Association between long-term exposure of ambient air pollutants and cardiometabolic diseases: A 2012 Korean Community Health Survey

Background and aim

The associations of long-term exposure to particulate matter <10 μm in size (PM₁₀), nitrogen dioxide (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and ozone (O₃) with cardiometabolic diseases (CMD) remain uncertain in the Korean population. Therefore, we sought to examine the associations between PM₁₀, NO₂, CO, SO₂, and O₃ and CMD using data collected from the Korean Community Health Survey.

国内妊娠合并糖尿病热点研究

以万方数据库妊娠合并糖尿病相关中文文献为数据源，运用共词分析、社会网络分析方法探索该领域当前研究热点及未来发展趋势。结果显示当前热点主要集中在妊娠期糖尿病监测、护理及疾病影响等方面，未来研究趋势为该疾病诊断、预防和干预管理等。     

Potential of phloroglucinol to improve erectile dysfunction associated with streptozotocin-induced diabetes in rats

ObjectiveDiabetes is a common metabolic disease with several complications in its patients. Often, people living with diabetes develop erectile dysfunction (ED). The primary aim of this work was to investigate the effect of phloroglucinol in diabetes-induced ED in rats.MethodsMale Wistar rats were given 52 mg/kg of streptozotocin, by intraperitoneal injection, to induce diabetes and ED. Subsequently, animals were grouped into three groups: group 1, diabetic control; group 2, low-dose phloroglucinol (150 mg/kg body weight); and group 3, high-dose phloroglucinol (250 mg/kg body weight). A group of six normal rats served as a normal control. The rats were treated with phloroglucinol for six weeks and then were assessed for treatment effects. Sexual behavior, glycosylated hemoglobin A1c (HbA1c) values, serum testosterone, serum nitric oxide (NO), blood pressure and sperm count were measured after the end of treatment.ResultsAfter a 6-week treatment period, the high dose of phloroglucinol significantly decreased HbA1c values in diabetic rats. Rats treated with phloroglucinol had increased serum testosterone, NO and sperm count. Animals treated with 250 mg/kg phloroglucinol performed similar to normal rats in the sexual behavioral study, suggesting the reversal of complications of ED. Conversely, a decrease in the blood pressure in treated groups was observed.ConclusionThe results highlight the protective effect of phloroglucinol in diabetes-induced ED in rats warranting further studies.     

Association of non-alcoholic fatty liver disease with microvascular complications of type 2 diabetes

IntroductionNon-alcoholic fatty liver disease (NAFLD) affects risks of type 2 diabetes (T2D), diabetes-related complications, and cardiovascular disease in a complex manner. This study is designed to clarify associations of sonographically-detected NAFLD and serum liver enzymes with diabetes-related microvascular complications.MethodsA matched case-contorl study was designed for 440 patients with T2D and at least one of the chronic diabetes-related microvascular complications and 495 age- and gender-matched control patients with T2D.ResultsConsidering pre-existing and newly developed chronic microvascular complications, diabetic peripheral neuropathy was found in 347 out of 935 (37.1%) study patients, diabetic retinopathy in 141/935 (15.1%), and diabetic nephropathy in 103/935 (11.0%). Diagnosis of diabetic retinopathy and diabetic nephropathy were inversely associated with the presence of NAFLD in the crude logistic regressions (OR [95% CI] = 0.18 [0.05–0.63], p value = 0.007; OR [95% CI] = 0.17 [0.04–0.59], p value = 0.011, respectively). The subgroup of NAFLD with elevated liver enzymes had lower odds of having diabetic peripheral neuropathy in the fully adjusted model (OR [95% CI] = 0.34 [0.12–0.98], p value = 0.048).ConclusionDiagnosis of NAFLD with or without elevated serum liver enzymes was inversely correlated with certain chronic diabetes microvascular complications. Possible explanations for this counter-intuitive and unexpected finding are discussed and center on reverse-causality, wherein sicker patients may develop beneficial compensatory physiological and behavioral adaptations. Diversity of studied patients, in particular with regards to the ethnic and racial differences among the Western and Asian populations may also partly account for contrasting findings of the relationship between NAFLD and microvascular complications of diabetes.     

Toll-like receptor 2 expression on monocytes and microvascular complications in type 2 diabetic patients

Diabetes mellitus (DM) is a chronic debilitating illness, and atherosclerotic changes are inevitable and usually neglected during the follow-up of diabetic patients. Toll-like receptor 2 (TLR2) is under trial in many studies to hold responsibility for atherosclerosis process progression as they suggest a malfunction of these receptors expressed on monocytes in diabetic patients. This study aimed to assess the association between the TLR2 and type 2 diabetes mellitus (T2DM) in Egyptian diabetic patients and to investigate its relationship with some diabetic complications.MethodsThis study included a 60 diabetic patients group 1 (diabetic complicated), group 2 (diabetic non-complicated) and 30 age-matched normal healthy blood donors.ResultsToll-like receptors (TLRs) expression was significantly associated with T2DM. In this study, the mean fluorescent intensity (MFI) of TLR2 was 596.9 ± 84.78 in group 1, 326.23 ± 62.98 in group 2 while in group 3 it was 208.47 ± 156.73. There was a significant correlation between MFI of TLR2 and random blood sugar (RBS) and glycated haemoglobin (HbA1c) (p < 0.05).ConclusionTLR2 was overexpressed in diabetic patients with microvascular complications compared to diabetic non-complicated patients and normal healthy controls.     

Diabetes mellitus inhibits complete recanalization in patients with middle cerebral artery occlusion

Methods: This was a retrospective cohort study. Data from 165 patients, with middle cerebral occlusion before t-PA therapy (from the YAMATO study databank), were retrospectively evaluated. Patients were classified into diabetic (D) or non-diabetic (ND) groups based on the history of diabetes mellitus (DM) or hemoglobin A1c levels of ≥ 6.5%. Arterial recanalization was assessed using magnetic resonance angiography or digital subtraction angiography at 2 points: 1) early recanalization, within 2 h; 2) delayed complete recanalization at 24 h. Good clinical outcome was defined as modified Rankin Scale score 0–2 at 3 months.

Results: A total of 33 (21%) were classified into the D and 127 (79%) in the ND groups. Early recanalization was similarly in the D and ND groups (61% vs. 52%, p = 0.434). However, complete recanalization at 24 h was infrequent in the D group (13% vs. 43%, p = 0.002). Among patients with early recanalization, 4 (22%) of 18 patients in the D group and 32 (56%) of 57 patients in the ND group had complete recanalization at 24 h (p = 0.015); while among those without early recanalization, 17 (30%) in the ND and none in the D groups had complete recanalization at 24 h (p = 0.028). Multivariate regression analysis showed DM was one of the independent negative factors for complete recanalization at 24 h (odds ratio 0.113, 95%CI: 0.027–0.472, p = 0.003). At 3 months, group with complete recanalization at 24 h achieved higher frequency of good outcome (67% vs. 49%, p = 0.046).

Conclusion: Diabetes might be a risk factor of incomplete recanalization at 24 h regardless of early recanalization.     

Current concepts in curative surgery for diabetic forefoot ulcers

Forefoot ulcerations in patients with diabetes are quite common. Underlying mechanical deformities of the foot in combination with neuropathy are the most important risk factors for ulcer development and adequate offloading is the mainstay of management. Most ulcers heal with local wound care, adequate blood supply, and pressure relief. If a foot deformity cannot be accommodated, ulcers will not heal or may recur. In this case, surgical correction of deformity is necessary. This paper reviews the most common procedures supported by medical evidence to heal neuropathic forefoot ulcers.