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1.
BMC Anesthesiol ; 24(1): 217, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951764

RESUMO

BACKGROUND: Postoperative hyperglycemia is associated with morbidity and mortality in non-diabetic surgical patients. However, there is limited information on the extent and factors associated with postoperative hyperglycemia. This study assessed the magnitude and associated factors of postoperative hyperglycemia among non-diabetic adult patients who underwent elective surgery at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 412 adult patients who underwent elective surgery at University of Gondar Comprehensive Specialized Hospital from April 14 to June 30, 2022 All consecutive postoperative non-diabetic elective surgical patients who were admitted to PACU during the data collection period and who fulfilled inclusion criteria were included in the study until the intended minimum sample size was achieved. And data were collected through interviews using a pretested semi-structured questionnaire. Postoperative hyperglycemia was defined as a blood glucose level of ≥ 140 mg/dl. Multivariable logistic regression was performed to identify the association between postoperative hyperglycemia and independent variables. Variables with a p-value less than 0.05 and a 95% confidence interval (CI) were considered statistically significant. RESULTS: A total of 405 patients' data were evaluated with a response rate of 98.3%. The median (IQR) age was 40 (28-52) years. The prevalence of postoperative hyperglycemia was 34.1% (95% CI: 29.4-39.0). Factors significantly associated with postoperative hyperglycemia included being overweight (AOR = 5.45, 95% CI: 2.46-12.0), American Society of Anesthesiologists (ASA) classification II and III (AOR = 2.37, 95% CI: 1.17-4.79), postoperative low body temperature (AOR = 0.18, 95% CI: 0.069-0.48), blood loss ≥ 500 ml (AOR = 2.33, 95% CI: 1.27-4.27), long duration of surgery, mild pain (AOR = 5.17, 95% CI: 1.32-20.4), and moderate pain (AOR = 7.63, 95% CI: 1.811-32.20). CONCLUSION AND RECOMMENDATION: One-third of the study participants had postoperative hyperglycemia. Weight, ASA classification, postoperative body temperature, duration of surgery, intraoperative blood loss, and postoperative pain were identified as a modifiable risk factors. Maintaining normal body temperature throughout the procedure, treating postoperative pain, and monitoring and controlling blood glucose level in patients at risk of hyperglycemia is crucial.


Assuntos
Hiperglicemia , Complicações Pós-Operatórias , Humanos , Etiópia/epidemiologia , Adulto , Feminino , Masculino , Estudos Transversais , Hiperglicemia/epidemiologia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Fatores de Risco , Hospitais Universitários , Prevalência , Glicemia/análise
2.
PeerJ ; 12: e17583, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38948211

RESUMO

Background: Recent studies suggest that gut microbiota composition, abundance and diversity can influence many chronic diseases such as type 2 diabetes. Modulating gut microbiota through targeted nutrition can provide beneficial effects leading to the concept of personalized nutrition for health improvement. In this prospective clinical trial, we evaluated the impact of a microbiome-based targeted personalized diet on hyperglycaemic and hyperlipidaemic individuals. Specifically, BugSpeaks®-a microbiome profile test that profiles microbiota using next generation sequencing and provides personalized nutritional recommendation based on the individual microbiota profile was evaluated. Methods: A total of 30 participants with type 2 diabetes and hyperlipidaemia were recruited for this study. The microbiome profile of the 15 participants (test arm) was evaluated using whole genome shotgun metagenomics and personalized nutritional recommendations based on their microbiota profile were provided. The remaining 15 participants (control arm) were provided with diabetic nutritional guidance for 3 months. Clinical and anthropometric parameters such as HbA1c, systolic/diastolic pressure, c-reactive protein levels and microbiota composition were measured and compared during the study. Results: The test arm (microbiome-based nutrition) showed a statistically significant decrease in HbA1c level from 8.30 (95% confidence interval (CI), [7.74-8.85]) to 6.67 (95% CI [6.2-7.05]), p < 0.001 after 90 days. The test arm also showed a 5% decline in the systolic pressure whereas the control arm showed a 7% increase. Incidentally, a sub-cohort of the test arm of patients with >130 mm Hg systolic pressure showed a statistically significant decrease of systolic pressure by 14%. Interestingly, CRP level was also found to drop by 19.5%. Alpha diversity measures showed a significant increase in Shannon diversity measure (p < 0.05), after the microbiome-based personalized dietary intervention. The intervention led to a minimum two-fold (Log2 fold change increase in species like Phascolarctobacterium succinatutens, Bifidobacterium angulatum, and Levilactobacillus brevis which might have a beneficial role in the current context and a similar decrease in species like Alistipes finegoldii, and Sutterella faecalis which have been earlier shown to have some negative effects in the host. Overall, the study indicated a net positive impact of the microbiota based personalized dietary regime on the gut microbiome and correlated clinical parameters.


Assuntos
Diabetes Mellitus Tipo 2 , Microbioma Gastrointestinal , Hiperglicemia , Hipertensão , Medicina de Precisão , Humanos , Masculino , Hipertensão/dietoterapia , Hipertensão/microbiologia , Feminino , Pessoa de Meia-Idade , Estudos Prospectivos , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/microbiologia , Hiperglicemia/dietoterapia , Hiperglicemia/microbiologia , Medicina de Precisão/métodos , Inflamação/dietoterapia , Estudo de Prova de Conceito , Hemoglobinas Glicadas/metabolismo , Hemoglobinas Glicadas/análise , Idoso , Hiperlipidemias/dietoterapia , Hiperlipidemias/sangue , Hiperlipidemias/microbiologia , Adulto , Proteína C-Reativa/análise , Proteína C-Reativa/metabolismo
3.
Scand Cardiovasc J ; 58(1): 2373099, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38949610

RESUMO

BACKGROUND: Acute Type A Aortic Dissection (AAAD) is one of the most life-threatening diseases, often associated with transient hyperglycemia induced by acute physiological stress. The impact of stress-induced hyperglycemia on the prognosis of ST-segment elevation myocardial infarction has been reported. However, the relationship between stress-induced hyperglycemia and the prognosis of AAAD patients remains uncertain. METHODS: The clinical data of 456 patients with acute type A aortic dissection were retrospectively reviewed. Patients were divided into two groups based on their admission blood glucose. Cox model regression analysis was performed to assess the relationship between stress-induced hyperglycemia and the 30-day and 1-year mortality rates of these patients. RESULTS: Among the 456 patients, 149 cases (32.7%) had AAAD combined with stress-induced hyperglycemia (SIH). The results of the multifactor regression analysis of the Cox model indicated that hyperglycemia (RR = 1.505, 95% CI: 1.046-2.165, p = 0.028), aortic coarctation involving renal arteries (RR = 3.330, 95% CI: 2.237-4.957, p < 0.001), aortic coarctation involving superior mesenteric arteries (RR = 1.611, 95% CI: 1.056-2.455, p = 0.027), and aortic coarctation involving iliac arteries (RR = 2.034, 95% CI: 1.364-3.035, p = 0.001) were independent influences on 1-year postoperative mortality in AAAD patients. CONCLUSION: The current findings indicate that stress-induced hyperglycemia measured on admission is strongly associated with 1-year mortality in patients with AAAD. Furthermore, stress-induced hyperglycemia may be related to the severity of the condition in patients with AAAD.


Assuntos
Aneurisma Aórtico , Dissecção Aórtica , Glicemia , Hiperglicemia , Humanos , Estudos Retrospectivos , Dissecção Aórtica/mortalidade , Dissecção Aórtica/sangue , Masculino , Feminino , Hiperglicemia/mortalidade , Hiperglicemia/sangue , Hiperglicemia/diagnóstico , Hiperglicemia/complicações , Pessoa de Meia-Idade , Fatores de Tempo , Fatores de Risco , Idoso , Glicemia/metabolismo , Aneurisma Aórtico/mortalidade , Aneurisma Aórtico/sangue , Medição de Risco , Doença Aguda , Biomarcadores/sangue , Prognóstico , Adulto
4.
BMC Geriatr ; 24(1): 585, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977983

RESUMO

BACKGROUND: The management of preoperative blood glucose levels in reducing the incidence of postoperative delirium (POD) remains controversial. This study aims to investigate the impact of preoperative persistent hyperglycemia on POD in geriatric patients with hip fractures. METHODS: This retrospective cohort study analyzed medical records of patients who underwent hip fracture surgery at a tertiary medical institution between January 2013 and November 2023. Patients were categorized based on preoperative hyperglycemia (hyperglycemia defined as ≥ 6.1mmol/L), clinical classification of hyperglycemia, and percentile thresholds. Multivariate logistic regression and propensity score matching analysis (PSM) were employed to assess the association between different levels of preoperative glucose and POD. Subgroup analysis was conducted to explore potential interactions. RESULTS: A total of 1440 patients were included in this study, with an incidence rate of POD at 19.1% (275/1440). Utilizing multiple logistic analysis, we found that patients with hyperglycemia had a 1.65-fold increased risk of experiencing POD compared to those with normal preoperative glucose levels (95% CI: 1.17-2.32). Moreover, a significant upward trend was discerned in both the strength of association and the predicted probability of POD with higher preoperative glucose levels. PSM did not alter this trend, even after meticulous adjustments for potential confounding factors. Additionally, when treating preoperative glucose levels as a continuous variable, we observed a 6% increase in the risk of POD (95% CI: 1-12%) with each 1mmol/L elevation in preoperative glucose levels. CONCLUSIONS: There exists a clear linear dose-response relationship between preoperative blood glucose levels and the risk of POD. Higher preoperative hyperglycemia was associated with a greater risk of POD. CLINICAL TRIAL NUMBER: NCT06473324.


Assuntos
Delírio , Fraturas do Quadril , Hiperglicemia , Complicações Pós-Operatórias , Humanos , Fraturas do Quadril/cirurgia , Fraturas do Quadril/sangue , Hiperglicemia/epidemiologia , Hiperglicemia/sangue , Feminino , Masculino , Estudos Retrospectivos , Idoso , Idoso de 80 Anos ou mais , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/sangue , Delírio/sangue , Delírio/epidemiologia , Delírio/diagnóstico , Delírio/etiologia , Glicemia/metabolismo , Glicemia/análise , Período Pré-Operatório , Incidência , Fatores de Risco , Pontuação de Propensão
5.
Enferm. actual Costa Rica (Online) ; (46): 58688, Jan.-Jun. 2024. tab
Artigo em Espanhol | LILACS, BDENF - Enfermagem, SaludCR | ID: biblio-1550244

RESUMO

Resumen Introducción: El control y la evaluación de los niveles glucémicos de pacientes en estado críticos es un desafío y una competencia del equipo de enfermería. Por lo que, determinar las consecuencias de esta durante la hospitalización es clave para evidenciar la importancia del oportuno manejo. Objetivo: Determinar la asociación entre la glucemia inestable (hiperglucemia e hipoglucemia), el resultado de la hospitalización y la duración de la estancia de los pacientes en una unidad de cuidados intensivos. Metodología: Estudio de cohorte prospectivo realizado con 62 pacientes a conveniencia en estado crítico entre marzo y julio de 2017. Se recogieron muestras diarias de sangre para medir la glucemia. Se evaluó la asociación de la glucemia inestable con la duración de la estancia y el resultado de la hospitalización mediante ji al cuadrado de Pearson. El valor de p<0.05 fue considerado significativo. Resultados: De las 62 personas participantes, 50 % eran hombres y 50 % mujeres. La edad media fue de 63.3 años (±21.4 años). La incidencia de glucemia inestable fue del 45.2 % y se asoció con una mayor duración de la estancia en la UCI (p<0.001) y una progresión a la muerte como resultado de la hospitalización (p=0.03). Conclusión: Entre quienes participaron, la glucemia inestable se asoció con una mayor duración de la estancia más prolongada y con progresión hacia la muerte, lo que refuerza la importancia de la actuación de enfermería para prevenir su aparición.


Resumo Introdução: O controle e avaliação dos níveis glicêmicos em pacientes críticos é um desafio e uma competência da equipe de enfermagem. Portanto, determinar as consequências da glicemia instável durante a hospitalização é chave para evidenciar a importância da gestão oportuna. Objetivo: Determinar a associação entre glicemia instável (hiperglicemia e hipoglicemia), os desfechos hospitalares e o tempo de permanência dos pacientes em uma unidade de terapia intensiva. Métodos: Um estudo de coorte prospectivo realizado com 62 pacientes a conveniência em estado crítico entre março e julho de 2017. Foram coletadas amostras diariamente de sangue para medir a glicemia. A associação entre a glicemia instável com o tempo de permanência e o desfecho da hospitalização foi avaliada pelo teste qui-quadrado de Pearson. O valor de p <0,05 foi considerado significativo. Resultados: Das 62 pessoas participantes, 50% eram homens e 50% mulheres. A idade média foi de 63,3 anos (±21,4 anos). A incidência de glicemia instável foi de 45,2% e se associou a um tempo de permanência mais prolongado na UTI (p <0,001) e uma progressão para óbito como desfecho da hospitalização (p = 0,03). Conclusão: Entre os participantes, a glicemia instável se associou a um tempo mais longo de permanência e com progressão para óbito, enfatizando a importância da actuação da equipe de enfermagem para prevenir sua ocorrência.


Abstract Introduction: The control and evaluation of glycemic levels in critically ill patients is a challenge and a responsibility of the nursing team; therefore, determining the consequences of this during hospitalization is key to demonstrate the importance of timely management. Objective: To determine the relationship between unstable glycemia (hyperglycemia and hypoglycemia), hospital length of stay, and the hospitalization outcome of patients in an Intensive Care Unit (ICU). Methods: A prospective cohort study conducted with 62 critically ill patients by convenience sampling between March and July 2017. Daily blood samples were collected to measure glycemia. The correlation of unstable glycemia with the hospital length of stay and the hospitalization outcome was assessed using Pearson's chi-square. A p-value <0.05 was considered significant. Results: Among the 62 patients, 50% were male and 50% were female. The mean age was 63.3 years (±21.4 years). The incidence of unstable glycemia was 45.2% and was associated with a longer ICU stay (p<0.001) and a progression to death as a hospitalization outcome (p=0.03). Conclusion: Among critically ill patients, unstable glycemia was associated with an extended hospital length of stay and a progression to death, emphasizing the importance of nursing intervention to prevent its occurrence.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Cuidados Críticos/estatística & dados numéricos , Diabetes Mellitus/enfermagem , Hospitalização/estatística & dados numéricos , Hiperglicemia/enfermagem
6.
Appetite ; 200: 107569, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-38901765

RESUMO

Consumption of foods with high glycaemic index (GI) can cause hyperglycemia, thus increasing postprandial hunger. Since circadian rhythm differs inter-individually, we describe glucose dips after breakfast/dinner with high/medium estimated meal GI among students with early (n = 22) and late chronotype (n = 23) and examine their relation to the feeling of hunger in a secondary analysis of a randomized cross-over nutrition trial. Glucose dips reflect the difference between the lowest glucose value recorded 2-3 h postprandially and baseline, presented as percentage of average baseline level. Associations between glucose dips and the feeling of hunger were analyzed using multilevel linear models. Glucose dips were lower after medium GI meals than after high GI meals among both chronotype groups (p = 0.03). Among early chronotypes, but not among late chronotypes, glucose dip values were lower after breakfast than after dinner (-4.9 % vs. 5.5 %, p = 0.001). Hunger increased throughout the day among both chronotypes but glucose dips were not related to the feeling of hunger at the meal following breakfast. Interestingly, lower glucose dip values 2-3 h postprandially occurred particularly after medium GI meals and were seen after breakfast among early chronotypes. These glucose dips did not predict hunger at meals after breakfast.


Assuntos
Glicemia , Ritmo Circadiano , Estudos Cross-Over , Índice Glicêmico , Fome , Refeições , Período Pós-Prandial , Estudantes , Humanos , Feminino , Masculino , Glicemia/metabolismo , Ritmo Circadiano/fisiologia , Adulto Jovem , Estudantes/psicologia , Adulto , Desjejum , Dieta , Adolescente , Hiperglicemia/prevenção & controle , Cronotipo
7.
Mol Med Rep ; 30(2)2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-38940333

RESUMO

Elevated levels of blood glucose in patients with ischemic stroke are associated with a worse prognosis. The present study aimed to explore whether hyperglycemia promotes microglial pyroptosis by increasing the oxygen extraction rate in an acute ischemic stroke model. C57BL/6 mice that underwent middle cerebral artery occlusion were used for assessment of blood glucose level and neurological function. The cerebral oxygen extraction ratio (CERO2), oxygen consumption rate (OCR) and partial pressure of brain tissue oxygen (PbtO2) were measured. To investigate the significance of the NOD­like receptor protein 3 (NLRP3) inflammasome, NLRP3­/­ mice were used, and the expression levels of NLRP3, caspase­1, full­length gasdermin D (GSDMD­FL), GSDMD­N domain (GSDMD­N), IL­1ß and IL­18 were evaluated. In addition, Z­YVAD­FMK, a caspase­1 inhibitor, was used to treat microglia to determine whether activation of the NLRP3 inflammasome was required for the enhancing effect of hyperglycemia on pyroptosis. It was revealed that hyperglycemia accelerated cerebral injury in the acute ischemic stroke model, as evidenced by decreased latency to fall and the percentage of foot fault. Hyperglycemia aggravated hypoxia by increasing the oxygen extraction rate, as evidenced by increased CERO2 and OCR, and decreased PbtO2 in response to high glucose treatment. Furthermore, hyperglycemia­induced microglial pyroptosis was confirmed by detection of increased levels of caspase­1, GSDMD­N, IL­1ß and IL­18 and a decreased level of GSDMD­FL. However, the knockout of NLRP3 attenuated these effects. Pharmacological inhibition of caspase­1 also reduced the expression levels of GSDMD­N, IL­1ß and IL­18 in microglial cells. These results suggested that hyperglycemia stimulated NLRP3 inflammasome activation by increasing the oxygen extraction rate, thus leading to the aggravation of pyroptosis following ischemic stroke.


Assuntos
Hiperglicemia , Inflamassomos , AVC Isquêmico , Camundongos Endogâmicos C57BL , Microglia , Proteína 3 que Contém Domínio de Pirina da Família NLR , Oxigênio , Piroptose , Animais , Microglia/metabolismo , AVC Isquêmico/metabolismo , AVC Isquêmico/patologia , Camundongos , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Oxigênio/metabolismo , Masculino , Hiperglicemia/metabolismo , Inflamassomos/metabolismo , Caspase 1/metabolismo , Modelos Animais de Doenças , Camundongos Knockout , Interleucina-1beta/metabolismo , Proteínas de Ligação a Fosfato/metabolismo , Consumo de Oxigênio , Gasderminas
8.
Medicina (Kaunas) ; 60(6)2024 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-38929473

RESUMO

Background and Objectives: The risk of developing glycemic dysregulation up to overt diabetes mellitus (DM) after an episode of acute pancreatitis (AP) is increasingly being analyzed. We aimed to assess the changes in serum glucose levels associated with the first episode of AP, as well as the impact of dysglycemia on outcomes such as the severity of inflammation, the length of hospitalization, mortality, and the persistence of hyperglycemia at follow-up. Materials and Methods: All patients experiencing their first episode of AP, who presented to the Emergency Room (ER) between 1 January 2020 and 31 December 2023, were retrospectively included. On-admission serum glucose and peak serum glucose during hospitalization were the biological markers used to assess glucose metabolism impairment, and they were correlated with outcomes of AP. Results: Our study included 240 patients, 46.67% (112 patients) having a biliary etiology for an AP flare. Patients with COVID-19-associated AP exhibited the highest on-admission and peak serum glucose levels (244.25 mg/dL and 305.5 mg/dL, respectively). A longer hospital stay was noted in patients with peak serum glucose levels of ≥100 mg/dL (9.49 days) compared to normoglycemic patients (6.53 days). Both on-admission and peak glucose levels were associated with elevated CRP levels during hospitalization. A total of 83.78% of patients who received antibiotics exhibited on-admission hyperglycemia, and 72.07% had peak serum glucose levels of ≥100 mg/dL. The presence of hyperglycemia at follow-up was associated with both on-admission and peak serum glucose levels of ≥100 mg/dL, as well as with a longer stay, higher CRP levels, and antibiotic use during index admission. Conclusions: On-admission hyperglycemia predicts a higher inflammatory response in patients at the first episode of AP, while the presence of hyperglycemia during hospitalization is associated with imaging and biological severity and longer hospitalizations, indicating a more severe disease course. Both on-admission and peak in-hospital hyperglycemia were identified as risk factors for sustained hyperglycemia at follow-up.


Assuntos
Glicemia , Tempo de Internação , Pancreatite , Humanos , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Pancreatite/sangue , Pancreatite/complicações , Glicemia/análise , Adulto , Tempo de Internação/estatística & dados numéricos , Hiperglicemia/complicações , Hiperglicemia/sangue , COVID-19/complicações , COVID-19/sangue , Idoso , Hospitalização/estatística & dados numéricos , Índice de Gravidade de Doença , Biomarcadores/sangue
9.
Clin Oral Investig ; 28(7): 392, 2024 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-38907052

RESUMO

OBJECTIVES: To investigate the four-year clinical outcome and marginal bone loss around narrow-diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and normo-glycemic individuals. MATERIALS AND METHODS: In 11 T2DM patients with a concentration of glycated hemoglobin (HbA1C) > 6.5% (test group) and 15 normoglycemic patients (HbA1C < 6.0%; control group), one narrow-diameter tissue level implant, placed in the posterior maxilla or mandible, was investigated. The clinical parameters probing depth (PD), bleeding on probing (BOP), attachment loss (CAL), recession, and papilla bleeding index (PBI) were assessed manually after 24 and 48 months of function. The paired digital periapical radiographs were analyzed regarding the change in marginal bone level (MBL) from baseline to 48 months post-op. The technical complications were recorded. RESULTS: In the T2DM group, 11 patients were available for follow-ups. The overall implant survival rate after 48 months was 100%. The differences in means for the clinical parameters and the MBL between the T2DM and normo-glycemic patients for the observation period were statistically non-significant. No technical complications were recorded. CONCLUSIONS: The study demonstrated an encouraging clinical outcome with ND implants in patients with uncontrolled T2DM compared to non-diabetics after 48 months' post loading. CLINICAL RELEVANCE: Patients with HbA1C > 6.5% may benefit from the treatment with narrow-diameter implants by avoiding complex surgical interventions with augmentation procedures. REGISTRATION NUMBER (CLINICALTRIALS.GOV): NCT04630691.


Assuntos
Planejamento de Prótese Dentária , Diabetes Mellitus Tipo 2 , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/complicações , Resultado do Tratamento , Implantes Dentários , Hemoglobinas Glicadas , Idoso , Implantação Dentária Endóssea/métodos , Perda do Osso Alveolar/diagnóstico por imagem , Índice Periodontal , Adulto , Hiperglicemia
10.
J Appl Biomed ; 22(2): 74-80, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38912862

RESUMO

Myo-inositol (MI), present in a variety of foods, is essential in several important processes of cell physiology. In this study, we explored the protective effects of MI against hyperglycemia and dyslipidemia in db/db mice, a typical animal model of type 2 diabetes mellitus (T2DM). MI supplement effectively suppressed the high plasma glucose and insulin levels and markedly relieved the insulin resistance (IR) in the db/db mice, comparable to metformin's effects. In MIN6 pancreatic ß cells, MI also restrained the upsurge of insulin secretion stimulated by high-concentration glucose but had no impact on the promoted cell proliferation. Moreover, MI abated the enhanced plasma triglyceride and total cholesterol levels in the db/db mice. Notably, the lipid droplet formation of mesenchymal stem cells (MSCs) from db/db mice was significantly diminished after the treatment of MI, indicating that MI could effectively inhibit the differentiation of db/db mouse MSCs into adipocytes. However, MI regretfully failed to control obesity in db/db mice. This work proved that MI significantly helped db/db mice's metabolic disorders, indicating that MI has potential as an effective adjunctive treatment for hyperglycemia and dyslipidemia in T2DM patients.


Assuntos
Diabetes Mellitus Tipo 2 , Dislipidemias , Inositol , Resistência à Insulina , Animais , Dislipidemias/tratamento farmacológico , Dislipidemias/metabolismo , Inositol/farmacologia , Inositol/uso terapêutico , Camundongos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/metabolismo , Masculino , Insulina/metabolismo , Insulina/sangue , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/efeitos dos fármacos , Glicemia/metabolismo , Glicemia/efeitos dos fármacos , Células Secretoras de Insulina/efeitos dos fármacos , Células Secretoras de Insulina/metabolismo , Adipócitos/metabolismo , Adipócitos/efeitos dos fármacos , Hiperglicemia/tratamento farmacológico , Hiperglicemia/metabolismo
11.
J Pharm Pharm Sci ; 27: 13074, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38919469

RESUMO

Purpose: This study evaluated the safety and efficacy of two insulin regimens for inpatient hyperglycemia management: combination short-plus long-acting insulin (basal-bolus insulin regimen, BBIR) vs. short-acting insulin only (correctional insulin only regimen, CIOR). Methods: Chart reviews identified noncritically ill patients with pre-existing type 2 diabetes mellitus receiving insulin injections. Study participants (N = 138) were divided into BBIR (N = 104) and CIOR (N = 34) groups. Data for the entire duration of each patient's stay were analyzed. Results: The primary outcome of percent hyperglycemic days was higher in BBIR vs. CIOR (3.97 ± 0.33% vs. 1.22 ± 0.38%). The safety outcome of percent hypoglycemic events was not different between BBIR and CIOR (0.78 ± 0.22% vs. 0.53 ± 0.37%). Regarding secondary outcomes, the percentage of euglycemic days was lower in BBIR vs. CIOR (26.74 ± 2.97% vs. 40.98 ± 5.91%). Overall blood glucose (BG) and daily insulin dose were higher in BBIR vs. CIOR (231.43 ± 5.37 vs. 195.55 ± 6.25 mg/dL and 41.36 ± 3.07 vs. 5.02 ± 0.68 units, respectively). Insulin regimen-associated differences in hyperglycemia and daily insulin dose persisted after adjusting for covariates. Conclusion: Our observations linking BBIR to worse glycemic outcomes differ from those reported in the randomized controlled Rabbit 2 and Rabbit 2 Surgery trials. This discrepancy can be partly explained by the fact that BBIR patients displayed worse glycemic baselines. Also, there was no diabetes stewardship team to monitor BG and modify insulin therapy, which is relevant since achieving euglycemia in BBIR patients requires more dose adjustments. This study highlights challenges with standard inpatient glycemic management and calls for further research assessing the benefits of pharmacist-led diabetes stewardship.


Assuntos
Diabetes Mellitus Tipo 2 , Hospitais Comunitários , Hiperglicemia , Hipoglicemiantes , Insulina , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Masculino , Feminino , Hiperglicemia/tratamento farmacológico , Pessoa de Meia-Idade , Insulina/administração & dosagem , Insulina/uso terapêutico , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/uso terapêutico , Idoso , Estudos Retrospectivos , Glicemia/efeitos dos fármacos
12.
Front Endocrinol (Lausanne) ; 15: 1385583, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38919473

RESUMO

Background: The prevalence of diabetes has risen fast with a considerable weighted prevalence of undiagnosed diabetes or uncontrolled diabetes. Then it becomes more necessary to timely screen out and monitor high-risk populations who are likely to be ignored during the COVID-19 pandemic. To classify and find the common risks of undiagnosed diabetes and uncontrolled diabetes, it's beneficial to put specific risk control measures into effect for comprehensive primary care. Especially, there is a need for accurate yet accessible prediction models. Objective: Based on a cross-sectional study and secondary analysis on the health examination held in Changchun City (2016), we aimed to evaluate the factors associated with hyperglycemia, analyze the management status of T2DM, and determine the best cutoff value of incidence of diabetes in the first-degree relatives to suggest the necessity of early diagnosis of diabetes after first screening. Results: A total of 5658 volunteers were analyzed. Prevalence of T2DM and impaired fasting glucose were 8.4% (n=477) and 11.5% (n=648), respectively. There were 925 participants (16.3%) with a family history of T2DM in their first-degree relatives. Multivariable analysis demonstrated that family history was associated with hyperglycemia. Among the 477 patients with T2DM, 40.9% had not been previously diagnosed. The predictive equation was calculated with the following logistic regression parameters with 0.71 (95% CI: 0.67-0.76) of the area under the ROC curve, 64.0% of sensitivity and 29% of specificity (P < 0.001): P = \frac{1}{1 + e^{-z}}, where z = -3.08 + [0.89 (Family history-group) + 0.69 (age-group)+ 0.25 (BMI-group)]. Positive family history was associated with the diagnosis of T2DM, but not glucose level in the diagnosed patients. The best cutoff value of incidence of diabetes in the first-degree relatives was 9.55% (P < 0.001). Conclusions: Family history of diabetes was independently associated with glucose dysfunction. Classification by the first-degree relatives with diabetes is prominent for targeting high-risk population. Meanwhile, positive family history of diabetes was associated with diabetes being diagnosed rather than the glycemic control in patients who had been diagnosed. It's necessary to emphasize the linkage between early diagnosis and positive family history for high proportions of undiagnosed T2DM.


Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Feminino , Masculino , China/epidemiologia , Pessoa de Meia-Idade , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/diagnóstico , Fatores de Risco , Adulto , Prevalência , COVID-19/epidemiologia , Glicemia/análise , Família , Idoso , Hiperglicemia/epidemiologia , Incidência
13.
Nat Commun ; 15(1): 5394, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38918428

RESUMO

Adipose tissue macrophages (ATMs) influence obesity-associated metabolic dysfunction, but the mechanisms by which they do so are not well understood. We show that miR-6236 is a bona fide miRNA that is secreted by ATMs during obesity. Global or myeloid cell-specific deletion of miR-6236 aggravates obesity-associated adipose tissue insulin resistance, hyperglycemia, hyperinsulinemia, and hyperlipidemia. miR-6236 augments adipocyte insulin sensitivity by inhibiting translation of negative regulators of insulin signaling, including PTEN. The human genome harbors a miR-6236 homolog that is highly expressed in the serum and adipose tissue of obese people. hsa-MIR-6236 expression negatively correlates with hyperglycemia and glucose intolerance, and positively correlates with insulin sensitivity. Together, our findings establish miR-6236 as an ATM-secreted miRNA that potentiates adipocyte insulin signaling and protects against metabolic dysfunction during obesity.


Assuntos
Adipócitos , Hiperglicemia , Resistência à Insulina , Insulina , MicroRNAs , Obesidade , PTEN Fosfo-Hidrolase , Transdução de Sinais , MicroRNAs/metabolismo , MicroRNAs/genética , Obesidade/metabolismo , Obesidade/genética , Animais , Adipócitos/metabolismo , Hiperglicemia/metabolismo , Hiperglicemia/genética , Humanos , Insulina/metabolismo , Resistência à Insulina/genética , Camundongos , Masculino , PTEN Fosfo-Hidrolase/metabolismo , PTEN Fosfo-Hidrolase/genética , Camundongos Endogâmicos C57BL , Macrófagos/metabolismo , Tecido Adiposo/metabolismo , Células Mieloides/metabolismo , Camundongos Knockout , Hiperinsulinismo/metabolismo , Hiperinsulinismo/genética
14.
BMC Public Health ; 24(1): 1697, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38918764

RESUMO

BACKGROUND: Glucose metabolism regulation is influenced by age and meal skipping, although research on their interplay with hyperglycemia remains limited. This study aims to explore the intricate relationship between meal-skipping patterns and hyperglycemia risk across distinct age groups in South Korean adults. METHODS: Utilizing data from the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2013 to 2020, comprising 28,530 individuals aged 19 years and older, this study employed multivariable logistic regression models to examine the associations between meal-skipping patterns and the risk of hyperglycemia. RESULTS: Meal-skipping patterns were categorized into three groups: no skipping (NS), skipping breakfast (SB), and skipping dinner (SD). Age groups were defined as "young" (aged 19-44), "middle-aged" (aged 45-64), and "elderly" adults (over 65 years old). Among "young" adults, SB was associated with a 1.33-fold higher risk of hyperglycemia (OR = 1.33, 95% CI = 1.14-1.54) compared to NS. Conversely, in "elderly" adults, SD was linked to a 0.49-fold reduced risk (95% CI = 0.29-0.82) when compared to NS. Additionally, we observed that the Korean Health Eating Index (KHEI) scores, representing the quality of diet on a scale of 0 to 100, were consistently lower in SB compared to NS across all age groups. Intriguingly, specifically among the "elderly" group, this score was higher in SD compared to NS (p < 0.001). CONCLUSIONS: This study demonstrates age-specific variations in the association between meal-skipping patterns and the risk of hyperglycemia.


Assuntos
Comportamento Alimentar , Hiperglicemia , Inquéritos Nutricionais , Humanos , República da Coreia/epidemiologia , Adulto , Hiperglicemia/epidemiologia , Pessoa de Meia-Idade , Estudos Transversais , Masculino , Feminino , Idoso , Adulto Jovem , Fatores Etários , Fatores de Risco , Refeições
15.
Cardiovasc Diabetol ; 23(1): 190, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38824608

RESUMO

BACKGROUND: Coronary three-vessel disease (CTVD) accounts for one-third of the overall incidence of coronary artery disease, with heightened mortality rates compared to single-vessel lesions, including common trunk lesions. Dysregulated glucose metabolism exacerbates atherosclerosis and increases cardiovascular risk. The stress hyperglycemia ratio (SHR) is proposed as an indicator of glucose metabolism status but its association with cardiovascular outcomes in CTVD patients undergoing percutaneous coronary intervention (PCI) remains unclear. METHODS: 10,532 CTVD patients undergoing PCI were consecutively enrolled. SHR was calculated using the formula: admission blood glucose (mmol/L)/[1.59×HbA1c (%)-2.59]. Patients were divided into two groups (SHR Low and SHR High) according to the optimal cutoff value of SHR. Multivariable Cox regression models were used to assess the relationship between SHR and long-term prognosis. The primary endpoint was cardiovascular (CV) events, composing of cardiac death and non-fatal myocardial infarction (MI). RESULTS: During the median follow-up time of 3 years, a total of 279 cases (2.6%) of CV events were recorded. Multivariable Cox analyses showed that high SHR was associated with a significantly higher risk of CV events [Hazard Ratio (HR) 1.99, 95% Confidence interval (CI) 1.58-2.52, P < 0.001). This association remained consistent in patients with (HR 1.50, 95% CI 1.08-2.10, P = 0.016) and without diabetes (HR 1.97, 95% CI 1.42-2.72, P < 0.001). Additionally, adding SHR to the base model of traditional risk factors led to a significant improvement in the C-index, net reclassification and integrated discrimination. CONCLUSIONS: SHR was a significant predictor for adverse CV outcomes in CTVD patients with or without diabetes, which suggested that it could aid in the risk stratification in this particular population regardless of glucose metabolism status.


Assuntos
Biomarcadores , Glicemia , Doença da Artéria Coronariana , Hiperglicemia , Intervenção Coronária Percutânea , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Glicemia/metabolismo , Medição de Risco , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/mortalidade , Doença da Artéria Coronariana/terapia , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/diagnóstico , Biomarcadores/sangue , Fatores de Risco , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Fatores de Tempo , Hiperglicemia/sangue , Hiperglicemia/diagnóstico , Hiperglicemia/epidemiologia , Hiperglicemia/mortalidade , Resultado do Tratamento , Hemoglobinas Glicadas/metabolismo , Valor Preditivo dos Testes , Estudos Retrospectivos , Infarto do Miocárdio/sangue , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/mortalidade
16.
Rev Neurol ; 79(1): 1-9, 2024 Jul 01.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-38934944

RESUMO

INTRODUCTION: Morbidity remains high among patients who undergo successful mechanical thrombectomy (MT) for anterior circulation large vessel occlusion (LVO). Stress hyperglycemia worsens the prognosis after acute ischemic stroke (AIS), but aggressively treating hyperglycemia does not improve the outcome. There is no consensus on how to best manage glycemia after AIS. Glycemic variability (GV) reflects glycemic fluctuations over time and could be the culprit. We aimed to elucidate how GV impacts outcome of AIS patients treated with MT. PATIENTS AND METHODS: This was a single-center retrospective study. We consecutively included AIS patients who received MT for anterior circulation LVO. We recorded discrete blood glucose measurements within the first 24 hours post thrombectomy, from which we calculated two measures of GV: standard deviation (SD) and coefficient of variation. Univariate and multivariate analyses were conducted to identify predictors of poor functional outcome (modified Ranking scale score 3-6) and mortality at 3-month follow-up. RESULTS: We included 657 patients. Patients with poor functional outcome (42.5%) and patients that died (14.8%) had significantly higher GV as measured by SD. In a multivariable model adjusted for confounders, higher SD was associated with mortality -adjusted odds ratio: 1.020 (95% CI 1.001-1.040)- but not with functional outcome -adjusted odds ratio for modified Ranking scale score 3-6: 1.007 (95% CI 0.990-1.025)-. CONCLUSIONS: Our results suggest that higher GV after MT for anterior circulation AIS is an independent risk factor for 3-month mortality. Future trials should evaluate the benefit of reducing GV in this setting.


TITLE: Variabilidad glucémica tras trombectomía mecánica en el ictus isquémico agudo de la circulación anterior.Introducción. La morbilidad de los pacientes con ictus isquémico agudo (IIA) sometidos a trombectomía mecánica (TM) exitosa permanece alta. La hiperglucemia empeora el pronóstico tras un IIA, pero tratarla agresivamente no mejora los resultados. No existe consenso sobre el tratamiento óptimo de la glucemia después de un IIA. La variabilidad glucémica (VG), que refleja las fluctuaciones glucémicas a lo largo del tiempo, puede ser un factor importante. Nuestro objetivo fue investigar cómo la VG afecta el resultado de pacientes con IIA tratados con TM. Pacientes y métodos. Realizamos un estudio retrospectivo unicéntrico que incluyó a pacientes con IIA que recibieron TM para la oclusión de un gran vaso de la circulación anterior. Se registraron mediciones discretas de glucemia en las primeras 24 horas postrombectomía, a partir de las cuales se calcularon dos medidas de VG: desviación estándar y coeficiente de variación. Se realizó un análisis univariado y multivariado para identificar predictores de resultado funcional desfavorable (escala de Rankin modificada: 3-6) y mortalidad a los tres meses. Resultados. Se incluyó a 657 pacientes. Los que tenían una puntuación en la escala de Rankin modificada = 3 (42,5%) y los fallecidos (14,8%) tuvieron una VG significativamente mayor medida por desviación estándar. En un modelo multivariado, una mayor desviación estándar se asoció de forma independiente con la mortalidad ­odds ratio ajustada: 1,02 (intervalo de confianza al 95%: 1,001-1,04)­ pero no con el resultado funcional ­odds ratio ajustada de la escala de Rankin modificada = 3: 1,007 (intervalo de confianza al 95%: 0,99-1,025)­. Conclusiones. Nuestros resultados sugieren que una mayor VG tras la TM para el IIA de la circulación anterior es un factor de riesgo independiente de mortalidad a los tres meses. Los futuros ensayos deben evaluar el beneficio de reducir la VG en este contexto.


Assuntos
Glicemia , AVC Isquêmico , Trombectomia , Humanos , Masculino , Feminino , Estudos Retrospectivos , AVC Isquêmico/cirurgia , AVC Isquêmico/terapia , Idoso , Glicemia/análise , Pessoa de Meia-Idade , Hiperglicemia , Idoso de 80 Anos ou mais , Resultado do Tratamento
17.
BMJ Open Diabetes Res Care ; 12(3)2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38937276

RESUMO

INTRODUCTION: We previously reported predictors of mortality in 1786 adults with diabetes or stress hyperglycemia (glucose>180 mg/dL twice in 24 hours) admitted with COVID-19 from March 2020 to February 2021 to five university hospitals. Here, we examine predictors of readmission. RESEARCH DESIGN AND METHODS: Data were collected locally through retrospective reviews of electronic medical records from 1786 adults with diabetes or stress hyperglycemia who had a hemoglobin A1c (HbA1c) test on initial admission with COVID-19 infection or within 3 months prior to initial admission. Data were entered into a Research Electronic Data Capture (REDCap) web-based repository, and de-identified. Descriptive data are shown as mean±SD, per cent (%) or median (IQR). Student's t-test was used for comparing continuous variables with normal distribution and Mann-Whitney U test was used for data not normally distributed. X2 test was used for categorical variable. RESULTS: Of 1502 patients who were alive after initial hospitalization, 19.4% were readmitted; 90.3% within 30 days (median (IQR) 4 (0-14) days). Older age, lower estimated glomerular filtration rate (eGFR), comorbidities, intensive care unit (ICU) admission, mechanical ventilation, diabetic ketoacidosis (DKA), and longer length of stay (LOS) during the initial hospitalization were associated with readmission. Higher HbA1c, glycemic gap, or body mass index (BMI) were not associated with readmission. Mortality during readmission was 8.0% (n=23). Those who died were older than those who survived (74.9±9.5 vs 65.2±14.4 years, p=0.002) and more likely had DKA during the first hospitalization (p<0.001). Shorter LOS during the initial admission was associated with ICU stay during readmission, suggesting that a subset of patients may have been initially discharged prematurely. CONCLUSIONS: Understanding predictors of readmission after initial hospitalization for COVID-19, including older age, lower eGFR, comorbidities, ICU admission, mechanical ventilation, statin use and DKA but not HbA1c, glycemic gap or BMI, can help guide treatment approaches and future research in adults with diabetes.


Assuntos
COVID-19 , Diabetes Mellitus , Hemoglobinas Glicadas , Hiperglicemia , Readmissão do Paciente , SARS-CoV-2 , Humanos , COVID-19/mortalidade , COVID-19/complicações , Readmissão do Paciente/estatística & dados numéricos , Masculino , Feminino , Hiperglicemia/mortalidade , Hiperglicemia/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Hemoglobinas Glicadas/análise , Diabetes Mellitus/mortalidade , Diabetes Mellitus/epidemiologia , Hospitalização/estatística & dados numéricos , Adulto , Fatores de Risco , Idoso de 80 Anos ou mais , Glicemia/análise
18.
Life Sci ; 351: 122854, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-38901688

RESUMO

AIMS: To evaluate the cell proliferation and death, and structural morphology of the pancreatic islet cells of the rats with hyperglycemia in the first month of life and compare to those of the control rats. MAIN METHODS: Female Sprague-Dawley newborn rats received Streptozotocin (a beta-cytotoxic drug) at birth for diabetes induction. Control and hyperglycemic animals were euthanized on different days of life: 5, 10, 15, and 30. The pancreas was collected and processed for immunohistochemical analysis of cleaved Caspase-3 (cell death), Ki-67 (cell proliferation), PDX-1 (transcription factor responsible for insulin synthesis), and endocrine hormones (insulin, glucagon, and somatostatin). KEY FINDINGS: Control females showed a higher percentage (%) of Ki-67-positive(+) cells on D10 and D15, a higher % of insulin+ and somatostatin+ cells on D15 and D30, a lower % of PDX-1+ cells on D10, and a higher % of glucagon+ cells on D10 and D30. Hyperglycemic females showed a lower % of Ki-67+ cells on D15, a higher % of cleaved Caspase-3+ cells on D15, and insulin+ cells on D15 and D30. In the comparison among the experimental groups, the hyperglycemic females showed an increased % of cleaved Caspase-3+ and Ki-67+ cells and a lower % of PDX-1+ cells. SIGNIFICANCE: This study enabled a better understanding of the abnormal pancreas development regarding cellular proliferation, apoptosis, and hormonal synthesis in the neonatal period. Thus, the pancreatic islets of hyperglycemic rats do not reestablish the normal endocrine cell population, and cellular apoptosis overcame the proliferative activity of these cells.


Assuntos
Animais Recém-Nascidos , Proliferação de Células , Hiperglicemia , Ilhotas Pancreáticas , Ratos Sprague-Dawley , Animais , Feminino , Hiperglicemia/metabolismo , Hiperglicemia/patologia , Ratos , Ilhotas Pancreáticas/metabolismo , Ilhotas Pancreáticas/patologia , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Experimental/metabolismo , Morte Celular , Glucagon/metabolismo , Insulina/metabolismo , Antígeno Ki-67/metabolismo , Caspase 3/metabolismo , Somatostatina/metabolismo , Apoptose , Transativadores , Proteínas de Homeodomínio
19.
Int J Mol Sci ; 25(12)2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38928001

RESUMO

We examined whether the administration of growth hormone (GH) improves insulin resistance in females of a non-obese hyperglycemic mouse model after birth with low birth weight (LBW), given that GH is known to increase muscle mass. The intrauterine Ischemia group underwent uterine artery occlusion for 15 min on day 16.5 of gestation. At 4 weeks of age, female mice in the Ischemia group were divided into the GH-treated (Ischemia-GH) and non-GH-treated (Ischemia) groups. At 8 weeks of age, the glucose metabolism, muscle pathology, and metabolome of liver were assessed. The insulin resistance index improved in the Ischemia-GH group compared with the Ischemia group (p = 0.034). The percentage of type 1 muscle fibers was higher in the Ischemia-GH group than the Ischemia group (p < 0.001); the muscle fiber type was altered by GH. In the liver, oxidative stress factors were reduced, and ATP production was increased in the Ischemia-GH group compared to the Ischemia group (p = 0.014), indicating the improved mitochondrial function of liver. GH administration is effective in improving insulin resistance by increasing the content of type 1 muscle fibers and improving mitochondrial function of liver in our non-obese hyperglycemic mouse model after birth with LBW.


Assuntos
Modelos Animais de Doenças , Hiperglicemia , Resistência à Insulina , Fígado , Animais , Feminino , Camundongos , Hiperglicemia/tratamento farmacológico , Hiperglicemia/metabolismo , Fígado/metabolismo , Fígado/efeitos dos fármacos , Hormônio do Crescimento Humano/farmacologia , Hormônio do Crescimento Humano/administração & dosagem , Humanos , Gravidez , Proteínas Recombinantes/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Recém-Nascido de Baixo Peso
20.
PLoS One ; 19(6): e0305636, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38885232

RESUMO

Empagliflozin (EMPA) showed antiapoptotic, oxidative and anti-inflammatory potential effect. EMPA attenuates the inflammation and oxidative stress biomarkers in patients with heart failure while significantly decreases the malondialdehyde (a lipid peroxidation marker) levels in the plasma of diabetic patients. The present study examined the effects of moderate hyperglycemia on reproductive function. Sixty male Wister rats were divided and randomly allocated into four groups of 15 animals each . Diabetes was induced by a single intraperitoneal injection of a prepared solution containing STZ diluted in 0.1 M sodium citrate buffer (pH 4.5) at a dosage of 40 mg/kg body weight in selected in groups II and III for seven days before starting the treatment with EMPA. The current study revealed that EMPA for eight weeks prevented testicular high glucose-induced oxidative stress markers such as penile nitric oxide (NO), glutathione peroxidase (GPX) and total anti-oxidant capacity (TAC) in STZ-induced hyperglycemia in a rat model. In addition, EMPA ameliorated the high levels of endogenous Interleukin-6 (IL-6) present in gonads in response to an acute inflammatory found in the hyperglycemic STZ-induced rats. The present study further suggested the protective effects of EMPA and how it has a beneficial role and can effectively attenuate hyperglycemia-induced testicular oxidative damage and inflammatory markers as well as androgen dependent testicular enzymes activity as a protective role against the consequences of hyperglycemia and male sub-infertility.


Assuntos
Compostos Benzidrílicos , Glucosídeos , Hiperglicemia , Estresse Oxidativo , Ratos Wistar , Testículo , Animais , Masculino , Compostos Benzidrílicos/farmacologia , Glucosídeos/farmacologia , Testículo/efeitos dos fármacos , Testículo/metabolismo , Ratos , Estresse Oxidativo/efeitos dos fármacos , Hiperglicemia/tratamento farmacológico , Hiperglicemia/metabolismo , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/metabolismo , Óxido Nítrico/metabolismo , Interleucina-6/metabolismo , Glicemia/metabolismo , Antioxidantes/farmacologia , Antioxidantes/metabolismo , Glutationa Peroxidase/metabolismo
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