Erectile dysfunction in hemodialysis patients with diabetes mellitus: Association with age and hemoglobin A1c levels

Abstract Aim: Erectile dysfunction (ED) is common in patients with diabetes mellitus (DM) as well as those undergoing hemodialysis (HD). The purpose of this study is to investigate the frequency and severity of ED in HD patients with DM and those without DM. In addition, we examined the relationship between erectile function and several risk factors, including presence of DM and hemoglobin A1c levels in HD patients. Methods: This study involved 180 patients on HD, including 66 HD patients with DM (DM‐HD) and 114 patients without DM (non‐DM‐HD). We evaluated erectile function using an abridged five‐item version of the international index of erectile function (IIEF‐5). Logistic regression analysis was used to investigate the relationship between presence of ED and several risk factors. Results: The total score of IIEF‐5 in DM‐HD patients (9.5 ± 4.2) was significantly lower than in non‐DM‐HD patients (13.5 ± 5.7). The prevalence of severe ED was 42.4% and 18.4% in DM‐HD patients and non‐DM‐HD patients, respectively. Age, cardiovascular disease history, and DM were identified as independent risk factors for the presence of ED. Furthermore, age and elevated hemoglobin A1c levels were identified as independent risk factors for the presence of severe ED. Conclusion: DM‐HD patients are more likely to have ED, and particularly severe forms of ED, than non‐DM‐HD patients. DM and elevated hemoglobin A1c levels were associated with the presence of ED or severe ED, respectively. Aging was identified as an independent factor in both ED and severe ED.     

GLOMERULONEPHRITIS ASSOCIATED WITH LIVER CIRRHOSIS

The glomerular changes of 50 autopsy cases of liver cirrhosis of different etiologies, such as alcohol abuse, HB virus infection, and nonA–nonB virus infection, were studied by light, immunofluorescence and electron microscopy. The glomerular changes observed were as follows; membranoproliferative glomerulonephritis (MPGN) type 1 (7 cases), mild form or early stage of MPGN type 1 (7 cases), mesangial proliferative glomerulonephritis with sub–endothelial deposits (13 cases), and mesangial proliferative glomerulonephritis without subendothelial deposits (12 cases). These glomerular changes were frequently accompanied by predominant IgA deposition (78% of the immunofluorescence positive cases). Minimal glomerular changes without electron dense deposits were 11 cases, in which IgA was not present in the glomeruli. Thus, glomerulonephritis associated with liver cirrhosis has revealed a]spectrum'of glomerular changes from MPGN type 1 to mesangial proliferative glomerulonephritis with a common feature of predominant IgA deposition, despite various etiological factors of liver cirrhosis, such as alcohol abuse, hepatitis B virus infection, and nonA–nonB virus infection. A pathophysiological condition of liver cirrhosis, e.g. reduced phagocytic activity of the reticuloendothelial system of the cirrhotic liver, Is thought to be a major factor for development of these glomerular changes. The pathogenesis of IgA predominant glomerulonephritis associated with liver cirrhosis may be concerned in the pathogenesis of IgA nephropathy, which still remains to be clarified. ACTA PATHOL. JPN. 33: 333–346, 1983.     

Sirtuin 1 activator SRT1720 suppresses inflammation in an ovalbumin‐induced mouse model of asthma

Background and objective: In asthma, reduced histone deacetylase activity and enhanced histone acetyltransferase activity in the lungs have been reported. However, the precise function of Sirtuin 1 (Sirt1), a class III histone deacetylase, and the effect of the Sirt1 activator SRT1720 on allergic inflammation have not been fully elucidated. Methods: The effect of SRT1720, a synthetic activator of Sirt1, in an ovalbumin (OVA)‐induced asthma mouse model was investigated. The effect of SRT1720 and resveratrol on OVA stimulation in splenocytes from OVA‐sensitized and challenged mice was also examined. Results: In OVA‐sensitized and challenged mice (OVA mice) compared with saline‐sensitized and challenged mice (control mice), Sirt1 messenger RNA expression in the lungs was decreased (P = 0.02), while cellular infiltration, airway eosinophilia and bronchoalveolar lavage (BAL) fluid levels of interleukin (IL)‐4, IL‐5 and IL‐13 were increased (P < 0.01). In OVA mice, SRT1720 treatment decreased total and eosinophil cell counts and IL‐5 and IL‐13 levels in the BAL fluid compared with the vehicle treatment (P < 0.05). In OVA mice, SRT1720 treatment also decreased inflammatory cell lung infiltrates histologically (P = 0.002). Both SRT1720 and resveratrol suppressed OVA‐induced cell proliferation and IL‐6 (P < 0.05) and tumour necrosis factor‐α (TNF‐α) (P < 0.05) production in splenocytes (P < 0.01). Conclusions: The Sirt1 activator SRT1720 suppressed inflammatory cell infiltration and cytokine production in an OVA‐induced mouse model of asthma. SRT1720 and resveratrol suppressed OVA‐induced splenocyte proliferation and TNF‐α and IL‐6 production. Sirt1 activators might have beneficial effects in asthmatics by suppressing inflammation.