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1.
J Assoc Physicians India ; 67(10): 70-72, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31571457

RESUMO

Guidelines to diagnose Gestational Diabetes Mellitus (GDM) have changed a number of times from O'Sullivan and Mahan, Carpenter and Coustan, World Health Organization, American Diabetes Association to that of International Association of Diabetes in Pregnancy Study Group (IADPSG). The IADPSG guideline was based on Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) study which was performed in caucasian population only and thus literally cannot be considered as international. Recently a study commented that this guideline needs revision for standardization of this strategy for diagnosing GDM. Based on a prospective study, Diabetes in Pregnancy Study Group India (DIPSI) recommended A single step procedure of diagnosing GDM with 2hr PG > 140 mg/dl after 75g of oral glucose administered irrespective of the last meal timing. This guideline has been approved by the Ministry of Health Government of India, WHO, IDF and Federation of Gynaecologists and Obstetricians Society (FIGO). National Institute of Clinical Excellence (NICE) also recognises cut off value, 2hr PG > 140 mg/dl based on a study in multi ethnic population of UK. Hence, we can safely conclude, A Single Step procedure has settled the criteria for diagnosing GDM.


Assuntos
Diabetes Gestacional/diagnóstico , Feminino , Teste de Tolerância a Glucose , Humanos , Hiperglicemia , Índia , Gravidez , Estudos Prospectivos
2.
J Agric Food Chem ; 67(38): 10604-10613, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31466448

RESUMO

The aim of this study was to investigate the dipeptidyl peptidase-IV (DPP-IV) inhibition and metabolic stability of a casein-derived peptide Val-Pro-Tyr-Pro-Gln (VPYPQ) and its fragments as well as their release from casein following hydrolysis. Results showed that VPYPQ was the most potent DPP-IV inhibitory peptide among them with an IC50 value of 41.45 µM. This might be due to its two internal Pro residues at positions 2 and 4. Moreover, VPYPQ was resistant to hydrolysis by gastrointestinal enzymes and was relatively more stable to hydrolysis by DPP-IV and peptidases in plasma compared with its fragments. Additionally, oral administration of VPYPQ at a dose of 90 µmol/kg body weight could reduce the postprandial blood glucose levels in mice. More importantly, VPYPQ could be released efficiently from casein following hydrolysis by a combination of papain and in vitro digestion, reaching up to 3211.15 µg/g. Therefore, VPYPQ was a promising casein-derived DPP-IV inhibitor.


Assuntos
Caseínas/química , Preparações de Ação Retardada/química , Inibidores da Dipeptidil Peptidase IV/química , Peptídeos/química , Animais , Biocatálise , Glicemia/metabolismo , Preparações de Ação Retardada/administração & dosagem , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/metabolismo , Dipeptidil Peptidase 4/química , Dipeptidil Peptidase 4/metabolismo , Inibidores da Dipeptidil Peptidase IV/administração & dosagem , Teste de Tolerância a Glucose , Humanos , Hidrólise , Camundongos , Peptídeo Hidrolases/química , Peptídeo Hidrolases/metabolismo , Peptídeos/administração & dosagem , Ratos , Ratos Sprague-Dawley
3.
Rev. chil. endocrinol. diabetes ; 12(3): 162-164, jul. 2019. ilus
Artigo em Espanhol | LILACS | ID: biblio-1006497

RESUMO

La acromegalia, originada por un exceso de producción de Hormona de crecimiento (Gh), se caracteriza por crecimiento somático exagerado, alto riesgo cardio-metabólico, así como reducción de la expectativa de vida. Tiene una incidencia de 3-4 casos por millón de habitantes. El diagnóstico se retrasa hasta 10 años aumentando la morbi-mortalidad. Las alternativas terapéuticas incluyen medicamentos y cirugía, que van encaminados a reducir los efectos de masa tumoral, normalizar los parámetros bioquímicos y resolver las manifestaciones clínicas. En casos muy infrecuentes, el tumor hipofisario que la origina se asocia a silla turca vacía.


Acromegaly, caused by an excess production of growth hormone (Gh), it is characterized by exaggerated somatic growth, high cardio-metabolic risk, as well as reduction of life expectancy. It has an incidence of 3-4 cases per million population. The diagnosis is delayed up to 10 years increasing morbidity and mortality. The therapeutic alternatives include medications and surgery, which are aimed at reduce the effects of tumor mass, normalize biochemical parameters and resolve clinical manifestations. In very infrequent cases, the pituitary tumor that originates it is associated with empty sella syndrome. Key words: Acromegaly, Empty sella syndrome, Pituitary tumor.


Assuntos
Humanos , Feminino , Idoso , Neoplasias Hipofisárias/complicações , Acromegalia/complicações , Acromegalia/diagnóstico , Síndrome da Sela Vazia/complicações , Sela Túrcica/patologia , Fator de Crescimento Insulin-Like I/análise , Hormônio do Crescimento/análise , Imagem por Ressonância Magnética , Teste de Tolerância a Glucose
4.
Medicine (Baltimore) ; 98(27): e16096, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277108

RESUMO

Osteoporosis (OP) is a disease characterized by decreased bone mineral density (BMD) and an increased risk of osteoporotic fractures. Nutritional factors (including glucose and fats lipids), have been implicated in OP.We hypothesized that the levels of blood glucose and lipids could be biomarkers for predicting the risk of OP. To test this hypothesis, we evaluated the potential relationship between BMD and levels of blood glucose and lipids via a community-based study in China.This was a community-based cross-section analysis, and a total of 8584 cases were investigated. The BMD of the left calcaneus was measured using an ultrasonic bone densitometer. The levels of blood glucose (fasting blood glucose [FBG], 2-h blood glucose [2hBG], and glycosylated hemoglobin [HbAlc]), and lipids (triglyceride [TG], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) were measured and analyzed.In our study population, the levels of FBG, 2hBG, HbAlc, TC, LDL-C and HDL-C were higher in the OP group than in the low bone density and the normal bone density groups, while the levels of HbAlc, TC, and LDL-C in the low bone density group were higher than those in the normal bone density group. In males, the level of blood LDL-C in the low bone density group was higher than that in the normal bone density group. In postmenopausal subjects, the levels of FBG, 2hBG and HbA1C were higher than those in the normal bone density groups, and the level of HbA1C in the low bone density group was higher than that in the normal bone density group. Pearson linear trend analysis demonstrated that BMD was positively associated with TC and LDL-C in males and negatively associated with FBG, 2hBG and HbA1C in postmenopausal females. Moreover, logistic analysis showed that BMD was correlated with TC in premenopausal females and HbA1C in postmenopausal females.OP is generally associated with abnormal levels of blood glucose and/or lipids; nevertheless, the relationship between OP and abnormal levels of blood glucose and/or lipids is complicate and different subpopulations may have different susceptibilities. Therefore, further detailed studies are warranted.


Assuntos
Glicemia/análise , Densidade Óssea/fisiologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Osteoporose/sangue , Absorciometria de Fóton , Adulto , Idoso , Biomarcadores/sangue , Calcâneo/diagnóstico por imagem , Estudos Transversais , Feminino , Teste de Tolerância a Glucose , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Inquéritos e Questionários
5.
Medicine (Baltimore) ; 98(28): e16428, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305464

RESUMO

CONTEXT: Alarin has been reported to be relative to food intake and an increase in body weight. However, to date, no report has demonstrated the relationship between circulating alarin and diabetes in humans. OBJECTIVE: The objective of this study is to gain insight into the possible role of alarin in humans. DESIGN AND METHODS: 164 patients with newly diagnosed type 2 diabetes mellitus (nT2DM), 112 IGT and 134 healthy subjects were recruited for this study. In an interventional study, 29 nT2DM patients were treated by a weekly GLP-1RA for 6 months. Plasma alarin concentrations were measured by ELISA. RESULTS: Circulating alarin concentrations were significantly higher in both IGT and nT2DM subjects than in healthy individuals (0.40 ±â€Š0.14 and 0.54 ±â€Š0.24 vs 0.37 ±â€Š0.10 µg/L, P < .05 or P < .01), whereas in T2DM patients, circulating alarin levels were higher than in IGT subjects. Circulating alarin positively correlated with FBG, HbA1c, HOMA-IR, AUCglucose and TNFα (P < .05 or P < .01). Multivariate logistic regression revealed that circulating alarin levels were correlated with IGT and T2DM. GLP-1RA treatment for 6 months increased circulating alarin levels in T2DM patients (from 0.34 ±â€Š0.10 for baseline, to 0.39 ±â€Š0.14 for 12 weeks, and finally to 0.38 ±â€Š0.15 µg/L for 24 weeks; vs. pre-treatment P < .05). CONCLUSIONS: These data suggest that alarin might be involved in the pathogenesis of T2DM in humans. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR-OCS-13003185 (18/03/2013 ).


Assuntos
Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Peptídeo Semelhante a Galanina/sangue , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Hipoglicemiantes/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Estudos Transversais , Citocinas/sangue , Método Duplo-Cego , Feminino , Teste de Tolerância a Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
6.
J Assoc Physicians India ; 67(4): 66-70, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31309801

RESUMO

Abstract: Women with a history of Gestational Diabetes Mellitus (GDM) are at increased risk of future diabetes and related Non-Communicable Diseases (NCD) as are their offspring. "Transgenerational transmission occurs". Independent of genetic risk, offspring of hyperglycaemic pregnancies are at increased risk of early onset type 2 diabetes mellitus (Type 2 DM) and obesity. Differences exist in offspring risk of diabetes and obesity based on time and type of diabetes exposure in utero. There is a risk gradient, wherein type 2 DM exposure confers greater risk and reduces time to development of type 2 DM in the offspring compared with exposure to GDM and no diabetes exposure. These data suggest, glucose dose dependence in risk transmission. Given that the age of onset of prediabetes and type 2 DM is declining many reproductive age women may have undiagnosed diabetes or dysglycaemia when they become pregnant. This has great public health significance and it has become imperative that all pregnant women should be screened for hyperglycemia even if they have no symptoms. Ministry of Health, Government of India has developed the national guidelines for testing, diagnosis and management of hyperglycemia in pregnancy. These guidelines recommend early testing at booking, to be repeated again between 24-28 weeks if negative at first testing. The guideline also recommends that GDM can be diagnosed if the 2 hr PG is ≥140mg/dl after 75 gm of oral glucose administration without regard to the time of the last meal (i.e., fasting or non-fasting). This approach has also been endorsed by International Diabetes Federation (IDF), World Health Organization (WHO) and International Federation of Gynaecology and Obstetrics (FIGO) for resource constrained settings.The aim should be to target new born baby's birth weight, appropriate for gestational age (2.5 to 3.5 kg) to prevent the offspring developing NCD in the future. For this to happen early diagnosis and tight maternal glucose control during pregnancy similar to glycaemic level in the normal pregnancy, (FPG between 80 and 90 mg, 2 hr. post prandial between 110 and 120 mg) is necessary.


Assuntos
Diabetes Gestacional/metabolismo , Peso ao Nascer , Diabetes Mellitus Tipo 2 , Feminino , Teste de Tolerância a Glucose , Humanos , Índia , Gravidez , Resultado da Gravidez/epidemiologia
7.
Arch Endocrinol Metab ; 63(3): 241-249, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31166364

RESUMO

OBJECTIVE: To investigate the relationship of flavonoid intake during pregnancy with maternal excessive body weight and gestational diabetes mellitus (GDM). SUBJECTS AND METHODS: A cross-sectional study was conducted among 785 adult women in singleton pregnancies, and data were collected at the time of the oral glucose tolerance test. For the body mass index (BMI) classification according to the gestational age, the criteria of Atalah was used, and the diagnosis of GDM was based on the World Health Organization of 2014. Two 24-hour dietary recalls were obtained, and the usual intake was determined by the Multiple Source Method. Adjusted multinomial logistic regression was used to investigate the relationship of the flavonoids with overweight and obesity, and adjusted non-conditional logistic regression for the relationship of the flavonoids with GDM. RESULTS: The mean (SD) age of the women was 28 (5) years, 32.1% were overweight, 24.6% were obese and 17.7% were diagnosed with GDM. The median (P25, P75) of total flavonoid intake was 50 (31,75) mg/day. Considering the eutrophic women as the reference, the pregnant women with a higher total flavonoid intake [OR 0.62 (95% CI 0.38; 0.96)] and anthocyanidin intake [OR 0.62 (95% CI 0.40; 0.99)] were less likely to be obese when compared to the women with lower intakes. No association of the flavonoids intake with overweight or GDM was found. CONCLUSION: A very low intake of flavonoids was observed. The data suggest that the intake of foods naturally rich in total flavonoids and anthocyanidin has a beneficial role regarding obesity among pregnant women.


Assuntos
Diabetes Gestacional/metabolismo , Comportamento Alimentar , Flavonoides/administração & dosagem , Obesidade/metabolismo , Adulto , Estudos Transversais , Registros de Dieta , Feminino , Flavonoides/metabolismo , Teste de Tolerância a Glucose , Humanos , Pessoa de Meia-Idade , Gravidez , Adulto Jovem
8.
N Engl J Med ; 381(7): 603-613, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31180194

RESUMO

BACKGROUND: Type 1 diabetes is a chronic autoimmune disease that leads to destruction of insulin-producing beta cells and dependence on exogenous insulin for survival. Some interventions have delayed the loss of insulin production in patients with type 1 diabetes, but interventions that might affect clinical progression before diagnosis are needed. METHODS: We conducted a phase 2, randomized, placebo-controlled, double-blind trial of teplizumab (an Fc receptor-nonbinding anti-CD3 monoclonal antibody) involving relatives of patients with type 1 diabetes who did not have diabetes but were at high risk for development of clinical disease. Patients were randomly assigned to a single 14-day course of teplizumab or placebo, and follow-up for progression to clinical type 1 diabetes was performed with the use of oral glucose-tolerance tests at 6-month intervals. RESULTS: A total of 76 participants (55 [72%] of whom were ≤18 years of age) underwent randomization - 44 to the teplizumab group and 32 to the placebo group. The median time to the diagnosis of type 1 diabetes was 48.4 months in the teplizumab group and 24.4 months in the placebo group; the disease was diagnosed in 19 (43%) of the participants who received teplizumab and in 23 (72%) of those who received placebo. The hazard ratio for the diagnosis of type 1 diabetes (teplizumab vs. placebo) was 0.41 (95% confidence interval, 0.22 to 0.78; P = 0.006 by adjusted Cox proportional-hazards model). The annualized rates of diagnosis of diabetes were 14.9% per year in the teplizumab group and 35.9% per year in the placebo group. There were expected adverse events of rash and transient lymphopenia. KLRG1+TIGIT+CD8+ T cells were more common in the teplizumab group than in the placebo group. Among the participants who were HLA-DR3-negative, HLA-DR4-positive, or anti-zinc transporter 8 antibody-negative, fewer participants in the teplizumab group than in the placebo group had diabetes diagnosed. CONCLUSIONS: Teplizumab delayed progression to clinical type 1 diabetes in high-risk participants. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT01030861.).


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Complexo CD3/antagonistas & inibidores , Diabetes Mellitus Tipo 1/prevenção & controle , Adolescente , Adulto , Anticorpos Monoclonais Humanizados/efeitos adversos , Criança , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/imunologia , Progressão da Doença , Método Duplo-Cego , Exantema/induzido quimicamente , Feminino , Teste de Tolerância a Glucose , Antígeno HLA-DR3 , Antígeno HLA-DR4 , Humanos , Contagem de Linfócitos , Linfopenia/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Linfócitos T/imunologia , Adulto Jovem
9.
Zhonghua Er Ke Za Zhi ; 57(6): 440-444, 2019 Jun 02.
Artigo em Chinês | MEDLINE | ID: mdl-31216801

RESUMO

Objective: To explore the gene mutation characteristics and detailed clinical presentations of hyperglycemia caused by GCK mutations in 10 patients. Methods: The clinical and follow-up data of 10 patients with hyperglycemia caused by mutation of GCK gene were reviewed. The patients were ascertained between January 1, 2014 and August 31, 2018 at the Department of Pediatrics, the First Affiliated Hospital of Zhejiang University and Ningbo Women & Children's Hospital. Clinical data were collected, including age, gender, main complaint, family history, fasting blood glucose, fasting blood insulin, 2-hour blood glucose, 2-hour blood insulin after oral glucose tolerance test, glycosylated hemoglobin, anti-glutamic acid decarboxylase antibody and body mass index. Mutations of GCK gene were detected by Sanger sequencing or high-throughput sequencing of diabetes-related genes in the patients and their family members. Results: There were ten patients, 8 of them were male, 2 were female.The ages at diagnosis varied between 4.7 to 12.3 years. The patients usually did not have obvious clinical symptoms of diabetes mellitus. Most of them were unexpectedly found to have hyperglycemia and with impaired glucose metabolism in three consecutive generations. The fasting blood glucose of patients was 6.8-7.7 mmol/L, 2-hour postprandial blood glucose was 7.8-11.6 mmol/L. Fasting blood insulin was 0.5-8.5 mU/L, glucose tolerance test results showed that 2 h postprondial blood insulin was 1.3-55.4 mU/L. The level of glycosylated hemoglobin was 6.1%-6.8%. Anti-glutamic acid decarboxylase antibody was negative in all patients. The GCK mutations identified in patients and one of their parents were located at exon5 (4 cases), exon9 (2 cases), exon2 (1 case), exon4 (1 case), exon6 (1 case) and exon7 (1 case). Conclusions: Most of the hyperglycemia patients caused by GCK mutations did not have typical clinical symptoms of diabetes. The fasting blood glucose was slightly elevated. Abnormal glucose tolerance test results were found in all 10 patients. Three consecutive generations of family had impaired glucose metabolism. GCK mutations located at exon 5 were common in 10 cases. There was no correlation between type of mutations and plasma glucose levels in domestic and international researches. When fasting glucose was found abnormal in clinic, a complete family history should be taken and the GCK gene should be sequenced to confirm the diagnosis in time.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/genética , Glucoquinase/genética , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Hiperglicemia/genética , Glicemia , Criança , Pré-Escolar , Feminino , Marcadores Genéticos , Teste de Tolerância a Glucose , Humanos , Hiperglicemia/diagnóstico , Masculino , Mutação
10.
Life Sci ; 231: 116574, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31207311

RESUMO

AIMS: Electric lighting is beneficial to modern society; however, it is becoming apparent that light at night (LAN) is not without biological consequences. Several studies have reported negative effects of LAN on health and behavior in humans and nonhuman animals. Exposure of non-diabetic mice to dim LAN impairs glucose tolerance, whereas a return to dark nights (LD) reverses this impairment. We predicted that exposure to LAN would exacerbate the metabolic abnormalities in TALLYHO/JngJ (TH) mice, a polygenic model of type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: We exposed 7-week old male TH mice to either LD or LAN for 8-10 weeks in two separate experiments. After 8 weeks of light treatment, we conducted intraperitoneal glucose tolerance testing (ipGTT) followed by intraperitoneal insulin tolerance testing (ipITT). In Experiment 1, all mice were returned to LD for 4 weeks, and ipITT was repeated. KEY FINDINGS: The major results of this study are i) LAN exposure for 8 weeks exacerbates glucose intolerance and insulin resistance ii) the effects of LAN on insulin resistance are reversed upon return to LD, iii) LAN exposure results in a greater increase in body weight compared to LD exposure, iv) LAN increases the incidence of mice developing overt T2DM, and v) LAN exposure decreases survival of mice with T2DM. SIGNIFICANCE: In conclusion, LAN exacerbated metabolic abnormalities in a polygenic mouse model of T2DM, and these effects were reversed upon return to dark nights. The applicability of these findings to humans with T2DM needs to be determined.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Iluminação/efeitos adversos , Animais , Barorreflexo , Pressão Sanguínea , Peso Corporal , Ritmo Circadiano/fisiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/fisiopatologia , Modelos Animais de Doenças , Intolerância à Glucose/metabolismo , Teste de Tolerância a Glucose , Frequência Cardíaca , Hemodinâmica , Insulina/sangue , Resistência à Insulina/fisiologia , Luz , Masculino , Camundongos , Norepinefrina , Ganho de Peso
11.
Life Sci ; 231: 116577, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31211997

RESUMO

PURPOSE: Galectin-3 is associated with the process of inflammation and fibrosis. The aim of this study was both to evaluate of galectin-3, methylated arginines and hs-CRP in subjects with type 2 diabetes and prediabetes and to investigate a relation between serum galectin-3, methylated arginines and hs-CRP levels. METHODS: In this study, all subjects were defined as the control group, type 2 diabetes (n = 84) by fasting plasma glucose and prediabetes (n = 34) by 75-g oral glucose tolerance test. Also, participants with type 2 diabetes were divided into as group I (HbA1c ≤7%, n = 40) and group II (HbA1c ≥7%, n = 44). The analysis of serum methylated arginines levels was analyzed by tandem mass spectrometry. Galectin-3 levels were determined via chemiluminescent microparticle immunoassay (CMIA). RESULTS: Serum galectin-3, ADMA, L-NMMA and SDMA levels were significantly lower in the control group (13.3 ±â€¯3.42; 0.630 (0.13-1.36); 0.176 (0.02-0.53); 0.115 (0.04-0.26), respectively) compared to diabetic subjects (15.71 ±â€¯4.22; 0.825 (0.23-2.80); 0.366 (0.08-1.41); 0.1645 (0.06-0.47), p = 0.002, p = 0.01, p = 0.001 and p = 0.006, respectively). Galectin-3 was positively correlated with hs-CRP (r = 0.295 p = 0.001), L-NMMA (r = 0.181 p = 0.022), HbA1c (r = 0.247 p = 0.002), neopterin (r = 0.160 p = 0.045) and FPG (r = 0.207 p = 0.001) respectively. Also, there was positively correlated ADMA with FPG (r = 0.192 p = 0.016) and eAG (r = 0.235 p = 0.003). CONCLUSIONS: Thus, galectin-3 might be a useful prognostic marker in the population with prediabetes and diabetes. Moreover, it can be a marker showing the condition of developing complications in diabetic patients.


Assuntos
Arginina/sangue , Proteína C-Reativa/metabolismo , Diabetes Mellitus Tipo 2/sangue , Galectina 3/sangue , Estado Pré-Diabético/sangue , Adulto , Biomarcadores/sangue , Glicemia/metabolismo , Jejum/sangue , Feminino , Galectina 3/análise , Teste de Tolerância a Glucose , Hemoglobina A Glicada/metabolismo , Humanos , Resistência à Insulina , Masculino , Metilação , Pessoa de Meia-Idade
12.
Life Sci ; 230: 104-110, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31128138

RESUMO

BACKGROUND: Previous studies have demonstrated that type 2 diabetes mellitus (T2DM) is negatively correlated with the occurrence of aortic dissection (AD). This study aimed to investigate the effects of T2DM on the prognosis of Stanford type B AD (STBAD) patients after thoracic endovascular aortic repair (TEVAR). METHODS: STBAD patients (n = 141) who underwent TEVAR received an oral glucose tolerance test (OGTT) and were divided into a normal glucose (NG, n = 55) group, an abnormal glucose tolerance (AGT, n = 48) group and a T2DM (n = 38) group according to the results of the OGTT. Data on mortality, clinical complications, left ventricular (LV) remodeling and aortic remodeling were collected during the 3-year follow-up. RESULTS: Lower mortality and fewer clinical complications after TEVAR were found in the T2DM group than in the NG group. Multivariate linear regression analysis showed that 2-hour postprandial glucose (Glu-2h) was negatively correlated with mortality and the occurrence of clinical complications in STBAD patients after TEVAR. In addition, better LV remodeling, larger true lumen areas and smaller false lumen areas in both the proximal aortas and abdominal aortas were observed in the T2DM group than in the NG group. Furthermore, no significant differences in mortality or clinical complications after TEVAR were found between the NG group and the AGT group or between the T2DM group and the AGT group. CONCLUSION: During the 3-year follow-up period, mortality and clinical complications in STBAD patients after TEVAR were significantly reduced in the T2DM group. For STBAD patients who undergo TEVAR, properly relaxing of blood glucose control requirements may be beneficial for their prognosis.


Assuntos
Aneurisma Dissecante/fisiopatologia , Aorta Torácica/cirurgia , Adulto , Idoso , Aneurisma Dissecante/mortalidade , Aneurisma Dissecante/cirurgia , Aorta Abdominal/fisiopatologia , Aorta Torácica/fisiopatologia , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Seguimentos , Glucose/metabolismo , Teste de Tolerância a Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Remodelação Vascular
13.
Zhonghua Nei Ke Za Zhi ; 58(5): 372-376, 2019 May 01.
Artigo em Chinês | MEDLINE | ID: mdl-31060146

RESUMO

Objective: To explore the influence of lifestyle intervention on long-term diabetes in subjects with impaired glucose tolerance (IGT) returned to normal glucose tolerance (NGT) within 6 years. Methods: A total of 577 subjects (aged 25-74 years old) with IGT in Daqing were enrolled and randomly assigned to control, and diet, exercise and diet plus exercise groups in a six-year intervention trial in 1986. Subjects who were non-diabetic at the end of the intervention were followed up for additional 14 years. Results: Among all the subjects, 41.38% of them who had returned to NGT from IGT within 6 years maintained NGT status after 20 years, and had a lower incidence of diabetes than subjects maintained IGT status (46.55% vs. 75.25%). Of note, in the intervention group, the percentage of participants developed diabetes in the NGT subjects was significantly lower than that in the IGT group (43.71% vs. 76.25%) after 20 years. There was high long-term risk for diabetes in the IGT subjects after the adjustment of age, sex and baseline glucose (HR=1.81, 95%CI 1.27-2.58, P=0.001), whereas in the non-intervention group, no significant difference could be viewed in long-term diabetic risk between subjects maintained IGT status and those returned to NGT (71.43% vs. 65.22%) after adjusting of the same confounders (HR=1.03, 95%CI 0.45-2.35, P=0.94). Conclusions: IGT subjects who had returned to NGT in early years had lower risk for future diabetes than those who remained IGT. However, this beneficial effect could only be viewed in the intervention group, but not in the non-intervention group.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Intolerância à Glucose/prevenção & controle , Insulina/metabolismo , Adulto , Idoso , Glicemia/análise , Diabetes Mellitus Tipo 2/diagnóstico , Exercício , Seguimentos , Intolerância à Glucose/complicações , Teste de Tolerância a Glucose , Hemoglobina A Glicada/análise , Humanos , Hiperglicemia/complicações , Hiperglicemia/diagnóstico , Pessoa de Meia-Idade , Comportamento de Redução do Risco
14.
Eur J Endocrinol ; 180(6): 353-363, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31120231

RESUMO

Objective: Since many European countries use risk factor screening for gestational diabetes mellitus (GDM), we aimed to determine the performance of selective screening for GDM based on the 2013 WHO criteria. Design and Methods: Overall, 1811 women received universal screening with a 75 g oral glucose tolerance test (OGTT) with GDM in 12.5% (n = 231) women based on the 2013 WHO criteria. We retrospectively applied different European selective screening guidelines to this cohort and evaluated the performance of different clinical risk factors to screen for GDM. Results: By retrospectively applying the English, Irish, French and Dutch guidelines for selective screening, respectively 28.5% (n = 526), 49.7% (n = 916), 48.5% (n = 894) and 50.7% (n = 935) had at least one risk factor, with GDM prevalence of respectively 6.5% (n = 120), 7.9% (n = 146), 8.0% (n = 147) and 8.4% (n = 154). Using maternal age ≥30 and/or BMI ≥25 for screening, positive rate was 69.9% (n = 1288), GDM prevalence 10.2% (n = 188), sensitivity 81.4% (CI: 75.8­86.2%) and specificity 31.8% (CI: 29.5­34.1%). Adding other clinical risk factors did not improve detection. GDM women without risk factors had more neonatal hypoglycemia (14.4 vs 4.0%, P = 0.001) and labor inductions (39.7 vs 25.9%, P = 0.020) than normal-glucose tolerant women, and less cesarean sections than GDM women with risk factors (13.8 vs 31.0%, P = 0.010). Conclusions: By applying selective screening by European guidelines, about 50% of women would need an OGTT with the lowest number of missed cases (33%) by the Dutch guidelines. Screening with age ≥30 years and/or BMI ≥25, reduced the number of missed cases to 18.6% but 70% would need an OGTT.


Assuntos
Índice de Massa Corporal , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiologia , Idade Materna , Organização Mundial da Saúde , Adulto , Diabetes Gestacional/sangue , Europa (Continente)/epidemiologia , Feminino , Teste de Tolerância a Glucose/normas , Humanos , Gravidez , Estudos Retrospectivos , Fatores de Risco
15.
Toxicol Lett ; 312: 45-54, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31071422

RESUMO

Mercury (Hg) is a heavy metal and Hg exposure is associated with various neural, immune, and cardiovascular abnormalities. However, few studies have evaluated Hg's toxicologic effect on reproductive and metabolic functions. In this study, we assessed whether Hg exposure results in reproductive and metabolic abnormalities. Hg was administered to adult female Wistar rats, mimicking the Hg levels found in exposed human blood, and their reproductive and metabolic function was assessed. Rats exposed to Hg displayed abnormal estrous cyclicity and ovarian follicular development, with a reduction in ovarian antral follicles and an increase in atretic and cystic ovarian follicles. Uterine atrophy with the presence of inflammatory cells was observed in Hg-exposed rats. The presence of abnormal ovarian fat accumulation, as well as increased ovarian lipid drops accumulation, was observed in Hg-exposed rats. Ovarian oxidative stress was also present in the Hg-exposed rats. High fasting glucose levels, glucose, and insulin intolerance were observed in Hg-exposed rats. Thus, these data suggest that Hg exposure led to abnormal reproductive and metabolic features similar to those found in the polycystic ovary syndrome (PCOS) rat models.


Assuntos
Mercúrio/toxicidade , Síndrome do Ovário Policístico/induzido quimicamente , Animais , Glicemia , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Glucose/metabolismo , Teste de Tolerância a Glucose , Resistência à Insulina , Ratos , Ratos Wistar
16.
J Enzyme Inhib Med Chem ; 34(1): 981-989, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31072232

RESUMO

Diabetes mellitus (DM) is a global disease with a high incidence of type 2 diabetes. Current studies have shown that insulin enhancers play an important role in the treatment of type 2 diabetes and have great importance in the improvement of type 2 diabetes. In this research, Rosiglitazone was taken as the lead compound, and the structure was modified by using the bioisostere principle, and a new class of 2,4-thiazolanedione compound was designed and synthesised. The novel series of compounds were studied for their biological activities in vitro and in vivo. In vitro tests, the biological activities showed that the target compounds have good selective activation of peroxisome-proliferator-activated receptor γ (PPARγ), such as the compounds 6a, 6e, 6f, 6g and 6i, especially the compound 6e to PPARγ was EC50 = 0.03 ± 0.01 µmol/L in vitro. Then, in vivo biological activities' test results showed that the tendency of increasing in blood sugar had an obvious inhibiting effect, and had a significant insulin hypoglycaemic effect of enhancing and extending the exogenous. In addition, the results of cytotoxicity tests and acute toxicity tests (LD50) showed that these compounds belong to the low toxicity compounds.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Desenho de Drogas , Hipoglicemiantes/farmacologia , Insulina/metabolismo , Tiazolidinedionas/farmacologia , Animais , Glicemia/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Diabetes Mellitus Tipo 2/metabolismo , Relação Dose-Resposta a Droga , Teste de Tolerância a Glucose , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Humanos , Hipoglicemiantes/síntese química , Hipoglicemiantes/química , Camundongos , Modelos Moleculares , Estrutura Molecular , PPAR gama/metabolismo , Relação Estrutura-Atividade , Tiazolidinedionas/síntese química , Tiazolidinedionas/química
17.
BMC Public Health ; 19(1): 575, 2019 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-31092217

RESUMO

BACKGROUND: Sedentary time is associated with increased risk of type 2 diabetes, but the association between objectively measured sedentary time and incident gestational diabetes mellitus (GDM) has not been tested. The purpose of this paper is to test associations between objectively measured sedentary time and self-reported television time during pregnancy with incident GDM and plasma glucose levels among women at high risk for GDM. METHODS: At 20 weeks' gestation, pregnant women (n = 188) in the North East of England with a risk factor for GDM wore an activPAL accelerometer and reported their usual television time. Participants underwent a standard oral glucose tolerance test at 24-28 weeks' gestation. Regression analyses were used to test for associations of total and prolonged sedentary time, breaks in sedentary time, and television time with GDM and fasting and 2-h glucose levels. Interaction terms were applied to examine whether the association between each indicator of sedentary time and glucose levels differed by GDM status. RESULTS: Total sedentary time (hours/day) was not associated with incident GDM (OR 1.00 (95%CI 1.00, 1.01)). The association between total sedentary time and glucose levels depended on GDM status: sedentary time was associated with fasting (ß = 0.16 (95%CI 0.01, 0.31)) and 2-h (ß = 0.15 (95%CI 0.01, 0.30)) glucose levels for those without GDM, while breaks in sedentary time were associated with lower fasting (ß = - 0.55 (95%CI - 0.92, - 0.17)) and 2-h (ß = - 0.40 (95%CI - 0.77, - 0.03)) glucose levels for those with GDM. Prolonged sedentary time was associated with higher fasting glucose levels regardless of GDM status (ß 0.15 (0.01, 0.30)). Television time was associated with development of GDM (OR 3.03 (95%CI 1.21, 7.96)) but not with plasma glucose levels. CONCLUSIONS: This is the first study to test associations between posture-based measures of sedentary time during pregnancy and GDM and glucose levels. The findings presented here suggest the possible importance of minimizing or breaking up sedentary time for the management of glucose levels during pregnancy, at least among women at high risk of GDM. Further research is needed to understand the different roles of total sedentary time and television time in the development of GDM.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Diabetes Gestacional/etiologia , Comportamento Sedentário , Televisão , Acelerometria , Adulto , Glicemia/análise , Inglaterra , Feminino , Teste de Tolerância a Glucose , Humanos , Gravidez , Segundo Trimestre da Gravidez , Análise de Regressão , Fatores de Risco , Autorrelato
18.
J Dairy Sci ; 102(7): 6226-6234, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31128872

RESUMO

The present experiment was conducted to determine whether, during periods of negative energy balance, the increase in glucose availability, despite similar DMI and greater milk production, induced by a combined supplement of folic acid and vitamin B12 was related to effects of insulin on metabolism. Sixteen multiparous Holstein cows averaging 45 days in milk (standard deviation: 3) were assigned to 8 blocks of 2 animals each according to their milk production (45 kg/d; standard deviation: 6) during the week preceding the beginning of the experiment. Within each block, they received weekly intramuscular injections of either saline (CON) or folic acid and vitamin B12 (VIT) during 5 consecutive weeks. During the last week, the cows were fed 75% of their ad libitum intake during 4 d. Blood samples were taken the morning before starting the feed restriction and on the third day of feed restriction. On the fourth day of feed restriction, the daily meal was not served and an intravenous glucose tolerance test was performed. During the 4 wk preceding the feed restriction, milk production and DMI were not affected by treatments. During the feed restriction, the vitamin supplement tended to decrease milk fat concentration and increase milk concentration of lactose. Plasma concentrations of homocysteine, Ile, Leu, Val, and branched-chain AA increased in VIT cows during the restriction but not in CON cows. During the glucose tolerance test, insulin peak height was lower and insulin incremental positive area under the curve tended to be lower for VIT than for CON [83 (95% confidence interval, CI: 64-108) vs. 123 (95% CI: 84-180) µg·180 min/L, respectively]. Free fatty acid nadir was reached earlier for VIT than for CON [34 (95% CI: 26-43) vs. 46 (95% CI: 31-57) min, respectively]. Glucose area under the curve, clearance rate and peak height, insulin time to reach the peak and clearance rate, and free fatty acid nadir did not differ between VIT and CON. The reduction in insulin release during a glucose tolerance test without changes in glucose clearance rate or area under the curve suggests that the vitamin supplement improved insulin sensitivity in feed-restricted lactating dairy cows.


Assuntos
Glicemia/análise , Bovinos/sangue , Ácido Fólico/administração & dosagem , Teste de Tolerância a Glucose/veterinária , Insulina/sangue , Vitamina B 12/administração & dosagem , Aminoácidos/sangue , Animais , Dieta/veterinária , Suplementos Nutricionais , Metabolismo Energético , Ácidos Graxos não Esterificados/sangue , Feminino , Privação de Alimentos , Resistência à Insulina , Lactação/fisiologia , Lactose/análise , Lactose/metabolismo , Leite/química
19.
Diabetes Res Clin Pract ; 152: 39-52, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31063851

RESUMO

AIM: The purpose of the present study was to assess the relationship of sex hormone binding globulin (SHBG) and gestational diabetes mellitus (GDM). METHODS: The Cochrane Library, Medline, ScienceDirect, and Web of Science were searched for studies published from the inception of the databases up to February 2019. Our inclusion criteria were published observational full-text articles. All data were analyzed using Review Manager 5.3. Of 208 papers reviewed, 26 studies (n = 6668) were considered for meta-analysis. RESULTS: The SHBG level was significantly lower in women with GDM compared to healthy women (MD = -11.86; 95% CI: [-13.02, -10.71]). Also, SHBG in women with PCOS and GDM and obesity was significantly lower than women with PCOS without GDM (MD = -38.14; 95% CI: [-56.79, -19.48]) and normal weight women (MD: -58.96; 95% CI: [-79.32, -38.59]). SHBG in the second trimester was lower than that in the first trimester and pre-conception. CONCLUSIONS: This systematic review showed that the level of SHBG is significantly lower in GDM pregnant women than that in healthy women. The results of this systematic review about the relationship of GDM and SHBG and suggestion to assess this marker in early pregnancy should be considered with caution.


Assuntos
Biomarcadores/sangue , Diabetes Gestacional/diagnóstico , Diagnóstico Pré-Natal/métodos , Globulina de Ligação a Hormônio Sexual/análise , Adulto , Diabetes Gestacional/sangue , Feminino , Teste de Tolerância a Glucose , Humanos , Cuidado Pré-Concepcional/métodos , Gravidez , Primeiro Trimestre da Gravidez/sangue , Segundo Trimestre da Gravidez/sangue , Globulina de Ligação a Hormônio Sexual/metabolismo
20.
Diabetes Res Clin Pract ; 152: 23-28, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31078667

RESUMO

AIM: To confirm whether serum bilirubin is an independent risk factor of type 2 diabetes mellitus (T2DM) onset in patients with impaired fasting glycemia (IFG) and impaired glucose tolerance (IGT). METHODS: This was a prospective cohort study carried out at the Diabetic Identification Center of Tianjin Metabolic Diseases Hospital. Serum total bilirubin (TBIL) was measured at baseline and the patients were grouped according to baseline bilirubin quartiles. The outcome was the confirmation of T2DM by oral glucose tolerance test (OGTT) during the 3-year follow-up. Logistic regression was used to determine the risk factors for T2DM development and whether bilirubin levels are independently associated with T2DM development. RESULTS: Finally, 523 patients were analyzed. After 3 years, 310 participants were diagnosed with diabetes based on OGTT. Baseline quartiles of total bilirubin were inversely associated with diabetes risk, even after multivariable adjustment. The adjusted ORs for diabetes were 1.0 (reference), 0.83 (95% CI 0.74-0.96), 0.78 (95% CI 0.68-0.90), 0.74 (95% CI 0.64-0.87) for the 1st, 2nd, 3rd, and 4th quartiles of baseline serum total bilirubin, respectively (P < 0.001). CONCLUSION: In patients with IFG or IGT, low levels of serum total bilirubin were associated with a significantly increased risk of T2DM.


Assuntos
Bilirrubina/sangue , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/sangue , Intolerância à Glucose/sangue , Estado Pré-Diabético/sangue , Adulto , Idoso , Glicemia/metabolismo , Estudos de Coortes , Feminino , Teste de Tolerância a Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
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