Change in tear protein profile in diabetic retinopathy with duration of diabetes

AimsTo study change in tear protein profile with duration of diabetes and severity of diabetic retinopathy (DR) in type 2 diabetes patients.Materials and methodsTear protein profile was ascertained by SDS PAGE method in 30 patients with DR (group A) and 37 patients without DR (group B).ResultsSix distinct bands of proteins were identified; these proteins are as follows: 91 kDa (P1), 66 kDa (P2), 60 kDa (P3), 30 kDa (P4), 18.4 kDa (P5) and 14.4 kDa (P6). Prevalence of P3 was significant (p = 0.036) in group A, especially in cases with diabetes ≤8 years compared with diabetes >8 years (p = 0.0107). In group B, P2 was significantly prevalent (p < 0.0013) in cases with diabetes ≤8 years compared to diabetes >8 years. Considering the changes in terms of duration of diabetes in general, patients with diabetes of ≤8 years, P3 was significantly prevalent in group A compared to group B (p = 0.004); and when the duration of diabetes is >8 years, P2 was found significantly more in group A compared to group B (p = 0.01). No significant difference in P3 (p = 0.025), P4 (p = 0.2877), P5 (p = 0.4801), P6 (p = 0.0985) was observed in mild to moderate NPDR group compared to severe NPDR to PDR group. P1 and P2 were present only in severe NPDR and PDR.ConclusionVariable protein expression was observed with duration of diabetes and severity of diabetic retinopathy.     

Association between toll-like receptor2 Arg677Trp and 597T/C gene polymorphisms and pulmonary tuberculosis in Zahedan,Southeast Iran

BackgroundIt is well known that toll-like receptor 2 (TLR2) mediates responses of both innate and adaptive immunity to microbial pathogen, including mycobacteria. Single-nucleotide polymorphisms (SNPs) in the TLR2 gene that impair its function may be associated with the development of pulmonary tuberculosis (PTB). The aim of this study was to evaluate the possible association between TLR2 Arg677Trp and 597T/C polymorphisms and PTB in a sample of Iranian population.Materials and methodsThis case–control study was performed on 174 PTB and 177 healthy subjects. Tetra amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) was used to detect the SNPs.ResultsThere was no significant difference in the polymorphism of Arg677Trp of the TLR2 gene among PTB and control groups (p > 0.05). The results showed that there was a significant difference between case and control groups regarding 597T/C polymorphism (χ² = 12.21, p = 0.002). The TC and CC genotypes were found to be associated with the risk of PTB (OR = 2.13, 95% CI = 1.25–3.62, p = 0.005 and OR = 4.88, 95% CI = 1.56–15.26, p = 0.007, respectively).ConclusionOur data suggest that 597T/C polymorphism, but not Arg677Trp polymorphism, of the TLR-2 gene is a risk factor for susceptibility to PTB in a sample of Iranian population.     

Visit-to-visit variability in systolic blood pressure predicts development and progression of diabetic nephropathy,but not retinopathy,in patients with type 2 diabetes

ObjectiveTo investigate whether visit-to-visit variability in systolic blood pressure (SBP) can predict development and progression of diabetic nephropathy and retinopathy in patients with type 2 diabetes mellitus (T2DM).MethodsFrom 1995 through 1996, 664 T2DM patients visited our hospital for the first time and were subsequently examined 4 times or more and at least once annually.At first visit, 326 had normoalbuminuria, 644 had an estimated glomerular filtration rate (eGFR) of ≥ 45 ml/min/1.73 m², 526 had no diabetic retinopathy and 609 had no severe non-proliferative diabetic retinopathy (NPDR). They were followed through June 2012, at the latest.ResultsNinety patients developed microalbuminuria, 76 showed decrease of eGFR to < 45 ml/min/1.73 m², 113 developed mild–moderate NPDR and 50 progression to severe NPDR. The unadjusted, age- and sex-adjusted and multivariate-adjusted hazard ratios for development and progression of nephropathy, but not retinopathy, increased across tertiles of the standard deviation (SD) of SBP. Both the SD and coefficient of variation (CV) of SBP were significant predictors of development and progression of nephropathy, but not retinopathy, independently of mean SBP.ConclusionVisit-to-visit SBP variability is an independent predictor of development and progression of diabetic nephropathy, but not retinopathy, in T2DM patients.     

Potential Link Between C3a,C3b and Endothelial Progenitor Cells in Resistant Hypertension

IntroductionEndothelial progenitor cells (EPC) and complement C3 are involved in the pathophysiology of arterial hypertension. C3a is the negative regulator of progenitor cells egress during their mobilization from bone marrow. Previously, higher plasma concentration of C3 was observed in resistant arterial hypertension (RAH) than in controlled arterial hypertension (CAH). Thus, we hypothesized that RAH would be associated with complement C3 activation and reduced number of circulating EPCs.ObjectiveTo compare C3a, C3b and their correlation with circulating EPC in subjects with RAH and CAH.MethodsBlood pressure was measured by electronic sphygmomanometer. EPCs were identified as CD34+/CD133+/KDR+ cells by flow cytometry. C3a and C3b were determined using enzyme-linked immunosorbent assay (Quidel, CA).ResultsRAH group (n = 20) and CAH group (n = 20) and 17 healthy individuals (control group) were recruited. In the RAH group, C3a (858.1 ± 70.6 μg/dL) was higher than in the CAH group (816.1 ± 123.3 μg/dL; P < 0.001), and in the control group (751.3 ± 98.8; P < 0.001), C3b (564.1 ± 54.7 μg/dL) was higher than in the CAH group (490.2 ± 58.5 μg/dL; P < 0.001). In control group (456.3 ± 98.8; P < 0.001), statistically significant negative correlation was observed between C3a and blood levels of EPC (r = ?0.523, P = 0.018); statistically significant positive correlation was observed between systolic blood pressure and blood levels of C3a (r = 0.52, P = 0.02) and between systolic blood pressure and blood levels of C3b (r = 0.57, P = 0.009).ConclusionRAH is characterized by higher levels of C3 component fragments and a negative correlation between circulating C3a and EPCs.     

Association between hepatic lipase −514 C/T promoter polymorphism and myocardial infarction is modified by history of hypercholesterolemia and waist circumference

Background and aimsTo examine whether the association between the ?514 C/T polymorphism of the hepatic lipase gene and myocardial infarction (MI) is modified by history of hypercholesterolemia and increased waist circumference.Methods and resultsA total of 1940 pairs of nonfatal MI cases and population-based controls were genotyped. Multiple conditional logistic regression was used for data analyses. The ?514T variant was not associated with MI in the whole population. However, among people with history of hypercholesterolemia the T allele increased MI risk for heterozygous and homozygous carriers, respectively [OR = 1.25 (95%CI = 0.92–1.70) and OR = 1.59 (95%CI = 1.09–2.32). In contrast, the T allele decreased MI risk among people with no history of hypercholesterolemia [OR = 0.85 (95%CI = 0.70–1.03) and OR = 0.76 (95%CI = 0.60–0.97)], p for interaction = 0.004. Among subjects with normal waist circumference there was no association between the ?514T allele and MI for heterozygous and homozygous carriers, respectively [OR = 1.04 (95%CI = 0.86–1.25) and OR = 0.96 (95%CI = 0.77–1.21)], while among subjects with waist circumference above the limits of the metabolic syndrome definition there was a protective association [OR = 0.63 (95%CI = 0.45–0.90) and OR = 0.81 (95%CI = 0.53–1.25) p for interaction = 0.04].ConclusionThe ?514 T allele is associated with MI in opposite directions depending on the background of the studied population. This could explain what seem like inconsistent results across studies.     

Associations of polymorphisms in the apolipoprotein A1/C3/A4/A5 gene cluster with familial combined hyperlipidaemia in Hong Kong Chinese

BackgroundFamilial combined hyperlipidaemia (FCH) is the most common genetic dyslipidaemia associated with coronary artery disease. Single nucleotide polymorphisms (SNPs) and haplotypes in the APOA1/C3/A4/A5 gene cluster are associated with FCH in Caucasians and with elevated triglycerides (TG) in various ethnic groups. We examined these associations with FCH in Hong Kong Chinese.MethodsFifty-six Chinese FCH patients and 176 unrelated controls were studied. Thirteen SNPs in the APOA1/C3/A4/A5 cluster were genotyped.ResultsFour alleles in APOA5 were associated with FCH (P < 0.001). The ?1131T > C (rs662799) and ?3A > G (rs651821) SNPs in APOA5 were in almost complete linkage disequilibrium (LD, r² = 0.99), and their minor alleles were more frequent (P < 0.001) in FCH than controls (0.60 vs. 0.24). The odds ratio (OR) for FCH was 6.2 (95% CI, 2.6–14.8) and 6.1 (2.6–14.6) per copy of ?1131C and ?3G, respectively, and 24.6 (8.4–72.0) and 24.4 (8.4–70.9) in ?1131C and ?3G homozygotes, respectively, as compared to wild-type homozygotes. The 1891T > C (rs2266788) SNP was in LD (r² = 0.68) with ?1131T > C and ?3A > G, and the minor allele was more frequent in FCH than controls (0.42 vs. 0.19, P < 0.001). The 553G > T (rs2075291) nonsynonymous variant was also associated with FCH (0.15 vs. 0.04, P = 0.001) and, along with ?3A > G (or ?1131T > C) and 1891T > C, contributed to haplotypes predicting FCH. The two tightly linked SNPs, ?1131T > C and ?3A > G polymorphism were significantly associated with lipid traits in all subjects combined, with variant homozygous subjects having higher TG and LDL-C and lower HDL-C levels.ConclusionsSome common polymorphisms and haplotypes in APOA5 are closely associated with FCH in Hong Kong Chinese, and these differ from those found in Caucasians.     

Serum uric acid concentration is associated with worsening in severity of diabetic retinopathy among type 2 diabetic patients in Taiwan—A 3-year prospective study

AimsTo explore the role of serum uric acid (SUA) concentration in diabetic retinopathy (DR) for patients with type 2 diabetes mellitus (T2DM).MethodsA 3-year prospective study in 749 patients with T2DM and without proliferative diabetic retinopathy (PDR) was conducted at a medical center. Baseline SUA concentration and parameters of glycemic control, blood pressure, kidney disease, and lipid profiles were analyzed to determine their contribution to DR.ResultsFundus examination showed that 184 patients (24.6%) had non-proliferative retinopathy and 565 (75.4%) without DR at baseline. After 3 years, increase in the severity of DR was recognized in 103 patients (13.8%), including 81 patients with newly developed DR. Patients with increase in severity of DR positively associated with duration of DM (11.9 vs. 9.4 years, p = 0.001), HbA1c (7.6 vs. 7.2%, p = 0.001), albuminuria (45.5 vs. 31.0%, p = 0.006), and SUA (6.47 vs. 5.87 mg/dl, p < 0.001) than did those without change in DR stage. Cox regression showed that patients with SUA in the 3rd (5.9–6.9 mg/dl) and 4th (≥7.0 mg/dl) quartiles had hazard ratios for DR worsening of 2.57 and 3.66 (95% C.I. 1.30–5.08 and 1.92–7.00) when compared with patients with SUA in the 1st quartile (<4.9 mg/dl).ConclusionsSUA concentration is associated with the increase in severity of DR over a 3-year period in patients with T2DM. Further study is required to define the exact role of SUA in DR.     

Association between methylenetetrahydrofolate reductase (MTHFR) C677T/A1298C polymorphisms and essential hypertension: A systematic review and meta-analysis

ObjectiveMany studies have investigated the role of 5,10-methylenetetrahydrofolate reductase gene (MTHFR) C677T/A1298C polymorphisms in essential hypertension (EH), but results are inconclusive. The purpose of this meta-analysis was to clarify the effects of MTHFR C677T/A1298C polymorphisms on the risk of EH.MethodsElectronic databases were searched to identify relevant studies published until January 2014. Data were extracted by two independent authors. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association between MTHFR C677T/A1298C polymorphisms and the risk of EH using random effect models or fixed effect models. Finally, 30 studies with 5207 cases and 5383 controls were included for C677T polymorphism and 6 studies with 1009 cases and 994 controls were included for A1298C polymorphism.ResultsMeta-analysis results indicated that MTHFR C677T polymorphism contributed to an increased risk of EH (for T vs. C: OR = 1.30, 95%CI = 1.18–1.43; for TT + CT vs. CC: OR = 1.34, 95%CI = 1.24–1.46; for TT vs. CC: OR = 1.62, 95%CI = 1.32–1.99; for TT vs. CT + CC: OR = 1.41, 95%CI = 1.26–1.59). However, no significant association was detected between MTHFR A1298C polymorphism and the risk of EH.ConclusionThis meta-analysis supports that MTHFR C677T polymorphism plays a role in developing EH. MTHFR A1298C polymorphism may not be associated with an increased risk of EH. Further large and well-designed studies are warranted to confirm these findings.     

Influence of apolipoprotein E gene polymorphism on development of type 2 diabetes mellitus in Chinese Han population: A meta-analysis of 29 studies

ObjectivesPublished data regarding the association between apolipoprotein E (ApoE) gene polymorphism and type 2 diabetes mellitus (T2DM) risk in Chinese Han population were inconclusive. To derive a more precise estimation of the relationship between this variant and T2DM risk in Chinese Han population, we performed this meta-analysis.Design and methodsA computerized literature search was conducted to identify the relevant studies from PubMed, EMbase, Web of Science, CBMdisc, CNKI, and Google Scholar. Additionally, hand searching of the references of identified articles was performed. All the statistical tests were performed using Stata 11.0.ResultsA total of 29 articles with 4615 T2DM cases and 2867 controls were included in the present meta-analysis. The results showed evidence for significant association between ApoE gene polymorphism and T2DM risk (for ε2/ε3 vs. ε3/ε3: OR = 1.37, 95% CI = 1.12–1.68, P < 0.01; for ε3/ε4 vs. ε3/ε3: OR = 1.53, 95% CI = 1.23–1.91, P < 0.01; for ε4/ε4 vs. ε3/ε3: OR = 1.86, 95% CI = 1.22–2.84, P < 0.01; for ε2 allele vs. ε3 allele: OR = 1.28, 95% CI = 1.08–1.52, P = 0.01; for ε4 allele vs. ε3 allele: OR = 1.43, 95% CI = 1.22–1.68, P < 0.01). In addition, significant association was also found between ApoE gene polymorphism and diabetic nephropathy (DN) risk.ConclusionsThe results of this meta-analysis suggest that the ApoE ε2 and ε4 alleles may be associated with increased risks of T2DM and DN in Chinese Han population. Additional well-designed genome-wide association studies are required to confirm these results.     

Serum fibroblast growth factor 21 concentrations in type 2 diabetic retinopathy patients

Aims/purposeFibroblast growth factor 21 (FGF21) is a major metabolic regulator in the body that has been shown to be elevated in a number of metabolic disturbances including type 2 diabetes mellitus (T2DM) and the metabolic syndrome. However, little is known regarding the circulating levels of FGF21 in type 2 diabetic retinopathy (T2DR) and its association with the severity of the condition.MethodsIn a cross-sectional setting, 142 individuals, consisting of (1) T2DM patients without T2DR, (2) T2DM patients with T2DR, and (3) healthy control subjects were recruited for this study. Various clinical and biochemical parameters were assessed and entered for analysis.ResultsSerum FGF21 levels were significantly elevated in T2DM subjects without retinopathy (103.50 [75.75] pg/mL) compared with healthy controls (99.00 [126.75] pg/mL). Circulating FGF21 levels were comparable across different stages of T2DR (233.00 [109.00] for nonproliferative type 2 diabetic retinopathy [NPT2DR] vs. 215.00 [122.00] for proliferative type 2 diabetic retinopathy [PT2DR] groups, P = 361). FGF21, triglycerides, and duration of diabetes mellitus were significantly associated with T2DM in baseline models. However, after adjustment for potential confounders, in the final multivariate model, FGF21 emerged as the only significant factor associated with T2DM (OR = 13.772, 95% CI = 3.062–61.948, P = 001).ConclusionsSerum FGF21 concentrations are markedly elevated in patients with T2RN. The association between FGF21 and T2DR appears to be independent of the effects of potential confounding variables. These findings may suggest FGF21 as a novel surrogate diagnostic biomarker in initial stages of T2DR (particularly with FGF21 values above 135.5 pg/mL).     

The effects of ABCG5/G8 polymorphisms on HDL-cholesterol concentrations depend on ABCA1 genetic variants in the Boston Puerto Rican Health Study

Background and aimsATP-binding cassette transporters G5/G8 (ABCG5/G8) are associated with HDL-C concentrations. To assess whether the effect of ABCG5/G8 genetic variants on HDL-C concentrations is dependent on ATP-binding cassette transporters A1 (ABCA1), we studied potential interactions between single nucleotide polymorphisms (SNPs) at ABCG5/G8 (i7892 T > C, 5U145A > C, T54CA > G, T400KC > A) and ABCA1 (i27943 G > A, i48168 G > A, K219RG > A, i125970 G > C, 3U8995A > G) genes with HDL-C concentrations.Methods and resultsABCG5/G8 and ABCA1 SNPs were genotyped in 788 subjects (228 men and 560 women) who participated in the Boston Puerto Rican Health Study. Biochemical measurements were determined by standard procedures. Genotyping was performed using TaqMan^® assays according to routine laboratory protocols. Significant gene–gene interactions for HDL-C were found between ABCG8 (5U145A > C, T54CA > G, T400KC > A) SNPs and ABCA1_i48168 G > A genetic variant (P = 0.009, P = 0.042 and P = 0.036, respectively), in which carriers of the 5U145C and 54C alleles, and homozygotes for the T400 allele at ABCG8 genetic variants displayed lower HDL-C concentrations than homozygotes for the 5U145A and T54 alleles, and heterozygotes for the 400 K allele at ABCG8 SNPs, only if they were also homozygous for the minor allele (A) at the aforementioned ABCA1 SNP.ConclusionsThe gene–gene interactions reported in the present study support the hypothesis that the effect of ABCG5/G8 genetic variants on HDL-C concentrations is dependent on ABCA1 expression. Replication of these analyses to further populations, particularly with low HDL-C, is clearly warranted.     

Association of PTPN22 C1858T and CTLA-4 A49G polymorphisms with type 1 diabetes in Croatians

In this case–control study the association between the PTPN22 1858T and CTLA-4 49G gene variants and T1D in Croatian population was examined. We found that distribution of PTPN22 C1858T and CTLA-4 A49G genotypes between T1D patient (n = 102) and control (n = 193) groups differ significantly (p < 0.0001 and p = 0.012, respectively). Moreover, although the risk alleles of both SNPs are distributed more frequently in patients, the significant difference is observed only for PTPN22 1858T allele (p < 0.0001). This is therefore the first evidence that analyzed gene variants contribute to T1D pathogenesis in Croatian population.     

Association of PTPN22 C1858T and CTLA-4 A49G polymorphisms with type 1 diabetes in Croatians

In this case–control study the association between the PTPN22 1858T and CTLA-4 49G gene variants and T1D in Croatian population was examined. We found that distribution of PTPN22 C1858T and CTLA-4 A49G genotypes between T1D patient (n = 102) and control (n = 193) groups differ significantly (p < 0.0001 and p = 0.012, respectively). Moreover, although the risk alleles of both SNPs are distributed more frequently in patients, the significant difference is observed only for PTPN22 1858T allele (p < 0.0001). This is therefore the first evidence that analyzed gene variants contribute to T1D pathogenesis in Croatian population.     

Determinants of previous dilated eye examination among type II diabetics in Southwestern Nigeria

PurposeTo assess the prevalence and factors influencing previous dilated eye examination in screening for retinopathy among type II diabetics.MethodologyCross-sectional study of type II diabetic patients receiving treatment at a tertiary hospital in southwestern Nigeria was conducted with information on gender, age, duration of diabetes, current medication and previous dilated eye examination recorded. Eye examination included visual acuity, pen torch examination, applanation tonometry and direct ophthalmoscopy of the dilated eye in a dark room. Visual acuity was presented as classified by WHO while data was analyzed using SPSS version 11 and statistical significance inferred at P < 0.05.ResultsEighty three type II diabetics with mean age 57.5 ± 10.8 years and mean duration of diabetes of 6.6 years were studied. Visual impairment (< 6/18 in the better eye) and blindness (< 3/60 in the better eye) were recorded in 3.6% and 12% of the patients respectively while diabetic retinopathy was present in 21.6%. Only 24 [28.9%] diabetics had previous dilated eye examination; absence of eye symptoms [50.8%] and lack of referral [45.8%] were the main barriers to having previous dilated eye examination. Previous dilated eye examination was significantly influenced by the presence of visual impairment/blindness [P = 0.002], longer duration diabetes mellitus [P = 0.006], current insulin treatment [P = 0.040] and presence of non-diabetic vision threatening eye diseases [P = 0.016].ConclusionDilated eye examination rate is low; inadequate knowledge about diabetic retinopathy as well as low referral rates is contributory. Massive health education on diabetic retinopathy as well as development of sustainable retinopathy screening protocol would be helpful.     

Lipoprotein (a) and diabetic retinopathy

IntroductionLipoprotein little ‘a’ [Lp (a)] has been implicated in atherosclerotic vascular disease. Its association with diabetic retinopathy has been investigated in the present study.MethodsIn this cross-sectional study, 51 male patients with diabetes mellitus were selected. Detailed clinical evaluation and examination of eye including fundus was done. Laboratory investigations included fasting and post-prandial blood glucose, lipid profile, blood urea, 24 h urinary protein excretion and Lp (a) levels in serum.ResultsOut of the 51 patients selected in this study, 25 patients had non-proliferative diabetic retinopathy (NPDR), 14 had proliferative diabetic retinopathy (PDR) and 12 patients had no diabetic retinopathy (DR). Serum triglyceride, cholesterol/HDL ratio and lipid index had no relationship with severity of DR. It was interesting observation that HDL was higher and serum Lp (a) level was lower in patients with PDR than with NPDR.ConclusionLp (a) level is elevated in patients with DR. A causal relationship between Lp (a) and DR is presumptive. Interestingly patients with PDR had lower Lp (a) and higher HDL than with NPDR. This could suggest that atherogenic phenotype of dyslipidemia in patients with diabetes retards development of severe diabetic retinopathy.     

The genotype C could play a key role in hepatitis B virus associated nephritis among the Northwest Chinese children

BackgroundHepatitis B virus-associated glomerulonephritis (HBV-GN) is a kind of immune complex-induced glomerulonephritis. The present study was designed to determine whether Hepatitis B virus (HBV) genotype is associated with glomerulonephritis in north-west Chinese children.MethodsA total of 296 HBV-infected patients were enrolled in this study. The serum of patients was subjected to DNA extraction and the HBV genotypes were determined by PCR.ResultsThe results showed that genotype C (49%) was predominant within the subjects, compared to HBV/B (38.5%), B/C recombinant (7.4%) and none B/C (5.1%). The serum tests showed that the changes of Complement 3 (C3) and alanine amino transferase (ALT) levels in the genotype C patients were significantly greater than those in the genotype B patients. The frequency of genotype C in HBV-GN patients was higher than that in non HBV-GN patients (χ2 value = 30.239, P < 0.001). But, it was not associated with renal dysfunction. Furthermore, The genotype C was associated with high HBV-DNA load (82.9% vs 17.1%, P < 0.001), which is seen more frequently in the HBV-GN children (86.3% vs 13.3%, P = 0.004).ConclusionsThe genotype C may play a role in HBV-GN children, via favoring HBV replication.     

Renin angiotensin system polymorphisms in patients with metabolic syndrome (MetS)

BackgroundThe genes associated with hypertension could be genetic risk factors for metabolic syndrome (MetS).AimTo determine the frequency of M235T and T174M-AGT, I/D-ACE and A1166C-AGTR1 in hypertensive patients with MetS and to evaluate the relationship between these polymorphisms and central obesity and dyslipidemia, respectively.Materials and methodsWe performed AGT, AGTR1 and ACE genotyping in 56 hypertensive women (24 with MetS) and 71 normotensive women using PCR-RFLP methods and PCR, respectively.ResultsHypertensive patients carrying the mutated TT235, MM174 and DD genotypes had an 1.53 (p = 0.56), 1.78 (p = 0.52) and 1.28 (p = 0.78)-fold increased risk to develop MetS. Hypertensive carriers of both mutated TT235 and MM174 or TT235 and D/D or TT235 and CC + AC genotypes had an 8.15 (p = 0.04), 4.83 (p = 0.04) and 10.53 (p = 0.05)-fold increased risk to develop MetS. Hypertensive patients with MetS and TT, D/D or CC genotypes had higher body mass index compared to hypertensive patients without MetS (p ≤ 0.05 for all the genotypes). Hypertensive patients with MetS and TT235, MM174, D/D or CC1166 genotypes had higher triglyceride levels, lower HDL-cholesterol levels and higher waist circumference compared to hypertensive patients without MetS (p ≤ 0.05, except for the association between CC1166 and HDL-cholesterol level).ConclusionsThe effect of the T174M, I/D and A1166C polymorphisms on MetS may depend on the M235T polymorphism. Among hypertensive subjects with MetS, the presence of TT235, MM174, DD and CC1166 genotypes could be a risk factor for central obesity and dyslipidemia.     

Influence of flavonoid-rich fruit and vegetable intake on diabetic retinopathy and diabetes-related biomarkers

Objective(1) Determine the relationship between dietary flavonoid-rich fruit and vegetable consumption on diabetes-related biomarkers (e.g., HgbA1c) and diabetic retinopathy.MethodsData from 381 participants with diabetes from the NHANES 2003–2006 were analyzed. Blood samples were taken to measure C-reactive protein (CRP), HgbA1C, and fasting glucose and insulin. Diabetic retinopathy was assessed from a retinal imaging exam. A high-flavonoid fruit and vegetable consumption (HFVC) index variable was created from a food frequency questionnaire (FFQ).ResultsAfter adjustments, greater HFVC was associated (p < 0.05) with lower levels of CRP (β = − 0.005), HgbA1C (β = − 0.005) and glucose (β = − 0.59), with greater HFVC reducing the odds of having diabetic retinopathy by 30%.ConclusionAdults with diabetes consuming more flavonoid-rich fruits and vegetables had lower degrees of inflammation, better glycemic control, and reduced odds of diabetic retinopathy.     

Prevalence and risk factors for diabetic retinopathy in Asian Indians with young onset Type 1 and Type 2 Diabetes

AimTo assess the prevalence and risk factors for diabetic retinopathy (DR) in people with young onset type 1 (T1DM-Y) and type 2 diabetes (T2DM-Y).MethodsT1DM-Y(n = 150) and T2DM-Y(n = 150) participants, age between 10 and 25 years at diagnosis, had a complete clinical evaluation, biochemical assessment, and four field digital retinal colour photography. The Early Treatment Diabetic Retinopathy Study grading system was used to grade DR. Proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) were considered as sight threatening DR.ResultsThe prevalence of any DR was 53.3% [95% CI 45.3–61.3] in T1DM-Y (duration of diabetes: 12.4 ±7.4years) and 52.7% [44.7–60.7] in T2DM-Y (11.8 ± 8.3 years). The age and gender adjusted prevalence of DR, DME and PDR was 62.5%, 10% and 7.3% in T1DM-Y, whereas it was 65.8%,12.7% and 9.3% in T2DM-Y respectively. In multivariable logistic regression, diabetes duration [Odds ratio (OR) 1.99 per 5 years; CI 1.42–2.79], waist circumference [1.28 per 5 cm;1.05–1.56] and microalbuminuria [2.39 per 50 μg;1.07–5.31] were associated with DR in T1DM-Y, and diabetes duration [2.21 per 5 years; 1.61–3.02], diastolic blood pressure [1.54 per 5 mmHg;1.18–2.02], Glycated hemoglobin [1.37 per %;1.07–1.75] and lower stimulated C-peptide [1.54 per 0.5 pmol/ml;1.15–2.05;] were associated with DR in T2DM-Y.ConclusionOver half of the people with young-onset diabetes, regardless of type, have retinopathy within 10–12 years of diabetes duration, emphasizing the need for regular eye screening and aggressive control of glucose and blood pressure to prevent DR.