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1.
Cardiovasc Diabetol ; 21(1): 231, 2022 11 05.
Artigo em Inglês | MEDLINE | ID: mdl-36335340

RESUMO

BACKGROUND: Circulating thrombospondin-2 (TSP2) levels were associated with the development of heart failure (HF) in recent studies. However, these studies included only a minority of patients with type 2 diabetes, which is associated with an increased HF risk. As hyperglycemia induces TSP2 expression and its tissue expression increases in type 2 diabetes, we investigated the prospective association of circulating TSP2 with incident HF hospitalization (HHF), and its associations with longitudinal changes of echocardiographic parameters in type 2 diabetes. METHODS: Baseline serum TSP2 levels were measured in 4949 patients with type 2 diabetes to determine its association with incident HHF using multivariable Cox regression analysis. In the echocardiographic study, baseline serum TSP2 levels were measured in another 146 patients with type 2 diabetes but without cardiovascular diseases who underwent detailed transthoracic echocardiography at baseline and after 1 year. RESULTS: Over a median follow-up of 7.8 years, 330 of 4949 patients (6.7%) developed incident HHF. Baseline serum TSP2 levels were independently associated with the development of HHF (HR 1.31, 95%CI 1.06-1.62, p = 0.014) after adjustments for baseline conventional cardiovascular risk factors, atrial fibrillation, estimated glomerular filtration rate, albuminuria and high-sensitivity C-reactive protein level, use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, loop-diuretics, aspirin, insulin, metformin and sodium-glucose co-transporter 2 inhibitors. Moreover, baseline serum TSP2 levels were independently associated with increase in average E/e' and left atrial volume index (p = 0.04 and < 0.01, respectively). CONCLUSION: Serum TSP2 levels were independently associated with both incident HHF and deterioration in diastolic function in type 2 diabetes. TRIAL REGISTRATION: Not Applicable.


Assuntos
Diabetes Mellitus Tipo 2 , Insuficiência Cardíaca , Inibidores do Transportador 2 de Sódio-Glicose , Humanos , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Remodelação Ventricular , Fatores de Risco , Medição de Risco , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/induzido quimicamente , Hospitalização , Trombospondinas , Função Ventricular Esquerda
2.
J Endocrinol Invest ; 45(11): 2149-2156, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35831586

RESUMO

PURPOSE: Thyroid dysfunction in COVID-19 carries clinical and prognostic implications. In this study, we developed a prediction score (ThyroCOVID) for abnormal thyroid function (TFT) on admission amongst COVID-19 patients. METHODS: Consecutive COVID-19 patients admitted to Queen Mary Hospital were prospectively recruited during July 2020-May 2021. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were measured on admission. Multivariable logistic regression analysis was performed to identify independent determinants of abnormal TFTs. ThyroCOVID was developed based on a clinical model with the lowest Akaike information criteria. RESULTS: Five hundred and forty six COVID-19 patients were recruited (median age 50 years, 45.4% men, 72.9% mild disease on admission). 84 patients (15.4%) had abnormal TFTs on admission. Patients with abnormal TFTs were more likely to be older, have more comorbidities, symptomatic, have worse COVID-19 severity, higher SARS-CoV-2 viral loads and more adverse profile of acute-phase reactants, haematological and biochemical parameters. ThyroCOVID consisted of five parameters: symptoms (malaise), comorbidities (ischaemic heart disease/congestive heart failure) and laboratory parameters (lymphocyte count, C-reactive protein, and SARS-CoV-2 cycle threshold values). It was able to identify abnormal TFT on admission with an AUROC of 0.73 (95% CI 0.67-0.79). The optimal cut-off of 0.15 had a sensitivity of 75.0%, specificity of 65.2%, negative predictive value of 93.5% and positive predictive value of 28.1% in identifying abnormal TFTs on admission amongst COVID-19 patients. CONCLUSION: ThyroCOVID, a prediction score to identify COVID-19 patients at risk of having abnormal TFT on admission, was developed based on a cohort of predominantly non-severe COVID-19 patients.


Assuntos
COVID-19 , Tri-Iodotironina , Proteína C-Reativa , COVID-19/diagnóstico , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Testes de Função Tireóidea , Glândula Tireoide , Tireotropina , Tiroxina
3.
J Endocrinol Invest ; 44(3): 523-530, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32602078

RESUMO

PURPOSE: Findings on trabecular bone score (TBS), an index of bone quality, have been reported in prediabetes defined by impaired fasting glucose or HbA1c. Here, we assessed the bone mineral density (BMD) and TBS in prediabetes individuals with impaired glucose tolerance (IGT), and investigated the association of these bone parameters with serum levels of fibroblast growth factor 21 (FGF21), a hormone implicated in bone metabolism and with higher levels in IGT. METHODS: Chinese postmenopausal women aged 55-80 years, without diabetes, were recruited from the Hong Kong Cardiovascular Risk Factor Prevalence Study in 2016-2018. Normal glucose tolerance (NGT) was defined by fasting glucose < 5.6 mmol/L and 2-h plasma glucose (2hG) < 7.8 mmol/L, and IGT by 2hG 7.8-11 mmol/L. Serum levels of FGF21 and other bone metabolism regulators were measured. Insulin sensitivity was assessed by the Matsuda index. Independent determinants of TBS were evaluated using multivariable stepwise linear regression. RESULTS: 173 individuals with NGT and 73 with IGT were included. TBS was lower in those with IGT compared to those with NGT, while BMD was comparable. Individuals with IGT had significantly higher serum FGF21 levels, which in turn showed an independent inverse relationship with TBS, attenuated after inclusion of the Matsuda index. Serum FGF21 levels, however, did not correlate with BMD. CONCLUSION: Among Chinese postmenopausal women, bone quality was worse in IGT, despite comparable bone density. FGF21 levels showed a significant independent inverse relationship with TBS, partly attributed to insulin resistance. Whether FGF21 contributes to the impaired bone quality in IGT remains speculative.


Assuntos
Biomarcadores/metabolismo , Glicemia/análise , Densidade Óssea , Fatores de Crescimento de Fibroblastos/metabolismo , Fraturas Ósseas/patologia , Intolerância à Glucose/complicações , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estudos Transversais , Feminino , Seguimentos , Fraturas Ósseas/etiologia , Fraturas Ósseas/metabolismo , Teste de Tolerância a Glucose , Humanos , Resistência à Insulina , Pessoa de Meia-Idade , Prognóstico
4.
Osteoporos Int ; 31(10): 1955-1964, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32385660

RESUMO

Type 2 diabetes is associated with an increased risk of hip fractures. We hypothesize that long-term glycemic variability predicts incident hip fractures. We demonstrated that HbA1c variability predicted incident hip fractures independent of mean HbA1c, suggesting the potential benefits of minimizing glycemic variability in addition to optimizing mean glycemia for bone health. INTRODUCTION: Type 2 diabetes is associated with an increased risk of hip fractures, and a linear relationship between HbA1c levels and hip fracture incidence has been observed. We hypothesize that HbA1c variability also predicts incident hip fractures in type 2 diabetes. METHODS: Chinese individuals with type 2 diabetes aged ≥ 60 years were identified from electronic health records in Hong Kong between 2008 and 2012 and observed for incident hip fractures. Hip fracture was defined by the International Classification of Diseases (Ninth Revision) code 820. HbA1c variability was determined using standard deviation, adjusted standard deviation, and coefficient of variation of HbA1c measurements in the 5 years preceding the entry date. Multivariable Cox regression analysis was used to evaluate associations between HbA1c variability and incident hip fractures. RESULTS: A total of 83,282 participants were included. Their mean age was 71.3 ± 7.5 years, duration of diabetes 11.7 ± 7.7 years, baseline HbA1c 56.6 ± 13.5 mmol/mol (7.33 ± 1.23%), and median follow-up 6.8 years. All indices of HbA1c variability were significant independent predictors of incident hip fractures, with an adjusted hazard ratio of up to 1.29 (all p < 0.001), and remained to be independent predictors across groups of different intensity of glycemic control. Mean HbA1c ≥ 64 mmol/mol (8.0%) was associated with a 25% increase in incident hip fractures compared with mean HbA1c < 53 mmol/mol (7.0%). CONCLUSION: HbA1c variability is an independent positive predictor of hip fracture in type 2 diabetes, across the spectrum of varying degree of glycemic control, while a high HbA1c is also not advisable from the perspective of bone health.


Assuntos
Diabetes Mellitus Tipo 2 , Fraturas do Quadril , Idoso , Glicemia , China/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Hemoglobinas Glicadas/análise , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/etiologia , Humanos , Pessoa de Meia-Idade , Fatores de Risco
5.
J Hum Nutr Diet ; 33(5): 670-677, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32250007

RESUMO

INTRODUCTION: Little is known about the relationship of whole-grain intake with dietary fatty acids intake. The present study aimed to assess the whole-grain intake and its relationships with dietary fatty acids intake among multiethnic schoolchildren in Kuala Lumpur, Malaysia. METHODS: This cross-sectional study was conducted among 392 schoolchildren aged 9-11 years, cluster sampled from five randomly selected schools in Kuala Lumpur. Whole-grain and fatty acids intakes were assessed by 3-day, 24-h diet recalls. All whole-grain foods were considered irrespective of the amount of whole grain they contained. RESULTS: In total, 55.6% (n = 218) were whole-grain consumers. Mean (SD) daily intake of whole grain in the total sample was 5.13 (9.75) g day-1 . In the whole-grain consumer's only sample, mean (SD) intakes reached 9.23 (11.55) g day-1 . Significant inverse associations were found between whole-grain intake and saturated fatty acid (SAFA) intake (r = -0.357; P < 0.001), monosaturated fatty acid (MUFA) (r = -0.373; P < 0.001) and polyunsaturated fatty acid (PUFA) (r = -0.307; P < 0.001) intake. Furthermore, whole-grain intake was a significant predictor of SAFA (ß = -0.077; P = 0.004), MUFA (ß = -0.112; P = <0.001) and PUFA (ß = -0.202; P = <0.001) intakes, after controlling for sex, age and ethnicity. CONCLUSIONS: Whole-grain intake in Malaysia was well below recommendations. Schoolchildren who consumed higher whole grain tend to reduce fat intake; however, it would also reduce the SAFA, MUFA and PUFA intakes. Future collaboration may be conducted between industry, government and universities to promote unsaturated fatty acids-rich foods and whole-grain food, although not to promote processed whole-grain foods with a high sugar and salt content.


Assuntos
Dieta/estatística & dados numéricos , Gorduras na Dieta/análise , Ácidos Graxos/análise , Estudantes/estatística & dados numéricos , Grãos Integrais , Criança , Análise por Conglomerados , Estudos Transversais , Inquéritos sobre Dietas , Etnicidade/estatística & dados numéricos , Ácidos Graxos Monoinsaturados/análise , Ácidos Graxos Insaturados/análise , Feminino , Humanos , Malásia , Masculino , Recomendações Nutricionais
6.
Horm Metab Res ; 47(11): 833-8, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26267327

RESUMO

Identification of germline mutation in patients with apparently sporadic pheochromocytomas and paragangliomas is crucial. Clinical indicators, which include young age, bilateral or multifocal, extra-adrenal, malignant, or recurrent tumors, predict the likelihood of harboring germline mutation in Caucasian subjects. However, data on the prevalence of germline mutation, as well as the applicability of these clinical indicators in Chinese, are lacking. We conducted a cross-sectional study at a single endocrine tertiary referral center in Hong Kong. Subjects with pheochromocytomas and paragangliomas were evaluated for the presence of germline mutations involving 10 susceptibility genes, which included NF1, RET, VHL, SDHA, SDHB, SDHC, SDHD, TMEM 127, MAX, and FH genes. Clinical indicators were assessed for their association with the presence of germline mutations. Germline mutations, 2 being novel, were found in 24.4% of the 41 Chinese subjects recruited and 11.4% among those with apparently sporadic presentation. The increasing number of the afore-mentioned clinical indicators significantly correlated with the likelihood of harboring germline mutation in one of the 10 susceptibility genes. (r=0.757, p=0.026). The presence of 2 or more clinical indicators should prompt genetic testing for germline mutations in Chinese subjects. In conclusion, our study confirmed that a significant proportion of Chinese subjects with apparently sporadic pheochromocytoma and paraganglioma harbored germline mutations and these clinical indicators identified from Caucasians series were also applicable in Chinese subjects. This information will be of clinical relevance in the design of appropriate genetic screening strategies in Chinese populations.


Assuntos
Neoplasias das Glândulas Suprarrenais/genética , Povo Asiático/genética , Predisposição Genética para Doença , Paraganglioma/genética , Feocromocitoma/genética , Adulto , China , Mutação em Linhagem Germinativa/genética , Humanos , Pessoa de Meia-Idade , Curva ROC
8.
Nat Med ; 4(9): 1025-31, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9734395

RESUMO

Accelerated atherosclerosis in patients with diabetes is a major cause of their morbidity and mortality, and it is unresponsive to therapy aimed at restoring relative euglycemia. In hyperglycemia, nonenzymatic glycation and oxidation of proteins and lipids results in the accumulation of irreversibly formed advanced glycation endproducts. These advanced glycation endproducts engage their receptor in cells of the blood vessel wall, thereby activating mechanisms linked to the development of vascular lesions. We report here a model of accelerated and advanced atherosclerosis in diabetic mice deficient for apolipoprotein E. Treatment of these mice with the soluble extracellular domain of the receptor for advanced glycation endproducts completely suppressed diabetic atherosclerosis in a glycemia- and lipid-independent manner. These findings indicate interaction between the advanced glycation endproducts and their receptor is involved in the development of accelerated atherosclerosis in diabetes, and identify this receptor as a new therapeutic target in diabetic macrovascular disease.


Assuntos
Arteriosclerose/tratamento farmacológico , Diabetes Mellitus Experimental/complicações , Angiopatias Diabéticas/tratamento farmacológico , Produtos Finais de Glicação Avançada/metabolismo , Receptores Imunológicos/uso terapêutico , Animais , Arteriosclerose/etiologia , Linhagem Celular , Diabetes Mellitus Experimental/fisiopatologia , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Receptor para Produtos Finais de Glicação Avançada , Receptores Imunológicos/metabolismo , Proteínas Recombinantes de Fusão/metabolismo , Solubilidade , Spodoptera , Estreptozocina
9.
Neuroimage Clin ; 27: 102302, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32521474

RESUMO

The link between non-demented type 2 diabetes mellitus (T2DM) and different types of cognitive impairment is controversial. By controlling for co-morbidities such as cerebral macrovascular and microvascular changes, cerebral atrophy, amyloid burden, hypertension or hyperlipidemia, the current study investigated the cerebral blood flow of T2DM individuals as compared to cognitively impaired subjects recruited from a memory clinic. 15 healthy control (71.8 ± 6.1 years), 18 T2DM (62.5 ± 3.7 years), as well as 8 Subjective Cognitive Decline (69.5 ± 7.5 years), 12 Vascular Dementia (79.3 ± 4.2 years) and 17 Alzheimer's Disease (75.1 ± 8.2 years) underwent multi-parametric MRI brain scanning. Subjects with T2DM and from the memory clinic also had 18-F Flutametamol PET-CT scanning to look for any amyloid burden. Pseudocontinuous Arterial Spin Labeling (PCASL), MR Angiography Head, 3D FLAIR and 3D T1-weighted sequences were used to quantify cerebral blood flow, cerebrovascular changes, white matter hyperintensities and brain atrophy respectively. Vascular risk factors were retrieved from the medical records. The 37 subjects from memory clinic were classified into subjective cognitive decline (SCD), vascular dementia (VD) and Alzheimer's disease (AD) subgroups by a multi-disciplinary panel consisting of a neuroradiologist, and 2 geriatricians. Absolute cortical CBF in our cohort of T2DM, SCD, VD and AD was significantly decreased (p < 0.01) as compared to healthy controls (HC) in both whole brain and eight paired brain regions, after age, normalized grey matter volume and gender adjustment and Bonferroni correction. Subgroup analysis between T2DM, SCD, VD, and AD revealed that CBF of T2DM was not significantly different from AD, VD or SCD. By controlling for co-morbidities, impaired cortical CBF in T2DM was not related to microangiopathy or amyloid deposition, but to the interaction of triple risk factors (such as diabetes mellitus, hypertension, and hyperlipidemia). There was statistically significant negative correlation (p ≤ 0.05) between adjusted CBF and HbA1c in all brain regions of T2DM and HC (with partial correlation ranging from -0.30 to -0.46). Taken together, altered cerebral blood flow in T2DM might be related to disruption of cerebrovascular autoregulation related to vascular risk factors, and such oligemia occurred before clinical manifestation due to altered glycemic control.


Assuntos
Doença de Alzheimer/patologia , Circulação Cerebrovascular/fisiologia , Disfunção Cognitiva/fisiopatologia , Demência Vascular/patologia , Diabetes Mellitus Tipo 2/patologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/fisiopatologia , Encéfalo/irrigação sanguínea , Encéfalo/fisiopatologia , Disfunção Cognitiva/patologia , Demência Vascular/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Humanos , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos
10.
Arterioscler Thromb Vasc Biol ; 27(12): 2777-82, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17932317

RESUMO

OBJECTIVE: The purpose of this study was to examine the effects of PPAR-gamma agonist rosiglitazone, relative to sulfonylureas, on circulating levels of adiponectin and the prothrombotic factor, plasminogen activator inhibitor (PAI)-1, in type 2 diabetic patients, and to investigate, in animal models, whether the antithrombotic action of rosiglitazone was mediated through adiponectin. METHODS AND RESULTS: Our clinical study (n=64) showed that after 24-week add-on therapy, the rosiglitazone group had a greater mean reduction in plasma PAI-1 levels (25%, versus 12% in sulfonylurea group, P=0.002). Stepwise multiple linear regression analysis identified the reduction in plasma fasting glucose and the rise in adiponectin levels to be independently associated with the reduction in PAI-I concentration in the rosiglitazone-treated patients. Rosiglitazone (20 mg/kg/d) reduced adipose tissue PAI-1 mRNA expression and its plasma levels in wild-type C57 mice with diet-induced obesity (P<0.001), but this suppressive effect was attenuated in adiponectin knockout mice. Adenovirus-mediated overexpression of adiponectin led to a significant suppression of adipose tissue PAI-1 expression and its circulating concentrations in db/db diabetic mice. Our in vitro study demonstrated that recombinant adiponectin directly inhibited PAI-1 production in 3T3-L1 adipocytes. CONCLUSIONS: The antithrombotic effect of rosiglitazone is mediated, at least in part, through the suppressive effect of adiponectin on PAI-1 production.


Assuntos
Adiponectina/metabolismo , Diabetes Mellitus Tipo 2/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Hipoglicemiantes/uso terapêutico , PPAR gama/agonistas , Inibidor 1 de Ativador de Plasminogênio/metabolismo , Compostos de Sulfonilureia/uso terapêutico , Tiazolidinedionas/uso terapêutico , Células 3T3-L1 , Adenoviridae/genética , Adipócitos/metabolismo , Adiponectina/sangue , Adiponectina/genética , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/metabolismo , Animais , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Gorduras na Dieta/administração & dosagem , Modelos Animais de Doenças , Fibrinolíticos/farmacologia , Vetores Genéticos , Humanos , Hipoglicemiantes/farmacologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Obesidade/sangue , Obesidade/metabolismo , PPAR gama/metabolismo , Inibidor 1 de Ativador de Plasminogênio/sangue , Inibidor 1 de Ativador de Plasminogênio/genética , RNA Mensageiro/metabolismo , Proteínas Recombinantes/metabolismo , Rosiglitazona , Serpina E2 , Serpinas/sangue , Serpinas/metabolismo , Compostos de Sulfonilureia/farmacologia , Tiazolidinedionas/farmacologia , Transdução Genética , Resultado do Tratamento
11.
Plant Biol (Stuttg) ; 20(2): 213-222, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29222927

RESUMO

Phototropic leaf movement of plants is an effective mechanism for adapting to light conditions. Light is the major driver of plant photosynthesis. Leaf N is also an important limiting factor on leaf photosynthetic potential. Cotton (Gossypium hirsutum L.) exhibits diaheliotropic leaf movement. Here, we compared the long-term photosynthetic acclimation of fixed leaves (restrained) and free leaves (allowed free movement) in cotton. The fixed leaves and free leaves were used for determination of PAR, leaf chlorophyll concentration, leaf N content and leaf gas exchange. The measurements were conducted under clear sky conditions at 0, 7, 15 and 30 days after treatment (DAT). The results showed that leaf N allocation and partitioning among different components of the photosynthetic apparatus were significantly affected by diaheliotropic leaf movement. Diaheliotropic leaf movement significantly increased light interception per unit leaf area, which in turn affected leaf mass per area (LMA), leaf N content (NA ) and leaf N allocation to photosynthesis (NP ). In addition, cotton leaves optimised leaf N allocation to the photosynthetic apparatus by adjusting leaf mass per area and NA in response to optimal light interception. In the presence of diaheliotropic leaf movement, cotton leaves optimised their structural tissue and photosynthetic characteristics, such as LMA, NA and leaf N allocation to photosynthesis, so that leaf photosynthetic capacity was maximised to improve the photosynthetic use efficiency of light and N under high light conditions.


Assuntos
Gossypium/fisiologia , Nitrogênio/metabolismo , Fotossíntese/fisiologia , Fototropismo/fisiologia , Folhas de Planta/fisiologia , Clorofila/análise , Gossypium/anatomia & histologia , Luz , Movimento/fisiologia , Nitrogênio/análise , Folhas de Planta/anatomia & histologia , Folhas de Planta/química
12.
Diabetes Res Clin Pract ; 126: 25-29, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28189951

RESUMO

AIM: In Chinese, ethnicity-based and/or diabetes specific modifications of the Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations have been developed for determining estimated glomerular filtrate rate (eGFR). This study aimed to compare the performance of five different creatinine-based eGFR equations in predicting all-cause mortality among Chinese subjects with type 2 diabetes (T2DM). METHODS: A total of 6739 Chinese subjects with T2DM were included. Their eGFR was calculated using the MDRD, CKD-EPI, their respective modified equations for Chinese, and the diabetes specific CKD-EPI Chinese T2DM equations. Multiple Cox regression analysis was used to evaluate the associations of eGFR with all-cause mortality. C-statistics, net reclassification index (NRI) and integrated discrimination index (IDI) were applied to assess the discrimination and reclassification of each eGFR equation in predicting mortality outcome. RESULTS: Over a follow-up of 5.7years, the incidence of all-cause mortality was 12.9% (N=867). The CKD-EPI equation discriminated all-cause mortality better than the MDRD equation (C-statistics: 0.714 vs. 0.689, p<0.0001), and Chinese modification of their respective equations did not improve discrimination. Among the five eGFR equations evaluated, the CKD-EPI Chinese T2DM equation provided the best discrimination in predicting all-cause mortality among Chinese subjects with T2DM, and was the only equation providing a significantly positive NRI and IDI relative to the CKD-EPI equation. CONCLUSIONS: Among Chinese subjects with T2DM, our findings suggested that the CKD-EPI Chinese T2DM equation best predicted all-cause mortality, and relative to the CKD-EPI equation, conferred improved discrimination and reclassification.


Assuntos
Creatinina/análise , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/mortalidade , Taxa de Filtração Glomerular , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Creatinina/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Análise de Regressão , Insuficiência Renal Crônica/diagnóstico
13.
Biochim Biophys Acta ; 593(1): 149-57, 1980 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-7426642

RESUMO

Salt-induced changes in thylakoid stacking and chlorophyll fluorescence do not occur with granal membranes obtained by treatment of stacked thylakoids with digitonin. In contrast to normal untreated thylakoids, digitonin prepared granal membranes remain stacked under all ionic conditions and exhibit a constant high level of chlorophyll fluorescence. However, unstacking of these granal membranes is possible if they are pretreated with either acetic anhydride or linolenic acid. Trypsin treatment of the thylakoids inhibits the salt induced chlorophyll fluorescence and stacking changes but stacking of these treated membranes does occur when the pH is lowered, with the optimum being at about pH 4.5. This type of stacking is due to charge neutralization and does not require the presence of the 2000 dalton fragment of the polypeptide associated with the chlorophyll a/chlorophyll b light harvesting complex and known to be lost during treatment with trypsin (Mullet, J.E. and Arntzen, C.J. (1980) Biochim. Biophys. Acta 589, 100-117). Using the method of 9-aminoacridine fluorescence quenching it is argued that the surface charge density, on a chlorophyll basis, of unstacked thylakoid membranes is intermediate between digitonin derived granal and stromal membranes, with granal having the lowest value. The results are discussed in terms of the importance of surface negative charges in controlling salt induced chlorophyll fluorescence and thylakoid stacking changes. In particular, emphasis is placed on a model involving lateral diffusion of different types of chlorophyll protein complex within the thylakoid lipid matrix.


Assuntos
Clorofila/análise , Digitonina/farmacologia , Aminoacridinas/farmacologia , Cloroplastos/efeitos dos fármacos , Fluorescência , Membranas/ultraestrutura , Propriedades de Superfície
14.
Biochim Biophys Acta ; 589(2): 346-52, 1980 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-7356989

RESUMO

1. When suspended in a low cation-containing medium, chloroplast thylakoid membranes and carboxymethyl-cellulose particles quench the fluorescence from 9-aminoacridine (Searle, G.F.W. and Barber, J. (1978) Biochim. Biophys. Acta 502, 309--320). 2. Relief of this quenching is achieved by adding cations to the suspension medium with the order of effectiveness being C3+ greater than C2+ greater than C+, indicating that the fluorescence acts as an indicator of the surface electrical potential. 3. Using the Gouy-Chapman theory, the differential effect of divalent (methyl viologen) and monovalent (K+) cations has been used to calculate surface charge densities. 4. The calculations indicate that the surface charge density on the thylakoids significantly increases when cations are added to the low cation-containing medium. Under the same conditions the surface charge density of glutaraldehyde-fixed thylakoids and carboxymethyl-cellulose particles remained essentially constant. 5. It is argued that the 9-aminoacridine technique is able to probe localized areas on the membrane surface and that the variability of the surface charge density of untreated thylakoids may be due to redistribution of charges associated with membrane stacking as suggested by Barber and Chow (Barber, J. and Chow, W.S. (1979) FEBS Lett. 105, 5--10).


Assuntos
Aminoacridinas , Cloroplastos/ultraestrutura , Membranas Intracelulares/ultraestrutura , Cátions , Matemática , Concentração Osmolar , Plantas , Espectrometria de Fluorescência , Termodinâmica
15.
Biochim Biophys Acta ; 634(1): 174-90, 1981 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-7470497

RESUMO

The roles of specific cation binding, charge neutralization and electrostatic screening mechanisms in controlling salt-induced stacking and chlorophyll fluorescence changes in thylakoid membranes are examined in the light of new experimental evidence and theoretical calculations of the forces between membrane surfaces. A comparison of the biphasic stacking and fluorescence phenomena generated by organic mono- and divalent cations known sterically to inhibit specific binding with the effects generated by inorganic mono- and divalent cations suggests that the observed salt-induced changes at pH greater than or equal to 7.5 are predominantly governed by the electrostatic screening mechanism in agreement with previous work (e.g. Barber, J., Mills, J.D. and Love, A. (1977) FEBS Lett. 74, 174-181). Detailed calculations of the coulombic double layer repulsive force between negatively charged membrane surfaces immersed in a mixed electrolyte of valence type Z1+/Z1-,Z2+/Z1- were performed both under the constraints of fixed surface charged density and fixed surface potential. From a close comparison of the theoretical results with new experimental data on salt-induced stacking and fluorescence changes and a consideration of the contributions of the 'hydration' repulsive force and the van der Waals attractive force, it is argued that a reduction in surface charge density alone by lateral diffusion is probably insufficient to realize membrane stacking and that an increase in the van der Waals attractive force is necessary to account for the experimental observations perhaps through the formation of protein rich domains. In view of the complexity of the thylakoid membranes, the conclusions are to be considered qualitative. Nevertheless, these calculations give support to a model in which the cation induced chlorophyll fluorescence and stacking changes can be explained by lateral diffusion of two types of pigment protein complexes in the lipid matrix of the membrane. Such diffusion gives rise to changes in energy transfer between Photosystem II and Photosystem I and also to the creation of domains having low and high electrical surface charge density.


Assuntos
Clorofila/metabolismo , Cloroplastos/metabolismo , Membranas Intracelulares/metabolismo , Fotossíntese , Cátions , Cloroplastos/efeitos dos fármacos , Colina/farmacologia , Cinética , Magnésio/farmacologia , Potenciais da Membrana , Fotossíntese/efeitos dos fármacos , Plantas/metabolismo , Potássio/farmacologia
16.
Biochim Biophys Acta ; 635(2): 317-26, 1981 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-7236666

RESUMO

Salt-induced chlorophyll fluorescence and spillover changes in control and briefly sonicated chloroplasts have been studied under conditions where Photosystem II traps are closed. In a low-salt medium containing 10 mM KCl, control envelope-free chloroplasts exhibited good spillover, as measured by low chlorophyll fluorescence yield at room temperature, a high ratio of the fluorescence peaks F735/F685 at 77 K, and increased Photosystem I activity in the presence of 3-(3,4-dichlorophenyl)-1,1-dimethylurea and Photosystem II light. In contrast, when stacked chloroplasts were briefly sonicated and subsequently diluted into a low-salt medium, a high fluorescence yield at room temperature and a low ratio of F735/F685 at 77 K persisted. When unstacked chloroplasts were sonicated and then diluted into a high-salt medium, the room temperature fluorescence yield remained low. The results are interpreted in terms of a model relating the changes in chlorophyll fluorescence with the lateral diffusion of Photosystem I and Photosystem II chlorophyll-protein complexes in the plane of the thylakoid membrane creating randomized or segregated domains, depending on the degree of electrostatic screening of surface charges (Barber, J. (1980) FEBS Lett. 188, 1-10). It is argued that brief sonication of stacked chloroplasts separates stromal membranes from granal stacks, thus limiting the inter-mixing of the photosystems via lateral diffusion even when the ionic composition of the medium is varied. Consequently energy transfer from Photosystem II to Photosystem I is relatively poor and chlorophyll fluorescence from Photosystem II is enhanced. The loss of the salt effect on sonicated unstacked membranes can also be accommodated by the model. In this case it seems that the generation of small membrane fragments does not allow the normal salt-induced phase separation of the pigment-protein complexes to occur.


Assuntos
Cloroplastos/ultraestrutura , Fotossíntese , Cloroplastos/metabolismo , Cinética , Concentração Osmolar , Consumo de Oxigênio , Espectrometria de Fluorescência , Ultrassom
17.
Biochim Biophys Acta ; 591(1): 92-103, 1980 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-7388018

RESUMO

Salt induced chlorophyll fluorescence increase and thylakoid stacking have been measured under various conditions. 1. Aging of pea chloroplasts led to a loss of salt induced chlorophyll fluorescence increase and thylakoid stacking which is suggested to be due to a decrease in membrane fluidity as measured by 1,6-diphenylhextriene fluorescence polarization. 2. The aging treatment was accompanied by a decreased in surface charge density as indicated by chloroplast electrophoretic mobility measurements. 3. Lowering of the temperature to about 0 degrees C retarded the time courses of salt induced stacking and chlorophyll fluorescence increase. 4. Like aging, addition of linolenic acid led to an inhibition of the salt induced fluorescence and stacking phenomena but in this case there was a concomitant increase in electrophoretic mobility without any detectable change in the polarization of 1,6-diphenylhextriene fluorescence. 5. Maximum stacking occurred in both aged and fresh chloroplasts in a low salt medium at about pH 4.3 and the time course for the pH induced process was rapid and relatively temperature insensitive when compared with salt induced stacking. 6. The chlorophyll a/chlorophyll b ratio was lower for salt induced 'grana' than for pH induced 'grana'. 7. The results are discussed in terms of the hypothesis that changes in the lateral interaction of membrane pigment-protein complexes underlie the salt induced chlorophyll fluorescence increase and thylakoid stacking. It is argued that electrostatic screening by cations leads to the formation of domains of low-charge, fluorescent pigment-protein complexes, seggregated from domains of high-charge, quenching complexes, resulting in a increase in chlorophyll fluorescence yield and stacking at low-charge regions on adjacent membranes. In contrast to this, it is argued that the pH induced stacking occurs because of electrostatic neutralization, a mechanism which would not be expected to induce domain formation and associated chlorophyll fluorescence changes.


Assuntos
Clorofila/análise , Cloroplastos/ultraestrutura , Membranas Intracelulares/ultraestrutura , Difenilexatrieno , Concentração de Íons de Hidrogênio , Membranas Intracelulares/efeitos dos fármacos , Ácidos Linolênicos/farmacologia , Fluidez de Membrana , Concentração Osmolar , Fotossíntese , Plantas/ultraestrutura , Espectrometria de Fluorescência
18.
Plant Physiol ; 103(1): 105-113, 1993 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12231917

RESUMO

Wild-type and an atrazine-resistant biotype of Brassica napus, in which a glycine is substituted for the serine-264 of the D1protein, were grown over a wide range of constant irradiances in a growth cabinet. In the absence of serine-264, the function of photosystem II (PSII) was changed as reflected by changes in chlorophyll fluorescence parameters and in photosynthetic oxygen-evolving activity. The photochemical quenching coefficient was lower, showing that a larger proportion of the primary quinone acceptor is reduced at all irradiances. At low actinic irradiances, the nonphotochemical quenching coefficient was higher, showing a greater tendency for heat emission. Decreased rates of light-limited photosynthesis (quantum yield) and lower oxygen yields per single-turnover flash were also observed. These changes were observed even when the plants had been grown under low irradiances, indicating that the changes in PSII function are direct and not consequences of photoinhibition. In spite of the lowered PSII efficiency under light-limiting conditions, the light-saturated photosynthesis rate of the atrazine-resistant mutant was similar to that of the wild type. An enhanced susceptibility to photoinhibition was observed for the atrazine-resistant biotype compared to the wild type when plants were grown under high and intermediate, but not low, irradiance. We conclude that the replacement of serine by glycine in the D1 protein has a direct effect on PSII function, which in turn causes increased photoinhibitory damage and increased rates of turnover of the D1 protein. Both the intrinsic lowering of light-limited photosynthetic efficiency and the increased sensitivity to photoinhibition probably contribute to reduced crop yields in the field, to different extents, depending on growth conditions.

19.
Plant Physiol ; 115(1): 151-157, 1997 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12223796

RESUMO

Utilization of absorbed light energy by photosystem (PS) II for O2 evolution depends on the light-harvesting antenna size, but the role of antenna size in the photoinactivation of PSII seems controversial. To address this controversy, pea (Pisum sativum L.) plants were grown in low (50 [mu]mol m-2 s-1) or high (650 [mu]mol m-2 s-1) light. The doubled functional antenna size of PSII in low light allows each PSII to utilize twice as many photons at given flash light energies for O2 evolution. The application of a target theory to depict the photon dose dependency of PSII photoinactivation measured by repetitive-flash O2 yield and the ratio of variable to maximal chlorophyll fluorescence indicates that photoinactivation of PSII is probably a single-hit process in which repair or photoprotective mechanisms are only slightly involved. Furthermore, the exacerbation of photoinactivation of PSII with greater antenna size under anaerobic conditions strongly indicates that photoinactivation of PSII depends on antenna size.

20.
Plant Physiol ; 111(3): 867-875, 1996 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12226333

RESUMO

The role of high-light-induced chloroplast movement in the photoprotection of the facultative shade plant Tradescantia albiflora was investigated by comparison with pea (Pisum sativum L.) leaves, both grown in 50 [mu]mol photons m-2 s-1. Photoinactivation of photosystem II (PSII) in vivo was induced in 1.1% CO2 by varying either duration (0-2 h) of illumination (fixed at 1800 [mu]mol m-2 s-1) or irradiance (0-3000 [mu]mol m-2 s-1) at a fixed duration (1 h) after infiltration of leaves with water or lincomycin (an inhibitor of chloroplast-encoded protein synthesis). At all photon exposures, PSII of T. albiflora leaves showed a greater resistance to light stress than pea leaves, although both utilization of absorbed light by photosynthesis and psbA gene product synthesis were smaller than for pea leaves. This greater tolerance was not due to differences in PSII antenna size or the index of susceptibility of PSII to light stress, because these two parameters were comparable in both plants. However, the transmittance increase mediated by chloroplast movement was greater in T. albiflora than pea, resulting in a 10% decrease of absorbed light at high light. We suggest that the greater tolerance of PSII against light stress in T. albiflora may be partly ascribed to its light-induced chloroplast rearrangement.

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