Clinical and laboratory features of youth onset type 2 diabetes in Jamaica.

OBJECTIVES: To assess the frequency of youth onset Type 2 diabetes mellitus (T2D) in Jamaica and the characteristics of youth with this form of diabetes. METHODS: Patients from two major referral hospitals, diagnosed with diabetes before age 25 years and < 6 years prior to the study, were evaluated. Classification was based on the presence of GAD-65 and IA-2 diabetes autoantibodies (AB), fasting (FCP) and stimulated C-peptide (SCP) measurements, serum leptin and clinical phenotype as follows: (i) Type IA diabetes--AB+, (ii) Type lB diabetes--AB- and FCP < 230 pmol/l and/or SCP < 660pmol/l, (iii) Type 2 diabetes - AB- and FCP > 500 pmol/L and or SCP 2 1160 pmol/l (iv) Untypeable diabetes--AB- and FCP 230-500 pmol/l and or SCP 660-1160 pmol/l and (v) Lipoatrophic diabetes--clinical phenotype and serum leptin. RESULTS: Fifty-eight participants (21M, 37F, age 20-8 years, duration of diabetes 2.6-2 years) were enrolled in the study. Using the classification criteria, Type 1 diabetes was the most common form of diabetes: 18 (31%) Type 1A, 18 (31%) Type IB. Overall 22% (13 patients) had T2D. Patients with T2D were more likely to be female, older at diagnosis, obese and have a higher blood pressure when compared to those with Type 1 diabetes. In logistic regression analysis, age of diabetes onset, gender BMI, systolic and diastolic blood pressure were significantly associated with T2D. Obesity measured by BMI was the strongest predictor of T2D. CONCLUSIONS: While Type 1 diabetes was the predominant form of diabetes in this study, a significant proportion of Jamaicans with youth onset diabetes may have T2D. Obesity is the strongest clinical predictor of Type 2 diabetes in the young diabetic patient.

Cardiovascular risk profile in Caribbean youth with diabetes mellitus.

OBJECTIVE: To assess the effect of diabetes mellitus type on conventional and novel cardiovascular risk factors in patients, diagnosed with diabetes from two major referral hospitals in Jamaica, before age 25 years and with diabetes duration < 6 years. METHODS: Participants were classified based on the presence of GAD-65 and IA-2 autoantibodies, C-peptide, leptin and clinical phenotype. Trained observers obtained anthropometric measurements and sitting blood pressure. Fasting blood was taken for glucose, A1c, lipids, high sensitivity C-reactive protein and lipoprotein profile. RESULTS: Fifty-eight participants (21M; 37F age 20 +/- 8 [Mean +/- SD] years, diabetes duration 2.6 +/- 2 years) were enrolled. Thirty-six had Type 1 diabetes (T1D), thirteen Type 2 diabetes (T2D), six were not typed and three had lipoatrophic diabetes. Patients with Type 2 diabetes (T2D) were more obese with a higher systolic blood pressure but a lower A1c than those with Type 1 diabetes (T1D). Total cholesterol, LDL-cholesterol, triglycerides, VLDL, LDL and HDL particle numbers were similar in patients with T1D and T2D. HDL-cholesterol and LDL and HDL particle sizes were lower in patients with T2D but differences were no longer significant after adjusting for BMI. CONCLUSIONS: Risk factors for cardiovascular disease are common in patients with all forms of youth onset diabetes. Clinicians should therefore investigate these risk factors in their patients regardless of diabetes type.

Morphology offers no clues to asexual vs. sexual origin of small Acropora cervicornis (Scleractinia: Acroporidae) colonies / La morfología no ofrece pistas sobre el origen asexual o sexual de las colonias pequeñas de Acropora cervicornis (Scleractinia: Acroporidae)

Sexual recruitment of the staghorn coral, Acropora cervicornis, is accepted to be very rare. Instead, these branching corals proliferate through fragmentation leading to dense mono-specific and possibly monoclonal stands. For acroporid corals, which have suffered drastic population declines, dominance of asexual reproduction results in low levels of genotypic diversity and limited ability to re-colonize extirpated areas. Small colonies with a single encrusting, symmetrical base, and few incipient branches are frequently presumed to be the result of a settled planula (i.e. sexual reproduction). Here, we show that colonies fitting this description (i.e., presumed sexual recruits) can result from asexual fragmentation. Acropora cervicornis colonies (~20 cm diameter) were tagged and observed over eighteen months. In several cases, colony offshoots fused with the adjacent substrate forming secondary disc-like attachment points. Following natural fragmentation, these discs of tissue became separated from the original colony, and were observed to heal and give rise to smaller colonies with striking similarity to the expected morphology of a sexual recruit. Thus, presuming a colony is a sexual recruit based on appearance is unreliable and may lead to inflated expectations of genetic diversity among populations. The accurate assessment of recruitment and genetic diversity is crucial to predicting the recovery potential of these imperiled and ecologically irreplaceable reef corals. Rev. Biol. Trop. 54 (Suppl. 3): 145-151. Epub 2007 Jan. 15.

Se ha aceptado que el reclutamiento sexual del coral asta de venado, Acropora cervicornis, es muy raro. Por el contrario, estos corales ramificados proliferan a través de fragmentación, generando densas bases monoespecíficas e incluso monoclonales. Para corales acropóridos, los cuales han sufrido disminuciones de población drásticas, la dominancia de reproducción asexual resulta en bajos niveles de diversidad genotípica y abilidad limitada para recolonizar áreas de donde han sido erradicados. Frecuentemente se presume que las colonias pequeñas con una sola base incrustante simétrica y unas pocas ramas incipientes, son el resultado del asentamiento de una plánula (reproducción sexual). Aquí, nosotros demostramos que algunas colonias que calzan con esta descripción (supuesta reproducción sexual) pueden resultar de fragmentación asexual. Se etiquetaron y observaron colonias de Acropora cervicornis (~20 cm de diámetro) durante 18 meses. En muchos casos, los retoños de la colonia se fusionaron con el sustrato adyacente formando puntos de acoplamiento con forma de disco. Siguiendo con la fragmentación natural, estos discos de tejido se separaron de la colonia original, cicatrizaron y dieron paso a pequeñas colonias con tremenda similitud a la morfología esperada para un recluta sexual. Por lo tanto, asumir que una colonia es un recluta de origen sexual basándose en apariencia es poco fiable y puede generar expectativas infladas de diversidad genética entre poblaciones. La evaluación certera del reclutamiento y la diversidad genética es crucial para predecir la recuperación potencial de estos arrecifes de coral, los cuales están en peligro y son irremplazables.

High salad consumption in association with a reduction in the risk of diabetes mellitus

Few studies have investigated the role of fruit and vegetable consumption in the aetiology of NIDDM. This study was underaken to investigate the association between salad and fruit consumption and glucose intolerance. 1122 subjects aged 40-60 years in a population-based cross-sectional study underwent an oral glucose tolerance test between 1990 amd 1992. Diet was assesses using the "Health and Lifestyle Survey" food frequency questionnaire. The crude prevalence of underdiagnosed diabetes mellitus was 4.5 percent and IGT 16.8 percent. Abnormal glucose tolerance was positively associated with age, obesity, family history of diabetes, and socioeconomic groups. High consumption of salads in winter (OR = 0.29, 95 percent CI=0.09-0.95) and summer (OR=0.40, 95 percent CI=0.22-0.74) was inversely associated with the risk of having NIDDM. This association was maintained after adjustment for age, sex and family history. A non-significant inverse association between high comsumption of fruit and NIDDM (summer OR=0.55, 95 percent CI=0.29-1.06); winter OR=0.56 95 percent CI=0.31-1.01) was observed. Whether the association between high frequency of consumption of salads ad NIDDM represents a causal relationship or if salad comsumption is a marker of a "health lifestyle" remains to be elucidated. (AU)