementation in diabetic patients was associated with significant decrease in AI during one year treatment. This beneficial vascular effect was not associated with improvement in glucose homeostasis parameters.

Does adiponectin level explain the atherogenic properties of Hp 2-2 phenotype in type 2 diabetic patients?

OBJECTIVES: Haptoglobin (Hb) and adiponectin are antioxidant proteins and independent predictors of atherosclerotic vascular disease in diabetic patients. The link between Hp phenotype and circulating adiponectin levels were examined. METHODS: Diabetic patients were divided into two groups by Hp phenotype: Hp 2-2 group and non-Hp 2-2 group (Hp 2-1 and Hp 1-1). Blood glucose, HbA1C, insulin, lipids, CRP, HOMA-IR, 25OH vitamin D, leptin and adiponectin levels were measured. Pulse wave velocity (PWV) was performed using SphygmoCor (version 7.1, AtCor Medical, Sydney, Australia). RESULTS: PWV was significantly higher in patients homozygous for the 2 allele (Hp 2-2) compared to non-Hp 2-2 patients (Hp 1-1 and Hp 1-2), p < 0.0001. Adiponectin was significantly lower in Hp 2-2 patients than in non-Hp 2-2 group (p < 0.016). Neither leptin nor the leptin adiponectin ratio (LAR) differed significantly between groups. CONCLUSIONS: PWV was significantly higher and plasma adiponectin levels were significantly lower in diabetic patients homozygous for the 2 allele (Hp 2-2). These differences were detected despite the lack of by-phenotype differences in glycemic control, blood pressure level or presence of cardiovascular risk factor and suggest an active role of adiponectin in the pathophysiology of vascular disease in this population.

Treatment of rhinophyma with Er:YAG laser.

BACKGROUND AND OBJECTIVE: Rhinophyma is a benign, disfiguring disorder of the nose which presents the end stage of acne rosacea, and can also occasionally result in nasal airway obstruction. We describe the first series of patients treated with Erbium laser. STUDY DESIGN/MATERIALS AND METHODS: Severe-to-moderate rhinophyma in six patients were treated at our institution between 1995 and 1996, using the Erbium:YAG (Erb:YAG) laser. RESULTS: All patients achieved marked cosmetic improvement, with no complications. Post-operative healing time was seven to fourteen days-significantly shorter than similar other modalities. CONCLUSIONS: The Erbium laser provides very accurate tissue ablation and allows the sculpturing of the hypertrophied areas, offering good cosmetic results, with a very short healing period as shown in our study.

Breast augmentation with fresh-frozen homologous fat grafts.

The purpose of this report is to present a patient who underwent breast augmentation with fresh-frozen fat homografts in Russia 10 years ago, despite the publication of major complications following this procedure.