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1.
Mymensingh Med J ; 29(1): 209-214, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915360

RESUMO

Most of the mortalities among Diabetic Nephropathy patients are cardiovascular, if we identify the risk factor, measures can be taken to prevent it. Hence an objective was set to evaluate the association between carotid artery intima media thickness (CIMT) with eGFR in patients of CKD stage III, IV and V among patients with type 2 diabetes mellitus; also, correlation with age, BMI, lipid profile. This cross-sectional, observational study was performed in 70 patients in different stages of CKD in Diabetic Patients selected by Inclusion Criteria (Diabetic nephropathy patients with stages III, IV, V and exclusion Criteria (Acute kidney injury, History of carotid surgery, Patients of MI and stroke). This study was performed in Department of Nephrology, Dhaka Medical College in collaboration with the Department of Radiology and Imaging, laboratory of Department of Biochemistry and Department of Microbiology at Dhaka Medical College Hospital (By standard method in laboratory) from 1st January 2016 to 31st December 2016. eGFR was measured by MDRD formula and the CIMT was measured using an ultrasonographic examination. The mean CIMT was 0.9±0.21mm, and 62.9% of the subjects showed IMT thickening (≥1mm). The carotid IMT elevated significantly with the stage progression of CKD (Overall eGFR mean 28.8±14.5mL/min/1.73m² in CIMT<1mm with range from 6 to 54 and 9.1±9.0mL/min/1.73m² in CIMT ≥1mm with range from 3 to 32 (p=0.001). The eGFR was significantly lower in the patients with CIMT thickening than those without CIMT thickening. eGFR was also significantly associated with CKD stages (p=0.001), serum creatinine (p=0.001), BMI (r = -0.330, p=0.005), and negatively associated with age group, duration of hypertension, smoking. However, the CIMT was not significantly different among the patients at different stages of diabetic nephropathy (r = -0.172, p=156) and age group. It has been concluded that the mean CIMT was markedly high in patients with CKD compared to normal expected value. This study showed a relationship between the CIMT and the renal parameters as eGFR and the stages of diabetic nephropathy with a confirm association between the CIMT and diabetic macroangiopathy.


Assuntos
Artérias Carótidas/patologia , Espessura Intima-Media Carotídea , Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Mellitus/patologia , Rim/fisiopatologia , Insuficiência Renal Crônica/fisiopatologia , Bangladesh/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Taxa de Filtração Glomerular , Humanos , Insuficiência Renal Crônica/epidemiologia
2.
Life Sci ; 240: 117138, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31809715

RESUMO

Pyroptosis is a form of cell death mediated by gasdermin D (GSDMD); it is characterised by NLRP3 inflammasome activation, caspase activation, cell membrane pore formation, and the release of interleukin-1ß and interleukin-18. NLRP3 inflammasome activation plays a central role in pyroptosis. Recent research has suggested that NLRP3 inflammasome activation may be involved in the occurrence and development of diabetes mellitus and its associated complications. This finding provided the impetus for us to clarify the significance of pyroptosis in diabetes. In this review, we summarise the current understanding of the molecular mechanisms involved in pyroptosis, as well as recent advances in the role of NLRP3 inflammasome activation and pyroptosis in the development of diabetes and diabetic complications.


Assuntos
Complicações do Diabetes/tratamento farmacológico , Complicações do Diabetes/genética , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/genética , Inflamassomos/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Piroptose/genética , Animais , Complicações do Diabetes/patologia , Diabetes Mellitus/patologia , Humanos , Inflamassomos/efeitos dos fármacos , Piroptose/efeitos dos fármacos
3.
Nat Med ; 25(11): 1667-1679, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31700182

RESUMO

Increases in the prevalence of noncommunicable diseases (NCDs), particularly cardiometabolic diseases such as cardiovascular disease, stroke and diabetes, and their major risk factors have not been uniform across settings: for example, cardiovascular disease mortality has declined over recent decades in high-income countries but increased in low- and middle-income countries (LMICs). The factors contributing to this rise are varied and are influenced by environmental, social, political and commercial determinants of health, among other factors. This Review focuses on understanding the rise of cardiometabolic diseases in LMICs, with particular emphasis on obesity and its drivers, together with broader environmental and macro determinants of health, as well as LMIC-based responses to counteract cardiometabolic diseases.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Doenças Metabólicas/epidemiologia , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Países em Desenvolvimento , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Política de Saúde , Humanos , Doenças Metabólicas/metabolismo , Doenças Metabólicas/patologia , Fatores de Risco
4.
Int J Mol Sci ; 20(18)2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31505737

RESUMO

Hyperglycemia is the major characteristic of diabetes mellitus, and a chronically high glucose (HG) level causes ß-cell glucolipotoxicity, which is characterized by lipid accumulation, impaired ß-cell function, and apoptosis. TXNIP (Thioredoxin-interacting protein) is a key mediator of diabetic ß-cell apoptosis and dysfunction in diabetes, and thus, its regulation represents a therapeutic target. Recent studies have reported that p90RSK is implicated in the pathogenesis of diabetic cardiomyopathy and nephropathy. In this study, we used FMK (a p90RSK inhibitor) to determine whether inhibition of p90RSK protects ß-cells from chronic HG-induced TXNIP expression and to investigate the molecular mechanisms underlying the effect of FMK on its expression. In INS-1 pancreatic ß-cells, HG-induced ß-cell dysfunction, apoptosis, and ROS generation were significantly diminished by FMK. In contrast BI-D1870 (another p90RSK inhibitor) did not attenuate HG-induced TXNIP promoter activity or TXNIP expression. In addition, HG-induced nuclear translocation of ChREBP and its transcriptional target molecules were found to be regulated by FMK. These results demonstrate that HG-induced pancreatic ß-cell dysfunction resulting in HG conditions is associated with TXNIP expression, and that FMK is responsible for HG-stimulated TXNIP gene expression by inactivating the regulation of ChREBP in pancreatic ß-cells. Taken together, these findings suggest FMK may protect against HG-induced ß-cell dysfunction and TXNIP expression by ChREBP regulation in pancreatic ß-cells, and that FMK is a potential therapeutic reagent for the drug development of diabetes and its complications.


Assuntos
Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/metabolismo , Proteínas de Ciclo Celular/biossíntese , Regulação da Expressão Gênica/efeitos dos fármacos , Glucose/farmacologia , Células Secretoras de Insulina/metabolismo , Inibidores de Proteínas Quinases/farmacologia , Proteínas Quinases S6 Ribossômicas 90-kDa/antagonistas & inibidores , Animais , Linhagem Celular Tumoral , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Células Secretoras de Insulina/patologia , Ratos , Proteínas Quinases S6 Ribossômicas 90-kDa/metabolismo
5.
Int J Mol Sci ; 20(18)2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31491943

RESUMO

PURPOSE: Cataracts in patients with diabetes mellitus (DM) are a major cause of blindness in developed and developing countries. This study aims to examine whether the generation of reactive oxygen species (ROS) via the increased expression of glucose transporters (GLUTs) and the receptor for advanced glycation end products (RAGE) influences the cataract development in DM. METHODS: Lens epithelial cells (LECs) were isolated during cataract surgery from patients without DM or with DM, but without diabetic retinopathy. In a rat model, fructose (10% fructose, 8 or 12 weeks) with or without dapagliflozin (1.2 mg/day, 2 weeks) treatment did induce DM, as verified by blood pressure and serum parameter measurements. Immunofluorescence stainings and immunoblottings were used to quantify the protein levels. Endogenous O2˙¯ production in the LECs was determined in vivo with dihydroethidium stainings. RESULTS: We investigated that GLUT levels in LECs differed significantly, thus leading to the direct enhancement of RAGE-associated superoxide generation in DM patients with cataracts. Superoxide production was significantly higher in LECs from rats with fructose-induced type 2 DM, whereas treatment with the sodium-glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin prevented this effect in fructose-fed rats. Protein expression levels of the sodium/glucose cotransporter 2 (SGLT2), GLUT1, GLUT5, the nicotinamide adenine dinucleotide phosphate reduced form (NADPH) oxidase subunit p67-phox, NOX2/4 and RAGE were upregulated in fructose-fed animals, whereas dapagliflozin treatment reversed these effects. CONCLUSIONS: In rats with fructose-induced DM, dapagliflozin downregulates RAGE-induced NADPH oxidase expression in LECs via the inactivation of GLUTs and a reduction in ROS generation. These novel findings suggest that the SGLT2 inhibitor dapagliflozin may be a candidate for the pharmacological prevention of cataracts in patients with DM.


Assuntos
Cristalino/citologia , Cristalino/metabolismo , NADPH Oxidases/genética , Estresse Oxidativo/genética , Transportador 2 de Glucose-Sódio/genética , Idoso , Animais , Diabetes Mellitus/etiologia , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Modelos Animais de Doenças , Feminino , Frutose/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , NADPH Oxidases/metabolismo , Ratos , Espécies Reativas de Oxigênio/metabolismo , Transportador 2 de Glucose-Sódio/metabolismo
6.
Acta méd. costarric ; 61(3): 111-118, jul.-sep. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1019302

RESUMO

Resumen Objetivo : El objetivo del estudio fue analizar el consumo de azúcares añadidos por la población urbana costarricense y los factores asociados a este. Método: Estudio transversal donde se analizan los datos de 798 participantes del Estudio ELANS-Costa Rica, que constituyen una muestra representativa de la población urbana costarricense, (con edades entre 15 y 65 años). Para conocer el consumo de azúcares añadidos, se realizan dos recordatorios de 24 horas, en días no consecutivos. Se recolectan variables sociodemográficas, cantidad, lugar y momento del consumo. Resultados: El consumo de azúcares añadidos representa el 14,7% de la energía consumida por la población urbana costarricense, siendo este porcentaje mayor en las mujeres y en las personas más jóvenes. La mayor cantidad de azúcares añadidos se consume en el hogar y durante las meriendas. Las bebidas azucaradas constituyen la principal fuente de azúcares añadidos en la dieta costarricense, y las bebidas gaseosas son la fuente más importante en el quintil de mayor consumo. Conclusión: La ingesta de energía obtenida de los azúcares añadidos supera la recomendación máxima establecida por la Organización Mundial de la Salud, por lo tanto, es necesario establecer políticas públicas dirigidas a reducir su consumo y a la modificación de conductas asociadas a la preparación e ingesta de alimentos fuente de azúcares añadidos.


Abstract Aim: High consumption of added sugars has been associated with a greater risk of chronic diseases, appearance of caries and weight gain, which implies a lower quality of life for the population and an increase in costs for the health system. The aim of this study was to evaluate the intake of added sugar and its related factors in urban Costa Rican population. Methods : This was a cross-sectional study conducted in a representative sample of the Costa Rican urban population (798 participants aged between 15 and 65 years). To determine the consumption of added sugars, two 24 hours recalls were conducted, in non-consecutive days. Sociodemographic variables, quantity of food consumed, place and time of consumption were collected. Results: The consumption of added sugars represents 14.7% of total energy intake for the Costa Rican urban population. This consumption is higher among women and younger people. The greater amount of added sugars was consumed in the home and during snacks. Sugar-sweetened beverages were the main source of this added sugar in the Costa Rican diet and soft drinks were the most important source in the highest consumption quintile. Conclusions: The intake of energy obtained from the added sugars exceeds the máximum recommendation established by the World Health Organization, therefore it is necessary to establish public policies aimed at reducing consumption and modifying behaviors associated with the preparation and intake of food source of added sugars.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Bebidas Gaseificadas/efeitos adversos , Diabetes Mellitus/patologia , Açúcares/análise , Açúcares da Dieta/administração & dosagem , Obesidade/diagnóstico , Costa Rica
7.
Acta Diabetol ; 56(12): 1275-1282, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31401734

RESUMO

AIMS: To investigate the association between progressive macular ganglion cell/inner plexiform layer (mGCIPL) thinning and change of optical coherence tomography angiography (OCTA)-derived microvascular parameters in early-stage diabetic retinopathy (DR). METHODS: A retrospective cohort study involved 40 eyes presenting with no DR or mild non-proliferative DR at baseline, and 30 healthy controls were included. All participants underwent spectral-domain OCT and OCTA at baseline and at 6, 12, 18, and 24 months. Change of mGCIPL thickness and OCTA metrics including foveal avascular zone (FAZ) area and FAZ circularity, vessel density (VD), and perfusion index (PI) was measured. Correlations between mGCIPL thickness and OCTA metrics were explored using regression models. RESULTS: Average progressive mGCIPL loss was 0.45 µm per year. Three microvascular parameters were significantly impaired at 24 months compared to baseline (FAZ area: 0.34-0.36 mm2, VD: 18.9-18.5/mm, PI: 0.35-0.34). A strong positive correlation was found between loss of mGCIPL and VD from baseline to 24 months (r = 0.817, p < 0.001). Multivariable regression analysis showed that thinner baseline mGCIPL and greater loss of mGCIPL thickness (B = 0.658, p < 0.001) were significantly associated with change of VD. CONCLUSIONS: In the early stage of DR, progressive structural retinal neurodegeneration and parafoveal microvascular change seem to be highly linked. Advanced mGCIPL thinning might precede microvascular impairment in early DR.


Assuntos
Angiopatias Diabéticas/patologia , Neuropatias Diabéticas/patologia , Retinopatia Diabética/patologia , Degeneração Neural/patologia , Neurônios Retinianos/patologia , Vasos Retinianos/diagnóstico por imagem , Idoso , Estudos de Casos e Controles , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/patologia , Angiopatias Diabéticas/diagnóstico , Neuropatias Diabéticas/diagnóstico , Retinopatia Diabética/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/fisiopatologia , Progressão da Doença , Feminino , Angiofluoresceinografia , Humanos , Estudos Longitudinais , Macula Lutea/diagnóstico por imagem , Macula Lutea/patologia , Masculino , Pessoa de Meia-Idade , Degeneração Neural/diagnóstico , Degeneração Neural/etiologia , Retina/diagnóstico por imagem , Retina/patologia , Neurônios Retinianos/ultraestrutura , Vasos Retinianos/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
8.
Int J Nanomedicine ; 14: 5449-5475, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31409998

RESUMO

Purpose: We created and evaluated an enhanced topical delivery system featuring a combination of highly skin-permeable growth factors (GFs), quercetin (QCN), and oxygen; these synergistically accelerated re-epithelialization and granulation tissue formation of/in diabetic wounds by increasing the levels of GFs and antioxidants, and the oxygen partial pressure, at the wound site. Methods: To enhance the therapeutic effects of exogenous administration of GFs for the treatment of diabetic wounds, we prepared highly skin-permeable GF complexes comprised of epidermal growth factor (EGF), insulin-like growth factor-I (IGF-I), platelet-derived growth factor-A (PDGF-A), and basic fibroblast growth factor (bFGF), genetically attached, via the N-termini, to a low-molecular-weight protamine (LMWP) to form LMWP-EGF, LMWP-IGF-I, LMWP-PDGF-A, and LMWP-bFGF, respectively. Furthermore, quercetin (QCN)- and oxygen-carrying 1-bromoperfluorooctane (PFOB)-loaded nanoemulsions (QCN-NE and OXY-PFOB-NE) were developed to improve the topical delivery of QCN and oxygen, respectively. After confirming the enhanced penetration of LMWP-GFs, QCN-NE, and oxygen delivered from OXY-PFOB-NE across human epidermis, we evaluated the effects of combining LMWP-GFs, QCN-NE, and OXY-PFOB-NE on proliferation of keratinocytes and fibroblasts, and the chronic wound closure rate of a diabetic mouse model. Results: The optimal ratios of LMWP-EGF, LMWP-IGF-I, LMWP-PDGF-A, LMWP-bFGF, QCN-NE, and OXY-PFOB-NE were 1, 1, 0.02, 0.02, 0.2, and 60, respectively. Moreover, a Carbopol hydrogel containing LMWP-GFs, QCN-NE, and OXY-PFOB-NE (LMWP-GFs/QCN-NE/OXY-PFOB-NE-GEL) significantly improved scratch-wound recovery of keratinocytes and fibroblasts in vitro compared to that afforded by hydrogels containing each component alone. LMWP-GFs/QCN-NE/OXY-PFOB-NE-GEL significantly accelerated wound-healing in a diabetic mouse model, decreasing wound size by 54 and 35% compared to the vehicle and LMWP-GFs, respectively. Conclusion: LMWP-GFs/QCN-NE/OXY-PFOB-NE-GEL synergistically accelerated the healing of chronic wounds, exerting both rapid and prolonged effects.


Assuntos
Diabetes Mellitus/patologia , Hidrogéis/química , Fator de Crescimento Insulin-Like I/farmacologia , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Oxigênio/metabolismo , Quercetina/farmacologia , Absorção Cutânea , Cicatrização/efeitos dos fármacos , Animais , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Colágeno/biossíntese , Modelos Animais de Doenças , Emulsões/química , Fator de Crescimento Epidérmico/farmacologia , Epiderme/efeitos dos fármacos , Fator 2 de Crescimento de Fibroblastos/farmacologia , Humanos , Queratinócitos/citologia , Queratinócitos/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Peso Molecular , Nanopartículas/química , Nanopartículas/ultraestrutura , Octanos/química , Fator de Crescimento Derivado de Plaquetas/farmacologia , Protaminas/química , Absorção Cutânea/efeitos dos fármacos
9.
Diabetes Metab Syndr ; 13(4): 2445-2449, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405658

RESUMO

Diabetes mellitus is a chronic metabolic disorder that has a complex molecular and cellular pathophysiology, resulting in its dynamic progression and that may show differing responses to therapy. The incidence of diabetes mellitus increases with age and requires additive therapeutic agents for its management. SGLT2i and DPP-4 inhibitors and GLP-1 receptor agonists (GLP-1RA) are newly introduced antidiabetic drugs that work through differing mechanisms; DPP-4 inhibitors maintain the endogenous level of GLP1; GLP-1RA result in pharmacological levels of GLP1, whilst SGLT2i act on the proximal tubules of the kidney. They have shown efficacy in the management of diabetes and in contrast to other antidiabetic drugs, do not inherently cause hypoglycemia in therapeutic doses. Autophagy as a highly conserved mechanism to maintain cell survival and homeostasis by degradation of damaged or aged organelles and components, and recognised to be increasingly important in diabetes. In the present review, we discuss the modulatory effects of these newly introduced antidiabetic drugs on the autophagy process.


Assuntos
Autofagia , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/patologia , Hipoglicemiantes/uso terapêutico , Humanos , Prognóstico
10.
Diabetes Metab Syndr ; 13(4): 2653-2659, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405690

RESUMO

BACKGROUND: Metabolic syndrome (MS) increases the risk of heart disease, stroke, and other complications. AIM: The aim of this study was to assess the clinical and biochemical parameters of MS and its complications (cerebrovascular accidents, cardiovascular accidents, DN or chronic kidney disease (CKD) compared with healthy controls especially among the younger population in Northern India. MATERIAL AND METHODS: A total of 245 (healthy, MS and it's complicated) aged 18-70 years participated in the Open-Label, Single Centered; hospital-based random selection case-control comparative study. All anthropometric and biochemical assessment was done after proper consent. The metabolic syndrome was determined by IDF criteria. RESULTS: The key risk parameters in three groups i.e. Control, Metabolic syndrome, and Complicated was TG (96.5 ±â€¯46.9, 194.1 ±â€¯87.8, 148.0 ±â€¯102.2). LDL (91.2 ±â€¯27.2, 114.0 ±â€¯31.8, 69.1 ±â€¯42.5, BP (120.1 ±â€¯9.9, 139.3 ±â€¯13.3, 132.1 ±â€¯15.0) and high fasting glucose (81.1 ±â€¯13.7, 164.5 ±â€¯84.3, 138.0 ±â€¯74.5). The hs-CRP is also significantly increased in the complicated group. The subanalysis of data also indicates that younger middle age (36-55 years) group both male and female is obese, hypertensive, diabetic with lipid abnormality according to IDF criteria. CONCLUSION: The risk factors like high TG, low HDL, high BP, and high fasting glucose were found higher particularly in younger population which may lead to diagnosis & complications of diabetes, hypertension and lipid abnormality. Due to changing physiology in young and middle age population these individuals are moving towards metabolic syndrome easily and needs frequent monitoring, preventive checkups, and lifestyle changes to prevent complications.


Assuntos
Biomarcadores/análise , Doenças Cardiovasculares/etiologia , Transtornos Cerebrovasculares/etiologia , Diabetes Mellitus/etiologia , Síndrome Metabólica/complicações , Insuficiência Renal Crônica/etiologia , Adolescente , Adulto , Idoso , Antropometria , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Estudos de Casos e Controles , Transtornos Cerebrovasculares/metabolismo , Transtornos Cerebrovasculares/patologia , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Feminino , Seguimentos , Humanos , Lipídeos/análise , Masculino , Pessoa de Meia-Idade , Prognóstico , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/patologia , Adulto Jovem
11.
Int J Mol Sci ; 20(15)2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31370159

RESUMO

Mesenchymal stem cells (MSCs) are present in all organs and tissues, playing a well-known function in tissue regeneration. However, there is also evidence indicating a broader role of MSCs in tissue homeostasis. In vivo studies have shown MSC paracrine mechanisms displaying proliferative, immunoregulatory, anti-oxidative, or angiogenic activity. In addition, recent studies also demonstrate that depletion and/or dysfunction of MSCs are associated with several systemic diseases, such as lupus, diabetes, psoriasis, and rheumatoid arthritis, as well as with aging and frailty syndrome. In this review, we hypothesize about the role of MSCs as keepers of tissue homeostasis as well as modulators in a variety of inflammatory and degenerative systemic diseases. This scenario opens the possibility for the use of secretome-derived products from MSCs as new therapeutic agents in order to restore tissue homeostasis, instead of the classical paradigm "one disease, one drug".


Assuntos
Anti-Inflamatórios/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Células-Tronco Mesenquimais/efeitos dos fármacos , Psoríase/tratamento farmacológico , Idoso , Envelhecimento/genética , Animais , Artrite Reumatoide/genética , Artrite Reumatoide/metabolismo , Artrite Reumatoide/patologia , Contagem de Células , Diabetes Mellitus/genética , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Modelos Animais de Doenças , Exossomos/efeitos dos fármacos , Exossomos/metabolismo , Idoso Fragilizado , Homeostase/efeitos dos fármacos , Homeostase/genética , Humanos , Lúpus Eritematoso Sistêmico/genética , Lúpus Eritematoso Sistêmico/metabolismo , Lúpus Eritematoso Sistêmico/patologia , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/patologia , Comunicação Parácrina/efeitos dos fármacos , Psoríase/genética , Psoríase/metabolismo , Psoríase/patologia
12.
Environ Sci Pollut Res Int ; 26(30): 31111-31118, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31456145

RESUMO

The present study was conducted to examine the nephrotoxic effects of heavy metals including lead (Pb), manganese (Mn), arsenic (As), and cadmium (Cd) in diabetic and non-diabetic Wistar rats. Animals were exposed to heavy metals for 30 days, Pb was injected as lead acetate (C4H6O4Pb), Mn was injected as manganese chloride (MnCl2), Cd was injected as cadmium chloride (CdCl2), and As was administered orally to rats in the form of sodium arsenite (AsO2Na). Results showed that metal deposition trends in tissues were Pb > As > Cd > Mn and the urinary metal levels were Pb > Cd > As > Mn. Diabetic metal alone, as well as metal mixture-treated groups, showed decreased urinary metal levels as compared with non-diabetic metal alone and metal mixture-treated groups. Both diabetic- and non-diabetic metal mixture-treated groups revealed an increasing trend of blood urea nitrogen (BUN) and serum creatinine. In addition, heavy metal treatments resulted in elevated malondialdehyde (MDA) levels in the kidney tissue while decreased levels of catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione (GHS) were observed in the kidney tissue in comparison with the control group. The histological analysis of the kidney tissues showed tubular degeneration, fibrosis, and vacuolation as a result of heavy metal exposure. The present study revealed that co-exposure of heavy metals (Pb, Cd, Mn, As) induced more nephrotoxicity as compared with the metal alone treatment. Moreover, diabetic Wistar rats are more prone to kidney damage as a result of heavy metal exposure.


Assuntos
Diabetes Mellitus/patologia , Nefropatias/induzido quimicamente , Rim/efeitos dos fármacos , Metais Pesados/toxicidade , Animais , Catalase/metabolismo , Creatinina/metabolismo , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Rim/metabolismo , Rim/patologia , Nefropatias/metabolismo , Nefropatias/patologia , Masculino , Malondialdeído/metabolismo , Metais Pesados/farmacocinética , Ratos Wistar , Superóxido Dismutase/metabolismo , Distribuição Tecidual
13.
Acta Diabetol ; 56(12): 1293-1303, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31468199

RESUMO

AIMS: To evaluate superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) perfusion in macular and near/mid periphery regions in diabetic patients using widefield swept-source optical coherence tomography angiography (WSS-OCTA). METHODS: Ninety-four diabetic patients (94 eyes) classified as diabetics without diabetic retinopathy (no DR) (25 eyes), mild DR (23 eyes), moderate/severe DR (26 eyes), proliferative DR (20 eyes) and a control group of 25 healthy subjects (25 eyes) were imaged with the WSS-OCTA system (PLEX Elite 9000, Carl Zeiss Meditec Inc., Dublin, CA, USA). Quantitative analysis was performed in the macular and peripheral regions. The main outcome measures were perfusion density (PD) and vessel length density of SCP, DCP and CC. RESULTS: Peripheral retina (all sectors) showed lower SCP and DCP PD compared to the macular region (p < 0.001). In diabetics without DR and DR in different stages, SCP and DCP PD significantly decreased at advancing stages of DR (p < 0.001). At DCP level, central PD was significantly directly related to peripheral PD (superior, R = 0.682 and 0.479; temporal, R = 0.918 and 0.554; inferior, R = 0.711). A good sensitivity and an excellent specificity were found in terms of prediction of disease worsening, especially for central and temporal sectors in all plexuses and for all sectors both central and peripheral of DCP. CONCLUSIONS: The widefield OCTA is useful for the study of central and peripheral retina in diabetic patients with or without diabetic retinopathy, assessing good correlation between central and peripheral retina.


Assuntos
Retinopatia Diabética/diagnóstico , Angiofluoresceinografia/métodos , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Capilares/diagnóstico por imagem , Capilares/patologia , Estudos de Casos e Controles , Contagem de Células , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/patologia , Retinopatia Diabética/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Retina/diagnóstico por imagem , Retina/patologia , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/patologia
14.
Sensors (Basel) ; 19(17)2019 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-31450547

RESUMO

Even if still at an early stage of development, non-invasive continuous glucose monitoring (NI-CGM) sensors represent a promising technology for optimizing diabetes therapy. Recent studies showed that the Multisensor provides useful information about glucose dynamics with a mean absolute relative difference (MARD) of 35.4% in a fully prospective setting. Here we propose a method that, exploiting the same Multisensor measurements, but in a retrospective setting, achieves a much better accuracy. Data acquired by the Multisensor during a long-term study are retrospectively processed following a two-step procedure. First, the raw data are transformed to a blood glucose (BG) estimate by a multiple linear regression model. Then, an enhancing module is applied in cascade to the regression model to improve the accuracy of the glucose estimation by retrofitting available BG references through a time-varying linear model. MARD between the retrospectively reconstructed BG time-series and reference values is 20%. Here, 94% of values fall in zone A or B of the Clarke Error Grid. The proposed algorithm achieved a level of accuracy that could make this device a potential complementary tool for diabetes management and also for guiding prediabetic or nondiabetic users through life-style changes.


Assuntos
Técnicas Biossensoriais , Automonitorização da Glicemia/métodos , Glicemia/isolamento & purificação , Diabetes Mellitus/sangue , Algoritmos , Diabetes Mellitus/patologia , Humanos , Estudos Longitudinais , Estudos Retrospectivos
15.
Clin Biochem ; 73: 77-81, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31386833

RESUMO

OBJECTIVES: HbA1c shows low in patients with hemolysis, whereas glycated albumin (GA) is not affected by hemolysis. Therefore, the GA/HbA1c ratio reflects hemolysis in diabetic patients with hemolysis. Erythrocyte creatine (EC) is an indicator of hemolysis that reflects the mean erythrocyte age. The aim of this study was to examine whether HbA1c adjusted by EC accurately reflected glycemic control in patients with hemolysis. MATERIALS AND METHODS: A total of 238 individuals, consisting of 131 diabetic patients and 107 non-diabetic subjects, and consisting of 42 patients with hemolysis, and 196 subjects without hemolysis were selected for the study. HbA1c expressed in the IFCC units (iA1c) as well as in the NGSP units (A1C) were used. From the fact that EC and the GA/iA1c ratio showed a significant positive correlation, a formula for iA1c adjusted by EC (ECadj-iA1c) was created from a regression equation between EC and the GA/iA1c ratio. RESULTS: Significant correlations were observed between the GA/iA1c ratio and various hemolytic indicators but not between the GA/ECadj-iA1c ratio and those hemolytic indicators. The GA/iA1c ratio in individuals with hemolysis was significantly higher than in individuals without hemolysis, while no significant differences were observed in the GA/ECadj-iA1c ratio between the groups. Further, iA1c concentrations in non-diabetic patients with hemolysis were significantly lower than in the non-diabetic subjects without hemolysis, whereas ECadj-iA1c and GA concentrations showed no significant difference between the two groups. CONCLUSIONS: These results suggested that ECadj-iA1c accurately reflected glycemic control in patients with hemolysis.


Assuntos
Creatina/sangue , Diabetes Mellitus/sangue , Eritrócitos/metabolismo , Hemoglobina A Glicada/metabolismo , Hemólise , Idoso , Diabetes Mellitus/patologia , Eritrócitos/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Albumina Sérica/metabolismo
16.
Medicina (Kaunas) ; 55(7)2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31323919

RESUMO

Background and objectives: Anwar Ratol is one of the most famous cultivar of mango in South Asia, especially Pakistan. Mango leaves are left as food waste. This study evaluated the potential of mango (Anwar Ratol) leaves for their use against diabetes mellitus. Material and Methods: In this study, hydro-alcoholic extract of the plant leaves was prepared and evaluated by electrospray ionization mass spectroscopy (ESI-MS) and high-performance liquid chromatography (HPLC) for the presence of phytochemicals. The plant extract was administered to Alloxan induced diabetic mice followed by evaluation through oral glucose tolerance test; determination of postprandial glucose, body weight, lipid profile and histopathological evaluation of pancreas. Results: Chemical evaluation revealed the presence of mangiferin, rhamnetin, catechin, epicatechin, iriflophenone 3-C-ß-D-glucoside, gallic acid and other phenolic and flavonoid compounds. The plant extract exhibited a decrease in postprandial blood glucose following seven days therapy in diabetic mice. The extract also prevented the rise in blood glucose level as determined by glucose tolerance test in diabetic mice. Furthermore, therapy of diabetic mice with the extract prevented a decrease in body weight and decline in beta-cell mass associated with alloxan and improved lipid profile. Conclusion: The findings of the study clearly suggested that the leaf extract of the plant might possess anti-diabetic activity possibly due to the presence of mangiferin and other phytochemicals such as phenolic and flavonoid compounds. This study will serve as a basis for the use of mango leaf extract against diabetes. Furthermore, this study will also provide basis for the bioassay-based fractionation and isolation of active principles responsible for the antidiabetic potential of mango leaves.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Hipoglicemiantes/normas , Extratos Vegetais/farmacologia , Análise de Variância , Animais , Glicemia/efeitos dos fármacos , Diabetes Mellitus/patologia , Diabetes Mellitus/fisiopatologia , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/etiologia , Hipoglicemiantes/uso terapêutico , Mangifera , Espectrometria de Massas/instrumentação , Espectrometria de Massas/métodos , Camundongos , Paquistão , Fitoterapia/métodos , Fitoterapia/normas , Extratos Vegetais/uso terapêutico
17.
Diabetes Metab Syndr ; 13(2): 1021-1030, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336438

RESUMO

AIMS: Chronic unpredictable environmental stress (CUES) may induce predisposition to diabetes mellitus. This study investigates the role of CUES on impaired homeostasis. MATERIAL AND METHODS: Stressed group mice (n = 20) were exposed to CUES for 16 weeks. Weekly body weight, feed consumption, feed efficiency ratio, fasting blood glucose were monitored. Plasma HbA1c, plasma cortisol, plasma epinephrine and plasma insulin, serum lipids, antioxidants and carbohydrate metabolizing enzymes activity were assessed along with DNA damage and histopathological examination of liver, kidney, pancreas, spleen and skeletal muscles. RESULTS AND CONCLUSION: s: Fasting blood glucose levels & HbA1c in the stressed were significantly higher compared to control (p < 0.001). Serum lipids were found insignificantly higher in stressed mice compared to control. Body weights of the stressed mice and feed efficiency ratio were found significant (p < 0.001). Plasma corticosterone, plasma epinephrine, HOMA-IR was found to be significantly higher in the stressed group (p < 0.001). Plasma insulin level was found to be significantly lower in the stressed group (p < 0.001). Significant changes were observed in antioxidants level, carbohydrate metabolizing enzymes activity, peripheral tissues and DNA integrity. CUES initiates pathogenesis of diabetes.


Assuntos
Biomarcadores/análise , Diabetes Mellitus/etiologia , Exposição Ambiental/efeitos adversos , Intolerância à Glucose/complicações , Homeostase , Lipídeos/análise , Estresse Fisiológico , Animais , Antioxidantes/metabolismo , Glicemia/análise , Peso Corporal , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Feminino , Insulina/sangue , Camundongos , Fatores de Risco
18.
Diabetes Metab Syndr ; 13(2): 1041-1046, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336441

RESUMO

BACKGROUND: Obesity-related to metabolic syndrome was associated with a greater risk for development of chronic kidney disease (CKD). We aimed to assess the association between obesity and micro/macroalbuminuria in hypertensive patients with a poor estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. METHODS: One hundred old patients (median age 79 years ±â€¯inter-quartile range 68-84.7) with manifested hypertension (systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 85 mmHg) and a permanently poor eGFR for a duration time more than 3 months were enclosed. Albuminuria was defined as urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/gr and it was classified according to KDIGO 2012. The obesity was defined by a high body mass index (BMI>30 kg/m2). The waist circumference, HDL-C, triglycerides and serum glucose were measured. Chi-square tests and an adjusted model were performed. RESULTS: Chi-square tests showed significant association between classified albuminuria and both obesity and high serum triglycerides (x2 = 7.2, p = 0.02 and x2 = 8.3, p = 0.01 respectively). However, the adjusted model for the prediction of albuminuria showed that the presence of a high BMI was a non-significant risk factor, although diabetes mellitus and eGFR value were found to be significant risk factors (p = 0.03, OR = 4.3, 1.2-22.07 and p = 0.04, OR = 0.9, 0.9-1.007 respectively) adjusting to covariates including the high waist circumference. CONCLUSION: Obesity defined by a high BMI was not found to be a significant risk factor for micro/macroalbuminuria in hypertensive patients with a poor estimated glomerular filtration rate, when diabetes mellitus and the low eGFR value act as confounders.


Assuntos
Albuminúria/etiologia , Índice de Massa Corporal , Diabetes Mellitus/etiologia , Taxa de Filtração Glomerular , Hipertensão/complicações , Obesidade/fisiopatologia , Insuficiência Renal Crônica/etiologia , Idoso , Idoso de 80 Anos ou mais , Albuminúria/metabolismo , Albuminúria/patologia , Biomarcadores/análise , Estudos Transversais , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Feminino , Seguimentos , Humanos , Hipertensão/metabolismo , Hipertensão/patologia , Testes de Função Renal , Masculino , Prognóstico , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/patologia , Fatores de Risco , Circunferência da Cintura
19.
Diabetes Metab Syndr ; 13(2): 1405-1412, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336500

RESUMO

BACKGROUND: Psoriasis is an immune-mediated chronic inflammatory skin disease with unknown etiology. Current findings demonstrate that psoriatic patients are at higher risk of other systemic disorders such as diabetes mellitus. The present study was conducted to evaluate the association between psoriasis and diabetes mellitus. METHOD: The current study was conducted based on preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Using MeSH keywords we searched online databases of PubMed, Scopus, Web of Science, Science Direct, Embase, CINAHL, Cochrane Library, EBSCO and Google scholar search engine and the reference list of the retrieved articles until June 2018. Heterogeneity among studies was assessed using Cochran's Q test and I2 index and the random effects model was used to estimate Odds Ratio (OR) and 95% confidence interval (CI). Data were analyzed using Comprehensive Meta-Analysis (CMA) software version 2. RESULTS: Analysis of 38 eligible studies involving 922870 cases and 12808071 controls suggested the estimated OR to be 1.69 (95% Confidence Interval [CI]: 1.51-1.89; P < 0.001). Subgroup analysis was conducted based on study design and country of study and was significant (test for subgroup differences: P = 0.025 and P < 0.001, respectively). CONCLUSIONS: Our study indicated the significant association between psoriasis and diabetes. Therefore, psoriasis is a systemic disorder and other comorbidities should be considered in the management of patients with psoriasis.


Assuntos
Diabetes Mellitus/etiologia , Psoríase/complicações , Diabetes Mellitus/patologia , Humanos , Prognóstico
20.
Diabetes Metab Syndr ; 13(2): 1643-1647, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336535

RESUMO

Trans Fatty acids (TFAs) have long been used in food manufacturing due in part to their melting point at room temperature between saturated and unsaturated fats. However, increasing epidemiologic and biochemical evidence suggests that excessive trans fats in the diet are a significant risk factor for cardiovascular events as well as a risk factor for cancer and diabetes. A 2% absolute increase in energy intake from trans-fat has been associated with a 23% increase in cardiovascular risk. They increase the levels of low-density lipoprotein which is bad for health. Moreover, several epidemiological studies have been demonstrated that a high intake of TFAs increases the incidence of cancer and diabetes. On the other hand, total elimination of TFAs is not possible in a balanced diet due to their natural presence in dairy and meat products. Many products with almost 0.5 g trans-fat, if consumed over the course of a day, may approximate or exceed the 2 g maximum as recommended by the American Heart Association. The objective of the review to demonstrate the causal association between trans fatty acid intake and increase the risk of coronary heart disease through their influence on lipoprotein, association with atherosclerosis, stroke, diabetes and cancer.


Assuntos
Doenças Cardiovasculares/etiologia , Diabetes Mellitus/etiologia , Lipídeos/sangue , Neoplasias/etiologia , Ácidos Graxos Trans/efeitos adversos , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/patologia , Diabetes Mellitus/sangue , Diabetes Mellitus/patologia , Humanos , Neoplasias/sangue , Neoplasias/patologia , Prognóstico
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