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Kennedy EC, Hawkes CP. Approaches to Measuring Beta Cell Reserve and Defining Partial Clinical Remission in Paediatric Type 1 Diabetes. CHILDREN (BASEL, SWITZERLAND) 2024; 11:186. [PMID: 38397298 PMCID: PMC10887271 DOI: 10.3390/children11020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/26/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
CONTEXT Type 1 diabetes (T1D) results from the autoimmune T-cell mediated destruction of pancreatic beta cells leading to insufficient insulin secretion. At the time of diagnosis of T1D, there is residual beta cell function that declines over the subsequent months to years. Recent interventions have been approved to preserve beta cell function in evolving T1D. OBJECTIVE The aim of this review is to summarise the approaches used to assess residual beta cell function in evolving T1D, and to highlight potential future directions. METHODS Studies including subjects aged 0 to 18 years were included in this review. The following search terms were used; "(type 1 diabetes) and (partial remission)" and "(type 1 diabetes) and (honeymoon)". References of included studies were reviewed to determine if additional relevant studies were eligible. RESULTS There are numerous approaches to quantifying beta cell reserve in evolving T1D. These include c-peptide measurement after a mixed meal or glucagon stimuli, fasting c-peptide, the urinary c-peptide/creatinine ratio, insulin dose-adjusted haemoglobin A1c, and other clinical models to estimate beta cell function. Other biomarkers may have a role, including the proinsulin/c-peptide ratio, cytokines, and microRNA. Studies using thresholds to determine if residual beta cell function is present often differ in values used to define remission. CONCLUSIONS As interventions are approved to preserve beta cell function, it will become increasingly necessary to quantify residual beta cell function in research and clinical contexts. In this report, we have highlighted the strengths and limitations of the current approaches.
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Affiliation(s)
- Elaine C Kennedy
- Department of Paediatrics and Child Health, University College Cork, T12 DC4A Cork, Ireland
- INFANT Research Centre, University College Cork, T12 DC4A Cork, Ireland
| | - Colin P Hawkes
- Department of Paediatrics and Child Health, University College Cork, T12 DC4A Cork, Ireland
- INFANT Research Centre, University College Cork, T12 DC4A Cork, Ireland
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
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2
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Nakadate Y, Kawakami A, Oguchi T, Omiya K, Nakajima H, Yokomichi H, Sato H, Schricker T, Matsukawa T. Safety of intranasal insulin administration in patients undergoing cardiovascular surgery: An open-label, nonrandomized, dose-escalation study. JTCVS OPEN 2024; 17:172-182. [PMID: 38420553 PMCID: PMC10897660 DOI: 10.1016/j.xjon.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/19/2023] [Accepted: 11/26/2023] [Indexed: 03/02/2024]
Abstract
Objective This study aimed to determine the maximum safe dose of intranasal insulin administration during cardiac surgery. Methods This open-label, Phase 1, single-center, dose-escalation clinical trial recruited patients scheduled to undergo elective cardiac surgery or major vascular surgery requiring cardiopulmonary bypass between February and September 2021. They were grouped into 5 dose-escalation cohorts and administered 0, 40, 80, 160, and 240 IU insulin (n = 6 in each group) via a metered nasal dispenser after the induction of general anesthesia. Blood samples were collected at 10-minute intervals for the first 60 minutes and at 30-minute intervals thereafter. Hypoglycemia was defined as a blood glucose level <70 mg/dL. Patient recruitment was terminated after hypoglycemia was observed in 2 patients in any of the groups. Results In total, 27 of 29 enrolled patients were administered intranasal insulin or saline. Hypoglycemia was not observed after the administration of intranasal insulin in the 0, 40, 80, or 160 IU groups; however, it was observed in 2 of 3 patients in the 240 IU group. The serum insulin concentration was elevated in the 160-IU group, but the C-peptide concentration was not elevated in any of the groups. Conclusions The administration of up to 160 IU intranasal insulin did not induce clinically significant hypoglycemia. However, 160 IU intranasal insulin should be administered cautiously because insulin can enter the systemic circulation in a dose-dependent manner.
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Affiliation(s)
- Yosuke Nakadate
- Faculty of Medicine, Department of Anesthesiology, University of Yamanashi, Chuo, Yamanashi, Japan
- Department of Anesthesiology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Akiko Kawakami
- Faculty of Medicine, Department of Anesthesiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Takeshi Oguchi
- Faculty of Medicine, Department of Anesthesiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Keisuke Omiya
- Faculty of Medicine, Department of Anesthesiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroyuki Nakajima
- Faculty of Medicine, Department of Surgery 2, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroshi Yokomichi
- Faculty of Medicine, Department of Epidemiology and Environmental Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroaki Sato
- Department of Anesthesia, Royal Victoria Hospital, McGill University Health Centre Glen Site, Montreal, Canada
| | - Thomas Schricker
- Department of Anesthesia, Royal Victoria Hospital, McGill University Health Centre Glen Site, Montreal, Canada
| | - Takashi Matsukawa
- Faculty of Medicine, Department of Anesthesiology, University of Yamanashi, Chuo, Yamanashi, Japan
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Lu Y, Lim WS, Jin X, Zin Nyunt MS, Fulop T, Gao Q, Lim SC, Larbi A, Ng TP. Lower insulin level is associated with sarcopenia in community-dwelling frail and non-frail older adults. Front Med (Lausanne) 2022; 9:971622. [PMID: 36482911 PMCID: PMC9722960 DOI: 10.3389/fmed.2022.971622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/07/2022] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Sarcopenia is common among older individuals with and without type 2 diabetes mellitus (T2DM). There are conflicting evidence in support of the role of insulin in the development of age-related and T2DM-related sarcopenia. We investigated the relationships between the levels of fasting insulin and other blood biomarkers related to insulin or lipid metabolism with the presence of sarcopenia in two independent studies. MATERIALS AND METHODS In 246 pre-frail frail older individuals with (n = 41) and without T2DM (n = 205) in the Singapore Frailty Interventional Trial, sarcopenia was defined by low appendicular lean mass (ALM) relative to total body mass (skeletal muscle index, SMI = ALM/height2) and low lower limb strength or gait speed according to the Asian Working Group for Sarcopenia (AWGS) criteria released in 2019, and related to levels of fasting insulin and glucose, C-peptide, IGF-1, leptin, and active ghrelin. This investigation was validated in another independent study sample of 189 robust and pre-frail frail elderly in the Singapore Longitudinal Aging Study Wave 2 (SLAS-2). RESULTS Compared to non-sarcopenic individuals, those with sarcopenia and possible sarcopenia showed significantly lower fasting insulin (p < 0.05) in pre-frail/frail and non-frail older individuals. Consistent trends of relationships were observed for serum levels of C-peptide, IGF-1, leptin, and active ghrelin. In multivariable logistic regression models, sarcopenia was independently associated with low insulin (p < 0.05). Levels of fasting insulin, C-peptide, and leptin were also significantly associated with BMI, SMI, knee extension strength, gait speed, and physical activity score. CONCLUSION Dysregulated insulin secretion in diabetic and non-diabetic older individuals may play an important role in age-related and diabetes-related sarcopenia.
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Affiliation(s)
- Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Xia Jin
- The Third Hospital of Jinan, Jinan, China
| | - Ma Schwe Zin Nyunt
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tamas Fulop
- Department of Medicine, Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Su Chi Lim
- Department of Endocrinology, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Anis Larbi
- Department of Medicine, Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
- Biology of Ageing Laboratory, Singapore Immunology Network (SIgN), Agency for Science Technology and Research (A*STAR), Biopolis, Singapore, Singapore
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Abstract
First envisioned by early diabetes clinicians, a person-centred approach to care was an aspirational goal that aimed to match insulin therapy to each individual's unique requirements. In the 100 years since the discovery of insulin, this goal has evolved to include personalised approaches to type 1 diabetes diagnosis, treatment, prevention and prediction. These advances have been facilitated by the recognition of type 1 diabetes as an autoimmune disease and by advances in our understanding of diabetes pathophysiology, genetics and natural history, which have occurred in parallel with advancements in insulin delivery, glucose monitoring and tools for self-management. In this review, we discuss how these personalised approaches have improved diabetes care and how improved understanding of pathogenesis and human biology might inform precision medicine in the future.
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Affiliation(s)
- Alice L J Carr
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK.
| | - Carmella Evans-Molina
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
- Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
- Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Richard A Oram
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK.
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5
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Multiplexed quantification of insulin and C-peptide by LC-MS/MS without the use of antibodies. J Mass Spectrom Adv Clin Lab 2022; 25:19-26. [PMID: 35734440 PMCID: PMC9207678 DOI: 10.1016/j.jmsacl.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/08/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022] Open
Abstract
Simultaneous quantification of insulin and C-peptide without antibodies. Proteolysis with Glu-C permits sensitive and precise measurements. Calibration with certified reference material provides traceability. Relatively large bias when compared with a commercially available immunoassay.
Introduction The measurement of insulin and C-peptide provides a valuable tool for the clinical evaluation of hypoglycemia. In research, these biomarkers are used together to better understand hyperinsulinemia, hepatic insulin clearance, and beta cell function. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is an attractive approach for the analysis of insulin and C-peptide because the platform is specific, can avoid certain limitations of immunoassays, and can be multiplexed. Previously described LC-MS/MS methods for the simultaneous quantification of insulin and C-peptide measure the intact analytes and most have relied on immunoaffinity enrichment. These approaches can be limited in terms of sensitivity and interference from auto-antibodies, respectively. We have developed a novel method that does not require antibodies and uses proteolytic digestion to yield readily ionizable proteotypic peptides that enables the sensitive, specific, and simultaneous quantitation of insulin and C-peptide. Methods Serum samples were precipitated with acetonitrile. Analytes were enriched using solid phase extraction and then digested with endoproteinase Glu-C. Surrogate peptides for insulin and C-peptide were analyzed using targeted LC-MS/MS. Results Inter-day imprecision was below 20 %CV and linearity was observed down to the lower limit of quantitation for both analytes (insulin = 0.09 ng/mL, C-peptide = 0.06 ng/mL). Comparison to a commercially available insulin immunoassay (Beckman Coulter UniCel DxI 600 Access) revealed a 30% bias between methods. Conclusion A novel LC-MS/MS method for the simultaneous analysis of insulin and C-peptide using Glu-C digestion was developed and evaluated. A detailed standard operating procedure is provided to help facilitate implementation in other laboratories.
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Park YM, Yang CM, Cho HY. Therapeutic Effects of Insulin-Producing Human Umbilical Cord-Derived Mesenchymal Stem Cells in a Type 1 Diabetes Mouse Model. Int J Mol Sci 2022; 23:6877. [PMID: 35805883 PMCID: PMC9266974 DOI: 10.3390/ijms23136877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 02/01/2023] Open
Abstract
In patients with type 1 diabetes (T1D), compromised pancreatic β-cell functions are compensated through daily insulin injections or the transplantation of pancreatic tissue or islet cells. However, both approaches are associated with specific challenges. The transplantation of mesenchymal stem cells (MSCs) represents a potential alternative, as MSCs have tissue-forming capacity and can be isolated from various tissues. The human umbilical cord (hUC) is a good source of freely available MSCs, which can be collected through pain-free, non-invasive methods subject to minimal ethical concerns. We sought to develop a method for the in vitro generation of insulin-producing cells (IPCs) using MSCs. We examined the potential therapeutic uses and efficacy of IPCs generated from hUC-derived MSCs (hUC-IPCs) and human adipose tissue (hAD)-derived MSCs (hAD-IPCs) through in vitro experiments and streptozotocin (STZ)-induced C57BL/6 T1D mouse models. We discovered that compared to hAD-IPCs, hUC-IPCs exhibited a superior insulin secretion capacity. Therefore, hUC-IPCs were selected as candidates for T1D cell therapy in mice. Fasting glucose and intraperitoneal glucose tolerance test levels were lower in hUC-IPC-transplanted mice than in T1D control mice and hAD-IPC-transplanted mice. Our findings support the potential use of MSCs for the treatment of T1D.
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Affiliation(s)
- Yu Mi Park
- CHA Advanced Research Institute, 335, Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Korea
- Department of Biomedical Science, CHA University, 335, Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Korea
- Cell Therapy R&D Center, HansBiomed Corp, 7, Jeongui-ro 8-gil, Songpa-gu, Seoul 05836, Gyeonggi-do, Korea; (C.M.Y.); (H.Y.C.)
| | - Chang Mo Yang
- Cell Therapy R&D Center, HansBiomed Corp, 7, Jeongui-ro 8-gil, Songpa-gu, Seoul 05836, Gyeonggi-do, Korea; (C.M.Y.); (H.Y.C.)
| | - Hee Yeon Cho
- Cell Therapy R&D Center, HansBiomed Corp, 7, Jeongui-ro 8-gil, Songpa-gu, Seoul 05836, Gyeonggi-do, Korea; (C.M.Y.); (H.Y.C.)
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7
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Drai RV, Karonova TL, Mayorov AY, Makarenko IE, Dorotenko AR, Kulesh VS, Kovalik VV, Andreeva AT. Clinical Pharmacology of Insulin Aspart Biosimilar GP40071: Pharmacokinetic/Pharmacodynamic Comparability in Hyperinsulinemic Euglycemic Clamp Procedure. Clin Pharmacol Drug Dev 2022; 11:922-929. [PMID: 35230749 PMCID: PMC9541865 DOI: 10.1002/cpdd.1084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
Insulin aspart is a short‐acting insulin analogue that is used to control postprandial glycemia levels in diabetic patients. The aim of this clinical trial was to compare the pharmacokinetics and pharmacodynamics of GP40071 (GP‐Asp) and NovoRapid Penfill (Novo‐Asp) in a hyperinsulinemic euglycemic clamp (HEC). This trial was conducted as a part of a GP40071 biosimilar clinical development program. This was a phase I randomized, double‐blind, two‐period crossover study. Twenty‐six healthy male volunteers aged 18 to 45 years who met the inclusion criteria underwent the procedure of an HEC following a single subcutaneous injection of 0.3 IU/kg of either GP‐Asp or Novo‐Asp into the abdomen. After doses, plasma glucose levels were monitored every 5 minutes for 8 hours. The adjustment of the glucose infusion rate (GIR) was based on the blood glucose measurements. The GIR values were used to evaluate the PD profiles of the studied drugs. Regular blood sampling was performed during the study to obtain sufficient pharmacokinetic data. The 90% confidence intervals for the geometric mean ratios of the pharmacokinetic (AUCins.0‐t, Cins.max) and pharmacodynamic (GIRmax, AUCGIR0‐t) parameters of GP‐Asp were within the 80%–125% comparability limits. The safety profiles of the drugs were also comparable. Bioequivalence, similar PD, and safety of GP‐Asp and Novo‐Asp were demonstrated.
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Affiliation(s)
| | - Tatiana L Karonova
- Institute of Endocrinology, Almazov National Medical Research Center, Saint Petersburg, Russia
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8
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A novel method for the chaperone aided and efficient production of human proinsulin in the prokaryotic system. J Biotechnol 2022; 346:35-46. [DOI: 10.1016/j.jbiotec.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/27/2021] [Accepted: 01/13/2022] [Indexed: 02/07/2023]
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9
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Rodríguez-Pérez C, Gómez-Peña C, Pérez-Carrascosa FM, Vrhovnik P, Echeverría R, Salcedo-Bellido I, Mustieles V, Željka F, Arrebola JP. Trace elements concentration in adipose tissue and the risk of incident type 2 diabetes in a prospective adult cohort. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 286:117496. [PMID: 34438482 DOI: 10.1016/j.envpol.2021.117496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/23/2021] [Accepted: 05/28/2021] [Indexed: 06/13/2023]
Abstract
The aim of this work was to study the associations of adipose tissue trace element concentrations with type 2 diabetes (T2DM) incidence over a 16-year follow-up period in an adult cohort from Southern Spain. 16-year T2DM incidence was gathered from hospital records. Chemical analyses of Cr, V, Zn, Fe, Cu and Se in adipose tissue were performed using inductively coupled plasma mass spectrometry. Multivariable Cox-regression models were used. Complementary cross-sectional analyses with markers of glucose homeostasis at recruitment were performed by multivariable linear regression. Out of 214 participants, 39 developed T2DM during the follow-up. Adipose tissue concentrations of Fe (HR = 1.97, 95% CI: 0.99 to 2.58, p = 0.057), Cr (HR = 1.58, 95% CI: 1.07-2.33, p = 0.022) and Cu (HR = 1.61, 95% CI: 1.01-2.58, p = 0.046) were individually associated with T2DM incidence. When Fe, Cr and Cu were simultaneously entered in a model, only Cr was significantly associated with T2DM incidence (HR = 1.68, 95% CI: 1.02-2.76, p = 0.041). Furthermore, adipose tissue V (β = 0.283, p = 0.004) and Zn (β = 0.217, p = 0.028) concentrations were positively associated with β-pancreatic cell function (HOMA-β), while Se showed an inverse association (β = -0.049, p = 0.027). Although further research is warranted on the potential mechanisms of action, our results suggest that adipose tissue concentrations of certain trace elements (particularly Fe, Cr and Cu) are associated with the risk of incident T2DM, while V and Zn might have a protective effect. These biomarkers might complement prediction algorithms and contribute to identify patients with an increased risk of T2DM.
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Affiliation(s)
- Celia Rodríguez-Pérez
- Departmento de Nutrición y Bromatología, Universidad de Granada, Campus de Melilla, Spain; I Instituto de Nutrición y Tecnología de los Alimentos 'José Mataix', Universidad de Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain.
| | - Celia Gómez-Peña
- Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain; Unidad de Gestión Clínica de Farmacia Hospitalaria, Hospital Universitario San Cecilio, Granada, Spain
| | - Francisco M Pérez-Carrascosa
- Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain; Oncology Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Petra Vrhovnik
- Slovenian National Building and Civil Engineering Institute (ZAG), Ljubjana, Slovenia
| | - Ruth Echeverría
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain
| | - Inmaculada Salcedo-Bellido
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Vicente Mustieles
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Fiket Željka
- Ruđer Bošković Institute, Division for Marine and Environmental Research, Zagreb, Croatia
| | - Juan Pedro Arrebola
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada ibs.GRANADA, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
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10
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Barrios-Rodríguez R, Pérez-Carrascosa FM, Gómez-Peña C, Mustieles V, Salcedo-Bellido I, Requena P, Martín-Olmedo P, Jiménez-Moleón JJ, Arrebola JP. Associations of accumulated selected persistent organic pollutants in adipose tissue with insulin sensitivity and risk of incident type-2 diabetes. ENVIRONMENT INTERNATIONAL 2021; 155:106607. [PMID: 33971459 DOI: 10.1016/j.envint.2021.106607] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
Continuous exposure to low doses of persistent organic pollutant (POPs), such as those occurring in the general population, might contribute to the burden of type 2 diabetes mellitus (T2DM). However, evidences from longitudinal studies are scarce. We aimed to explore the associations of accumulated POP exposure with the development of T2DM by means of 1) longitudinal associations with the 16-year incidence of the disease, and 2) complementary cross-sectional analyses with markers of glucose homeostasis at recruitment. Organochlorine pesticide and polychlorinated biphenyl (PCB) concentrations were analyzed in adipose tissue samples and incident T2DM cases were retrieved from clinical records. Homeostatic model assessment values of insulin sensitivity/resistance and β-cell function at recruitment were calculated. Linear and Cox-regression models were performed. In individuals with normal weight/overweight (n = 293), we observed positive dose-response relationships between the studied POPs and T2DM risk, particularly for hexachlorobenzene (HCB) [hazard ratio (HR): 3.96 for 4th quartile versus 1st quartile (Q1); confidence interval (CI) 95%: 0.79, 19.71]. PCB-180 showed a positive but seemingly non-linear association with T2DM risk [HR of 3er quartile (Q3) versus Q1: 6.48; CI 95%: 0.82, 51.29]. Unadjustment for body mass index considerably increased the magnitude of the associations. In the cross-sectional study (n = 180), HCB and PCB-180 were inversely associated with insulin sensitivity and positively associated with insulin resistance parameters. Our results suggest that a higher burden of specific POPs in adipose tissue may disrupt glucose homeostasis, possibly contributing to increase T2DM risk, especially in non-obese adults.
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Affiliation(s)
- Rocío Barrios-Rodríguez
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Francisco M Pérez-Carrascosa
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Servicio de Oncología Radioterápica. Hospital Universitario Virgen de las Nieves, Granada, Spain.
| | - Celia Gómez-Peña
- Department of Pharmacy, San Cecilio University Hospital, Granada, Spain.
| | - Vicente Mustieles
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; University of Granada, Center for Biomedical Research (CIBM), Spain.
| | - Inmaculada Salcedo-Bellido
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Pilar Requena
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain.
| | - Piedad Martín-Olmedo
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Andalusian School of Public Health (EASP), Granada, Spain.
| | - José Juan Jiménez-Moleón
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
| | - Juan Pedro Arrebola
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
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11
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Salcedo-Bellido I, Gómez-Peña C, Pérez-Carrascosa FM, Vrhovnik P, Mustieles V, Echeverría R, Fiket Ž, Pérez-Díaz C, Barrios-Rodríguez R, Jiménez-Moleón JJ, Arrebola JP. Adipose tissue cadmium concentrations as a potential risk factor for insulin resistance and future type 2 diabetes mellitus in GraMo adult cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 780:146359. [PMID: 34030321 DOI: 10.1016/j.scitotenv.2021.146359] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/19/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
Adipose tissue has been recently highlighted as a promising matrix for evaluation of cadmium's (Cd) long-term exposure although not frequently considered in epidemiological studies. The association between Cd exposure and type 2 Diabetes Mellitus (T2DM) remains unclear. This work aimed to explore the association between adipose tissue Cd levels and T2DM incidence over a 16-year follow-up in an adult cohort from Southern Spain considering smoking status. We also performed complementary cross-sectional analyses focused on subclinical markers of glucose homeostasis at recruitment. Clinical information was obtained from hospital databases. Socio-demographic characteristics, lifestyle and diet were collected by face-to-face interviews. Homeostatic model assessment (HOMA) values of insulin sensitivity/resistance and β-cell function were calculated using fasting serum glucose, insulin, and C-peptide levels at recruitment. Adipose tissue Cd concentrations were quantified by inductively coupled plasma mass spectrometry. Statistical analyses were performed by means of Cox-regression and multivariable linear regression models. Participants in the 4th quartile (Q4) of Cd concentrations showed a non statistically-significant increased T2DM risk (Hazard Ratio (HR) Q4 vs Q1: 1.97; 95% Confidence Interval (CI): 0.69, 5.66). This association was particularly strong and suggestive in current smokers (HR: 2.19; 95% CI: 0.98, 4.98). Interestingly, smokers in the 2nd tertile (T2) of adipose tissue Cd levels showed increased log-transformed insulin resistance (beta T2 vs T1: 0.52; 95% CI: 0.07, 0.97), as well as higher log-transformed insulin levels (beta T2 vs T1: 0.52; 95% CI: 0.08, 0.95). We found evidences supporting that Cd exposure, particularly from tobacco smoking, could be a risk factor for T2DM. In addition, our results support the potential relevance of adipose tissue as a matrix for Cd exposure assessment.
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Affiliation(s)
- Inmaculada Salcedo-Bellido
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
| | - Celia Gómez-Peña
- Unidad de Gestión Clínica de Farmacia Hospitalaria, Hospital Universitario San Cecilio, Granada, Spain
| | - Francisco M Pérez-Carrascosa
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain; Radiation Oncology Department, Virgen de las Nieves University Hospital, Granada, Spain
| | - Petra Vrhovnik
- Slovenian National Building and Civil Engineering Institute (ZAG), Ljubljana, Slovenia
| | - Vicente Mustieles
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain; University of Granada, Center for Biomedical Research (CIBM), Granada, Spain
| | - Ruth Echeverría
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain
| | - Željka Fiket
- Ruđer Bošković Institute, Division for Marine and Environmental Research, Zagreb, Croatia
| | - Celia Pérez-Díaz
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain
| | - Rocío Barrios-Rodríguez
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain.
| | - José Juan Jiménez-Moleón
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
| | - Juan Pedro Arrebola
- Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain.
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12
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Janssen JAMJL. Hyperinsulinemia and Its Pivotal Role in Aging, Obesity, Type 2 Diabetes, Cardiovascular Disease and Cancer. Int J Mol Sci 2021; 22:ijms22157797. [PMID: 34360563 PMCID: PMC8345990 DOI: 10.3390/ijms22157797] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/11/2021] [Accepted: 07/13/2021] [Indexed: 01/10/2023] Open
Abstract
For many years, the dogma has been that insulin resistance precedes the development of hyperinsulinemia. However, recent data suggest a reverse order and place hyperinsulinemia mechanistically upstream of insulin resistance. Genetic background, consumption of the “modern” Western diet and over-nutrition may increase insulin secretion, decrease insulin pulses and/or reduce hepatic insulin clearance, thereby causing hyperinsulinemia. Hyperinsulinemia disturbs the balance of the insulin–GH–IGF axis and shifts the insulin : GH ratio towards insulin and away from GH. This insulin–GH shift promotes energy storage and lipid synthesis and hinders lipid breakdown, resulting in obesity due to higher fat accumulation and lower energy expenditure. Hyperinsulinemia is an important etiological factor in the development of metabolic syndrome, type 2 diabetes, cardiovascular disease, cancer and premature mortality. It has been further hypothesized that nutritionally driven insulin exposure controls the rate of mammalian aging. Interventions that normalize/reduce plasma insulin concentrations might play a key role in the prevention and treatment of age-related decline, obesity, type 2 diabetes, cardiovascular disease and cancer. Caloric restriction, increasing hepatic insulin clearance and maximizing insulin sensitivity are at present the three main strategies available for managing hyperinsulinemia. This may slow down age-related physiological decline and prevent age-related diseases. Drugs that reduce insulin (hyper) secretion, normalize pulsatile insulin secretion and/or increase hepatic insulin clearance may also have the potential to prevent or delay the progression of hyperinsulinemia-mediated diseases. Future research should focus on new strategies to minimize hyperinsulinemia at an early stage, aiming at successfully preventing and treating hyperinsulinemia-mediated diseases.
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Affiliation(s)
- Joseph A M J L Janssen
- Department of internal Medicine, Division of Endocrinology, Erasmus Medical Center, 40, 3015 GD Rotterdam, The Netherlands
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13
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Rodriguez-Calvo T, Chen YC, Verchere CB, Haataja L, Arvan P, Leete P, Richardson SJ, Morgan NG, Qian WJ, Pugliese A, Atkinson M, Evans-Molina C, Sims EK. Altered β-Cell Prohormone Processing and Secretion in Type 1 Diabetes. Diabetes 2021; 70:1038-1050. [PMID: 33947721 PMCID: PMC8173804 DOI: 10.2337/dbi20-0034] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 02/26/2021] [Indexed: 02/06/2023]
Abstract
Analysis of data from clinical cohorts, and more recently from human pancreatic tissue, indicates that reduced prohormone processing is an early and persistent finding in type 1 diabetes. In this article, we review the current state of knowledge regarding alterations in islet prohormone expression and processing in type 1 diabetes and consider the clinical impact of these findings. Lingering questions, including pathologic etiologies and consequences of altered prohormone expression and secretion in type 1 diabetes, and the natural history of circulating prohormone production in health and disease, are considered. Finally, key next steps required to move forward in this area are outlined, including longitudinal testing of relevant clinical populations, studies that probe the genetics of altered prohormone processing, the need for combined functional and histologic testing of human pancreatic tissues, continued interrogation of the intersection between prohormone processing and autoimmunity, and optimal approaches for analysis. Successful resolution of these questions may offer the potential to use altered prohormone processing as a biomarker to inform therapeutic strategies aimed at personalized intervention during the natural history of type 1 diabetes and as a pathogenic anchor for identification of potential disease-specific endotypes.
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Affiliation(s)
- Teresa Rodriguez-Calvo
- Institute of Diabetes Research, Helmholtz Zentrum Muenchen - German Research Center for Environmental Health, Munich-Neuherberg, Germany
| | - Yi-Chun Chen
- Department of Surgery, University of British Columbia and BC Children's Hospital Research Institute, Vancouver, Canada
| | - C Bruce Verchere
- Departments of Surgery and Pathology and Laboratory Medicine, University of British Columbia, Centre for Molecular Medicine and Therapeutics, and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Leena Haataja
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan Medical Center, Ann Arbor, MI
| | - Peter Arvan
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan Medical Center, Ann Arbor, MI
| | - Pia Leete
- Exeter Centre of Excellence for Diabetes, Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, U.K
| | - Sarah J Richardson
- Exeter Centre of Excellence for Diabetes, Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, U.K
| | - Noel G Morgan
- Exeter Centre of Excellence for Diabetes, Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, U.K
| | - Wei-Jun Qian
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA
| | - Alberto Pugliese
- Diabetes Research Institute, Leonard M. Miller School of Medicine, University of Miami, Miami, FL
| | - Mark Atkinson
- Departments of Pathology and Pediatrics, Diabetes Institute, University of Florida, Gainesville, FL
| | - Carmella Evans-Molina
- Center for Diabetes and Metabolic Diseases, Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
- Departments of Cellular and Integrative Physiology, Medicine, and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN
- Richard L. Roudebush VA Medical Center, Indianapolis, IN
| | - Emily K Sims
- Center for Diabetes and Metabolic Diseases, Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
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14
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Development of radioimmunoassay for estimation of C-peptide in human serum. J Radioanal Nucl Chem 2021. [DOI: 10.1007/s10967-020-07536-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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15
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Huynh T. Clinical and Laboratory Aspects of Insulin Autoantibody-Mediated Glycaemic Dysregulation and Hyperinsulinaemic Hypoglycaemia: Insulin Autoimmune Syndrome and Exogenous Insulin Antibody Syndrome. Clin Biochem Rev 2020; 41:93-102. [PMID: 33343044 PMCID: PMC7731936 DOI: 10.33176/aacb-20-00008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Autoimmune glycaemic dysregulation and hyperinsulinaemic hypoglycaemia mediated by insulin autoantibodies is an increasingly recognised but controversial phenomenon described in both exogenous insulin naïve (insulin autoimmune syndrome) and exposed (exogenous insulin antibody syndrome) individuals. There has been a significant proliferation of case reports, clinical studies and reviews in the medical literature in recent years which have collectively highlighted the discrepancy between experts in the field with regard to the nomenclature, definition, proposed pathophysiology, as well as the clinical and biochemical diagnostic criteria associated with the condition. The essential characteristics of the condition are glycaemic dysregulation manifesting as episodes of hyperglycaemia and unpredictable hyperinsulinaemic hypoglycaemia associated with high titres of endogenous antibodies to insulin. Although the hypoglycaemia is often life-threatening and initiation of targeted therapies critical, the diagnosis is often delayed and attributable to various factors including: the fact that existence of the condition is not universally accepted; the need to exclude surreptitious causes of hypoglycaemia; the diverse and often complex nature of the glycaemic dysregulation; and the challenge of diagnostic confirmation. Once confirmed, the available therapeutic options are expansive and the reported responses to these therapies have been variable. This review will focus on our evolving understanding, and the associated diagnostic challenges - both clinical and laboratory - of this complex condition.
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Affiliation(s)
- Tony Huynh
- Department of Endocrinology and Diabetes, Queensland Children’s Hospital, South Brisbane 4101, Australia
- Department of Chemical Pathology, Mater Pathology, South Brisbane 4101, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia
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16
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Li M, Song L, Yuan J, Zhang D, Zhang C, Liu Y, Lin Q, Wang H, Su K, Li Y, Ma Z, Liu D, Dong J. Association Between Serum Insulin and C-Peptide Levels and Breast Cancer: An Updated Systematic Review and Meta-Analysis. Front Oncol 2020; 10:553332. [PMID: 33194614 PMCID: PMC7658676 DOI: 10.3389/fonc.2020.553332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 10/08/2020] [Indexed: 01/07/2023] Open
Abstract
Background Several studies have reported that hyperinsulinemia plays a part in the etiology of breast cancer. However, no consensus has been reached. Therefore, we conducted a meta-analysis to explore the role of insulin and C-peptide in breast cancer. Methods A systematic search in PubMed, Embase, and The Cochrane Library was conducted up to September, 2020. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to measure effect sizes. Publication bias was assessed using the Egger test. Stability of these results was evaluated using sensitivity analyses. Results Fourteen articles including 27,084 cases and five articles including 2,513 cases were extracted for serum insulin levels and C-peptide levels. We found that C-peptide levels were positively associated with breast cancer with overall SMD = 0.37 (95% CI = 0.09–0.65, I2 = 89.1%). Subgroup analysis by control source illustrated a positive relationship between breast cancer and C-peptide levels in population-based control. Subgroup analysis by C-peptide level indicated a positive correlation between breast cancer and C-peptide levels no matter C-peptide levels in case group is ≤3 ng/ml or >3 ng/ml. Subgroup analysis by age showed that C-peptide level positively correlated to breast cancer in women between the ages of 50 and 60. However, we did not identify any relationship between breast cancer and insulin levels (SMD = 0.22, 95% CI = −0.06–0.50, I2 = 97.3%). Conclusion This meta-analysis demonstrated that C-peptide levels were positively related to breast cancer in women, and no relationship between insulin levels and breast cancer was found.
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Affiliation(s)
- Manwen Li
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Limin Song
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Junhua Yuan
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Di Zhang
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Caishun Zhang
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Yuan Liu
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Qian Lin
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Haidan Wang
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Kaizhen Su
- Clinical Medicine Department, Medical College, Qingdao University, Qingdao, China
| | - Yanrun Li
- Clinical Medicine Department, Medical College, Qingdao University, Qingdao, China
| | - Zhengye Ma
- Clinical Medicine Department, Medical College, Qingdao University, Qingdao, China
| | - Defeng Liu
- Clinical Medicine Department, Medical College, Qingdao University, Qingdao, China
| | - Jing Dong
- Special Medicine Department, School of Basic Medicine, Qingdao University, Qingdao, China.,Physiology Department, Medical College, Qingdao University, Qingdao, China
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17
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Østergaard M, Mishra NK, Jensen KJ. The ABC of Insulin: The Organic Chemistry of a Small Protein. Chemistry 2020; 26:8341-8357. [DOI: 10.1002/chem.202000337] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/15/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Mads Østergaard
- Department of ChemistryUniversity of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg C Denmark
| | - Narendra Kumar Mishra
- Department of ChemistryUniversity of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg C Denmark
| | - Knud J. Jensen
- Department of ChemistryUniversity of Copenhagen Thorvaldsensvej 40 1871 Frederiksberg C Denmark
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18
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Guildford L, Crofts C, Lu J. Can the Molar Insulin: C-Peptide Ratio Be Used to Predict Hyperinsulinaemia? Biomedicines 2020; 8:biomedicines8050108. [PMID: 32375229 PMCID: PMC7277201 DOI: 10.3390/biomedicines8050108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 01/18/2023] Open
Abstract
Hyperinsulinaemia is the precursor to numerous metabolic disorders. Early diagnosis and intervention could improve population health. Diagnosing hyperinsulinaemia is problematic because insulin has a very short half-life (2–5 min). It is theorised that c-peptide levels (half-life 20–30 min) would be a better proxy for insulin due to both hormones being released in equimolar amounts. However, the correlation between c-peptide and insulin levels is unknown. We aim to identify their correlation following a four-hour oral glucose tolerance test (OGTT). Data were obtained from records of routine medical care at St Joseph’s Hospital, Chicago, IL, USA, during 1977. Two hundred and fifty-five male and female participants aged over 20 years undertook a four-hour OGTT with plasma glucose, insulin and c-peptide levels recorded. Correlation was assessed with Pearson’s correlation. There was a weak correlation between insulin and c-peptide, which increased to moderate across the four-hour OGTT (r = 0.482–0.680). There was no significant change in this relationship when data was subdivided according to either the WHO glucose status or Kraft insulin response. Although there was a correlation between insulin and c-peptide, it was too weak to recommend the use of c-peptide as an alternative biomarker for the diagnosis of hyperinsulinaemia.
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Affiliation(s)
- Lynda Guildford
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0627, New Zealand;
- School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1010, New Zealand
| | - Catherine Crofts
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0627, New Zealand;
- Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0632, New Zealand
- Correspondence: (C.C.); (J.L.); Tel.: +64-9-921-9999 (ext. 6030) (C.C.); +64-9-921-9999 (ext. 7381) (J.L.)
| | - Jun Lu
- School of Public Health and Interdisciplinary Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0627, New Zealand;
- School of Science, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 1010, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, Auckland 1010, New Zealand
- Institute of Biomedical Technology, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
- College of Life and Marine Sciences, Shenzhen University, Shenzhen 518071, China
- College of Food Engineering and Nutrition Sciences, Shaanxi Normal University, Xi’an 710119, China
- Correspondence: (C.C.); (J.L.); Tel.: +64-9-921-9999 (ext. 6030) (C.C.); +64-9-921-9999 (ext. 7381) (J.L.)
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19
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Abstract
Good glucose management through an insulin dose regime based on the metabolism of glucose helps millions of people worldwide manage their diabetes. Since Banting and Best extracted insulin, glucose management has improved due to the introduction of insulin analogues that act from 30 minutes to 28 days, improved insulin dose regimes, and portable glucose meters, with a current focus on alternative sampling sites that are less invasive. However, a piece of the puzzle is still missing-the ability to measure insulin directly in a Point-of-Care device. The ability to measure both glucose and insulin concurrently will enable better glucose control by providing an improved estimate for insulin sensitivity, minimizing variability in control, and maximizing safety from hypoglycaemia. However, direct detection of free insulin has provided a challenge due to the size of the molecule, the low concentration of insulin in blood, and the selectivity against interferants in blood. This review summarizes current insulin detection methods from immunoassays to analytical chemistry, and sensors. We also discuss the challenges and potential of each of the methods towards Point-of-Care insulin detection.
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Wang Y, Gao Y, Cai X, Chen L, Zhou L, Ma Y, Gong S, Han X, Ji L. Clinical Implications of Urinary C-Peptide Creatinine Ratio in Patients with Different Types of Diabetes. J Diabetes Res 2019; 2019:1747684. [PMID: 31485449 PMCID: PMC6702841 DOI: 10.1155/2019/1747684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 07/19/2019] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Urinary C-peptide creatinine ratio (UCPCR) is used as a marker of endogenous insulin secretion. This study aims to assess the effectiveness of UCPCR for distinguishing between type 1 diabetes (T1DM) and non-T1DM (monogenic diabetes and T2DM) and predicting therapeutic choices in type 2 diabetes (T2DM) patients. METHODS Twenty-three patients with genetically confirmed monogenic diabetes (median age 35.0 years (interquartile range 30.0-47.0), 13 (56.5%) men), 56 patients with T1DM (median age 46.0 years (interquartile range 26.5-59.5), 28 (50.0%) men), 136 patients with T2DM (median age 53.0 years (interquartile range 42.0-60.0), 87 (64.0%) men), and 59 healthy subjects (median age 36.0 years (30.0-42.0), 26 (44.1%) men) were included. UCPCR was collected in the morning. Receiver operating characteristic (ROC) curves were used to identify optimal UCPCR cut-off values to differentiate T1DM from non-T1DM. This UCPCR cut-off was used to divide T2DM patients into two groups, and the two groups were compared. RESULTS The UCPCR was lower in patients with T1DM compared with T2DM, monogenic diabetes, and healthy subjects, while the UCPCR was similar in T2DM and monogenic diabetes. A UCPCR cut-off of ≥0.21 nmol/mmol distinguished between monogenic diabetes and T1DM (area under the curve [AUC], 0.949) with 87% sensitivity and 93% specificity. UCPCR ≥ 0.20 nmol/mmol had 82% sensitivity and 93% specificity for distinguishing between T2DM and T1DM, with an AUC of 0.932. UCPCR was not reliable for distinguishing between monogenic diabetes and T2DM (AUC, 0.605). Twenty-five of 136 (18.4%) T2DM patients had UCPCR ≤ 0.20 nmol/mmol. Compared with T2DM patients with a UCPCR > 0.20 nmol/mmol, T2DM patients with UCPCR ≤ 0.20 nmol/mmol had a lower serum C-peptide (fasting C-peptide, 0.39 nmol/L vs. 0.66 nmol/L, P < 0.001; postprandial C-peptide, 0.93 nmol/L vs. 1.55 nmol/L, P < 0.001), lower BMI (22.8 kg/m2 vs. 25.2 kg/m2, P = 0.006), and higher percentage of insulin or secretagogue therapy (92.0% vs. 59.5%, P = 0.002). CONCLUSIONS UCPCR is a practical and noninvasive marker that can distinguish between TIDM and T2DM or monogenic diabetes. UCPCR ≤ 0.20 nmol/mmol reflects severe impaired beta cell function and the need for insulin or secretagogue therapy in T2DM patients.
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Affiliation(s)
- Yanai Wang
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
| | - Ying Gao
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
| | - Xiaoling Cai
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
| | - Ling Chen
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
| | - Lingli Zhou
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
| | - Yumin Ma
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
| | - Siqian Gong
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
| | - Xueyao Han
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
| | - Linong Ji
- Departments of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing 100044, China
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Izzo V, Greco C, Corradini D, Infante M, Staltari MT, Romano M, Bellia A, Lauro D, Uccioli L. Insulin autoimmune syndrome in an Argentine woman taking α-lipoic acid: A case report and review of the literature. SAGE Open Med Case Rep 2018; 6:2050313X18819601. [PMID: 30627435 PMCID: PMC6311546 DOI: 10.1177/2050313x18819601] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 11/19/2018] [Indexed: 11/28/2022] Open
Abstract
Insulin autoimmune syndrome is an unusual cause of spontaneous hypoglycaemia in non-Asian populations. In the majority of cases, this syndrome appears a few weeks after the administration of drugs containing a sulfhydryl group. A strong association between this syndrome and HLA-DR4 has been shown. Only seven cases have been described in non-Asian patients. We report the first case of insulin autoimmune syndrome in an Argentine woman taking alfa-lipoic acid. She developed hypoglycaemic symptoms approximately 1 month after starting therapy. Blood sampling collected during an episode of symptomatic hypoglycaemia showed low blood glucose level (2.39 mmol/L), high level of serum insulin (1971.55 pmol/L), inappropriately high level of C-peptide (2.36 nmol/L) and high levels of insulin antibodies (274.78 IU/mL). HLA-DNA typing identified DRB1*04:03. Due to the widespread use of alfa-lipoic acid for its antioxidant properties, clinicians should be aware that it may trigger an autoimmune hypoglycaemia in people with a genetic predisposition.
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Affiliation(s)
- Valentina Izzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carla Greco
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Diana Corradini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marco Infante
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Maria Romano
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Alfonso Bellia
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Davide Lauro
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Luigi Uccioli
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Kaiser M, Jacobsen S, Andersen PH, Bækbo P, Cerón JJ, Dahl J, Escribano D, Theil PK, Jacobson M. Hormonal and metabolic indicators before and after farrowing in sows affected with postpartum dysgalactia syndrome. BMC Vet Res 2018; 14:334. [PMID: 30404636 PMCID: PMC6223068 DOI: 10.1186/s12917-018-1649-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 10/15/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Postpartum dysgalactia syndrome (PDS) in sows is difficult to diagnose and the pathogenesis is obscure. Hormonal changes related to the disease are often difficult to distinguish from those found in the normal transition period from gestation to lactation. The study aimed to investigate metabolic and hormonal changes related to PDS with the goal of identifying potential biomarkers in sows suffering from PDS (PDS+). Selected biomarkers were examined by comparing 38 PDS+ sows with 38 PDS negative (PDS-) sows. The sows were sampled every 24 h from 60 h ante partum (a.p.) to 36 h post partum (p.p.). RESULTS Compared to the baseline (60 to 36 h a.p.), cortisol in serum and saliva and fasting blood glucose concentrations increased in PDS+ as well as PDS- sows. C-peptide decreased relative to the baseline in PDS+ sows, and prolactin and 8-epi prostaglandin F2 alpha (8-epi-PGF2α) decreased in PDS- sows. Concentrations of cortisol in serum and saliva, salivary chromogranin A (CgA), fasting blood glucose, C-peptide, and 8-epi-PGF2α differed significantly between PDS+ and PDS- sows, with levels of cortisol in serum and saliva, salivary CgA, and 8-epi-PGF2α in serum being different in the two groups already before parturition. Concentrations of salivary CgA were significantly lower in PDS- sows than in PDS+ sows during the entire study period. CONCLUSIONS The results suggest that salivary CgA, cortisol and serum 8-epi-PGF2α may potentially serve as early diagnostic indicators for PDS. The consistently higher salivary CgA concentration in PDS+ sows compared to PDS- sows may indicate that homeostatic disturbances are present between 36 to 60 h before parturition in sows developing PDS. The higher serum and saliva cortisol concentration in PDS+ sows compared to PDS- sows could reflect an early sign of inflammation or stress. The significantly lower C-peptide in PDS+ sows compared to PDS- sows may reflect a lower food intake. Our results contribute to the understanding of the pathogenesis of PDS, and the homeostatic disturbances detected before parturition warrants further investigation. The diagnostic potential of the markers identified in this study should be investigated further in a larger population of sows.
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Affiliation(s)
- Marianne Kaiser
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark
| | - Stine Jacobsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Agrovej 8, 2630 Taastrup, Denmark
| | - Pia Haubro Andersen
- Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O. Box 7054, SE-750 07 Uppsala, Sweden
| | - Poul Bækbo
- SEGES, Danish Pig Research Centre, Agro Food Park 15, 8200 Aarhus N, Denmark
| | - José Joaquin Cerón
- Department of Animal Medicine and Surgery, Regional “Campus of Excellence Mare Nostrum”, University of Murcia, Espinardo, 30100 Murcia, Spain
| | - Jan Dahl
- Danish Agriculture and Food Council, Axelborg, Axeltorv 3, 1709 Copenhagen V, Denmark
| | - Damián Escribano
- Department of Animal Medicine and Surgery, Regional “Campus of Excellence Mare Nostrum”, University of Murcia, Espinardo, 30100 Murcia, Spain
| | - Peter Kappel Theil
- Department of Animal Science - Molecular nutrition and reproduction, Aarhus University, Blichers Allé 20, 8830 Tjele, Denmark
| | - Magdalena Jacobson
- Faculty of Veterinary Medicine and Animal Science, Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O. Box 7054, SE-750 07 Uppsala, Sweden
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A sensitive electrochemiluminescent biosensor based on AuNP-functionalized ITO for a label-free immunoassay of C-peptide. Bioelectrochemistry 2018; 123:211-218. [DOI: 10.1016/j.bioelechem.2018.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/16/2018] [Accepted: 05/19/2018] [Indexed: 11/22/2022]
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Oh J, Kim JH, Park HD. Clinical Utility and Cross-Reactivity of Insulin and C-Peptide Assays by the Lumipulse G1200 System. Ann Lab Med 2018; 38:530-537. [PMID: 30027696 PMCID: PMC6056384 DOI: 10.3343/alm.2018.38.6.530] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/21/2018] [Accepted: 07/09/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Measurement of insulin and C-peptide concentrations is important for deciding whether insulin treatment is required in diabetic patients. We aimed to investigate the analytical performance of insulin and C-peptide assays using the Lumipulse G1200 system (Fujirebio Inc., Tokyo, Japan). METHODS We examined the precision, linearity, and cross-reactivity of insulin and C-peptide using five insulin analogues and purified proinsulin. A method comparison was conducted between the Lumipulse G1200 and Roche E170 (Roche Diagnostics, Mannheim, Germany) systems in 200 diabetic patients on insulin treatment. Reference intervals for insulin and C-peptide concentrations were determined in 279 healthy individuals. RESULTS For insulin and C-peptide assays, within-laboratory precision (% CV) was 3.78-4.14 and 2.89-3.35%, respectively. The linearity of the insulin assay in the range of 0-2,778 pmol/L was R²=0.9997, and that of the C-peptide assay in the range of 0-10 nmol/L was R²=0.9996. The correlation coefficient (r) between the Roche E170 and Lumipulse G1200 results was 0.943 (P<0.001) for insulin and 0.996 (P<0.001) for C-peptide. The mean differences in insulin and C-peptide between Lumipulse G1200 and the Roche E170 were 19.4 pmol/L and 0.2 nmol/L, respectively. None of the insulin analogues or proinsulin showed significant cross-reactivity with the Lumipulse G1200. Reference intervals of insulin and C-peptide were 7.64-70.14 pmol/L and 0.17-0.85 nmol/L, respectively. CONCLUSIONS Insulin and C-peptide tests on the Lumipulse G1200 show adequate analytical performance and are expected to be acceptable for use in clinical areas.
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Affiliation(s)
- Jongwon Oh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung Doo Park
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Jendrzejewski J, Obołończyk Ł, Leczycka ME, Utracka A, Ciura P, Makowski W, Sworczak K. A case report of insulin autoimmune syndrome in a Central European individual. Clin Chem Lab Med 2018; 56:e132-e134. [PMID: 29683798 DOI: 10.1515/cclm-2018-0189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 03/27/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Jarosław Jendrzejewski
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Łukasz Obołończyk
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Martina Eva Leczycka
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Alicja Utracka
- Central Laboratory of the University Clinical Centre, Medical University of Gdansk, Gdańsk, Poland
| | | | | | - Krzysztof Sworczak
- Department of Endocrinology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
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Andrade RLM, Callo G, Horta BL. Peptídeo C e mortalidade cardiovascular: revisão sistemática e metanálise. Rev Panam Salud Publica 2018; 43:e23. [PMID: 31093247 PMCID: PMC6459372 DOI: 10.26633/rpsp.2019.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 10/25/2018] [Indexed: 11/24/2022] Open
Abstract
Objetivo Analisar as evidências de associação entre peptídeo C e mortalidade cardiovascular e geral disponíveis na literatura. Métodos Foi realizada uma revisão sistemática das bases de dados MEDLINE e EMBASE. Foram incluídos artigos publicados em inglês, português ou espanhol relatando estudos observacionais que investigaram a associação entre o peptídeo C e a mortalidade cardiovascular e geral. Buscou-se ainda avaliar a associação entre peptídeo C e fatores de risco cardiometabólicos, fatores hemodinâmicos e medidas antropométricas. A qualidade metodológica dos estudos foi avaliada de acordo com os critérios da escala Newcastle-Ottawa. Resultados Foram identificados 107 estudos relacionados ao tema. Ao final do processo de triagem, foram incluídos 18 artigos que apresentavam dados sobre a associação entre peptídeo C e risco cardiovascular. Cinco estudos forneceram dados sobre a relação entre peptídeo C e mortalidade cardiovascular e geral. O peptídeo C esteve associado positivamente ao IMC em chineses, e inversamente ao HDL colesterol em amostras populacionais na Ásia, Oriente Médio e Estados Unidos. Todavia, não foi possível realizar metanálise para os componentes de risco cardiovascular. Por outro lado, o peptídeo C esteve associado com a mortalidade cardiovascular (RR = 1,62; IC95%: 0,99 a 2,66) e geral (RR = 1,39; IC95%: 1,04 a 1,84). Conclusão Na revisão sistemática e metanálise realizadas, os níveis séricos de peptídeo C estiveram associados positivamente com a mortalidade geral em todos os indivíduos e com a mortalidade cardiovascular em pessoas sem comorbidades. Com base nesses resultados, é possível recomendar o emprego do peptídeo C na prática clínica como proxy da condição de resistência à insulina associada a mortalidade cardiovascular.
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Affiliation(s)
| | - Gabriela Callo
- Universidade Federal de Pelotas (UFPel), Programa de Pós-Graduação em Epidemiologia, Pelotas (RS), Brasil
| | - Bernardo Lessa Horta
- Universidade Federal de Pelotas (UFPel), Programa de Pós-Graduação em Epidemiologia, Pelotas (RS), Brasil
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Pujia A, Gazzaruso C, Montalcini T. An update on the potential role of C-peptide in diabetes and osteoporosis. Endocrine 2017; 58:408-412. [PMID: 28374151 DOI: 10.1007/s12020-017-1286-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/20/2017] [Indexed: 01/02/2023]
Abstract
PURPOSE C-peptide secretion is deficient or absent in type 1 diabetes mellitus. It is well accepted that insulin replacement therapy cannot prevent the development of long-term diabetes-related complications, which can often be disabling or even life-threatening. Several cross-sectional investigations have suggested that residual C-peptide production in patients with type 1 diabetes mellitus would help prevent a number of complications. In animal models of diabetes and in patients with type 1 diabetes mellitus, C-peptide replacement improves renal function, skin and skeletal muscle blood flow, nerve conduction, glucose utilization, and other diabetes-related complications. Recent investigations suggest a new beneficial effect of C-peptide, which to date has never been studied. It is known that osteoporosis is the most prevalent short-term complication in type 1 diabetes mellitus. This review will highlight new insights into the pathophysiology and future therapeutic modalities for osteoporosis in individuals with diabetes. METHODS This review provides a concise summary of old and new insights into the role of C-peptide in diabetes-related complications. RESULTS The data suggest that C-peptide is a bioactive peptide, acting independently of insulin, which binds to a G-protein-coupled membrane binding site in different cell types. By triggering Ca2+-dependent intracellular signaling pathways, both Na+, K+-ATPase and endothelial nitric oxide synthase are activated. C-peptide may act on osteoblast cells by ERK 1/2 pathway activation, modulate collagen biosynthesis and RANKL expression. Furthermore, C-peptide-deficient postmenopausal women, not affected by diabetes, have a lower bone mineral density than those with normal C-peptide levels. CONCLUSION Taken together these studies encourage further investigations to elucidate the role of C-peptide in preventing bone loss in type 1 diabetes mellitus and in those individuals with C-peptide deficiency and osteoporosis.
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Affiliation(s)
- Arturo Pujia
- Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, 88100, Italy
| | - Carmine Gazzaruso
- Internal and Emergency Medicine and Center for Applied Clinical Research (Ce.R.C.A.) Clinical Institute "Beato Matteo", Vigevano, 27029, Italy
| | - Tiziana Montalcini
- Clinical Nutrition Unit, Menopause Clinic, Department of Clinical and Experimental Medicine, University Magna Graecia, Catanzaro, 88100, Italy.
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Shepherd M, Colclough K, McDonald TJ. Tests aiding diagnosis of monogenic diabetes. PRACTICAL DIABETES 2017. [DOI: 10.1002/pdi.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Maggie Shepherd
- Institute of Biomedical and Clinical Science; University of Exeter Medical School; Exeter UK
- Exeter NIHR Clinical Research Facility; Royal Devon and Exeter NHS Foundation Trust; Exeter UK
| | - Kevin Colclough
- Molecular Genetics Laboratory; Royal Devon and Exeter NHS Foundation Trust; Exeter UK
| | - Tim J McDonald
- Blood Sciences; Royal Devon and Exeter NHS Foundation Trust; Exeter UK
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29
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El-Shenawy NS, Al-Harbi MS, Al Hamayani FFE. Hormonal and organ-specific dysfunction induced by the interaction between titanium dioxide nanoparticles and salicylic acid in male mice. J Basic Clin Physiol Pharmacol 2017; 27:425-35. [PMID: 27054601 DOI: 10.1515/jbcpp-2015-0124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/30/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Nanomaterials coating gained much concern in orthopedic implants and cosmetics. Drug combination may be a promising strategy for treating multi-factorial diseases. Titanium dioxide (TDN) nanoparticles are being widely used in many industries as well as in medicine and pharmacology. Therefore, increased human and environmental exposure can be expected, which has put TDN under toxicological scrutiny, and it is necessary to address the potential health and safety implications of nanomaterials used in nanomedicine. The toxicity of titanium oxide nanoparticles (TDN) and salicylic acid (SA) separately or in combination was studied for 21 days. METHODS The liver and kidney biomarker were determined, and hormones and oxidative stress levels were detected in mice. RESULTS The intraperitoneal (i.p.) injection of TDN and SA in combination had a potential toxicological effect on major organs and hormonal homeostasis of mice. TDN and SA could antagonistically interact to affect the liver and kidney functions. No synergistic damage was observed in the liver function of mice that were treated with both TDN and SA as compared to the SA group. TDN acted as a synergistic agent to SA in the case of total cholesterol and total proteins levels. SA acted as antagonistic to the effect of TDN when injected together in mice because the effect on kidney functions is less than that predicted on the basis of the additive. The effect of co-administration of SA and TDN on the following hormones; triiodothyronine, thyroxine, estradiol II and insulin various among additive, potentiation, antagonistic and no effect, respectively as compared to TDN group. The interaction of TDN and SA was also found to induce oxidative stress as indicated by the increase in lipid peroxidation (LPO) levels. The decrease in the level of the reduced glutathione in the co-treated group indicated that there were no synergistic damages. SA and TDN co-administration could induce a potential increase in LPO levels in liver, kidney, and spleen but not in heart tissue. These results have not suggested that TDN and SA have a synergistic sub-chronic toxicity in mice after i.p. administration. SA may decrease the toxicity of TDN to some degree that could be related to the potentiation chemical reaction between SA and TDN. CONCLUSIONS Our results suggested that the damage observed in mice treated with TDN and SA is organ-specific and associated with hormonal homeostasis and oxidative damage.
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Ismail AAA. The insulin autoimmune syndrome (IAS) as a cause of hypoglycaemia: an update on the pathophysiology, biochemical investigations and diagnosis. Clin Chem Lab Med 2017; 54:1715-1724. [PMID: 27071154 DOI: 10.1515/cclm-2015-1255] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/23/2016] [Indexed: 12/11/2022]
Abstract
Insulin autoimmune syndrome (IAS) is considered to be very rare in Caucasians. Understanding its pathophysiology is paramount in (a) appreciating its potential impact on analyses of pancreatic hormones and (b) explaining its highly variable clinical manifestations in non-diabetic, non-acutely ill patients with indeterminate hypoglycaemia. The underlying aetiology of IAS is the presence of variable affinity/avidity endogenous insulin antibodies in significant amounts. The two types of insulin antibodies namely antibodies which bind insulin and/or proinsulin(s) and receptor antibodies (insulin mimetic) will be discussed. Their biochemical and immunological roles in causing hypoglycaemia will be highlighted. Clinical manifestations of IAS can vary from mild and transient to spontaneous, severe and protracted hypoglycaemia necessitating in extreme cases plasmapheresis for glycaemic control. Antibodies of IAS can interfere in pancreatic immunoassay tests causing erroneous and potentially misleading results. Thorough testing for endogenous insulin antibodies must be considered in the investigations of non-diabetic, non-acutely ill patients with indeterminate and/or unexplained hypoglycaemia.
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31
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Déchelotte B, Girot H, Chagraoui A, Prevost G, Brunel V. Dipotassium ethylenediaminetetraacetic acid is better than tripotassium salt for electrochemiluminescence insulin measurement. Clin Chim Acta 2016; 463:45-46. [DOI: 10.1016/j.cca.2016.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 09/19/2016] [Indexed: 10/20/2022]
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The progress of luminescent assay in clinical diagnosis and treatment of diabetes mellitus. J Electroanal Chem (Lausanne) 2016. [DOI: 10.1016/j.jelechem.2016.07.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Behan LA, Carmody D, Rogers B, Hannon MJ, Davenport C, Tormey W, Smith D, Thompson CJ, Stanton A, Agha A. Low-dose hydrocortisone replacement is associated with improved arterial stiffness index and blood pressure dynamics in severely adrenocorticotrophin-deficient hypopituitary male patients. Eur J Endocrinol 2016; 174:791-9. [PMID: 27025241 DOI: 10.1530/eje-15-1187] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 03/29/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Increased cardiovascular and cerebrovascular morbidity and mortality in hypopituitary subjects may be linked to inappropriate glucocorticoid exposure; however, the pathophysiology remains unclear. We aimed to examine the effect of three commonly prescribed hydrocortisone (HC) regimens on vascular risk factors. DESIGN An open crossover study randomising ten hypopituitary men with severe adrenocorticotrophic hormone deficiency to three HC dose regimens: dose A (20mg mane and 10mg tarde), dose B (10mg mane and 10mg tarde) and dose C (10mg mane and 5mg tarde). METHODS Following 6 weeks on each regimen, participants underwent 24-h serum cortisol sampling, 24-h ambulatory blood pressure (BP) measurements, calculation of the Ambulatory Arterial Stiffness Index (AASI), oral glucose tolerance testing and fasting serum osteoprotegerin (OPG) sampling. RESULTS There were no differences in 24-h BP between dose regimens and controls; however, low-dose HC replacement (dose C) was associated with the lowest AASI, indicating a less stiff arterial tree (P<0.05) compared with the other dose regimens. Loss of the physiologic nocturnal BP dip was more common in higher HC replacement regimens, although only significant for dose B compared with dose C (P=0.03). Twenty per cent of patients had abnormal glucose tolerance, but this was unrelated to dose regimen. OPG correlated strongly with 24-h BP in those on dose A only (r=0.65, P=0.04). CONCLUSION Currently prescribed HC replacement doses do not result in significant differences in absolute BP levels or improvements in insulin sensitivity. However, lower HC doses may result in lower arterial stiffness and a more physiological nocturnal BP dip. Long-term studies are required to confirm these findings and evaluate their impact on vascular morbidity in this patient group.
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Affiliation(s)
- Lucy-Ann Behan
- Department of EndocrinologyBeaumont Hospital and RCSI Medical School, Dublin, Ireland
| | - David Carmody
- Department of EndocrinologyBeaumont Hospital and RCSI Medical School, Dublin, Ireland
| | - Bairbre Rogers
- Department of EndocrinologyBeaumont Hospital and RCSI Medical School, Dublin, Ireland
| | - Mark J Hannon
- Department of EndocrinologyBeaumont Hospital and RCSI Medical School, Dublin, Ireland
| | - Colin Davenport
- Department of EndocrinologyBeaumont Hospital and RCSI Medical School, Dublin, Ireland
| | - William Tormey
- Department of Chemical PathologyBeaumont Hospital, Dublin, Ireland Biomedical SciencesUlster University, Coleraine, Northern Ireland, UK
| | - Diarmuid Smith
- Department of EndocrinologyBeaumont Hospital and RCSI Medical School, Dublin, Ireland
| | | | - Alice Stanton
- Department of Molecular and Cellular TherapeuticsRCSI Research Institute, Dublin, Ireland
| | - Amar Agha
- Department of EndocrinologyBeaumont Hospital and RCSI Medical School, Dublin, Ireland
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Se CH, Chuah KA, Mishra A, Wickneswari R, Karupaiah T. Evaluating Crossbred Red Rice Variants for Postprandial Glucometabolic Responses: A Comparison with Commercial Varieties. Nutrients 2016; 8:nu8050308. [PMID: 27213446 PMCID: PMC4882720 DOI: 10.3390/nu8050308] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 12/17/2022] Open
Abstract
Consumption of white rice predisposes some Asian populations to increased risk of type 2 diabetes. We compared the postprandial glucometabolic responses to three newly-developed crossbred red rice variants (UKMRC9, UKMRC10, UKMRC11) against three selected commercial rice types (Thai red, Basmati white, Jasmine white) using 50-g carbohydrate equivalents provided to 12 normoglycaemic adults in a crossover design. Venous blood was drawn fasted and postprandially for three hours. Glycaemic (GI) and insulin (II) indices, incremental areas-under-the-curves for glucose and insulin (IAUCins), indices of insulin sensitivity and secretion, lactate and peptide hormones (motilin, neuropeptide-Y, orexin-A) were analyzed. The lowest to highest trends for GI and II were similar i.e., UKMRC9 < Basmati < Thai red < UKMRC10 < UKMRC11 < Jasmine. Postprandial insulinaemia and IAUCins of only UKMRC9 were significantly the lowest compared to Jasmine. Crude protein and fiber content correlated negatively with the GI values of the test rice. Although peptide hormones were not associated with GI and II characteristics of test rice, early and late phases of prandial neuropeptide-Y changes were negatively correlated with postprandial insulinaemia. This study indicated that only UKMRC9 among the new rice crossbreeds could serve as an alternative cereal option to improve diet quality of Asians with its lowest glycaemic and insulinaemic burden.
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Affiliation(s)
- Chee-Hee Se
- School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
| | - Khun-Aik Chuah
- School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
| | - Ankitta Mishra
- School of Environmental and Natural Resource Sciences, Faculty of Science and Technology, National University of Malaysia (UKM), Bangi, Selangor 43600, Malaysia.
| | - Ratnam Wickneswari
- School of Environmental and Natural Resource Sciences, Faculty of Science and Technology, National University of Malaysia (UKM), Bangi, Selangor 43600, Malaysia.
| | - Tilakavati Karupaiah
- School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia.
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Ghoneim MAM, Hassan AI, Mahmoud MG, Asker MS. Effect of polysaccharide from Bacillus subtilis sp. on cardiovascular diseases and atherogenic indices in diabetic rats. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:112. [PMID: 27037095 PMCID: PMC4815154 DOI: 10.1186/s12906-016-1093-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 03/23/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Diabetes mellitus induces chronic complications such as cardiovascular damage, cataracts and retinopathy, nephropathy, and polyneuropathy. The main aim of the study was to isolate and identify both of bacterial strain and exopolysaccharide to assess the possible efficiency of exopolysaccharide (BSEPS) from Bacillus subtilus sp .suppress on cardiovascular diseases, atherogenic and coronary risk indices in diabetic rats. METHODS The bacterial strain used was isolated from mangrove tree sediment by serial dilution and the spread-plate technique and identified by morphological, physiological, and biochemical characteristics, and by 16S rRNA analysis. The BSEPS was extracted from the bacterial supernatant by four volumes child ethanol then the functional groups, MW and chemical analysis were detected by Fourier-transform infrared (FTIR), gel permeation chromatograph (GPC) and High-performance liquid chromatography (HPLC). Also an antioxidant activity was measured by using 2,2-diphenyl-1-picrylhydrazyl (DPPH). Thirty-two male Sprague-Dawley rats were equally randomized into four groups: control group supplemented with normal saline (Group I); the second group supplemented with BSEPS (Group II); diabetic group supplemented with normal saline (Group III) and the diabetic group supplemented with BSEPS (Group IV). Diabetes was induced by Streptozotocin (STZ) (65 mg/kg BW) intraperitoneally. BSEPS (100 mg/kg BW) was administered orally for four weeks, following STZ induction. RESULTS The isolated strain was identified based on 16S rRNA sequence as Bacillus subtilis sp. suppress. A preliminary chemical analysis of BSEPS indicated that the monosaccharides were mannuronic acid, glucuronic acid, glucose, galactose, and mannose in a molar ratio of 1.6:1.5:1.0:2.3:1.4, respectively, with a molecular weight of 1.66 × 10(4) g mol(-1) and a molecular number of 7.64 × 10(3) g mol(-1). BSEPS inhibited 2,2-diphenyl-1-picrylhydrazyl radical activity, and BSEPS supplement reduced glucose (p < 0.05) and troponin levels while insulin levels increased (p < 0.05). BSEPS also reduced total serum cholesterol, low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and triglycerides, and elevated high-density lipoprotein-cholesterol (HDL). In parallel, intercellular adhesion molecule (ICAM), and vascular cell adhesion molecule (VCAM) levels in STZ-induced diabetic rats were reduced. Moreover, polysaccharides reduced atherogenic and coronary risk indices, which were confirmed by histopathological examination of the heart and aorta. CONCLUSIONS Our study suggests that BSEPS improves hyperglycemia, dyslipidemia, and cardiovascular disease risk in STZ-induced diabetic rats.
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Affiliation(s)
- Mona A M Ghoneim
- Department of Radioisotopes, Nuclear Research Centre, Atomic Energy Authority, Dokki, Giza, Egypt
| | - Amal I Hassan
- Department of Radioisotopes, Nuclear Research Centre, Atomic Energy Authority, Dokki, Giza, Egypt.
| | - Manal G Mahmoud
- Microbial Biotechnology Department, National Research Centre, 33 Bohouth St., Dokki, Giza, 12311, Egypt
| | - Mohsen S Asker
- Microbial Biotechnology Department, National Research Centre, 33 Bohouth St., Dokki, Giza, 12311, Egypt
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Habibi E, Omidinia E, Heidari H, Fazli M. Flow injection amperometric detection of insulin at cobalt hydroxide nanoparticles modified carbon ceramic electrode. Anal Biochem 2016; 495:37-41. [DOI: 10.1016/j.ab.2015.11.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 11/22/2015] [Accepted: 11/24/2015] [Indexed: 12/01/2022]
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McDonald TJ, Perry MH. Detection of C-Peptide in Urine as a Measure of Ongoing Beta Cell Function. Methods Mol Biol 2016; 1433:93-102. [PMID: 27083170 DOI: 10.1007/7651_2016_330] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
C-peptide is a protein secreted by the pancreatic beta cells in equimolar quantities with insulin, following the cleavage of proinsulin into insulin. Measurement of C-peptide is used as a surrogate marker of endogenous insulin secretory capacity. Assessing C-peptide levels can be useful in classifying the subtype of diabetes as well as assessing potential treatment choices in the management of diabetes.Standard measures of C-peptide involve blood samples collected either fasted or, most often, after a fixed stimulus (such as oral glucose, mixed meal, or IV glucagon). Despite the established clinical utility of blood C-peptide measurement, its widespread use is limited. In many instances this is due to perceived practical restrictions associated with sample collection.Urine C-peptide measurement is an attractive noninvasive alternative to blood measures of beta-cell function. Urine C-peptide creatinine ratio measured in a single post stimulated sample has been shown to be a robust, reproducible measure of endogenous C-peptide which is stable for three days at room temperature when collected in boric acid. Modern high sensitivity immunoassay technologies have facilitated measurement of C-peptide down to single picomolar concentrations.
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Affiliation(s)
- T J McDonald
- Blood Sciences, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK. .,University of Exeter Medical School, RILD Building, Barrack Road, Exeter, EX2 5DW, UK.
| | - M H Perry
- Blood Sciences, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK
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Suresh S, Vijayakumar T. Correlations of Insulin Resistance and Serum Testosterone Levels with LH:FSH Ratio and Oxidative Stress in Women with Functional Ovarian Hyperandrogenism. Indian J Clin Biochem 2015; 30:345-50. [PMID: 26089623 PMCID: PMC4469060 DOI: 10.1007/s12291-014-0447-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 05/15/2014] [Indexed: 12/12/2022]
Abstract
Functional ovarian hyperandrogenism (FOH) is a form of polycystic ovary syndrome (PCOS) characterized by elevated circulating levels of androgens derived from the ovary. Insulin resistance (IR) is the most common etiological factor in women with FOH. IR causes the generation of increased oxidative stress (OS) and diminished antioxidant status. OS is directly correlated with both IR and testosterone levels, which consequently contribute to endocrine and biochemical alterations in FOH women. In the current study, elevations in total testosterone, free testosterone and luteinizing hormone (LH) levels accompanied by a decrease in follicle stimulating hormone (FSH) level leading to higher LH:FSH ratio were the prominent endocrine changes observed in women with FOH. A significant increase in fasting blood levels of glucose and insulin, as well as an elevated IR were also seen in FOH women, as compared to their age matched controls. Women with FOH have higher pro-oxidant and lower anti-oxidant levels in blood than their age matched controls. In FOH women, elevations in LH:FSH ratio and OS are correlated more with hyperandrogenemia than with IR. Of the androgens, free rather than total testosterone has better positive correlations with elevated LH:FSH ratio and OS, and hence, the former is a better predictive marker for the development of biochemical PCOS in women with FOH.
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Affiliation(s)
- S. Suresh
- />Department of Biochemistry, School of Medical Education, Mahatma Gandhi University, Gandhinagar-P.O, Kottayam, 686006 Kerala India
| | - T. Vijayakumar
- />Educare Institute of Dental Sciences, Kiliamannil Campus, Chattiparamba-P.O, Malappuram, Kerala India
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Thomas S, Suresh S, Sudheesh M, Vijayakumar T. Association of insulin resistance with adipocytokine levels in patients with metabolic syndrome. Indian J Clin Biochem 2015; 30:155-60. [PMID: 25883422 PMCID: PMC4393391 DOI: 10.1007/s12291-014-0423-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 01/22/2014] [Indexed: 12/13/2022]
Abstract
Metabolic syndrome (MetS) results from the derangement of adipocyte physiology and carbohydrate metabolism. Obesity and insulin resistance (IR) are integral features of MetS. The adipokine alterations in MetS often correlate with IR and body fat content. High adipose tissue content is associated with a decreased production of adiponectin and excessive production of tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6), all of which induce IR. The present study evaluated the adipokine alterations in MetS and their association with IR. The findings of the current study indicate that MetS is associated with significant decrease in adiponectin and increase in TNF-α and IL-6. The present study also found that the adipocyte derived inflammatory adipokines, TNF-α and IL-6 correlate with IR while the anti-inflammatory adipokines, adiponectin does not correlate with the degree and severity of IR.
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Affiliation(s)
- Sajimon Thomas
- />Dianova Laboratories, Gandhinagar, Kottayam, Kerala 686 008 India
| | - S. Suresh
- />Department of Biochemistry, School of Medical Education, Mahatma Gandhi University, Gandhinagar, Kottayam, Kerala 686 008 India
| | - M. Sudheesh
- />Dianova Laboratories, Gandhinagar, Kottayam, Kerala 686 008 India
| | - T. Vijayakumar
- />Department of Basic Medical Sciences, Educare Institute of Dental Sciences, Malappuram, Kerala India
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Jones AG, Hattersley AT. The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabet Med 2013; 30:803-17. [PMID: 23413806 PMCID: PMC3748788 DOI: 10.1111/dme.12159] [Citation(s) in RCA: 368] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 12/19/2012] [Accepted: 02/14/2013] [Indexed: 12/16/2022]
Abstract
C-peptide is produced in equal amounts to insulin and is the best measure of endogenous insulin secretion in patients with diabetes. Measurement of insulin secretion using C-peptide can be helpful in clinical practice: differences in insulin secretion are fundamental to the different treatment requirements of Type 1 and Type 2 diabetes. This article reviews the use of C-peptide measurement in the clinical management of patients with diabetes, including the interpretation and choice of C-peptide test and its use to assist diabetes classification and choice of treatment. We provide recommendations for where C-peptide should be used, choice of test and interpretation of results. With the rising incidence of Type 2 diabetes in younger patients, the discovery of monogenic diabetes and development of new therapies aimed at preserving insulin secretion, the direct measurement of insulin secretion may be increasingly important. Advances in assays have made C-peptide measurement both more reliable and inexpensive. In addition, recent work has demonstrated that C-peptide is more stable in blood than previously suggested or can be reliably measured on a spot urine sample (urine C-peptide:creatinine ratio), facilitating measurement in routine clinical practice. The key current clinical role of C-peptide is to assist classification and management of insulin-treated patients. Utility is greatest after 3-5 years from diagnosis when persistence of substantial insulin secretion suggests Type 2 or monogenic diabetes. Absent C-peptide at any time confirms absolute insulin requirement and the appropriateness of Type 1 diabetes management strategies regardless of apparent aetiology.
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Affiliation(s)
- A G Jones
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, UK.
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Hsieh FC, Lee CL, Chai CY, Chen WT, Lu YC, Wu CS. Oral administration of Lactobacillus reuteri GMNL-263 improves insulin resistance and ameliorates hepatic steatosis in high fructose-fed rats. Nutr Metab (Lond) 2013; 10:35. [PMID: 23590862 PMCID: PMC3637306 DOI: 10.1186/1743-7075-10-35] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 04/14/2013] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (DM), characterized by peripheral insulin resistance, is the most common form of diabetes. Probiotics are live micro-organisms that, when administered in adequate amounts, confer delaying effect on DM development. In this study, the effects Lactobacillus reuteri GMNL-263 (Lr263), a new probiotic strain developed by our laboratory, on insulin resistance and the development of hepatic steatosis in high-fructose fed rats were explored. Furthermore, the relevant regulatory pathways involved were also investigated. METHOD Male Sprague-Dawley rats were fed a high-fructose diet with or without Lr263 administration for 14 weeks. The composition of fecal microbiota, oral glucose tolerance, glycated haemoglobin, insulin, leptin, C-peptide, and incretins were measured. The markers of liver injury, serum and hepatic lipids profile, activity of hepatic antioxidant enzyme, and proinflammatory cytokines in adipose tissue were investigated. Additionally, the expression of hepatic lipogenic genes and insulin signaling related genes in adipose tissue were also studied. Liver sections were examined for hepatic steatosis using hematoxylin-eosin staining. RESULTS The levels of serum glucose, insulin, leptin, C-peptide, glycated hemoglobin, GLP-1, liver injury markers, lipid profile in serum and liver were significantly increased in high-fructose-fed rats. However, after Lr263 administration, the elevation of these parameters was significantly suppressed. Feeding of Lr263 reversed the decreased number of bifidobacterium species and lactobacillus species and increased number of clostridium species induced by high fructose treatment. The decreased activities of hepatic antioxidant enzymes in HFD rats were dramatically reversed by Lr263 treatment. Concentrations of IL-6 and TNF-α in adipose tissue which were elevated in high fructose treatment were markedly decreased after Lr263 feeding. Decreased levels of PPAR-γ and GLUT4 mRNA after high fructose treatment were significantly enhanced by Lr263 administration. Lr263 consumption normalized the increased lipogenic gene (Srebp-1c, FAS, and Elvol6) expressions stimulated by high fructose. Administration of Lr263 significantly ameliorated hepatic steatosis observed in high fructose treated rats. CONCLUSION Our study provided evidences clarifying the effectiveness of Lr263 on reducing insulin resistance as well as hepatic steatosis formation in high-fructose-fed rats and suggested that Lr263 may be a promising therapeutic agent in treating type 2 diabetes.
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Affiliation(s)
- Feng-Ching Hsieh
- Department of Medical Laboratory Science and biotechnology, Kaohsiung Medical University, 6F, Chi-Shih Building, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan
- Department of Research and Development, GenMont Biotech. Inc, Tainan, Taiwan
| | - Chia-Lin Lee
- Department of Research and Development, GenMont Biotech. Inc, Tainan, Taiwan
| | - Chee-Yin Chai
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Tzu Chen
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ying-Chen Lu
- Department of Biological Science and Technology, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Ching-Shuang Wu
- Department of Medical Laboratory Science and biotechnology, Kaohsiung Medical University, 6F, Chi-Shih Building, 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan
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Stoyanov AV, Connolly S, Rohlfing CL, Rogatsky E, Stein D, Little RR. Human C-peptide Quantitation by LC-MS Isotope-Dilution Assay in Serum or Urine Samples. ACTA ACUST UNITED AC 2013; 4. [PMID: 31942247 PMCID: PMC6961834 DOI: 10.4172/2157-7064.1000172] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In this communication we report a simple and efficient approach to C-peptide quantitation using isotope dilution mass-spectrometry analysis. The method facilitates quantitation of C-peptide levels at least one order of magnitude lower compared to concentration levels achieved with an IDA method reported previously. The improvement was due to more intensive sample preparation procedure that, in turn, makes it possible to increase the sample load without a corresponding increase in matrix effects. We also show the results of a comparison study with a second laboratory using a similar previously reported method for C-peptide quantitation.
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Affiliation(s)
| | - Shawn Connolly
- University of Missouri, School of Medicine, Columbia MO, USA
| | - Curt L Rohlfing
- University of Missouri, School of Medicine, Columbia MO, USA
| | - Eduard Rogatsky
- Albert Einstein College of Medicine, Yeshiva University, Bronx NY, USA
| | - Daniel Stein
- Albert Einstein College of Medicine, Yeshiva University, Bronx NY, USA
| | - Randie R Little
- University of Missouri, School of Medicine, Columbia MO, USA
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Ntzouvani A, Nomikos T, Petrogianni M, Dede V, Stamatakis G, Manios Y. Effect of fortified milk on lyso‐platelet‐activating factor acetyltranferase and lipoprotein‐associated phospholipase A
2
in hypercholesterolemic adults. EUR J LIPID SCI TECH 2013. [DOI: 10.1002/ejlt.201200190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Agathi Ntzouvani
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Tzortzis Nomikos
- Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Petrogianni
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Vasiliki Dede
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - George Stamatakis
- Department of Chemistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
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Asanghanwa M, van Genderen F, Verhaeghen K, Van der Auwera B, Sobngwi E, Mbanya JC, van Schravendijk C. Validation of an enzyme-linked immunosorbent assay for C-peptide analysis in Cameroon. Diabetes Res Clin Pract 2012; 98:459-64. [PMID: 23089552 DOI: 10.1016/j.diabres.2012.09.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 09/20/2012] [Indexed: 11/21/2022]
Abstract
AIMS To validate an ELISA method for C-peptide analysis in Cameroon. METHODS We evaluated the linearity, detection limit, functional sensitivity, precision and accuracy, and further investigated for cross-reactivity by proinsulin, and interferences by lipids, bilirubin and hemoglobin. This method was compared with the Roche electrochemiluminescence immunoassay. C-peptide stability was assessed following a series of freeze-thaw cycles, and after storage at room temperature. The C-peptide reference range was determined by analyzing fifty plasma samples of Cameroonians without diabetes. RESULTS The ELISA was linear at least up to 7.09 μg/L, and had a detection limit of 0.09 μg/L, and a functional sensitivity of 0.32 μg/L. The inter- and intraassay %CV were 2.9-9.9%, and 5.2-9.4%, respectively. Recoveries were 81-94% in serum, and 93-98% in buffer. Comparison with the ECLIA yielded a good correlation coefficient (R(2)=0.98). There was no cross-reactivity with proinsulin, and no interference with lipids, bilirubin and hemoglobin. C-peptide was stable at room temperature for 24 h and up to 7 freeze-thaw cycles for medium (1-6 μg/L) and high (>6 μg/L) levels (<-15°C and <-70°C). The reference range for C-peptide was 0.38-3.63 μg/L. CONCLUSIONS This method is suitable for C-peptide analysis in low-income countries like Cameroon.
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Affiliation(s)
- M Asanghanwa
- Diabetes Research Centre, Brussels Free University, B-1090 Brussels, Belgium
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Jones AG, Besser REJ, Shields BM, McDonald TJ, Hope SV, Knight BA, Hattersley AT. Assessment of endogenous insulin secretion in insulin treated diabetes predicts postprandial glucose and treatment response to prandial insulin. BMC Endocr Disord 2012; 12:6. [PMID: 22681724 PMCID: PMC3405447 DOI: 10.1186/1472-6823-12-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 06/08/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In patients with both Type 1 and Type 2 diabetes endogenous insulin secretion falls with time which changes treatment requirements, however direct measurement of endogenous insulin secretion is rarely performed. We aimed to assess the impact of endogenous insulin secretion on postprandial glucose increase and the effectiveness of prandial exogenous insulin. METHODS We assessed endogenous insulin secretion in 102 participants with insulin treated diabetes (58 Type 1) following a standardised mixed meal without exogenous insulin. We tested the relationship between endogenous insulin secretion and post meal hyperglycaemia. In 80 participants treated with fast acting breakfast insulin we repeated the mixed meal with participants' usual insulin given and assessed the impact of endogenous insulin secretion on response to exogenous prandial insulin. RESULTS Post meal glucose increment (90 minute - fasting) was inversely correlated with endogenous insulin secretion (90 minute C-peptide) (Spearman's r = -0.70, p < 0.001). Similar doses of exogenous prandial insulin lowered glucose increment more when patients had less endogenous insulin; by 6.4(4.2-11.1) verses 1.2(0.03-2.88) mmol/L (p < 0.001) for patients in the lowest verses highest tertiles of endogenous insulin. CONCLUSIONS In insulin treated patients the measurement of endogenous insulin secretion may help predict the degree of postprandial hyperglycaemia and the likely response to prandial insulin.
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Affiliation(s)
- Angus G Jones
- Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK
| | - Rachel EJ Besser
- Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK
| | - Beverley M Shields
- Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK
| | - Timothy J McDonald
- Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK
- Royal Devon and Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK
| | - Suzy V Hope
- Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK
| | - Bridget A Knight
- Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK
| | - Andrew T Hattersley
- Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK
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Development of SI-traceable C-peptide certified reference material NMIJ CRM 6901-a using isotope-dilution mass spectrometry-based amino acid analyses. Anal Bioanal Chem 2012; 404:13-21. [DOI: 10.1007/s00216-012-6097-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 05/02/2012] [Accepted: 05/02/2012] [Indexed: 01/01/2023]
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Bowman P, McDonald TJ, Shields BM, Knight BA, Hattersley AT. Validation of a single-sample urinary C-peptide creatinine ratio as a reproducible alternative to serum C-peptide in patients with Type 2 diabetes. Diabet Med 2012; 29:90-3. [PMID: 21883437 DOI: 10.1111/j.1464-5491.2011.03428.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Serum C-peptide can be used in Type 2 diabetes as a measure of endogenous insulin secretion, but practicalities of collection limit its routine clinical use. Urine C-peptide creatinine ratio is a non-invasive alternative that is stable for at least 3 days at room temperature in boric acid preservative. We aimed to assess the utility of urine C-peptide creatinine ratio in individuals with Type 2 diabetes as an alternative to serum C-peptide. METHODS We assessed, in 77 individuals with Type 2 diabetes, the reproducibility of, and correlations between, fasting and postprandial urine C-peptide creatinine ratio and serum C-peptide, and the impact of renal impairment (estimated glomerular filtration rate < 60 ml min(-1) 1.73 m(-2)) on these correlations. RESULTS Urine C-peptide creatinine ratio was at least as reproducible as serum C-peptide [fasting coefficient of variation mean (95% CI): 28 (21-35)% vs. 38 (26-59)% and 2-h post-meal 26 (18-33)% vs. 27 (20-34)%. Urine C-peptide creatinine ratio 2 h post-meal was correlated with stimulated serum C-peptide, both the 2-h value (r = 0.64, P < 0.001) and the 2-h area under the C-peptide curve (r = 0.63, P < 0.001). The association seen was similar in patients with and without moderate renal impairment (P = 0.6). CONCLUSIONS In patients with Type 2 diabetes, a single urine C-peptide creatinine ratio is a stable, reproducible measure that is well correlated with serum C-peptide following meal stimulation, even if there is moderate renal impairment. Urine C-peptide creatinine ratio therefore has potential for use in clinical practice in the assessment of Type 2 diabetes.
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Affiliation(s)
- P Bowman
- Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK.
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Shields BM, Peters JL, Cooper C, Powell RJ, Knight BA, Hyde C, Hattersley AT. Identifying clinical criteria to predict Type 1 diabetes, as defined by absolute insulin deficiency: a systematic review protocol. BMJ Open 2012; 2:bmjopen-2012-002309. [PMID: 23274675 PMCID: PMC4399143 DOI: 10.1136/bmjopen-2012-002309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Management of a patient's diabetes is entirely dependent upon the type of diabetes they are deemed to have. Patients with Type 1 diabetes are insulin deficient so require multiple daily insulin injections, whereas patients with Type 2 diabetes still have some endogenous insulin production so insulin treatment is only required when diet and tablets do not establish good glycaemic control. Despite the importance of a correct diagnosis, classification of diabetes is based on aetiology and relies on clinical judgement. There are no clinical guidelines on how to determine whether a patient has Type 1 or Type 2 diabetes. We aim to systematically review the literature to derive evidence-based clinical criteria for the classification of the major subtypes of diabetes. METHODS AND ANALYSIS We will perform a systematic review of diagnostic accuracy studies to establish clinical criteria that predict the subsequent development of absolute insulin deficiency seen in Type 1 diabetes. Insulin deficiency will be determined by reference standard C-peptide concentrations. Synthesis of criteria identified will be undertaken using hierarchical summary receiver operating characteristic curves. ETHICS AND DISSEMINATION As this is a systematic review, there will be no ethical issues. We will disseminate results by writing up the final systematic review and synthesis for publication in a peer-reviewed journal and will present at national and international diabetes-related meetings.
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Affiliation(s)
- Beverley M Shields
- NIHR Exeter Clinical Research Facility, University of Exeter Medical School, University of Exeter, Exeter, UK
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