Current Issue : April - June Volume : 2015 Issue Number : 2 Articles : 8 Articles
Background: Irisin is a novel myokine secreted in response to peroxisome proliferator-activated receptor ?\ncoactivator-1? (PGC-1?) activation through exercise. The first-degree relatives (FDRs) of type 2 diabetes mellitus\n(T2DM) patients bear a lifetime risk for developing T2DM, especially after 40 years old. However, the circulating irisin\nlevels in middle-aged FDRs of T2DM is unclear. We therefore investigated the association between circulating irisin\nand pancreatic ?-cell function in normal-glucose-tolerance (NGT) subjects.\nMethods: In this cross-sectional study, we recruited 412 supposed healthy subjects aged 40-60 who were FDRs of\nT2DM patients but without previous diagnosis of T2DM. Of the 412 individuals, 254 had NGT and 60 were newly\ndiagnosed T2DM based on the results of a 75 g oral glucose tolerance test (OGTT- World Health Organization\ndiagnostic criteria). We measured irisin in the newly diagnosed T2DM group (n = 60) and in an age- and\nsex-matched NGT subgroups (n = 62). Serum irisin was quantified by ELISA, and its association with metabolic\nparameters was analysed by Pearson�s correlation and multiple linear regression analyses.\nResults: There was no significant difference in serum irisin between middle-aged newly diagnosed T2DM patients\nand the NGT control group. Circulating irisin was correlated with haemoglobin A1c (r = 0.202, p = 0.026) and\nestimated glomerular filtration rate (r = 0.239, p = 0.010). Multiple linear regression revealed that only homeostasis model\nassessment-? (HOMA-?) was associated with irisin in NGT subjects after adjusting for confounding factors. However,\nsimilar analysis in T2DM did not reveal a significant association between circulating irisin and metabolic parameters.\nConclusions: There was no significant difference in serum irisin between middle-aged newly diagnosed T2DM patients\nand the NGT controls. Serum irisin level was closely related to HOMA-? in NGT, suggesting that irisin may play a crucial\nrole in pancreatic ?-cell function....
Background: The purpose of this study was to carry out a cross-cultural adaptation to Brazilian Portuguese,\nvalidation, and comparison of two questionnaires to measure adherence in patients with type 1 diabetes. There are\nno validated instruments to measure treatment adherence in Brazilian patients with type 1 diabetes.\nMethods: Type 1 diabetes outpatients of a tertiary hospital in Southern Brazil were recruited to examine\npsychometric properties of the Diabetes Self-Management Profile (DSMP) and Self-Care Inventory-revised (SCI-R)\nadapted to Brazilian Portuguese. Analyses assessed the reliability and validity according to its associations with\nglycated hemoglobin (A1C). Seventy-five patients [age: 34.9 �± 13.7 years; A1C: 9.2 �± 2% (75 mmol/mol); diabetes\nduration: 18.1 �± 11.8 years] were evaluated.\nResults: The translated versions of the instruments showed adequate internal consistency (DSMP Cronbachâ��s\n? =0.76; SCI-R Cronbachâ��s ? =0.71). A positive correlation was found between all the items and total scores, except for\nitem 12 in DSMP and item 13 in SCI-R, and for this reason, these items were excluded from the translated versions.\nIn predictive validity analysis, A1C correlated significantly with the DSMP total (r = ?0.46) and with the SCI-R\ntotal (r = ?0.44).\nConclusions: The Brazilian Portuguese versions of DSMP and SCI-R yielded a reliable and valid tool to measure\nadherence treatment for patients with type 1 diabetes, with a significant correlation between total scores and A1C....
Background: Coronary artery disease (CAD) is a major cardiovascular complication in diabetic patients. Despite the\nsignificant association between obesity and diabetes, the majority of the diabetic subjects are not obese in an Asian\npopulation. This study evaluated the association between obesity and coronary artery disease (CAD) according to\nthe diabetes status in a Korean population.\nMethods: The association between obesity and CAD using the parameters of any plaque, obstructive plaque, and\ncoronary artery calcium score (CACS) >100 according to the presence of diabetes was evaluated in 7,234 Korean\nadults who underwent multi-detector computed tomography for general health evaluations. Obesity was defined\nas a body mass index (BMI) ?25 kg/m2.\nResults: The prevalence of obesity was significantly higher in diabetic subjects than in non-diabetic subjects, but the\nmajority of the diabetic subjects were non-obese (48% vs. 37%, p <0.001). The incidence of any plaque (58% vs. 29%),\nobstructive plaque (20% vs. 6%), and CACS >100 (20% vs. 6%) were significantly higher in diabetic patients than\nin non-diabetic subjects (p <0.001, respectively). Incidence of any plaque (33% vs. 26%, p <0.001), obstructive\nplaque (7% vs. 6%, p = 0.014), and CACS >100 (8% vs. 6%, p = 0.002) was significantly higher in non-diabetic subjects\nwith obesity than in those without obesity, but the incidence of all coronary parameters was not different in diabetic\nsubjects according to the obesity status. After adjusting for confounding risk factors including age, gender,\nhypertension, dyslipidemia, current smoking, and mild renal dysfunction, obesity was independently associated\nwith increased risks of any plaque (OR 1.14) and CACS >100 (OR 1.31) only in non-diabetic subjects (p <0.05,\nrespectively). Multiple logistic regression models revealed that diabetes was independently associated with all coronary\nparameters.\nConclusion: Despite a significantly higher prevalence of obesity in diabetic subjects than in non-diabetic subjects,\nobesity is associated with the presence of any plaque and severe coronary calcification only in subjects without\nestablished diabetes among Korean population....
Background: Metabolic syndrome (MetS) is a clustering of five metabolic risk factors including abdominal\nobesity, elevated blood pressure, hypertriglyceridemia, low high-density lipoprotein cholesterol (HDL-C), and\nimpaired fasting glucose. Few studies have fully reported the strength of clustering of these risk factors in a\nparent-offspring relationship. This analysis describes the associations between parents and their adult offspring\nin regard to MetS. It also estimates the association between each risk factor in parents and the presence of\nMetS in their offspring.\nMethods: We analyzed data for 1193 offspring (565 sons, and 628 daughters) from the Framingham Offspring\nStudy who attended examinations 5, 6, and 7. Information about their parents was collected from examinations\n13, 14 and 15 of the Framingham Original Cohort study. We used pedigree file to combine parental and\noffspring�s data. Participants were classified as having the MetS according to the Adult Treatment Panel III\ncriteria. Analyses were conducted separately for mothers and fathers. Logistic regression was used to estimate\nthe associations.\nResults: After adjusting for age, education, smoking, alcohol consumption and physical activity level of\noffspring, no significant association was found between father�s and their offspring�s MetS. Mother�s MetS was\nsignificantly and positively associated with their daughter�s MetS (adjusted odds ratio or adj OR: 1.63; 95%\nconfidence Interval, CI:1.02-2.61), but not with their sons� MetS. When analyzed by individual components,\nmaternal impaired glucose (adj OR: 2.03; 95% CI: 1.02- 9.31), abdominal obesity (adj OR: 1.56; 95% CI: 0.98- 2.55) and\nlow HDL-C (adj OR: 2.12; 95% CI: 1.36-3.32) were associated daughter�s MetS. Maternal low HDL-C and raised total\ncholesterol showed marginal association with son�s MetS. For fathers, only impaired glucose (adj OR: 4.91; 95%\nCI: 2.07- 11.68) was associated with their daughter�s MetS.\nConclusions: Using the data from Framingham Heart Study, we demonstrate differential association of MetS and its\ncomponents between parents and offspring. Mother�s MetS was strongly related with daughter�s MetS, but the\nassociation was inconsistent with son�s MetS. No association was found between father�s MetS and offspring�s Mets.\nThese results provide evidence that daughters with mother�s MetS are in higher risk than daughters or sons with\nfather�s MetS....
Background/objectives: Cardioprotective effects of Mediterranean-style diet have been shown. Instead of excluding\nfoods, replacement or addition may facilitate compliance with impact on glucose metabolism of individuals at\ncardiometabolic risk. This study investigated the effect of changing selected nutrients intake on glucose metabolism\nduring a lifestyle intervention tailored to living conditions of prediabetic Brazilians.\nSubjects/methods: 183 prediabetic adults treated under the Brazilian public health system underwent an 18-month\nintervention on diet and physical activity. Dietary counseling focused on reducing saturated fat replaced by unsaturated\nfatty acids. Data were collected at baseline and after follow-up. ANOVA and multiple linear regression were used to test\nassociation of changes in nutrients intake with changes in plasma glucose.\nResults: Changes in fasting and 2-h plasma glucose but not in weight, HOMA-IR or C-reactive protein decreased after\nintervention across tertiles of MUFA changes (p-trend 0.017 and 0.024, respectively). Regression models showed that\nincrease in MUFA intake was independently associated with reduction in fasting (? -1.475, p = 0.008) and 2-h plasma\nglucose (? -3.321, p = 0.007). Moreover, increase in soluble fibers intake was associated with decrease in fasting plasma\nglucose (? -1.579, p = 0.038). Adjustment for anthropometric measurements did not change the results but did after\nincluding change in insulin in the models.\nConclusions: Increases of MUFA and soluble fibers intakes promote benefits on glucose metabolism, independently of\nadiposity, during a realistic lifestyle intervention in at-risk individuals. Mechanisms mediating these processes may\ninclude mainly insulin sensitivity improvement....
Background: The purpose of this research was to study the gene expression of interleukin-6 (IL-6), tumor necrosis factor-?\n(TNF-?), nuclear factor kappa B (NF-?B), vascular endothelial growth factor A (VEGF-A) and adiponectin (AdipoQ) genes in\nthe visceral (omental, mesenteric) and subcutaneous adipose tissue depots in metabolic syndrome (MS).\nWe studied 23 women with MS, with a mean age of 50.7 �± 4.5 years and mean body mass index (BMI) of 45.6 �± 9.8 kg/m2.\nThe control group included 10 women, with a mean age of 40.6 �± 8.7 years and normal BMI (22.3 �± 3.7 kg/m2). The gene\nexpression levels in the omental (OAT), mesenteric (MAT) and subcutaneous (SAT) adipose tissues were assessed by\nquantitative real-time PCR.\nFindings: Increased gene expression levels of IL-6 and TNF-? were detected in MAT in patients with MS, compared\nwith the control group (p < 0.05 and p < 0.005, respectively). Significant positive correlations were observed between\nIL-6 mRNA expression levels in OAT and the content of CD14 + cells in the peripheral blood (r = 0.55, p < 0.05), as well\nas between NF-?B and VEGF-A mRNA levels in OAT (r = 0.43, p < 0.05) in patients with MS. The AdipoQ gene expression\nlevels in OAT were significantly decreased in women with MS compared with the control group (p < 0.05). In addition,\nthere were inverse correlations between AdipoQ gene levels in MAT and serum CRP levels (r = ?0.63, p < 0.05), as well\nas between AdipoQ gene levels in MAT and serum IL-6 levels (r = ?0.46, p < 0.05).\nConclusion: These data demonstrate that proinflammatory gene expression of MAT in women with MS was increased\ncompared with the control group. The AdipoQ gene expression levels in OAT were significantly decreased in women\nwith MS compared with the control group....
Objective: The aim of this study was to determine the role of serum prolidase activity and the possible association\nwith oxidative stress parameters in non-diabetic metabolic syndrome.\nMethods: 30 obese patients without metabolic syndrome (MetS), 34 non-diabetic obese patients with MetS, and 23\nvolunteer control subjects were enrolled in the study. Fasting plasma glucose (FPG), plasma glucose following 75 g\nglucose administration, high-density lipoprotein- cholesterol (HDL-C), high-density lipoprotein- cholesterol (LDL-C),\ntotal cholesterol, triglyceride (TG), total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index\n(OSI), and prolidase activities of all subjects were analyzed.\nResults: Prolidase levels was significantly higher in MetS group compared to both obese and control groups\n(p < 0.001 and p < 0.05 respectively). Prolidase was also higher in the obese group than in the control group\n(p < 0.05). Prolidase was negatively correlated with TAS and HDL-C (r = ?0,362, p < 0.001; r = ?0.320, p < 0.01,\nrespectively) and positively correlated with BMI, weight, waist-c, SBP, DBP, TG, TC, LDL-C.\nConclusion: Prolidase activity may have a role in the pathogenesis of metabolic syndrome....
Background: Diabetic peripheral neuropathy (DPN) is one of the most common microvascular complications of\ndiabetes. Glycemic variability could be an independent risk factor for diabetes complications in addition to average\nglucose. Type 2 diabetes with well-controlled glycosylated hemoglobin A1c (HbA1c) may have different terms of\nglycemic variability and vascular complication consequences. The aim of the study is to investigate the relationship\nbetween glycemic variability and DPN in type 2 diabetes with well-controlled HbA1c (HbA1c < 7.0%).\nMethods: 45 type 2 diabetes with well-controlled HbA1c(HbA1c < 7.0%) and with DPN (DM/DPN group) were\nrecruited in the study, and 45 type 2 diabetes with well-controlled HbA1c and without DPN (DM/ââ?¬â??DPN group) were\nset as controls. The two groups were also matched for age and diabetic duration. Blood pressure, body mass index\n(BMI), insulin sensitivity index (Matsuda index, ISI), total cholesterol (TC), triglyceride (TG), high density lipoprotein\ncholesterol (HDLC), and low density lipoprotein cholesterol (LDLC) were tested in the two groups. And all patients were\nmonitored using the continuous glucose monitoring (CGM) system for consecutive 72 hours. The multiple parameters\nof glycemic variability included the standard deviation of blood glucose (SDBG), mean of daily differences (MODD) and\nmean amplitude of glycemic excursions (MAGE).\nResults: The DM/DPN group had a greater SDBG, MODD and MAGE, when compared to the DM/ââ?¬â??DPN group\n(p < 0.05). BMI, TC, and LDLC of DM/DPN group were lower than those of DM/ââ?¬â??DPN group (p < 0.05). The patients\nwith hypoglycemia were comparable between the two groups (p > 0.05). Univariate analysis showed DPN was closely\nassociated with BMI (OR 0.82, CI 0.72ââ?¬â??0.94, p = 0.005), TC (OR 0.63, CI 0.42ââ?¬â??0.93, p = 0.02), LDLC (OR 0.4, CI 0.20ââ?¬â??0.80,\np = 0.009), SDBG (OR 2.95, CI 1.55ââ?¬â??5.61, p = 0.001), MODD (OR 4.38, CI 1.48ââ?¬â??12.93, p = 0.008), MAGE (OR 2.18,\nCI 1.47ââ?¬â??3.24, p < 0.001). Multivariate logistic regression analysis showed that MAGE (OR 2.05, CI 1.36ââ?¬â??3.09, p = 0.001)\nand BMI (OR 0.85, CI 0.73ââ?¬â??0.99, p = 0.033) were significantly correlating with DPN. Glycemic variability, evaluated by\nMAGE, was the most significantly independent risk factor for DPN.\nConclusions: There was a close relationship between glycemic variability evaluated by MAGE and DPN in type 2\ndiabetes with well-controlled HbA1c....
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