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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(11): 1445-1449, 2019 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-31838819

RESUMO

Objective: To explore the association of the glycosylated hemoglobin (HbA1c) level at admission with 90 days functional outcome in patients with spontaneous intracerebral hemorrhage (ICH). Methods: Patients admitted to the Department of Neurology, Tongji Hospital from January to December 2017 were prospectively and continuously enrolled in this study. Clinical data were collected at admission and functional outcomes 90 days after ICH were assessed by using the modified RANKIN scale. Univariate and multivariate conditional logistic regression models were constructed. Patients were divided into four groups according to the quartile of HbA1c values. The median value of HbA1c in each group was taken as the substitute value and P for trend was calculated. The logistic regression model was fitted by restricted cubic splines to investigate the association between HbA1c level and outcome of ICH. Results: A total of 345 patients with ICH were enrolled, including 214 with favorable outcomes and 131 with poor outcomes (99 severe disability cases and 32 deaths). The risk of poor 90 days outcomes was significantly associated with HbA1c level at admission indicated by multivariate logistic regression analysis, and the P for trend test was <0.001 (middle-level group vs. low-level group: OR=2.33, 95%CI: 1.07-5.07; high-level group vs. low-level group: OR=2.52, 95%CI: 1.12-5.64; extremely high-level group vs. low-level group: OR=6.80, 95%CI: 3.01-15.34). Results from the restricted cubic spline showed that there was a linear correlation between HbA1c level at admission and poor 90 days outcomes of ICH (χ(2)=14.81, P<0.001; non- linear test: P=0.118). Compared with patients with HbA1c level of 6.5%, the risk of poor outcomes in patients with HbA1c level of <6.5% decreased linearly with the decrease in HbA1c level at admission, and the risk in patients with HbA1c level >6.5% was higher but not significantly. Conclusion: There was correlation between high HbA1c level at admission and 90 days poor outcome of ICH. High HbA1c level is an independent prediction indicator for ICH.


Assuntos
Hemorragia Cerebral/diagnóstico , Diabetes Mellitus/sangue , Hemoglobina A Glicada/metabolismo , Hospitalização/estatística & dados numéricos , Biomarcadores/sangue , Glicemia/metabolismo , Hemorragia Cerebral/mortalidade , Hemorragia Cerebral/fisiopatologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidade , Hemoglobina A Glicada/análise , Humanos , Modelos Logísticos , Resultado do Tratamento
2.
Adv Clin Exp Med ; 28(11): 1571-1575, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31756066

RESUMO

Despite great advances in medicine, the proper treatment of arterial hypertension (AH), diabetes mellitus (DM) and chronic kidney disease (CKD) remains a major challenge. Untreated, undiagnosed AH or DM may lead to the development of CKD and consequently to the occurrence of cardiovascular events. Adropin and irisin are newly discovered proteins which may play a role in the development and progression of the chronic diseases mentioned above. Endothelium dysfunction could be a bonding point. The following review paper focuses on adropin and irisin concentrations and their correlations in AH, DM and CKD. Lower adropin concentrations have been measured in patients with primary AH when compared to healthy volunteers. Irisin has reduced blood pressure on nitric oxide (NO)-dependent pathways in experimental studies; a negative correlation between irisin and blood pressure values has also been observed in preeclamptic women. Irisin also plays a role in insulin sensitivity and metabolic disorders. Lower irisin levels have been observed in patients with DM type 2 in comparison to a nondiabetic control group. It is also lower in the serum of pregnant women with gestational DM. A negative correlation between irisin and estimated glomerular filtration rate (EGFR) has also been noted. Adropin and irisin are newly described myokines measured in human plasma in healthy and disease status. Their exact function has not been specified yet and requires further studies.


Assuntos
Diabetes Mellitus/fisiopatologia , Fibronectinas/sangue , Hipertensão/fisiopatologia , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Peptídeos/sangue , Insuficiência Renal Crônica/fisiopatologia , Biomarcadores/sangue , Proteínas Sanguíneas , Diabetes Mellitus/sangue , Diabetes Mellitus/metabolismo , Fibronectinas/metabolismo , Humanos , Hipertensão/sangue , Hipertensão/metabolismo , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/metabolismo
3.
BMC Infect Dis ; 19(1): 915, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664936

RESUMO

BACKGROUND: A bi-directional interaction between diabetes mellitus and tuberculosis is well established and has been likened to that between HIV and TB. Whereas HIV screening is standard of care test in sub Saharan Africa TB programs, the same is not true for diabetes mellitus (DM). Sub Saharan Africa, a region with high TB infection rates, is going through an epidemiological transition with rapidly rising prevalence of diabetes. We aimed at characterizing TB patients with DM in order to identify factors associated with TB-DM dual disease among patients attending TB clinics in Dar es Salaam. METHODS: A cross-sectional study was conducted between September 2016 and January 2017 among patients attending TB clinics in Dar es Salaam. We collected socio-demographic characteristics, anthropometric measurements and screened for diabetes by measuring fasting blood glucose that was followed by a 2 h postprandial glucose for participants with impaired fasting blood glucose. We examined for socio-demographic and clinical factors associated with diabetes using logistic regression analysis. RESULTS: Of the 660 enrolled participants with TB, 25 (3.8%) were on treatment for diabetes while 39 (6.1%) and 147 (23%) of the remaining 635 participants were ultimately diagnosed with DM and impaired fasting blood glucose respectively. The overall prevalence of DM was 9.7% (64/660). Independent risk factors for diabetes included: age > 44 years {OR 4.52, 95% CI: [1.28-15.89]}; family history of diabetes {OR 3.42, 95% [CI 1.88-6.21]}. HIV sero-positive TB patients were less likely to have DM compared to those who were HIV sero-negative {OR 0.35, 95% CI [0.17-0.73]}. CONCLUSIONS: Screening for diabetes should be advocated for TB patients aged above 44 years and/or with a family history of diabetes. HIV sero-negative TB patients were more likely to have DM compared to those who were HIV sero-positive. Further studies are needed to confirm this observation and the underlying factors.


Assuntos
Diabetes Mellitus/epidemiologia , Programas de Rastreamento , Tuberculose/epidemiologia , Adulto , Glicemia/análise , Estudos Transversais , Diabetes Mellitus/sangue , Feminino , HIV/imunologia , Soropositividade para HIV , Humanos , Modelos Logísticos , Masculino , Anamnese , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Escarro/microbiologia , Inquéritos e Questionários , Tanzânia/epidemiologia , Tuberculose/virologia , Adulto Jovem
4.
Medicine (Baltimore) ; 98(39): e17273, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574841

RESUMO

BACKGROUND: Previous study has reported that Fuyuan Xingnao Decoction (FYXND) can be utilized for the treatment of patients with diabetes mellitus (DM) combined cerebral infarction (CI) effectively. METHODS: We will search from the following databases of MEDLINE, EMBASE, Cochrane Library, PsycINFO, Global Health, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All databases will be searched from the inception to the present without language limitation. Two independent authors will perform literature selection, information collection, and methodological quality assessment. Statistical analysis will be carried out using RevMan 5.3 software. RESULTS: This study will provide accurate results on the effectiveness and safety of FYXND on DM and CI through primary and secondary outcomes. The primary outcome is neurological deficit. The secondary outcomes consist of fasting blood glucose, hemoglobin Alc, fasting insulin, quality of life, and adverse effects. CONCLUSIONS: This well-designed study will establish high quality evidence of the effectiveness and safety of FYXND for DM and CI to facilitate the clinical practice and guideline development.


Assuntos
Infarto Cerebral/tratamento farmacológico , Complicações do Diabetes/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Infarto Cerebral/etiologia , Complicações do Diabetes/sangue , Complicações do Diabetes/complicações , Diabetes Mellitus/sangue , Humanos , Projetos de Pesquisa , Revisão Sistemática como Assunto , Resultado do Tratamento
5.
Transplant Proc ; 51(8): 2527-2532, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31473010

RESUMO

OBJECTIVES: To study the outcome of living kidney donors with prediabetes and to evaluate the utilization of baseline HbA1c to identify donors at high risk for developing diabetes during the postdonation follow-up period. PATIENTS AND METHODS: Living kidney donors with prospectively collected preoperative fasting glucose and HbA1c results were included in the study. Donors were categorized to the high-risk group when both results were in the prediabetic range, the low-risk group when only 1 result was in the prediabetic range, and the control group when both results were normal. RESULTS: Ninety-three donors were followed for 75.9 ± 23.3 months. A higher proportion of donors in the high-risk group progressed to diabetes compared with donors in the low-risk and control groups (31.3% vs 6.5% vs 0.0%, respectively; P < .001). Donors with prediabetes were not at a higher risk for new-onset hypertension (4.4% vs 10.0% vs 7.7%, in control, low-risk, and high-risk groups, respectively; P = .519) or microproteinuria (7.3% vs 10.3% vs 0.0%, in control, low-risk, and high-risk groups, respectively; P = .478) and exhibited equivalent postdonation renal function compared with donors with normal glucose metabolism. CONCLUSIONS: HbA1c can identify donors with prediabetes who are at risk for progression to diabetes. Our results indicate that carefully accepted donors with prediabetes are not at increased risk of renal function deterioration in the immediate postdonation period.


Assuntos
Diabetes Mellitus/sangue , Seleção do Doador/métodos , Hemoglobina A Glicada/análise , Doadores Vivos/estatística & dados numéricos , Estado Pré-Diabético/sangue , Jejum/sangue , Feminino , Humanos , Transplante de Rim , Masculino , Pessoa de Meia-Idade , Fatores de Risco
6.
Transplant Proc ; 51(7): 2228-2231, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474289

RESUMO

BACKGROUND: The aim of this study is to investigate the frequency and risk factors of new-onset diabetes after donation in kidney donors without diabetes. METHODS: Living donors of kidney transplants between 1998 and 2016 were evaluated. To detect the blood glucose profile of the donors, preoperative fasting glucose (pro-G), nephrectomy evening glucose (nG), and postoperative day 1 fasting glucose (post-G) values were measured. RESULTS: A total of 195 cases were included in the study. The mean follow-up time in months ± SD (range) was 56 ± 45 (12-215). Of these, 28 (14.3%) donors developed diabetes. The pro-G (103 ± 7.6 vs 93 ± 9.0), nG (208 ± 122 vs 163 ± 67) and post-G (121 ± 25 vs 111 ± 21) values of the donors with new-onset diabetes were higher. Nineteen donors (9.7%) had normal pro-G, nG, and post-G values (group A). However, there were 153 (78.5%) cases with at least 1 abnormal value (group B) and 25 (12.8%) cases that had abnormal values in all (pro-G, nG, and post-G) measurements (group C). The incidence of new-onset diabetes was 0 (0%) in group A, 11% in group B, and 48% in group C (P < .001). In multiple regression analysis, pro-G (Exp[B], 1.08; 95% CI, 1.04-1.13; P < .001) and basal glomerular filtration rate (Exp[B], 0.96; 95% CI, 0.94-0.99; P < .01) independently associated with new-onset diabetes. CONCLUSIONS: In kidney donors without a history of diabetes, the development of diabetes after donor nephrectomy is an important problem. Pre- and postoperative blood glucose levels provide important information to predict these cases.


Assuntos
Diabetes Mellitus/etiologia , Hiperglicemia/etiologia , Complicações Intraoperatórias/etiologia , Doadores Vivos , Nefrectomia/efeitos adversos , Complicações Pós-Operatórias/etiologia , Coleta de Tecidos e Órgãos/efeitos adversos , Adulto , Glicemia/análise , Diabetes Mellitus/sangue , Jejum/sangue , Feminino , Taxa de Filtração Glomerular , Humanos , Hiperglicemia/sangue , Complicações Intraoperatórias/sangue , Rim/cirurgia , Transplante de Rim , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/sangue , Fatores de Risco
7.
Diabetes Metab Syndr ; 13(4): 2647-2652, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405689

RESUMO

AIMS: The purpose of this study was to investigate the effectiveness of an inpatient diabetes care education during the first year of internal medicine residency training on inpatient glycemic control. METHODS: The program was comprised of 1-hr small group teaching per 4-week rotation and twice-a-week morning insulin round by an endocrinologist. Inpatient insulin management guideline leaflet was provided to all internal medicine residents. We retrospectively collected the point-of-care testing for glucose (POCT-glu) data in patients admitted to the general medicine wards and compared the mean of blood glucose (BG) before and after the education program. A total of 134438 POCT-glu values from 7055 patients were analyzed. RESULTS: After the initiation of the education program, mean BG levels significantly decreased during the first year and were lowest during the second year after education (Mean BG at baseline was 161.38 ±â€¯64.10 mg/dL; 1st year, 159.48 ±â€¯62.53 mg/dL and 2nd year, 155.60 ±â€¯64.94 mg/dL, p-value < 0.0001). The reduction of BG levels was more pronounced in the patients with previously undiagnosed diabetes mellitus than patients with underlying diabetes mellitus. The rates of severe hypoglycemia (defined by BG < 40 mg/dL or 2.2 mmol/L) were not significantly different before and after education (baseline 0.12%, 1st year 0.14%, and 2nd year 0.14%, p-value = 0.632). CONCLUSIONS: Lack of confidence and inadequate knowledge of insulin treatment in physicians were important barriers to glycemic management. Consistent education in internal medicine residents led to a significant improvement in inpatient glycemic control.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Educação de Pós-Graduação em Medicina/normas , Hiperglicemia/prevenção & controle , Hipoglicemia/prevenção & controle , Pacientes Internados/estatística & dados numéricos , Medicina Interna/educação , Guias de Prática Clínica como Assunto/normas , Idoso , Biomarcadores/análise , Glicemia/análise , Diabetes Mellitus/sangue , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Hospitalização , Humanos , Hipoglicemiantes/uso terapêutico , Internato e Residência , Masculino , Pessoa de Meia-Idade , Testes Imediatos , Prognóstico , Melhoria de Qualidade , Estudos Retrospectivos
8.
Biomed Res Int ; 2019: 6509083, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428641

RESUMO

Objective: To investigate the epidemiological features of obesity in rural Northeast China. Design: This was a 2017-2018 cross-sectional study of 10,891 participants aged ≥40 years that was designed to investigate the prevalence of obesity in rural areas of Liaoning Province. Demographic data, biochemical parameters, and physical examinations were completed by well-trained personnel. Logistic regression analyses were then carried out to investigate independent risk factors and associated cardiometabolic comorbidities of obesity. Results: The proportions of general obesity only, central obesity only, and combined obesity were 1.0%, 31.3%, and 17.4%, respectively. Overall, 49.8% of our subjects were obese. Female gender, being married, being separated/divorced/widowed, or eating more meat were significantly associated with obesity. Smoking, higher family income, or regular physical exercise were negatively associated with obesity. General obesity only was significantly correlated with hypertension, diabetes, and high triglycerides (OR = 2.79, OR = 2.79, and OR = 3.37, resp.). General obesity only was irrelevant to high total cholesterol, low high-density lipoprotein cholesterol, and high low-density lipoprotein cholesterol, although central obesity only, or combined obesity, was relevant to these factors. Prehypertension and prediabetes showed a positive association with different types of obesity. Conclusions: We identified a high prevalence of general and central obesity in rural Northeast China, with similar independent risk factors. Participants with combined obesity had the highest risk of cardiometabolic comorbidities, indicating that the combined use of both waist circumference and body mass index is useful in practice.


Assuntos
Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Obesidade/epidemiologia , População Rural , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Colesterol/sangue , Comorbidade , Estudos Transversais , Diabetes Mellitus/sangue , Feminino , Humanos , Hipertensão/sangue , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Prevalência , Fatores de Risco , Triglicerídeos/sangue
9.
Phytother Res ; 33(11): 2841-2848, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31429148

RESUMO

Maintaining glycemic control in diabetes and prediabetes is necessary to prevent many health complications and mortality. Although different hypoglycemic drugs are used for this purpose, there is still a growing interest in the use of medicinal plants due to their low price, easy availability, and fewer or no side effects. Moringa (Moringa oleifera Lam.) is a medicinal plant that has been traditionally used in the management of diabetes. This review aims to present the existing literature published until February 2019 on the role of moringa leaves in glycemia and their physiological mechanisms. In the conducted studies, moringa leaves have shown to reduce glycemia, without causing any adverse effects. The proposed mechanisms for reducing glycemia include inhibition of α-amylase and α-glucosidase activities, increased glucose uptake in the muscles and liver, inhibition of glucose uptake from the intestine, decreased gluconeogenesis in the liver, and increased insulin secretion and sensitivity. However, these studies are limited in numbers and mostly conducted in animals, in vitro and in vivo. Therefore, long-term human studies are required to determine the hypoglycemic effect of moringa leaves, their physiological mechanisms, active ingredients, and safety. Overall, this review provides evidence that moringa leaves have the possibility to be used as a glycemic control agent in diabetes and prediabetes.


Assuntos
Glicemia/efeitos dos fármacos , Hipoglicemiantes/farmacologia , Moringa oleifera/química , Extratos Vegetais/farmacologia , Animais , Glicemia/metabolismo , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Avaliação de Medicamentos/estatística & dados numéricos , Humanos , Hipoglicemiantes/uso terapêutico , Fígado/efeitos dos fármacos , Fitoterapia/métodos , Extratos Vegetais/uso terapêutico , Folhas de Planta/química , Plantas Medicinais/química , Estado Pré-Diabético/sangue , Estado Pré-Diabético/tratamento farmacológico , Transdução de Sinais/efeitos dos fármacos
10.
Rev Med Suisse ; 15(659): 1444-1447, 2019 Aug 21.
Artigo em Francês | MEDLINE | ID: mdl-31436059

RESUMO

Continuous glucose monitoring is a technique that allows near-continuous measurement of interstitial glucose concentration. Much progress has been made in this area. The management of certain diabetic patients, in particular type 1, has been considerably improved thanks to the use of this technique. Many pitfalls have been crossed to allow its commercialization. There is still a lot of progress to be made. A good knowledge of these new devices is necessary to understand their strengths and weaknesses. This article briefly discusses the state of the art in this area and the expected perspectives of this attractive but expensive technology that must meet the ever-increasing but legitimate expectations of diabetic patients.


Assuntos
Automonitorização da Glicemia , Diabetes Mellitus , Glicemia/análise , Automonitorização da Glicemia/economia , Automonitorização da Glicemia/instrumentação , Diabetes Mellitus/sangue , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/terapia , Testes Hematológicos/instrumentação , Humanos
11.
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
12.
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
13.
Biosens Bioelectron ; 143: 111622, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31470172

RESUMO

Blood glucose sensing is very important for diabetic management. It is shifting towards a continuous glucose monitoring because such a system can alleviate patient suffering and provide a large number of glucose measurements. Here, we proposed a novel approach for the development of durable and accurate enzymatic continuous glucose monitoring system (CGMS). For the long-term durable and selective immobilization of glucose oxidase on a microneedle electrode, a biocompatible engineered mussel adhesive protein was employed through efficient electrochemical oxidation strategy. For the accurate performance in in vivo environments, we also suggested dual real-time compensated algorithms to cover both temperature and time-lag differences. After pre-clinical and pilot-clinical evaluations, we confirmed that our proposed CGMS has an outstanding performance compared with various commercially available continuous systems and achieves comparable performance to disposable glucose sensors.


Assuntos
Técnicas Biossensoriais , Automonitorização da Glicemia , Glicemia/isolamento & purificação , Diabetes Mellitus/sangue , Glicemia/química , Humanos , Sistemas de Infusão de Insulina , Monitorização Fisiológica , Agulhas
14.
J Med Case Rep ; 13(1): 258, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31366392

RESUMO

BACKGROUND: Neonatal diabetes mellitus with hyperglycemia during the first 6 months of life is a rare disorder that can occur in all races and societies. CASE PRESENTATION: In this study, we introduced an Iranian (Persian) 65-day-old patient with neonatal diabetes mellitus with novel homozygous mutation in the pancreatic and duodenal homeobox 1, PDX1, gene, which is also known as IPF1 gene, located in exon 2. This case was a newborn boy born in Vali-Asr Hospital, Tehran; he was diagnosed as having hyperglycemia on 28th day. Genetic analysis detected a homozygous mutation on PDX1 gene on chromosome 13. It is a novel homozygous mutation in the PDX1 gene (NM_000209.3), p.Phe167Val. This mutation was confirmed by Sanger sequencing. There was no evidence of agenesis of the pancreas. CONCLUSIONS: We reported a case of neonatal diabetes mellitus due to novel homozygous mutation in the PDX1 gene without exocrine pancreas manifestations.


Assuntos
Diabetes Mellitus/genética , Proteínas de Homeodomínio , Hiperglicemia/genética , Transativadores , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Humanos , Hiperglicemia/sangue , Hiperglicemia/tratamento farmacológico , Lactente , Recém-Nascido , Doenças do Recém-Nascido , Insulina/administração & dosagem , Irã (Geográfico) , Masculino , Mutação
15.
Lipids Health Dis ; 18(1): 156, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31351479

RESUMO

BACKGROUND: The ratio of triglycerides to HDL cholesterol (TG/HDL-C ratio) is known as a good predictor for cardiovascular disease. The purpose of this study was to compare discrimination for cardiovascular risk by different cut-off values of the TG/HDL-C ratio. METHODS: Receiver operating characteristic (ROC) analysis was performed for the relationship between TG/HDL-C ratio and accumulation of cardio-metabolic risk factors including visceral obesity, hypertension and diabetes. Logistic regression analysis was performed for the relationships of TG/HDL-C ratio with cardio-metabolic risk factors using the cut-off values obtained by ROC analysis and conventional cut-off values (men, 3.75; women, 3.00). RESULTS: In ROC analysis, the optimal cut-off values for TG/HDL-C ratio were 2.967 in men and 2.237 in women, which were much smaller than the conventional cut-of values. Odds ratios for multiple cardio-metabolic risk factors of subjects with vs. subjects without a high TG/HDL-C ratio in men and women were 5.75 (4.43-7.46) and 18.76 (10.32-34.13), respectively, by using the new cut-off values and they were 5.03 (3.96-6.39) and 16.11 (9.20-28.20), respectively, by using the conventional cut-off values. The odds ratios for visceral obesity, hypertension and diabetes were comparable when using these two different cut-off values. CONCLUSION: Cut-off values should be ideally calculated by ROC analysis. However, the discrimination power of cut-off values for the TG/HDL-C ratio calculated by ROC analysis for cardio-metabolic risk was similar to those by using the conventional cut-off values. Further studies using cardiovascular events as outcomes in the analysis may be needed to determine more suitable cut-off values of the TG/HDL-C ratio.


Assuntos
HDL-Colesterol/sangue , Diabetes Mellitus/sangue , Hipertensão/sangue , Obesidade Abdominal/sangue , Triglicerídeos/sangue , Adulto , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Diabetes Mellitus/etiologia , Feminino , Humanos , Hipertensão/etiologia , Modelos Logísticos , Masculino , Obesidade Abdominal/etiologia , Razão de Chances , Curva ROC , Fatores de Risco
16.
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
17.
Toxicol Lett ; 314: 98-105, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31348986

RESUMO

Parental exposure to cigarette smoke is closely related to the development of long-term metabolic diseases in the offspring. However, different exposure times at various developmental stages may cause these effects to vary. In this study, mice were exposed to cigarette smoke condensate (CSC) during the developmental time stages of paternal puberty or/and maternal pregnancy. The results showed that either paternal or maternal exposure to CSC could lead to increased low birth weight (LBW) and fetal growth restriction (FGR) of the offspring, but maternal factors were the leading ones. Moreover, maternal exposure during pregnancy could induce lipid metabolism abnormalities in the adulthood offspring. Most importantly, additional paternal CSC exposure further induced diabetes in adolescent offspring who experienced altered weight gain, blood lipids, and glucose metabolism. A preliminary analysis indicated that the offspring with metabolic abnormalities also had significant changes in their intestinal microbiota. In conclusion, this study showed that parental CSC exposure has an impact on the metabolic properties of the offspring, and multiple parental exposures to adverse factors may significantly increase the risk of long-term metabolic abnormalities.


Assuntos
Glicemia/metabolismo , Fumar Cigarros/efeitos adversos , Diabetes Mellitus/etiologia , Exposição Materna/efeitos adversos , Exposição Paterna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal , Fumaça/efeitos adversos , Fatores Etários , Animais , Biomarcadores/sangue , Peso ao Nascer , Diabetes Mellitus/sangue , Feminino , Retardo do Crescimento Fetal/etiologia , Microbioma Gastrointestinal , Lipídeos/sangue , Masculino , Camundongos Endogâmicos C57BL , Gravidez , Medição de Risco , Fatores de Risco
18.
Clin Lab ; 65(7)2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31307185

RESUMO

BACKGROUND: HbA1c concentration is an indicator of the development of long-term complications in diabetic pa-tients. Different sample storage conditions could affect HbA1c values and consequently, clinician's diagnosis. In this study, we studied the effects of various temperatures of storage over time on HbA1c results. METHODS: A total of 40 fresh whole blood samples with various levels of HbA1c were selected for separate HbA1c measurements at three different temperatures (-20°C, 4°C, and 25°C) on subsequent days (0, 7, 14, and 21 days af-ter sample collection) with Cobas Integra 400 assays (Roche Diagnostics, Mannheim Germany). RESULTS: The value of HbA1c at initial measurement (7.05 ± 1.45) was insignificantly higher than results of temper-ature of -20°C and 4° but compared to results at the temperature of 25°C, (6.08% ± 0.86 % after day 7, 5.52% ± 0.80 after day 14, 4.81 % ± 0.66 after day 21) values of initial measurements were significantly higher. CONCLUSIONS: We concluded that the refrigerator or freezer storage temperature is applicable for the measurement of HbA1c by Cobas Integra 400 without adverse effects on the stability of samples on subsequent days.


Assuntos
Diabetes Mellitus/sangue , Hemoglobina A Glicada/análise , Manejo de Espécimes/métodos , Temperatura Ambiente , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Fatores de Tempo
19.
J Assoc Physicians India ; 67(4): 26-29, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31309791

RESUMO

Introduction: Diabetes mellitus is a global pandemic. The increased platelet activity may play a role in the development of vascular complications of this metabolic disorder. The mean platelet volume (MPV) is an indicator of the average size and activity of platelets. Larger platelets are younger and exhibit more activity. Aims and Objectives: To determine the MPV in diabetics with different glycemic control (HbA1C), to see if there is a difference in MPV between diabetics with and without vascular complications, and to determine the correlation of MPV with fasting blood glucose, glycosylated hemoglobin (HbA1c), body-mass index, and duration of diabetes in the diabetic patients. Methodology: Platelet counts and MPV were measured in 160 Type 2 diabetic patients using an automated blood cell counter. The blood glucose levels and HbA1c levels were also measured. All patients were divided in 2 groups, group A, which includes patients with HbA1C≤8 % and group B, which includes patients with HbA1C>8 %. Statistical evaluation was performed using Student's t test and Pearson correlation tests. Results: The mean platelet counts and MPV were higher in diabetics with higher HbA1C (group B) compared to the diabetics with lower HbA1C (group A) [288.30 ± 103.96 X 109/l vs. 265.83 ± 66.97 X 109/l (P= 0.16)], 13.77 ± 0.08 fl versus 11.86 ± 0.66 fl (P= 0.0001), respectively. MPV showed a positive correlation with fasting blood glucose (regression (r) = 0.18) and HbA1C levels (P=0.0001). HbA1C and MPV increases with increase in duration of DM, which were 8.62±0.96 and 8.51±1.09 % (p=0.49) and 13.24±1.27 and 13.10±1.37 (p=0.50) respectively in both group with duration >5 years and ≤5 years. On the basis of vascular complications, HbA1C, MPV and Duration of DM were (in both group with and without complications respectively), 8.58±0.01 % and 8.56±0.09 % (p=0.03), 13.12±1.40 fl and 12.80±1.21fl (p=0.13), 9.11±3.22 years and 2.5±2.2 years (p<0.0001). Conclusion: Our results showed significantly higher MPV in diabetic patients with higher HbA1C (poor glycemic control). This indicates that elevated MPV could be either the cause for or due to the effect of the vascular complications. Hence, platelets may play a role and MPV can be used as a simple parameter to assess the vascular events in diabetes.


Assuntos
Diabetes Mellitus/metabolismo , Hemoglobina A Glicada/metabolismo , Volume Plaquetário Médio , Plaquetas , Diabetes Mellitus/sangue , Humanos , Contagem de Plaquetas
20.
Nutrients ; 11(7)2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31277481

RESUMO

Allomyrina dichotoma larva is a nutritional-worthy future food resource and it contributes to multiple pharmacological functions. However, its antidiabetic effect and molecular mechanisms are not yet fully understood. Therefore, we investigated the hypolipidemic effect of A. dichotoma larva extract (ADLE) in a high-fat diet (HFD)-induced C57BL/6J mice model. Glucose tolerance and insulin sensitivity in HFD-induced diabetic mice significantly improved after ADLE administration for six weeks. The levels of serum triglyceride (TG), aspartate aminotransferase (AST), alanine transferase (ALT) activity, and lipid accumulation were increased in the liver of HFD-fed mice, but the levels were significantly reduced by the ADLE treatment. Moreover, hepatic fibrosis and inflammatory gene expression in the liver from HFD-treated mice were ameliorated by the ADLE treatment. Dephosphorylation of AMP-activated protein kinase (AMPK) by palmitate was inhibited in the ADLE treated HepG2 cells, and subsequently reduced expression of lipogenic genes, such as SREPBP-1c, ACC, and FAS were observed. The reduced expression of lipogenic genes and an increased phosphorylation of AMPK was also observed in the liver from diabetic mice treated with ADLE. In conclusion, ADLE ameliorates hyperlipidemia through inhibition of hepatic lipogenesis via activating the AMPK signaling pathway. These findings suggest that ADLE and its constituent bioactive compounds are valuable to prevent or treat hepatic insulin resistance in type 2 diabetes.


Assuntos
Besouros , Diabetes Mellitus/prevenção & controle , Dieta Hiperlipídica , Hipoglicemiantes/farmacologia , Resistência à Insulina , Fígado/efeitos dos fármacos , Proteínas Quinases Ativadas por AMP/metabolismo , Animais , Biomarcadores/sangue , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Besouros/química , Besouros/crescimento & desenvolvimento , Diabetes Mellitus/sangue , Diabetes Mellitus/enzimologia , Diabetes Mellitus/genética , Modelos Animais de Doenças , Regulação Enzimológica da Expressão Gênica , Células Hep G2 , Humanos , Hipoglicemiantes/isolamento & purificação , Larva/química , Lipogênese/efeitos dos fármacos , Lipogênese/genética , Fígado/enzimologia , Masculino , Camundongos Endogâmicos C57BL , Fosforilação , Transdução de Sinais
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