Effects of diabetes mellitus and aluminum toxicity on myocardial calcium transport

Associations of multiple plasma metals with the risk of type 2 diabetes in Chinese adults: A cross-sectional study

Evidence regarding the associations between co-exposure to multiple metals and diabetes risk was scarce. This study aimed to evaluate the associations of multiple metals with diabetes risk using multiple statistical methods. This cross-sectional study included 192 diabetic patients and 189 healthy subjects. We employed inductively coupled plasma mass spectrometry (ICP-MS) to determine the plasma concentrations of 18 metals. Least absolute shrinkage and selection operator (LASSO) regression, logistic regression, and Bayesian kernel machine regression (BKMR) were applied to evaluate associations of multiple metals with diabetes risk comprehensively. These models consistently suggested that aluminium and selenium were positively associated with diabetes risk, while manganese, rubidium, and lead were negatively associated with diabetes risk. Age-specific differences of selenium and sex-specific differences of manganese in diabetes risk were also observed based on stratified analyses. According to RCS analyses, we obtained dose-response relationships between metals and diabetes risk:(1) there were inverted U-shaped associations of plasma aluminium and selenium with diabetes risk, with the threshold close to 20.5µg/L and 75.9µg/L, respectively (both P for overall < 0.05; both P for non-linearity < 0.05). (2) There were L-shaped associations of rubidium and lead with diabetes risk, with the turning point close to 144.5µg/L and 2.5µg/L, respectively (both P for overall < 0.05; both P for non-linearity < 0.05). (3) Manganese was linearly and negatively correlated with diabetes risk when concentrations of manganese were less than approximately 4.2 μg/L (P for overall < 0.05; P for non-linearity = 0.268). The BKMR model also revealed a negative combined effect of metal mixtures on diabetes risk and potential interactions between six pairs of metals (aluminium-manganese, aluminium-selenium, aluminium-rubidium, aluminium-lead, manganese-selenium, and manganese-rubidium). In summary, we need to pay attention to the role of low plasma levels of aluminium, selenium, manganese, rubidium, and lead in diabetes, especially regarding their safety windows.

Association Between Serum Concentrations of (Certain) Metals and Type 2 Diabetes Mellitus

The findings regarding trace element concentrations in patients diagnosed with type 2 diabetes and healthy controls are inconsistent, and therefore, we determined to gather them in the form of a review to further indicate the need for more advanced knowledge development. In our study, we reviewed articles and studies that involved the topics of micronutrient and metal associations with the occurrence and development of type 2 diabetes. We mainly included works regarding human-based studies, but with limited research results, animal-based research was also taken into account. With some newer studies, we reached for initial assumptions of previous statements. The results indicated that higher serum levels of lead, cadmium, arsenic, bromine, barium, strontium, nickel, aluminum, calcium, copper, and ferritin are positively associated with diabetic prevalence. Both too-low and too-high levels of zinc, selenium, and magnesium may be connected to the development of diabetes. Chromium has the capability of insulin response modulation, with enhanced insulin-cell binding, and thus, lower serum levels of chromium can be found in diabetic patients. There are contradictory discoveries regarding manganese. Its supplementation can possibly cease the development of insulin resistance and type 2 diabetes. On the contrary, other studies reported that there is no such connection. Our work indicates that, as micronutrients play a significant role in the pathogenesis of metabolic disorders, more research regarding their bodily homeostasis and type 2 diabetes should be conducted.

A review of the epidemiological and laboratory evidence of the role of aluminum exposure in pathogenesis of cardiovascular diseases

The objective of the present study was to review the epidemiological and laboratory evidence on the role of aluminum (Al) exposure in the pathogenesis of cardiovascular diseases. Epidemiological data demonstrated an increased incidence of cardiovascular diseases (CVD), including hypertension and atherosclerosis in occupationally exposed subjects and hemodialysis patients. In addition, Al body burden was found to be elevated in patients with coronary heart disease, hypertension, and dyslipidemia. Laboratory studies demonstrated that Al exposure induced significant ultrastructural damage in the heart, resulting in electrocardiogram alterations in association with cardiomyocyte necrosis and apoptosis, inflammation, oxidative stress, inflammation, and mitochondrial dysfunction. In agreement with the epidemiological findings, laboratory data demonstrated dyslipidemia upon Al exposure, resulting from impaired hepatic lipid catabolism, as well as promotion of low-density lipoprotein oxidation. Al was also shown to inhibit paraoxonase 1 activity and to induce endothelial dysfunction and adhesion molecule expression, further promoting atherogenesis. The role of Al in hypertension was shown to be mediated by up-regulation of NADPH-oxidase, inhibition of nitric oxide bioavailability, and stimulation of renin-angiotensin-aldosterone system. It has been also demonstrated that Al exposure targets cerebral vasculature, which may be considered a link between Al exposure and cerebrovascular diseases. Findings from other tissues lend support that ferroptosis, pyroptosis, endoplasmic reticulum stress, and modulation of gut microbiome and metabolome are involved in the development of CVD upon Al exposure. A better understanding of the role of the cardiovascular system as a target for Al toxicity will be useful for risk assessment and the development of treatment and prevention strategies.

Aluminum alters excitability by inhibiting calcium, sodium, and potassium currents in bovine chromaffin cells

Aluminum (Al³⁺ ) has long been related to neurotoxicity and neurological diseases. This study aims to describe the specific actions of this metal on cellular excitability and neurotransmitter release in primary culture of bovine chromaffin cells. Using voltage-clamp and current-clamp recordings with the whole-cell configuration of the patch clamp technique, online measurement of catecholamine release, and measurements of [Ca²⁺ ]_c with Fluo-4-AM, we have observed that Al³⁺ reduced intracellular calcium concentrations around 25% and decreased catecholamine secretion in a dose-dependent manner, with an IC₅₀ of 89.1 μM. Al³⁺ blocked calcium currents in a time- and concentration-dependent manner with an IC₅₀ of 560 μM. This blockade was irreversible since it did not recover after washout. Moreover, Al³⁺ produced a bigger blockade on N-, P-, and Q-type calcium channels subtypes (69.5%) than on L-type channels subtypes (50.5%). Sodium currents were also inhibited by Al³⁺ in a time- and concentration-dependent manner, 24.3% blockade at the closest concentration to the IC₅₀ (399 μM). This inhibition was reversible. Voltage-dependent potassium currents were low affected by Al³⁺ . Nonetheless, calcium/voltage-dependent potassium currents were inhibited in a concentration-dependent manner, with an IC₅₀ of 447 μM. This inhibition was related to the depression of calcium influx through voltage-dependent calcium channels subtypes coupled to BK channels. In summary, the blockade of these ionic conductance altered cellular excitability that reduced the action potentials firing and so, the neurotransmitter release and the synaptic transmission. These findings prove that aluminum has neurotoxic properties because it alters neuronal excitability by inhibiting the sodium currents responsible for the generation and propagation of impulse nerve, the potassium current responsible for the termination of action potentials, and the calcium current responsible for the neurotransmitters release.

The influence of aluminium and copper upon the early aggregatory behaviour and size of Islet amyloid polypeptide under simulated physiological conditions

BACKGROUND AND AIM

Islet amyloid polypeptide/amylin deposition in the form of amyloid plaques is a common pathological feature observed in the pancreatic tissue of those with Type II Diabetes Mellitus. Its propensity to form amyloid fibrils and the resultant toxicity of this peptide in vivo is influenced by both the concentration and species of metal present in situ. Herein, we examine the influence of Al (III) and Cu (II), applied at equimolar and supra-stoichiometric concentrations on the initial aggregatory behaviour of amylin under near physiological conditions.

METHODS

Dynamic light scattering measurements, which monitored the aggregation status and size of the peptide in real time, were performed during the early lag-phase of fibrillogenesis (T ≤ 30 min) in the absence or presence of metal ions.

RESULTS

Islet amyloid polypeptide (10 µM) rapidly aggregated when introduced into a physiological medium favouring the formation of large, agglomerated structures (> 1000 nm) after 30 min incubation. Neither the addition of equimolar or excess metals significantly influenced the size of the peptide when intensity distributions were consulted; however, number distributions indicated that both Al (III) and Cu (II) may have had, an albeit temporary, stabilising influence upon the conformations present within solution.

CONCLUSION

These results infer that small oligomeric species are likely transient entities that are rapidly incorporated into large agglomerates during the very initial stages of fibrillogenesis. While both Al (III) and Cu (II) both inhibited agglomeration to some degree, their stabilising affect upon peptide aggregation was limited over the juncture of the experiments performed herein; hence, it is difficult to say whether these metal ions play a role in enhancing the toxicity of these peptides through influencing their aggregation in the short-term.

Pilot Study of Trace Elements in the Infusion of Medicinal Plants Used for Diabetes Treatment

The purpose of this study was to evaluate trace element contents in different medicinal plants used for diabetes treatments by residents in Asir region. Five medicinal plants-Tut leaves (Mulberry), olive leaves (Olea europaea), clove (Syzygium aromaticum), Luban Dhakar (Boswellia carterii), and Karela or bitter melon (Momordica charantia)-were collected from two cities, Khamis Mushait and Abha, in the Asir region, Saudi Arabia. Infusions (hot water extracts) were obtained from each plant, and elemental analysis was conducted using inductively coupled plasma mass spectrometry (ICP-MS). Fourteen elements (Al, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Sr, Cd, Ba, and Pb) were measured in all plants. The results revealed that the fourteen elements were present at different levels (µg/g) in all plants. Momordica charantia exhibited high levels of essential (Mn (251.4), Co (1.18), Cu (54.64), and Se (2.18)) and toxic elements (Al (39.20), As (0.57), Cd (0.33), and Pb (4.48)), followed by Syzygium aromaticum (Mn (736.36)) and Boswellia carterii (Pb (0.93)), which exceeded the PMTDI in traditional doses used for diabetes treatments. However, Mulberry and Olea europaea did not exceed the daily guideline values for all elements. Based on our findings, we cautiously recommend the latter two plants for the traditional treatment of diabetes, because they are not considered as source of harm based on their levels of elements. Their use should be restricted by comprehensive compound analysis to guarantee their safe use.

Aluminium toxicosis: a review of toxic actions and effects

Aluminium (Al) is frequently accessible to animal and human populations to the extent that intoxications may occur. Intake of Al is by inhalation of aerosols or particles, ingestion of food, water and medicaments, skin contact, vaccination, dialysis and infusions. Toxic actions of Al induce oxidative stress, immunologic alterations, genotoxicity, pro-inflammatory effect, peptide denaturation or transformation, enzymatic dysfunction, metabolic derangement, amyloidogenesis, membrane perturbation, iron dyshomeostasis, apoptosis, necrosis and dysplasia. The pathological conditions associated with Al toxicosis are desquamative interstitial pneumonia, pulmonary alveolar proteinosis, granulomas, granulomatosis and fibrosis, toxic myocarditis, thrombosis and ischemic stroke, granulomatous enteritis, Crohn's disease, inflammatory bowel diseases, anemia, Alzheimer's disease, dementia, sclerosis, autism, macrophagic myofasciitis, osteomalacia, oligospermia and infertility, hepatorenal disease, breast cancer and cyst, pancreatitis, pancreatic necrosis and diabetes mellitus. The review provides a broad overview of Al toxicosis as a background for sustained investigations of the toxicology of Al compounds of public health importance.

Role of Geographic Information System in Assessing Determinants of Cardiovascular Disease: An Experience From a Low- and Middle-Income Country

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the world. The determinants of CVD in an urban population using conventional and geographic information system techniques were attempted as a community-based census-type cross-sectional study in Kerala, India, among 1649 individuals residing in 452 households. Sociodemographic details, risk factor exposures, and self-reported disease prevalence were determined. Location of houses, wells from which subjects drew drinking water, and distances of the house from the outer road (proxy for air pollution) were mapped using differential global positioning system and pH of water samples determined. Prevalence of CVD was 5.8%. Significant predictors of CVD were male gender, diabetes mellitus, hypertension, and hypothyroidism. Statistically significant spatial association was found between CVD and groundwater pH. Geographic information system technology is useful in identification of spatial clustering and disease hotspots for designing preventive strategies targeting CVD.

The relationship of plasma aluminum to oxidant-antioxidant and inflammation status in asthma patients

Aluminum (Al) is a non-essential mineral which human beings are exposed to on day-to-day life. The purpose of this study was to assess the concentrations of plasma Al and the relationship of those levels with risk factors for asthma. In total, 27 allergic asthmatics and 30 healthy volunteers were enrolled. Plasma Al and selected blood parameters were measured, and a pulmonary function test was performed. Higher Al concentrations were found in the asthmatics than the healthy controls. Increased immunoglobulin E, high-sensitivity C-reactive protein, lipid peroxidation products, and pro-inflammatory cytokines (tumor necrosis factor-α and interleukin [IL]-4) were observed, but IL-10 and overall antioxidant and enzyme activities were lower. Associations between oxidative-antioxidant status and inflammatory markers with plasma Al levels in asthmatics were noted. Al status was also linked to cytokine concentrations and pulmonary function. In conclusion, abnormal Al distribution may further precipitate oxidative stress and inflammation, alter Th1/Th2 lymphocyte balance, and therefore contribute to the development of asthma.

Trace and toxic element patterns in nonsmoker patients with noninsulin-dependent diabetes mellitus, impaired glucose tolerance, and fasting glucose

PROJECT:

Noninsulin dependent diabetes mellitus is supposed to be associated with fluctuations in the plasma levels of several trace elements. There is accumulating evidence that the metabolism of several trace elements is altered in patients with noninsulin dependent diabetes mellitus and that these nutrients might have specific roles in the pathogenesis and progression of this disorder.

PROCEDURE:

The aim of the present study is to compare the levels of essential trace and toxic elements including lead (Pb), arsenic (As), cadmium (Cd), chromium (Cr), aluminium (Al), nickel (Ni), cobalt (Co), iron (Fe), copper (Cu), selenium (Se), zinc (Zn), vanadium (V), manganese (Mn), barium (Ba), silver (Ag), and mercury (Hg) in patients with noninsulin dependent diabetes mellitus (n = 31), impaired glucose tolerance (n = 20), impaired fasting glucose (n = 14), and healthy controls (n = 22). Plasma concentrations of the elements were measured by using inductively coupled plasma mass spectrometry.

RESULTS:

The results indicated that values of lead, nickel, aluminium, copper, and chromium were significantly higher, but not above toxic levels, in the plasma of nonsmoker patients with noninsulin dependent diabetes mellitus (P < 0.05). The values for these elements were found to be significantly higher (P < 0.05) in patients with impaired fasting glucose than in controls. Moreover, a statistically significant correlation was found between plasma levels of glycated hemoglobin and of some trace elements like lead, nickel, aluminium, copper, chromium, cadmium, and mercury.

CONCLUSIONS

Thus, it was concluded that chronic complications of glucose metabolism disorders might be associated with alterations in the levels of some trace elements. Nevertheless, some more timely and extensive studies are required to clarify the exact mechanisms of each of these changes.

Aluminum: impacts and disease

Aluminum is the most widely distributed metal in the environment and is extensively used in modern daily life. Aluminum enters into the body from the environment and from diet and medication. However, there is no known physiological role for aluminum within the body and hence this metal may produce adverse physiological effects. The impact of aluminum on neural tissues is well reported but studies on extraneural tissues are not well summarized. In this review, the impacts of aluminum on humans and its impact on major physiological systems are summarized and discussed. The neuropathologies associated with high brain aluminum levels, including structural, biochemical, and neurobehavioral changes, have been summarized. In addition, the impact of aluminum on the musculoskeletal system, respiratory system, cardiovascular system, hepatobiliary system, endocrine system, urinary system, and reproductive system are discussed.

Aluminum in enteral nutrition formulas and parenteral solutions

BACKGROUND

To examine the aluminum content of several commercially available enteral nutrition formulas and parenteral solutions.

METHODS

Twelve enteral nutrition formulas and 10 parenteral solutions were commonly used in routine clinical care of patients and obtained from different medical companies in Turkey. The aluminum contents were determined by electrothermal atomic absorption spectrophotometry.

RESULTS

We found that aluminum concentration in the enteral nutrition formulas and the parenteral solutions to range from 87.6 to 961.2 ng/mL and 58.4 to 1232.0 ng/mL, respectively.

CONCLUSIONS

Careful clinical and biochemical monitoring are warranted to determine whether it will be necessary to eliminate aluminum contamination of enteral and parenteral preparations used in patients, particularly infants, with reduced kidney function who may be at risk for aluminum intoxication.

Effect of insulin treatment on smooth muscle calmodulin levels in rats with long-term streptozotocin-diabetes

Altered responses to several agonists have been reported in various smooth muscles from experimentally-diabetic animals suggesting a defective contractile process of smooth muscle. Recently, decreased smooth muscle calmodulin levels have been reported in streptozotocin-diabetic rats. However, the effectiveness of insulin on the decreased calmodulin levels in diabetic rats has not been questioned. Therefore, the present study was designed to examine the effect of insulin on smooth muscle calmodulin levels from streptozotocin-diabetic rats. Calmodulin levels of the smooth muscle were measured by a radioimmunoassay technique. Streptozotocin diabetes caused a significant decrease in tissue calmodulin levels of smooth muscles. Insulin therapy for 20 days did not correct the changes in calmodulin levels of rat smooth muscles, although it normalised blood glucose in streptozotocin-diabetic rats. These findings suggest that the altered smooth muscle calmodulin may contribute the defective contractile responses in diabetes and these changes may be resistant to insulin therapy.

Altered alpha-adrenergic responses of vas deferens to noradrenaline and tyramine from rats with short- and long-term alloxan diabetes

1. Functional and morphological abnormalities in vas deferens have been reported by both experimental and clinical studies as a cause of genital function abnormalities in diabetic males. 2. In the present study, contractile effects of noradrenaline and tyramine in isolated vas deferens from rats with short- and long-term alloxan diabetes were investigated by comparing with those from control rats. For this purpose, intrinsic activities (alpha E value) and apparent affinity constants (pD2 value) for contractile effects of noradrenaline and tyramine in the isolated rat vas deferens were calculated in normal rats and rats with short- and long-term alloxan diabetes. 3. Apparent affinity constants for contractile effects of noradrenaline in the isolated rat vas deferens were increased depending on both short- and long-term alloxan diabetes. By contrast, apparent affinity constants for contractile effects of tyramine in the isolated rat vas deferens were attenuated due to both short- and long-term alloxan diabetes. Intrinsic activities for both noradrenaline- and tyramine-induced contractions of rat vas deferens, however, were increased due to short-term diabetes and decreased due to long-term diabetes. 4. Experimental findings obtained in this study indicate that vas deferens preparations from rats with short- and long-term alloxan-induced diabetes exhibit altered alpha-adrenergic responsiveness depending on time elapsed. While short-term alloxan diabetes causes enhanced alpha-adrenergic responses in the rat vas deferens, the long-term diabetes decreases the responses in this tissue.

Effect of short and long term streptozotocin diabetes on smooth muscle calmodulin levels in the rat

Diabetes mellitus is a metabolic disease associated with certain complications which have also been demonstrated in the experimental models of this disease. Altered responses to several agonists have been reported in various smooth muscles from alloxan or streptozotocin diabetic animals. Since these reports revealed a defect in the contractile process of smooth muscles from experimentally-induced diabetes, short and long term effects of diabetes on calmodulin levels in the smooth muscles of aorta, trachea, vas deferens and duodenum were investigated using streptozotocin diabetic rats. In spite of the fact that most of the reports have demonstrated the defective contractions in long term diabetic rats, short term effect (for 1 week) of diabetes on calmodulin levels in the smooth muscles of aorta, trachea, vas deferens and duodenum was also investigated in the present study using streptozotocin diabetic rats to understand whether the changes in calmodulin dependent contractile process begin at an earlier stage of the disease. Tissue calmodulin levels of the smooth muscles were measured by the radioimmunoassay technique using a [125I]-labeled kit. Although rats injected with streptozotocin exerted the characteristics of diabetes such as polyuria, polydipsy, polyphagy and elevated blood glucose levels, unchanged calmodulin levels were found in the rats with short term streptozotocin diabetes. In contrast, long term streptozotocin diabetes (for 8 weeks) was found to cause a significant decrease in tissue calmodulin levels of these four smooth muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum interaction with phosphoinositide-associated signal transduction

Concerning molecular and cellular mechanisms of aluminum toxicity, recent studies support the hypothesis that interactions of aluminum ions with elements of signal transduction pathways are apparently primary events in cells. In the case of the phosphoinositide-associated signalling pathway of neuroblastoma cells, guanine nucleotide-binding proteins (G proteins) and a phosphatidylinositol-4,5-diphosphate (PIP2)-specific phospholipase C are probable interaction sites for inhibitory actions of aluminum ions. Following interiorization of aluminum by the cell, metal interactions decrease the accumulation of inositol phosphates, especially that of inositol-1,4,5-triphosphate (IP3), concomitant with derangements of intracellular Ca2+ homeostasis. In the presence of high concentrations of Ca2+, formation of IP3 is also diminished in aluminum-pretreated cells, presumably involving a process not requiring Mg(2+)-dependent G proteins. At higher aluminum doses, metal-induced changes in the lipid milieu of the membrane-bound phospholipase may play a role. These types of primary interactions of aluminum ions with elements of cellular communication channels are probably crucial in the manifestation of the multifacetted aluminum toxicity syndrome. If present as a phosphate-like fluoro-aluminate, a stimulatory role of aluminum ions is displayed in G protein-coupled transmembrane signalling.

Aluminium impacts elements of the phosphoinositide signalling pathway in neuroblastoma cells

Inositol phosphate formation was examined in aluminium-treated murine neuroblastoma cells labelled with [3H]-myoinositol. Employing fluoride-stimulated intact cells, aluminium (0.2 microM to 1 mM) reduced inositol phosphate formation in a dose-dependent manner. In digitonin-permeabilized cells, stimulated with nonhydrolyzable GTP[S], inositol phosphate formation was also inhibited by increasing aluminium doses; the IC50 value was about 20 microM aluminium, while the inositol phosphate level was reduced 2.5 to 3 fold by 50 microM aluminium. The inhibitory effect of aluminium (50 microM) could not be reversed by increasing GTP[S] concentrations up to 500 microM. Prechelation of aluminium to citrate or EGTA completely abolished the aluminium-triggered inhibition of fluoride-stimulated inositol phosphate formation in intact cells, but had little effect on the inhibition of permeabilized cells stimulated with GTP[S]. In neuroblastoma cells phosphoinositide hydrolysis could be evoked either through a pathway involving the Mg2+/guanine nucleotide binding (Gp) protein, or via a pathway operative in the presence of high intracellular Ca2+ concentrations. In the Mg2+/Gp protein-mediated pathway, formation of inositol triphosphate, IP3, inositol diphosphate, IP2, and inositol monophosphate, IP, was apparently inhibited by aluminium in an interdependent manner. As to the Ca(2+)-mediated pathway, aluminium application mainly diminished the release of IP3. Following interiorization, aluminium thus acts upon elements critical for phosphoinositide-associated signal transduction. An aluminium target apparently resides on the Gp protein. Phosphatidylinositol-4,5-diphosphate-specific phospholipase C probably harbours a second aluminium target.

Aluminium interferes with signal transduction in neuroblastoma cells

The effects of aluminium on inositol phosphate formation were examined in murine neuroblastoma cells labelled with [3H]-myo-inositol. In aluminium-pretreated cells, the bradykinin-triggered inositol triphosphate, IP3, release and the change in intracellular [Ca2+] were appreciably less compared with the control group. Stimulating digitonin-permeabilized cells with non-hydrolyzable guanosine 5'-[gamma-thio]-triphosphate, GTP[S], inositol phosphate formation decreased in the presence of aluminium. A primary target of aluminium toxicity may reside on the guanine nucleotide-binding protein(Gp)/phospholipase C system, at a site different from that of the GTP[S] binding site.