Current Issue : July - September Volume : 2015 Issue Number : 3 Articles : 6 Articles
Theaimof the studywas to test the performance of a newdefinition of metabolic syndrome (MetS),which better describes metabolic\ndysfunction in children. Methods. 15,794 youths aged 6ââ?¬â??18 years participated. Mean z-score for CVD risk factors was calculated.\nSensitivity analyses were performed to evaluate which parameters best described the metabolic dysfunction by analysing the score\nagainst independent variables not included in the score. Results.More youth had clustering of CVD risk factors (>6.2%) compared\nto the number selected by existingMetS definitions (International Diabetes Federation (IDF) < 1%).Waist circumference and BMI\nwere interchangeable, but using insulin resistance homeostasis model assessment (HOMA) instead of fasting glucose increased the\nscore. The continuous MetS score was increased when cardiorespiratory fitness (CRF) and leptin were included. A mean z-score\nof 0.40ââ?¬â??0.85 indicated borderline and above 0.85 indicated clustering of risk factors. A noninvasive risk score based on adiposity\nand CRF showed sensitivity and specificity of 0.85 and an area under the curve of 0.92 against IDF definition ofMetS. Conclusions.\nDiagnosis for MetS in youth can be improved by using continuous variables for risk factors and by including CRF and leptin....
Type 2 diabetes (T2DM) confers increased risk of endothelial dysfunction, coronary heart disease, and vulnerability to vein graft\nfailure after bypass grafting, despite glycaemic control. This study explored the concept that endothelial cells (EC) cultured from\nT2DMand nondiabetic (ND) patients are phenotypically and functionally distinct. Cultured human saphenous vein- (SV-) ECwere\ncompared between T2DM and ND patients in parallel. Proliferation, migration, and in vitro angiogenesis assays were performed;\nwestern blotting was used to quantify phosphorylation of Akt, ERK, and eNOS. The ability of diabetic stimuli (hyperglycaemia,\nTNF-????, and palmitate) to modulate angiogenic potential of ND-EC was also explored. T2DM-EC displayed reduced migration\n(?30%) and angiogenesis (?40%) compared with ND-EC and a modest, nonsignificant trend to reduced proliferation. Significant\ninhibition of Akt and eNOS, but not ERK phosphorylation, was observed in T2DM cells. Hyperglycaemia did not modify ND-EC\nfunction, but TNF-???? and palmitate significantly reduced angiogenic capacity (by 27% and 43%, resp.), effects mimicked by Akt\ninhibition. Aberrancies of EC function may help to explain the increased risk of SV graft failure in T2DM patients. This study\nhighlights the importance of other potentially contributing factors in addition to hyperglycaemia that may inflict injury and longterm\ndysfunction to the homeostatic capacity of the endothelium....
Little information exists on the trajectory and determinants of adiponectin, a possible insulin sensitizer and marker for\ninflammation and endothelial function, across the duration of type 1 diabetes. The Wisconsin Diabetes Registry Study followed\nan incident cohort ?30 years of age when diagnosed with type 1 diabetes during 1987ââ?¬â??1992 up to 20-year duration. Adiponectin was\nconcurrently and retrospectively (from samples frozen at ?80?C) measured for those participating in a 20-year exam (n = 304),\nduring 2007ââ?¬â??2011. Adiponectin levels were higher in females, declined through adolescence, and increased with age thereafter.\nLower levels were associated with greater body weight and waist circumference and with higher insulin dose, especially at longer\ndiabetes durations.Higher levels were associated with higher HbA1c and, at longer durations, with higher albumin-creatinine ratio.\nAdiponectin levels showed consistency within individuals that was not explained by these factors. We conclude that markers for\ninsulin resistance are associated with lower adiponectin, andmarkers for potential microvascular complications are associated with\nhigher adiponectin. The previously reported relationship with HbA1c remains largely unexplained. Additional individual specific\nfactors likely also influence adiponectin level. The relationship between adiponectin and urinary protein excretion may enable\nidentification of those predisposed to kidney disease earlier in type 1 diabetes....
Diabetic kidney disease is the leading cause of end-stage renal disease. Albuminuria is recognized as the most important\nprognostic factor for chronic kidney disease progression. For this reason, blockade of renin-angiotensin system remains the main\nrecommended strategy, with either angiotensin converting enzyme inhibitors or angiotensin II receptor blockers. However, other\nantiproteinuric treatments have begun to be studied, such as direct renin inhibitors or aldosterone blockers. Beyond antiproteinuric\ntreatments, other drugs such as pentoxifylline or bardoxolone have yielded conflicting results. Finally, alternative pathogenic\npathways are being explored, and emerging therapies including antifibrotic agents, endothelin receptor antagonists, or transcription\nfactors show promising results. The aim of this review is to explain the advances in newer agents to treat diabetic kidney disease,\nalong with the background of the renin-angiotensin system blockade....
Introduction. The purpose of this study was to analyze the influence of metabolic phenotypes during the construction of ROC\ncurves for waist circumference (WC) cutpoint selection. Materials and Methods. A total of 1,902 subjects of both genders were\nselected from theMaracaibo CityMetabolic Syndrome Prevalence Study database. Two-Step Cluster Analysis (TSCA) was applied\nto select metabolically healthy and sick men and women. ROC curves were constructed to determineWC cutoff points by gender.\nResults.Through TSCA, metabolic phenotype predictive variables were selected: HOMA2-IR and HOMA2-????cell for women and\nHOMA2-IR, HOMA2-????cell, and TAG for men. Subjects were classified as healthy normal weight, metabolically obese normal\nweight, healthy and metabolically disturbed overweight, and healthy and metabolically disturbed obese. FinalWC cutpoints were\n91.50 cm for women (93.4% sensitivity, 93.7% specificity) and 98.15 cm for men (96% sensitivity, 99.5% specificity). Conclusions.\nTSCA in the selection of the groups used in ROC curves construction proved to be an important tool, aiding in the detection\nof MOWN and MHO which cannot be identified with WC alone. The resulting WC cutpoints were <91.00cm for women and\n<98.00 cm for men. Furthermore, anthropometry is insufficient to determine healthiness, and, biochemical analysis is needed to\nproperly filter subjects during classification....
Peripheral neuropathy is a chronic complication of diabetes mellitus. To investigated the efficacy and safety of the extended\ntreatment of diabetic peripheral neuropathy with thymosin ?4 (T?4), male diabetic mice (db/db) at the age of 24 weeks were\ntreatedwith T?4 or saline for 16 consecutive weeks. Treatment of diabetic mice with T?4 significantly improved motor (MCV) and\nsensory (SCV) conduction velocity in the sciatic nerve and the thermal and mechanical latency. However, T?4 treatment did not\nsignificantly alter blood glucose levels. Treatment with T?4 significantly increased intraepidermal nerve fiber density. Furthermore,\nT?4 counteracted the diabetes-induced axon diameter and myelin thickness reductions and the ?-ratio increase in sciatic nerve.\nIn vitro, compared with dorsal root ganglia (DRG) neurons derived from nondiabetic mice, DRG neurons derived from diabetic\nmice exhibited significantly decreased neurite outgrowth, whereas T?4 promoted neurite growth in these diabetic DRG neurons.\nBlockage of the Ang1/Tie2 signaling pathway with a neutralized antibody against Tie2 abolished T?4-increased neurite outgrowth.\nOur data demonstrate that extended T?4 treatment ameliorates diabetic-induced axonal degeneration and demyelination, which\nlikely contribute to therapeutic effect of T?4 on diabetic neuropathy.The Ang1/Tie2 pathway may mediate T?4-induced axonal\nremodeling....
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