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1.
Thainá Rodrigues Melo Santos Juliana Valeria Melo Nathalie Carvalho Leite Gil Fernando Salles Claudia Regina Lopes Cardoso 《Journal of diabetes and its complications》2018,32(8):770-776
Aims
To investigate the associated factors with the vibration threshold perception (VPT) in patients with type 2 diabetes and to assess whether it is useful for detection of diabetic peripheral neuropathy (DPN).Methods
VPTs were measured with Vibration Sensory Analyzer (VSA-3000) in 426 diabetic patients. The diagnosis of DPN was based on Neuropathy Symptom Score and Neuropathy Disability Score (NDS). ROC curve analysis and multiple linear and logistic regressions were performed to investigate the associations between VPT and DPN.Results
Values of VPT were progressively higher according to NDS stages. Age, height, diabetes duration, and mean cumulative HbA1c exposure (partial correlation coefficients: 0.34; 0.27; 0.10; and 0.13; respectively) were the variables independently associated with VPT. Area under ROC curve of VPT for detection of DPN was 0.71 (95% CI: 0.66–0.75) and >8.9?μm was its best cut-off value. VPT, age, female sex, height, diabetes duration and mean HbA1c levels were the independent correlates of the presence of DPN. An increased VPT triplicate the likelihood of having DPN (OR: 3.24; 95% CI: 2.05–5.11).Conclusions
VPT, measured by an automatic device, shares common correlates with DPN and is strongly associated with its presence. VPT testing may be useful as a screening tool for DPN assessment. 相似文献2.
Tine Maria Hansen Birgitte Brock Anne Juhl Asbjørn Mohr Drewes Henrik Vorum Carl Uggerhøj Andersen Poul Erik Jakobsen Jesper Karmisholt Jens Brøndum Frøkjær Christina Brock 《Journal of diabetes and its complications》2019,33(4):323-328
Aims
Emerging evidence shows, that distal symmetric peripheral neuropathy (DSPN) also involves alterations in the central nervous system. Hence, the aims were to investigate brain metabolites in white matter of adults with diabetes and DSPN, and to compare any cerebral disparities with peripheral nerve characteristics.Methods
In type 1 diabetes, brain metabolites of 47 adults with confirmed DSPN were compared with 28 matched healthy controls using proton magnetic resonance spectroscopy (H-MRS) in the parietal region including the sensorimotor fiber tracts.Results
Adults with diabetes had 9.3% lower ratio of N-acetylaspartate/creatine (NAA/cre) in comparison to healthy (p?<?0.001). Lower NAA/cre was associated with lower sural (p?=?0.01) and tibial (p?=?0.04) nerve amplitudes, longer diabetes duration (p?=?0.03) and higher age (p?=?0.03). In addition, NAA/cre was significantly lower in the subgroup with proliferative retinopathy as compared to the subgroup with non-proliferative retinopathy (p?=?0.02).Conclusions
The association to peripheral nerve dysfunction, indicates concomitant presence of DSPN and central neuropathies, supporting the increasing recognition of diabetic neuropathy being, at least partly, a disease leading to polyneuropathy. Decreased NAA, is a potential promising biomarker of central neuronal dysfunction or loss, and thus may be useful to measure progression of neuropathy in diabetes or other neurodegenerative diseases. 相似文献3.
Signe T. Andersen Kasper Grosen Hatice Tankisi Morten Charles Niels T. Andersen Henning Andersen Ioannis N. Petropoulos Rayaz A. Malik Troels S. Jensen Pall Karlsson 《Journal of diabetes and its complications》2018,32(12):1153-1159
Aims
In this cross-sectional study, we explored the utility of corneal confocal microscopy (CCM) measures for detecting diabetic polyneuropathy (DPN) and their association with clinical variables, in a cohort with type 2 diabetes.Methods
CCM, nerve conduction studies, and assessment of symptoms and clinical deficits of DPN were undertaken in 144 participants with type 2 diabetes and 25 controls. DPN was defined according to the Toronto criteria for confirmed DPN.Results
Corneal nerve fiber density (CNFD) was lower both in participants with confirmed DPN (n?=?27) and in participants without confirmed DPN (n?=?117) compared with controls (P?=?0.04 and P?=?0.01, respectively). No differences were observed for CNFD (P?=?0.98) between participants with and without DPN. There were no differences in CNFL and CNBD between groups (P?=?0.06 and P?=?0.29, respectively). CNFD was associated with age, height, total- and LDL cholesterol.Conclusions
CCM could not distinguish patients with and without neuropathy, but CNFD was lower in patients with type 2 diabetes compared to controls. Age may influence the level of CCM measures. 相似文献4.
Alin O. Stirban Cosmina I. Bondor Bogdan Florea Ioan A. Veresiu Norina A. Gavan 《Journal of diabetes and its complications》2018,32(9):851-856
Objective
Advanced glycation end products (AGE) contribute to the development of diabetes complications. Their accumulation in skin can be non-invasively assessed by measurement of skin autofluorescence (SAF). Our study investigated whether SAF correlates with measures of diabetic peripheral neuropathy (DPN).Methods
In a multi-center study (8 centers), 497 consecutive individuals with diabetes mellitus were investigated.Forearm SAF was measured using the AGE Reader (Groningen, The Netherlands). DPN was assessed using the Toronto Clinical Neuropathy Score (TCNS), the Neuropathy Symptoms Score (NSS) and the Neuropathy Disability Score (NDS).Results (mean?±?SD)
According to the TCNS, SAF (arbitrary units - AU) was increased in individuals with DPN (TCNS?>?5): 2.59?±?0.56?AU compared with those without DPN (TCNS?≤?5): 2.45?±?0.53?AU, (p?=?0.04) and significantly increased with the severity of DPN (p?=?0.028).Higher SAF was detected in individuals with neuropathic deficits (NDS?>?2): 2.58?±?0.56?AU vs. those without deficits (NDS?≤?2): 2.45?±?0.53?AU, (p?=?0.009) as well as in individuals with symptoms (NSS?>?2): 2.54?±?0.56?AU vs. those without symptoms (NSS?≤?2): 2.40?±?0.47?AU, (p?=?0.022).Conclusions
Accumulation of AGE in skin is increased in individuals with DPN and progresses with the severity of DPN. Therefore, SAF measurement, an easy-to-use, quick and non-invasive method, might help in identifying subjects at high risk for having DPN. 相似文献5.
L. Darwish M.M. Nguyen M. Saleem K.A. Eakin N. Herrmann K.S. Sugamori P.I. Oh P. Yang J. Mitchell K.L. Lanctôt W. Swardfager 《Journal of diabetes and its complications》2019,33(5):390-397
Background
Lower serum concentrations of the osteoblast-derived protein, osteocalcin, have been associated with poorer glycemic control, insulin resistance and atherosclerosis, and with the development of type 2 diabetes (T2DM).Methods
This study compares concentrations of two physiological forms of osteocalcin, carboxylated (cOCN) and uncarboxylated (unOCN), between participants with T2DM (n?=?20) and age-, gender- and body mass index (BMI)-matched participants without T2DM (n?=?40) among patients with coronary artery disease (CAD), and it explores relationships between osteocalcin concentrations and cardiovascular risk factors.Results
Concentrations of unOCN (2.71?±?1.86 vs. 4.70?±?2.03?ng/mL; t?=??3.635, p?=?0.001) and cOCN (8.70?±?2.27 vs. 10.77?±?3.69?ng/mL; t?=??2.30, p?=?0.025) were lower in participants with T2DM. In participants without T2DM, concentrations of cOCN were associated with fitness (VO2Peak rho?=?0.317, p?=?0.047) and lower body fat (rho?=??0.324, p?=?0.041). In participants with T2DM, lower unOCN was associated with HbA1c (rho?=??0.516, p?=?0.020). Higher body mass was associated with higher unOCN (rho?=?0.423, p?=?0.009) in participants without T2DM, but with lower concentrations of both unOCN (rho?=??0.590, p?=?0.006) and cOCN (rho?=??0.632, p?=?0.003) in participants with T2DM.Conclusion
In patients with CAD, lower osteocalcin concentrations were related to type 2 diabetes, and to adverse fitness, metabolic and obesity profiles. 相似文献6.
Wuquan Deng Xiaoying Dong Yuping Zhang Youzhao Jiang Debin Lu Qinan Wu Ziwen Liang Gangyi Yang Bing Chen 《Diabetes research and clinical practice》2014
Aims
The assessment of transcutaneous oxygen pressure (TcPO2) may serve as a non-invasive and lower-cost alternative to nerve conduction studies (NCSs) for the diagnosis of diabetic peripheral neuropathy (DPN). The aim of this study was to determine whether the measurement of TcPO2 is useful for evaluating DPN.Methods
We performed a cross-sectional study of 381 consecutive hospitalized diabetic patients classified by clinical examination and NCS as having DPN. Anthropometric and metabolic parameters were assessed. The TcPO2 examination was performed in both supine and sitting positions.Results
Three hundred and one patients had DPN. The TcPO2 in both the supine and sitting positions was highest in the Non-DPN group and lower in the confirmed DPN group than the other three groups (p < 0.001). The Non-DPN group had the lowest sitting-supine position difference in TcPO2 among the groups (p < 0.001). The risk factors strongly associated with DPN included sitting-supine position difference in TcPO2 (OR = 4.971, p < 0.001), diabetic retinopathy (DR) (odds ratio [OR] = 3.794, p = 0.002), and HbA1c (OR = 1.534, p = 0.033). The area under the curve (AUC) of the sitting-supine position difference in TcPO2 was 0.722 and revealed an optimal cut-off point for the identification of DPN (19.5 mmHg) that had a sensitivity of 0.611 and a specificity of 0.738 based on AUC analysis.Conclusions
This large study of diabetic patients confirms that the sitting-supine position difference in TcPO2 is higher in DPN patients than control subjects, indicating that TcPO2 examination is a promising valuable diagnostic tool for DPN. 相似文献7.
Lynda A. Wilmott Richard C. Grambergs Jeremy C. Allegood Timothy J. Lyons Nawajes Mandal 《Journal of diabetes and its complications》2019,33(3):195-201
Objective
Sphingolipids have a fundamental role in many cellular processes, and they have been implicated in insulin resistance and Diabetes Mellitus (DM) and its complications, including diabetic retinopathy (DR). Little is known about how bioactive sphingolipids relate to retinopathies in human DM. In this study, we analyzed the sphingolipid composition of type 2 diabetic (T2DM) and non-diabetic human vitreous samples.Methods
We conducted an observational study on post-mortem human vitreous samples from non-diabetic (Controls; n?=?4; age: 71.6?±?11.0?years, mean?±?SD) and type 2 diabetic (T2DM; n?=?9; age: 67.0?±?9.2?years) donors to identify changes in sphingolipid composition. Samples were analyzed by a triple quadrupole mass spectrometer and individual sphingolipid species were identified and quantified using established protocols.Results
The total quantity (pmol/mg) of ceramide (Cer), lactosylceramide (Lac-Cer), and sphingomyelin (SM) were increased in type 2 diabetic vitreous samples. Among individual species, we found a general trend of increase in the longer chain species of ceramides, hexosylceramides (Hex-Cer), Lac-Cer, and SM.Conclusions
This study shows the presence of measurable levels of sphingolipids in human vitreous. The results indicate changes in sphingolipid composition in the vitreous due to type 2 diabetes, which could be connected to the disease pathologies of the retina, retinal vessels, vitreous and the surrounding tissues. 相似文献8.
Hazem M. El-Ashmawy Hisham S. Roshdy Zizi Saad Azza M. Ahmed 《Journal of the Saudi Heart Association》2019,31(1):24-31
Objective
To assess the relationship between serum endostatin (ES) and coronary artery calcification (CAC) in type 2 diabetic (T2DM) patients.Methods
The study included 110 participants with coronary artery disease (CAD); 55 with T2DM, for serum ES levels by enzyme-linked immunosorbent assay and CAC by contrast-enhanced spiral computed tomography (CT).Results
Mean serum ES value was 66.54?ng/mL [95% confidence interval (CI), 61.77–71.32?ng/mL]. Serum ES levels positively correlated with Agatston score index [ASI; r?=?0.701, p?<?0.001; high sensitive C-reactive protein (hs-CRP) r?=?0.783, p?<?0.001]. On multiple regression analysis, the highest three ES quartiles (2, 3, and 4) were related to ASI in diabetic patients, adjusted ES level was an independent predictor of CAD [odds ratio (OR) = 1.065; 95% CI, 1.008–1.126; p?=?0.026] and for the number of coronary vessels affected (OR?=?1.089; 95% CI, 1.018–1.164; p?=?0.013) in T2DM patients. Receiver operating characteristics (ROC) analysis showed serum ES at a cutoff value of 86.5?ng/mL can predict the risk of CAC in T2DM, with a sensitivity of 74.1%, specificity of 71.4%, p?<?0.001 and area under curve (AUC) of 0.776.Conclusion
Measurement of serum ES levels can improve diagnosis of CAC and could be useful as a high sensitive marker for the presence and progression of atherosclerosis in T2DM patients. 相似文献9.
Gulay Imadoglu Yetkin Aysegul Atak Yucel İshak Özel Tekin Mustafa Yılmaz Hakan Atalay Ertan Yetkin 《Journal of diabetes and its complications》2019,33(2):134-139
Background
It has been shown that functional status of dendritic cells (DCs) in diabetic patients with unstable angina pectoris (UAP) are more mature and activated than diabetic patients without coronary artery disease (CAD) and none diabetic patients with UAP. Accordingly we aimed to assess the activation of DCs in patients with CAD with/and without Diabetes Mellitus (DM) and compare to those in subjects with normal coronary arteries (NCA).Materials and methods
Twenty three patients with severe CAD who were scheduled to coronary artery by-pass grafting surgery and 6 patients with angiographycally NCAs were included in the study. Activation of peripheral blood DCs have been analyzed by flow cytometric measures of CD86 activation.Results
In patients with CAD and without DM, DC activation significantly increased after stimulation of oxidesized LDL (135?±?121 vs 248?±?197 p?=?0.024). However this activation didn't significantly increased in patients with CAD and DM (100?±?20 vs 120?±?97, p?=?0,54). Patients with NCAs and without DM showed marked activation of CD86 after stimulation with ox-LDL.Conclusion
We have documented that DC activation, upon stimulation of ox-LDL has blunted in patients with CAD compared to patients with NCAs. Moreover this defective activation is more pronounced in those with diabetic patients with CAD. 相似文献10.
Shiyun Wang Rong Zhang Tao Wang Feng Jiang Cheng Hu Weiping Jia 《Journal of diabetes and its complications》2019,33(2):178-181
Aims
The common copy number variant (CNV) in the haptoglobin (Hp) gene may influence the susceptibility to diabetic macrovascular diseases. We aimed to investigate the relationship of the genetic variant rs2000999, located in the haptoglobin-related protein (HPR) gene, with serum Hp levels and diabetic macrovascular diseases in Chinese type 2 diabetes patients.Methods
The Hp CNV and rs2000999 were genotyped in a group of 5457 Chinese patients with type 2 diabetes. Associations of rs2000999 with the common Hp CNV, susceptibility to diabetic macrovascular diseases and related metabolic traits were analysed. Furthermore, 886 patients were selected to detect serum Hp levels and to evaluate the correlation between rs2000999 and serum Hp levels.Results
The genetic variant rs2000999 was not associated with diabetic macrovascular diseases (P = 0.6109), while subjects carrying the A allele had higher levels of low-density lipoprotein cholesterol (P?=?0.0578) and a smaller inter-adventitial diameter of the common carotid artery (P?=?0.0266). Additionally, rs2000999 exhibited strong association with serum Hp levels (P?=?2.03?×?10?21).Conclusions
The genetic variant rs2000999 was not associated with diabetic macrovascular diseases but showed an association with metabolic traits and serum Hp levels in Chinese patients with type 2 diabetes. 相似文献11.
Saeko Osawa Naoto Katakami Ihoko Sato Hiroyo Ninomiya Kazuo Omori Yuichi Yamamoto Mitsuyoshi Takahara Kazuyuki Miyashita Fumie Sakamoto Dan Kawamori Takaaki Matsuoka Iichiro Shimomura 《Journal of diabetes and its complications》2018,32(9):839-844
Aims
Tissue accumulatedadvanced glycation end products (AGEs) can be evaluated non-invasively by an autofluorescence reader as skin autofluorescence (skin AF)·The present study investigated whether skin AF is associated with diabetic micro- and macroangiopathies in Japanese patients with type 2 diabetes mellitus (T2DM).Methods
Skin AF was measured in 193 enrolled Japanese patients with T2DM and 24 enrolled healthy non-diabetic subjects by using the AGE reader®. Diabetic micro- and macroangiopathies were evaluated in the T2DM patients.Results
Skin AF was significantly increased in patients with T2DM than in age- and sex-matched non-diabetic controls (2.35?±?0.51 [mean?±?SD] and 1.91?±?0.29, respectively, p?=?0.001). In subjects with T2DM, skin AF was associated with age, pack-years of smoking, and eGFR (estimated glomerular filtration rate) independently. Skin AF was significantly increased in patients with diabetic retinopathy, neuropathy, nephropathy, and macroangiopathy than in those without them, and significantly associated with the number of diabetic complications. Moreover, skin AF was an independent predictor for diabetic retinopathy, neuropathy, and nephropathy but not macroangiopathy, after adjusting for major traditional risk factors.Conclusions
Skin AF is an independent predictor for diabetic retinopathy, neuropathy and nephropathy in Japanese patients with T2DM. 相似文献12.
Henrik Ø. Hjortkjær Tonny Jensen Jannik Hilsted Ulrik M. Mogensen Helle Corinth Peter Rossing Lars Køber Klaus F. Kofoed 《Journal of diabetes and its complications》2019,33(2):171-177
Aims
Type 1 diabetes is associated with increased cardiovascular (CV) morbidity and mortality, and cardiovascular autonomic neuropathy (CAN) is an important CV risk factor. The study aimed to explore associations between CAN and altered cardiac chamber sizes in persons with type 1 diabetes.Methods
This was a cross-sectional study of 71 asymptomatic, normoalbuminuric participants with long-term type 1 diabetes (39 with CAN, determined by >1 abnormal autonomic function test) examined with cardiac multi detector computed tomography scans, which allowed measurements of left ventricular mass and all four cardiac chamber volumes. Cardiac chambers were indexed according to body surface area (ml/m2 or g/m2).Results
Persons with and without CAN had mean?±?SD age of 57?±?7 and 50?±?8?years (p?<?0.001) and diabetes duration of 36?±?11 and 32?±?9?years (p?<?0.05), respectively. Increasing autonomic dysfunction, evaluated by decrease in heart rate variability during deep breathing (in beats per minute), was associated with larger right (?0.5, 95% CI ?1.0 to ?0.0, p?<?0.05) and trend towards larger left (?0.4, 95% CI ?0.8–0.0, p?<?0.1) ventricular volumes in multivariable linear regression.Conclusions
Our results suggest that impaired autonomic function may be associated with modest enlargement of ventricular volumes; this might be an early sign of progression towards heart failure. 相似文献13.
Cinzia Ciccacci Andrea Latini Carla Greco Cristina Politi Cinzia D&#x;Amato Davide Lauro Giuseppe Novelli Paola Borgiani Vincenza Spallone 《Journal of diabetes and its complications》2018,32(1):11-17
Aims
Diabetic polyneuropathy (DPN) and cardiovascular autonomic neuropathy (CAN) affect a large percentage of diabetic people and impact severely on quality of life. As it seems that miRNAs and their variations might play a role in these complications, we investigated whether the rs3746444 SNP in the MIR499A gene could be associated with susceptibility to DPN and/or CAN.Methods
We analyzed 150 participants with type 2 diabetes. DNA was extracted from peripheral blood samples and genotyping was performed by TaqMan genotyping assay. Cardiovascular tests, MNSI-Q and MDNS for neuropathic symptoms and signs, VPT, and thermal thresholds were used for CAN and DPN assessment. We performed a genotype-phenotype correlation analysis.Results
We observed that the GG genotype was associated with a higher risk of developing CAN (P = 0.002 and OR = 16.08, P = 0.0005 and OR = 35.02, for early and confirmed CAN, respectively) and DPN (P = 0.037 and OR = 6.56), after correction for BMI, sex, age, HbA1c and disease duration. Moreover, the GG genotype was associated with worse values of MDNS (P = 0.017), VPT (P = 0.01), thermal thresholds (P = 0.01), and CAN score (P < 0.001). A logistic multivariate analysis confirmed that MIR499A GG genotype, disease duration and HbA1c contributed to early CAN (R2 = 0.26), while the same variables and age contributed to DPN (R2 = 0.21). With a multiple linear regression, we observed that GG genotype (P = 0.001) and disease duration (P = 0.035) were the main variables contributing to the CAN score (R2 = 0.35).Conclusions
We described for the first time that the MIR499A genetic variation could be involved in diabetic neuropathies susceptibility. In particular, patients carrying the rs3746444 GG genotype had a higher risk of CAN development, together with a more severe form of CAN. 相似文献14.
Deepakraj Gajanana Manisha Ganapathi Raikar Pradhum Ram Vikas Bhalla Vincent Figueredo Sean Janzer Jon C. George 《Cardiovascular Revascularization Medicine》2019,20(3):207-209
Introduction
There is scarcity of data validating portable digital ankle-brachial index (ABI) with contrast angiography in peripheral arterial disease (PAD). Our aim was to provide an objective analysis of the relationship between digital ABI (dABI) and peripheral angiographic data.Methods
Consecutive patients with symptoms of PAD between May 2014 to May 2015 at Einstein Medical Center, Philadelphia, who were undergoing simultaneous dABI and peripheral angiography, were evaluated. Measurements were made using the FloChec? Digital ABI system (Bard) prior to the scheduled peripheral angiogram.Results
The final cohort consisted of 51 patients. Mean age was 68.8?±?9.5?years with 55% being male. Aorto-iliac disease accounted for 13% of the total lesions, while femoro-popliteal lesions comprised 55%. The FloChec? digital ABI had a sensitivity of 84% and a positive predictive value of 84%. The area under the receiver operating characteristic curve was 0.74 (p?=?0.007). On multivariate analysis, FloChec? digital ABI was still an independent predictor of PAD, Odds ratio 6.8 (2.3–20.6, p?=?0.001).Conclusion
A portable, point-of-care digital ABI system can be used as a valuable, simple, cost-effective and reliable screening tool with high sensitivity and accuracy. To date, ours is the first study validating FloChec? digital ABI with the gold standard angiographic data. 相似文献15.
Dheyauldeen shabeeb Masoud Najafi Gholamreza Hasanzadeh Mohammed Reza Hadian Ahmed Eleojio Musa Alireza Shirazi 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(4):591-600
Introduction
Peripheral neuropathy is one of the main complications of diabetes mellitus. One of the features of diabetic nerve damage is abnormality of sensory and motor nerve conduction study. An electrophysiological examination can be reproduced and is also a non-invasive approach in the assessment of peripheral nerve function. Population-based and clinical studies have been conducted to validate the sensitivity of these methods. When the diagnosis was based on clinical electrophysiological examination, abnormalities were observed in all patients.Method
In this research, using a review design, we reviewed the issue of clinical electrophysiological examination of diabetic peripheral neuropathy in articles from 2008 to 2017. For this purpose, PubMed, Scopus and Embase databases of journals were used for searching articles.Results/findings
The researchers indicated that diabetes (both types) is a very disturbing health issue in the modern world and should be given serious attention. Based on conducted studies, it was demonstrated that there are different procedures for prevention and treatment of diabetes-related health problems such as diabetic polyneuropathy (DPN). The first objective quantitative indication of the peripheral neuropathy is abnormality of sensory and motor nerve conduction tests. Electrophysiology is accurate, reliable and sensitive. It can be reproduced and also is a noninvasive approach in the assessment of peripheral nerve function.Conclusion
The methodological review has found that the best method for quantitative indication of the peripheral neuropathy compared with all other methods is clinical electrophysiological examination. For best results, standard protocols such as temperature control and equipment calibration are recommended. 相似文献16.
I. Stafeev N. Podkuychenko S. Michurina I. Sklyanik A. Panevina E. Shestakova K. Yah&#x;yaev V. Fedenko E. Ratner A. Vorotnikov M. Menshikov Y. Yashkov Ye. Parfyonova M. Shestakova 《Journal of diabetes and its complications》2019,33(2):148-159
Background
Obesity and type 2 diabetes mellitus (T2DM) are among the most important morbidity factors. In this study we tested the hypothesis that low proliferative potential of adipose derived stromal cells (ADSC) associates with reduced formation of new fat depots, excess accumulation of fat in the functional adipocytes and their hypertrophy, resulting in fat inflammation and insulin resistance.Methods
We screened two groups of obese patients with or without T2DM, matched for BMI, age, and duration of obesity to test the hypothesis that hypertrophy and decreased renewal of adipocytes may underlie transition from obesity to T2DM. All patients were matched for carbohydrate metabolism (fasting blood glucose level, glycated hemoglobin, HOMA-IR index and M-index). The subcutaneous and omental fat tissue biopsies were obtained during bariatric surgery from obese individuals with or without T2DM. The morphology and immunophenotype of subcutaneous and omental fat was assessed in frozen tissue sections. ADSC were isolated from both types of fat tissue biopsies and screened for morphology, proliferative potential and inflammatory status.Results
The non-diabetic patients had normal carbohydrate metabolism and moderate insulin resistance measured by HOMA-IR and hyperinsulinemic clamp (M-index), while T2DM patients were extremely insulin resistant by both indexes. The average size of diabetic adipocytes was higher than that of non-diabetic in both subcutaneous and omental fat tissues, indicating adipocyte hypertrophy in T2DM. Both these tissues contained higher level of macrophage infiltration and increased M1-like to M2-like ratio of macrophage subpopulations, suggesting increased fat inflammation in T2DM. This was confirmed by increased activatory phosphorylation of stress-induced JNK1/2 in diabetic ADSC.Conclusion
These results suggest that blunted proliferation and increased hypertrophy of diabetic ADSC may lead to reduced insulin sensitivity via increased inflammation mediated by M1 macrophages and JNK1/2 pathway. 相似文献17.
Jin Ook Chung Seon-Young Park Ji Hyun Han Dong Hyeok Cho Dong Jin Chung Min Young Chung 《Journal of diabetes and its complications》2018,32(4):357-361
Objective
To evaluate the relationship between levels of serum apolipoproteins and the prevalence of cardiovascular autonomic neuropathy (CAN) in type 2 diabetes.Methods
In total, 3199 individuals with type 2 diabetes were investigated in a cross-sectional study. The diagnosis of CAN was made based on the results of a cardiovascular reflex test. Serum apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) levels were measured.Results
Serum apoA-1 levels were significantly low in individuals with CAN, but there was no significant association between serum apoB levels and CAN. According to the degree of cardiovascular autonomic dysfunction, the average apoA-I levels were significantly different after adjusting for other covariates (normal, 1.32?g/l, 95% confidence interval [CI] 1.30–1.35; early, 1.29?g/l, 95% CI 1.27–1.31; definite, 1.27?g/l, 95% CI 1.25–1.30; P for trend?=?0.010). In the multivariable analysis, the statistically significant association between apoA-I and CAN remained after adjusting for the risk factors (odds ratio per standard deviation increase in the log-transformed value, 0.65; 95% CI, 0.43–0.97, P?=?0.036). Additional adjustments for serum high-sensitivity C-reactive protein (or fibrinogen) concentrations eliminated this relationship.Conclusions
Serum apoA-I levels are inversely associated with the prevalence of CAN in individuals with type 2 diabetes. Our data also suggest that a putatively increased risk of CAN associated with decreased apoA-I levels might be mediated by correlated increases in the levels of inflammatory markers. 相似文献18.
Giuseppe d&#x;Annunzio Andrea Beccaria Angela Pistorio Enrico Verrina Nicola Minuto Roberto Pontremoli Alberto La Valle Mohamad Maghnie 《Journal of diabetes and its complications》2018,32(10):955-960
Aims
Diabetic Nephropathy (DN) is rarely encountered in childhood, otherwise early subclinical abnormalities are detectable few years after diabetes diagnosis. Our aim was to evaluate the incidence rate of microalbuminuria in childhood onset type 1 diabetes (DM1) patients. Secondary aim was to examine which variables could influence the development of DN.Methods
We longitudinally evaluated 137 young patients with DM1 from diagnosis (1994–2004) for a median of 11.8?years (1st–3rd q: 9.7–15.0). Overnight albumin excretion rate, degree of metabolic control, presence of microangiopathic complications and autoimmune co-morbidities were retrospectively collected.Results
DN was observed in 16/137 cases (11.7%), with an incidence rate of 10.0 per 1000?person-years. Young T1D patients with persistent micro/macro-albuminuria were more likely to have higher HbA1c concentrations over the last four years (P?=?0.04), and were more likely to have retinopathy (P?=?0.011) and subclinical peripheral neuropathy (P?=?0.003).Conclusions
DN predictors were age at DM1 diagnosis and mean HbA1c levels. Even if DN incidence is lower than reported, periodical screening is mandatory. Moreover, borderline microalbuminuria as additional risk factor deserves attention. 相似文献19.
Alfred Gatt Kevin Cassar Owen Falzon Christian Ellul Kenneth P. Camilleri Jean Gauci Stephen Mizzi Anabelle Mizzi Cassandra Sturgeon Nachiappan Chockalingam Cynthia Formosa 《Primary Care Diabetes》2018,12(4):312-318
Aims
The purpose of this study was to investigate whether heat emitted from the feet of patients with type 2 diabetes (DM) and peripheral arterial disease (PAD) differed from those with type 2 diabetes without complications (DM).Methods
A non-experimental, comparative prospective study design was employed in a tertiary referral hospital. Out of 223 randomly selected participants (430 limbs) who were initially tested, 62 limbs were categorized as DM + PAD and 22 limbs as DM without PAD. Subjects with evidence of peripheral neuropathy were excluded. Participants underwent thermographic imaging. Automatic segmentation of regions of interest extracted the temperature data.Results
A significant difference in temperature in all the toes between the two groups was found (p = 0.005, p = 0.033, p = 0.015, p = 0.038 and p = 0.02 for toes 1–5 respectively). The mean forefoot temperature in DM + PAD was significantly higher than that in DM (p = .019), with DM + PAD having a higher mean temperature (28.3 °C) compared to DM (26.2 °C). Similarly, the toes of subjects with DM + PAD were significantly warmer than those of subjects with DM only.Conclusions
Contrary to expectations the mean toe and forefoot temperatures in DM patients with PAD is higher than in those with DM only. This unexpected result could be attributed to disruption of noradrenergic vasoconstrictor thermoregulatory mechanisms with resulting increased flow through cutaneous vessels and subsequent increased heat emissivity. These results demonstrate that thermography may have potential in detecting PAD and associated temperature differences. 相似文献20.
Ramón Rodríguez-Olivares Nahid El Faquir Zouhair Rahhab Lennart van Gils Ben Ren Rafi Sakhi Marcel L. Geleijnse Ron van Domburg Peter P.T. de Jaegere Jose L. Zamorano Gómez Nicolas M. Van Mieghem 《Cardiovascular Revascularization Medicine》2019,20(2):126-132