Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 6 Articles
Aim: Inflammation is thought to play a major role in impaired metabolism. However, the metabolic and inflammatory response of adipose tissue, to a pro-inflammatory stimulus is poorly defined in patients with Type 2 Diabetes Mellitus (T2DM). We therefore aimed to investigate whether adipose tissue in T2DM would display an altered response to E. coli LipoPolySaccharide (LPS). \r\nMaterials and methods: Twelve patients with T2DM and 12 control subjects received an intravenous bolus injection of LPS (0.3 ng/kg). Abdominal subcutaneous adipose tissue biopsies, serum and plasma were obtained at 0, 2, 4, 6 and 8 hours after LPS. The gene expression of Tumour Necrosis Factor-a (TNF), InterLeukin-6 (IL-6), lipoprotein lipase (LPL), hormone sensitive lipase (HSL), fatty acid synthase (FASN), adiponectin and peroxisome proliferator-activated recptor ? (PPAR?) was analysed by real time reverse transcription Polymerase Chain Reaction (PCR). \r\nResults: The expression of TNF and IL-6 in adipose tissue increased after LPS administration without any difference between groups (2-way ANOVA, effect of time: p<0.001 and p=0.0001, respectively). In contrast, the expression of LPL, HSL and adiponectin in adipose tissue increased only in control subjects (2-way ANOVA, effect of time X group: p=0.03; p=0.02 and p=0.02, respectively). There was no effect of LPS on FASN or PPAR? in either group. \r\nConclusion: Patients with T2DM demonstrate a resistance to LPS in terms of inducing important mediators of lipolysis and lipogenesis, although the expression of TNF and IL-6 in adipose tissue increased in both groups. And thus, adipose tissue may contribute to the acute inflammation-related metabolic complications seen in T2DM....
Background: The American Diabetes Association (ADA) has published several diabetes treatment algorithms, but\r\nnone have been tested in real-life settings. The aim of this study is to analyze the feasibility of achieving and/or\r\nmaintaining HbA1c levels <7.0% using current diabetes treatment guidelines and the resources available in the\r\npublic health care system of Brazil.\r\nMethods: A one-year, single-arm interventional study was conducted with type 2 diabetes patients in a primary\r\ncare unit. Intervention consisted of intensification of lifestyle changes and sequential prescription of drugs based on\r\nADA guidelines using the medications available through the publicly funded Unified Health System (Sistema �šnico\r\nde Sa�ºde, SUS).\r\nResults: Ninety patients (age: 62.7�±10.4 years; diabetes duration: 8.2�±9.1 years) completed the trial. During the\r\nintervention period, increases were observed in number of oral antidiabetic agent (OAD) classes per patient\r\n(1.50�±0.74 vs. 1.67�±0.7; p=0.015), OAD pills per patient (2.64�±1.89 vs. 3.33�±2.23 pills/patient; p <0.001), insulin\r\ndosage (0.20�±0.29 vs.0.50�±0.36 UI/kg/day; p=0.008) and number of patients on insulin (19 [21%] vs. 31 [34%];\r\np<0.01), but no improvement in HbA1c (7.2�±1.6% vs. 7.3�±1.5%; p=0.453) or frequency of patients on target, defined\r\nas HbA1c <7% (53.3% vs. 48.9%; p=0.655). Patients with baseline HbA1c <7% had a small increase in HbA1c during\r\nthe trial (6.3�±0.4 vs. 6.7�±0.9%; p=0.002). No such change was observed in those with baseline HbA1c =7%.\r\nConclusions: In this group of patients with a mean baseline HbA1c of 7.2%, implementation of 2006/2009\r\nADA/EASD guidelines led to achievement of the therapeutic goal of HbA1c <7% in a small proportion of patients...
The present study investigates the relationship between diabetes metabolic control represented by levels of HbA1c, early glycation\r\nproducts-(fructosamine (FAM)), serum-advanced glycation end products (s-AGEs), lipoperoxidation products (LPO), advanced\r\noxidation protein products (AOPP) and circulating TGF-Ã?Ÿ in young patients with DM1. The study group consisted of 79 patients\r\nwith DM1 (8ââ?¬â??18 years). 31 healthy children were used as control (1ââ?¬â??16 years). Baseline characteristics of patients were compared\r\nby Studentââ?¬â?¢s t-test and nonparametric Mann-Whitney test (Statdirect), respectively. The correlations between the measured\r\nparameters were examined using Pearson correlation coefficient r and Spearmanââ?¬â?¢s rank test, respectively. A P value < 0.05\r\nwas considered as statistically significant. HbA1c was measured by LPLC, s-AGEs spectrofluorimetrically, LPO and AOPP\r\nspectrophotometrically and TGF-Ã?Ÿ by ELISA. Our results showed that parameters of glycation and oxidation are significantly\r\nhigher in patients with DM1 than in healthy control. The level of serum TGF-Ã?Ÿ was significantly higher in diabetics in comparison\r\nwith control: 7.1(3.6; 12.6) versus 1.6(0.8; 3.9) ng/mL. TGF-Ã?Ÿ significantly correlated with age and duration of DM1. There was\r\nnot found any significant relation between TGF-Ã?Ÿ and parameres of glycation and oxidation. However, these results do not exclude\r\nthe association between TGF-Ã?Ÿ and the onset of diabetic complications....
Patientâ��s skin and subcutaneous adipose tissue thicknesses are the primary criteria that determine the optimal insulin needle length in subcutaneous insulin treatment. The present study aims to measure skin thickness and subcutaneous adipose tissue thickness in patients with diabetes mellitus and to investigate the association of these measurements with waist circumference and body mass index. The study included 449 subjects (152 patients with DM and 297 healthy controls, mean age: 44.58 �± 14.25 year) aged 18 years or older. The primary endpoint was the time of comparison of skin thicknesses and subcutaneous adipose tissue thicknesses between patients with diabetes mellitus and healthy subjects and the secondary endpoint was the time of assessment of the relationship between skin and subcutaneous adipose tissue thicknesses and body mass index and waist circumference. Skin and subcutaneous adipose tissue thicknesses were measured by ultrasonography. Overall, average skin thickness values were 1.95 mm (1.05-3.92) for triceps, 2.35 mm (1.07-3.82) for anterior abdomen and 1.97 mm (1.12-3.12) for anterior thigh, while subcutaneous adipose tissue thicknesses were 6.42 mm (1.01-33.5) for triceps, 15.73 mm (1.04-39.3) for anterior abdomen and 7.92 mm (1.48-31.6) for anterior thigh. Triceps and anterior thigh skin thickness values were higher in the diabetes mellitus group compared to healthy controls (p<0.01 for both) while subcutaneous adipose tissue thicknesses were similar between the two groups. There was a positive correlation between body mass index and waist circumference and between skin and subcutaneous adipose tissue thicknesses (p<0.01 for both). The largest skin thickness measured in the present study was 3.92 mm, which supports the previous reports that short needle tips could be used safely in individuals with diabetes mellitus....
Background. The Vanilloid subfamily of transient receptor potential (TRPV) ion channels has been widely implicated in detecting\r\nosmotic and mechanical stress. In the current study, we examine the functional expression of TRPV4 channels in cell volume\r\nregulation in cells of the human collecting duct. Methods. Western blot analysis, siRNA knockdown, and microfluorimetry were\r\nused to assess the expression and function of TRPV4 in mediating Ca2+-dependent mechanical stimulation within a novel system\r\nof the human collecting duct (HCD). Results. Native and siRNA knockdown of TRPV4 protein expression was confirmed by\r\nwestern blot analysis. Touch was used as a cell-directed surrogate for osmotic stress.Mechanical stimulation of HCD cells evoked a\r\ntransient increase in [Ca2+]i that was dependent upon thapsigargin-sensitive store release and Ca2+ influx. At 48 hrs, high glucose\r\nand mannitol (25mM) reduced TRPV4 expression by 54% and 24%, respectively. Similar treatment doubled SGK1 expression.\r\nTouch-evoked changes were negated following TRPV4 knockdown. Conclusion. Our data confirm expression of Ca2+-dependent\r\nTRPV4 channels in HCDcells and suggest that a loss of expression in response to high glucose attenuates the ability of the collecting\r\nduct to exhibit regulatory volume decreases, an effect that may contribute to the pathology of fluid and electrolyte imbalance as\r\nobserved in diabetic nephropathy....
Objective.We evaluated the association between four polymorphisms in the CRP gene with circulating levels of C-reactive protein\r\n(CRP), type 2 diabetes (T2D), obesity, and risk score of coronary heart disease. Methods.We studied 402 individuals and classified\r\nthem into four groups: healthy, obese, T2D obese, and T2D without obesity, from Guerrero, SouthwesternMexico. Blood levels of\r\nCRP, glucose, cholesterol, triglycerides, and leukocytes were measured. Genotyping was performed by PCR/RFLP, and the risk score\r\nfor coronary heart disease was determined by the Framinghamâ��s methodology. Results. The TT genotype of SNP rs1130864 was\r\nassociated with increased body mass index and T2D patients with obesity. We found that the haplotype 2 (TGAG) was associated\r\nwith increased levels of CRP (�Ÿ = 0.3; 95%CI: 0.1, 0.5; P = 0.005) and haplotype 7 (TGGG) with higher body mass index (BMI)\r\n(�Ÿ = 0.2; 95%CI: 0.1, 0.3; P < 0.001). The risk score for coronary heart disease was associated with increased levels of CRP, but\r\nnot with any polymorphism or haplotype. Conclusions. The association between the TT genotype of SNP rs1130864 with obesity\r\nand the haplotype 7 with BMI may explain how obesity and genetic predisposition increase the risk of diseases such as T2D in the\r\npopulation of Southwestern Mexico....
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