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Chen Y, Xie K, Han Y, Ju H, Sun J, Zhao X. The association between triglyceride-glucose index and its combination with systemic inflammation indicators and all-cause and cardiovascular mortality in the general US population: NHANES 1999-2018. Lipids Health Dis 2024; 23:289. [PMID: 39256829 PMCID: PMC11386374 DOI: 10.1186/s12944-024-02277-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Accepted: 08/28/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND The correlation between the triglyceride-glucose (TyG) index and mortality in the general population remains controversial, with inconsistent conclusions emerging from different studies. OBJECTIVE This study aims to investigate whether there is an association between the TyG index and mortality in the general population in the United States, and to explore whether a new index combining the TyG index with systemic inflammation indicators can better predict all-cause and cardiovascular mortality risks in the general population than using the TyG index alone. METHODS Calculate the systemic inflammation indicators and TyG index for each participant based on their complete blood count, as well as their triglyceride and glucose levels in a fasting state. TyG-inflammation indices were obtained by multiplying the TyG index with systemic inflammation indicators (TyG-NLR, TyG-MLR, TyG-lgPLR, TyG-lgSII, and TyG-SIRI). Based on the weighted Cox proportional hazards model, assess whether the TyG and TyG-Inflammation indices are associated with mortality risk in the general population. Restricted cubic splines (RCS) are used to clarify the dose-response relationship between the TyG and TyG-Inflammation indices and mortality, and to visualize the results. Time-dependent receiver operating characteristic (ROC) curves are used to evaluate the accuracy of the TyG and TyG-Inflammation indices in predicting adverse outcomes. RESULTS This study included 17,118 participants. Over a median follow-up period of 125 months, 2595 patients died. The TyG index was not found to be related to mortality after adjusting for potentially confounding factors. However, the TyG-inflammation indices in the highest quartile (Q4), except for TyG-lgPLR, were significantly associated with both all-cause and cardiovascular mortality, compared to those in the lowest quartile (Q1). Among them, TyG-MLR and TyG-lgSII showed the strongest correlations with all-cause mortality and cardiovascular mortality. Specifically, compared to their respective lowest quartiles (Q1), participants in the highest quartile (Q4) of TyG-MLR had a 48% increased risk of all-cause mortality (95% CI: 1.23-1.77, P for trend < 0.0001), while participants in the highest quartile (Q4) of TyG-lgSII had a 92% increased risk of cardiovascular mortality (95% CI: 1.31-2.81, P for trend < 0.001). Time-dependent ROC curve analysis showed that the TyG-MLR had the highest accuracy in predicting long-term mortality outcomes. CONCLUSIONS The TyG-Inflammation indices constructed based on TyG and systemic inflammation indicators are closely related to mortality in the general population and can better predict the risk of adverse outcomes. However, no association between TyG and mortality in the general population was found.
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Affiliation(s)
- Yan Chen
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, People's Republic of China
| | - Kailing Xie
- The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, People's Republic of China
| | - Yuanyuan Han
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, People's Republic of China
| | - Haonan Ju
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, People's Republic of China
| | - Jiaxi Sun
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, People's Republic of China
| | - Xin Zhao
- Department of Cardiology, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, People's Republic of China
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Yu MW, Wu WJ, Lin CL, Liu CJ, Peng WY, Huang PY, Huang YW, Hu JT, Chang HC, Liou JM. Trajectories of hepatic steatosis and incidence of cardiovascular disease over a 29-year follow-up. Hepatol Res 2024. [PMID: 39158502 DOI: 10.1111/hepr.14101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/20/2024]
Abstract
AIM To examine the dynamic change in hepatic steatosis status during repeated assessments over time, and its potential impact on the risk of developing cardiovascular disease (CVD). METHODS We assessed trajectories of hepatic steatosis and other metabolic disorders in 3134 middle-aged adults undergoing longitudinal assessment of ultrasonography during a pre-baseline period (1993-2009) in a population-based cohort study of liver health. Subsequently, we determined the association of hepatic steatosis trajectories with the incidence of CVD among 2185 CVD-free individuals, followed until 2021. Metabolic risk factors and cardiovascular events (including coronary heart disease and stroke) were determined through medical examination and linkage with nationwide health databases. RESULTS We identified three discrete trajectories of hepatic steatosis according to changing pattern over time through group-based trajectory modeling: "stable, non-steatosis" (n = 1298), "intermittent" (n = 921), and "persistent steatosis" (n = 915). During the pre-baseline period, hepatic steatosis trajectories were associated with trajectories of developing diabetes and hypertension, and persistent steatosis (vs. other trajectories) was associated with higher risks and rapidly progressive disease patterns. At a median 13.6 years of follow-up, 629 CVD events occurred. A persistent (vs. non-steatosis: HR 1.44, 95% CI 1.17-1.76), but not intermittent, steatosis pattern predicted the future risk of CVD, after adjustment for age, sex, smoking, and obesity. This association was independent of genetic background, and remained after accounting for pre-baseline body-mass index, other cardiometabolic risk factors, Framingham risk score, medications, and hepatic fibrosis score. CONCLUSIONS The persistence of hepatic steatosis is associated with trajectories of metabolic disorder development and increased risk of CVD. These data have important implications for practice and further research.
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Affiliation(s)
- Ming-Whei Yu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wan-Jung Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chih-Lin Lin
- Department of Gastroenterology, Ren-Ai Branch, Taipei City Hospital, Taipei, Taiwan
| | - Chun-Jen Liu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wei-Ya Peng
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Pin-Yu Huang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yi-Wen Huang
- Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jui-Ting Hu
- Liver Center, Cathay General Hospital Medical Center, School of Medicine, Fu-Jen Catholic University College of Medicine, Taipei, Taiwan
| | - Hung-Chuen Chang
- Division of Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- School of Medicine, Fu Jen Catholic University College of Medicine, Taipei, Taiwan
| | - Jyh-Ming Liou
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
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Ayat P, Sawass Najjar D, Alkaissi H, Gill H, Otey J, AlFaraj M, McFarlane SI. Differential Effect of Hyperglycemia on the Odds of Cancer Among the Adult Population of the United States. Cureus 2024; 16:e63061. [PMID: 39050345 PMCID: PMC11268948 DOI: 10.7759/cureus.63061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
Objective Accumulating evidence indicates a relationship between diabetes and cancer risk, with obesity, insulin resistance, and hyperglycemia being implicated as the major underlying pathogenetic mechanisms of increased cancer risk among people with diabetes. We aim to assess the differential effect of dysglycemia (prediabetes and diabetes) on the strength of association (odds) of cancer amongst the adult US diabetic population. Material and methods We analyzed data from the 1997-2013 National Health Interview Survey (NHIS) dataset, which applies a multistage area probability sampling design. We used descriptive statistics and logistic regression analyses to test the strengths of the association between diabetes, prediabetes, and cancer before and after adjusting for major risk factors for cancer, including age and body mass index (BMI). Results A total of 722,532 individuals were surveyed, with a mean age of 47.18 ±0.3 years (±SEM) and a BMI of 26.9 ±0.01 kg/m2. Between 1997 and 2013, BMI increased from 26.0 to 27.4 kg/m2, the diabetes rate increased from 4.1% to 7.6%, and associated cancer rates increased from 6.6% to 9.0%. Body mass index was 27.1 vs. 26.8 kg/m2, P < 0.01, for those with and without cancer, respectively. The unadjusted odds ratio for cancer was 1.92 (1.78-2.08) (95% CI) and 2.20 (2.13-2.27) for prediabetes and diabetes, respectively. After adjusting for age, BMI, race, and cigarette smoking, the odds ratio for cancer was 1.12 (1.03-1.22), P < 0.01, and 1.15 (1.11-1.18), P <0.01, for prediabetes and diabetes, respectively. Conclusion Among US adults, the increasing rate of diabetes over the years was associated with an increased rate of cancer. Diabetes and prediabetes have a graduated effect on cancer risk. While obesity is generally implicated as an underlying pathophysiologic link between diabetes and cancer, our study showed a modest difference in BMI between those with and without cancer. In addition, the effect of diabetes and prediabetes on the odds of cancer persisted after adjusting for BMI. These data collectively suggest that hyperglycemia is an attractive pathophysiologic mechanism that may play a role in increasing the odds of cancer among diabetic and prediabetic populations. Our study is consistent with the accumulating evidence implicating hyperglycemia in the pathogenesis of cancer, where glucose is used in PET scanning to detect cancer (the Warburg effect), and the ketogenic diet appears to be useful in cancer management, enhancing the effect of chemotherapeutic agents.
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Affiliation(s)
- Parinaz Ayat
- Internal Medicine, State University of New York (SUNY) Downstate Health Science University, New York City, USA
| | - Diana Sawass Najjar
- Internal Medicine, State University of New York (SUNY) Downstate Health Science University, New York City, USA
| | - Hussam Alkaissi
- Internal Medicine, National Institutes of Health (NIH) National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Bethesda, USA
| | - Harjinder Gill
- Internal Medicine, State University of New York (SUNY) Downstate Health Science University, New York City, USA
| | - Jennifer Otey
- Medicine, State University of New York (SUNY) Downstate Health Science University, New York City, USA
| | - Marwa AlFaraj
- Integrative Medicine, State University of New York (SUNY) Downstate Health Science University, New York City, USA
| | - Samy I McFarlane
- Internal Medicine, Endocrine Division, State University of New York (SUNY) Downstate Health Science University, New York City, USA
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Chun DW, Lee YJ, Lee JH, Lee JW. Longitudinal trajectories of atherogenic index of plasma and risks of cardiovascular diseases: results from the Korean genome and epidemiology study. Thromb J 2023; 21:99. [PMID: 37723571 PMCID: PMC10506251 DOI: 10.1186/s12959-023-00542-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Although the atherogenic index of plasma (AIP) based on a single measurement is a known risk factor for cardiovascular disease (CVD), little is known about whether changes in AIP over time are related to incident CVD. We aimed to determine whether AIP trajectory, which reflects homogenous AIP trends for a particular period, is associated with CVD risk. METHODS Data from 5,843 participants of the Korean Genome and Epidemiology Study (KoGES) were analyzed. The KoGES had been conducted biennially from the baseline survey (2001-2002) to the eighth follow-up survey (2017-2018). The research design specifies the exposure period from baseline to the third follow-up, designates the latent period at the fourth follow-up, and establishes the event accrual period from the fifth to the eighth follow-up. During the exposure period, we identified two trajectories: a decreasing (n = 3,036) and an increasing group (n = 2,807) using latent variable mixture modeling. Information on CVD was collected initially through the self-reporting, followed by in depth person-to-person interview conducted by a well-trained examiner. During the event accrual period, the cumulative incidence rates of CVD between the two AIP trajectory groups were estimated using Kaplan-Meier analysis with the log-rank test. Multiple Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS The increasing AIP trajectory group had a significantly higher cumulative incidence rate of CVD than the decreasing AIP trajectory group. Compared to the decreasing AIP trajectory group, the increasing AIP trajectory group had a higher risk of incident CVD (HR: 1.31, 95% CI: 1.02-1.69) after adjusting for confounders. CONCLUSIONS The risk of incident CVD increased when the AIP level showed an increasing trend and remained high over a long period. This suggests that checking and managing the trajectory of the AIP can be a preventive strategy for incident CVD.
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Affiliation(s)
- Dong-Wook Chun
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Yae-Ji Lee
- Department of Biostatistics and Computing, Yonsei University, Seoul, 03722, Republic of Korea
| | - Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Republic of Korea.
- Department of Medicine, Hanyang University School of Medicine, Seoul, 04763, Republic of Korea.
| | - Ji-Won Lee
- Department of Family Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, 06237, Republic of Korea.
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Shehnaz SI, Roy A, Vijayaraghavan R, Sivanesan S. Luteolin Mitigates Diabetic Dyslipidemia in Rats by Modulating ACAT-2, PPARα, SREBP-2 Proteins, and Oxidative Stress. Appl Biochem Biotechnol 2023; 195:4893-4914. [PMID: 37103741 DOI: 10.1007/s12010-023-04544-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 04/28/2023]
Abstract
Diabetic dyslipidemia is a crucial link between type-2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular diseases (ASCVD). Natural biologically active substances have been advocated as complementary remedies for ASCVD and T2DM. Luteolin, a flavonoid, exhibits antioxidant, hypolipidemic, and antiatherogenic effects. Hence, we aimed to determine influence of luteolin on lipid homeostasis and hepatic damage in rats with T2DM induced by high-fat-diet (HFD) and streptozotocin (STZ). After being fed HFD for 10 days, male Wistar rats received 40 mg/kg STZ intraperitoneal injection on 11th day. Seventy-two hours later, hyperglycemic rats (fasting glucose > 200 mg/dL) were randomized into groups, and oral hydroxy-propyl-cellulose, atorvastatin (5 mg/kg), or luteolin (50 mg/kg or 100 mg/kg) administered daily, while continuing HFD for 28 days. Luteolin significantly ameliorated dyslipidemia levels and concomitantly improved atherogenic index of plasma in a dose-dependent manner. Increased levels of malondialdehyde and diminished levels of superoxide dismutase, catalase, and glutathione in HFD-STZ-diabetic rats were significantly regulated by luteolin. Luteolin significantly intensified PPARα expression while decreasing expression of acyl-coenzyme A:cholesterol acyltransferase-2 (ACAT-2) and sterol regulatory element binding protein-2 (SREBP-2) proteins. Moreover, luteolin effectively alleviated hepatic impairment in HFD-STZ-diabetic rats to near-normal control levels. The findings of the present study expound mechanisms by which luteolin mitigated diabetic dyslipidemia and alleviated hepatic impairment in HFD-STZ-diabetic rats by amelioration of oxidative stress, modulation of PPARα expression, and downregulation of ACAT-2 and SREBP-2. In conclusion, our results imply that luteolin may be efficacious in management of dyslipidemia in T2DM, and future research may be essential to substantiate our findings.
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Affiliation(s)
- Syed Ilyas Shehnaz
- Department of Pharmacology, Saveetha Medical College & Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, 602105, Tamil Nadu, India.
| | - Anitha Roy
- Centre for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, 600077, Tamil Nadu, India
| | - Rajagopalan Vijayaraghavan
- Department of Research and Development, Saveetha Institute of Medical and Technical Sciences, Chennai, 602105, Tamil Nadu, India
| | - Senthilkumar Sivanesan
- Department of Research and Development, Saveetha Institute of Medical and Technical Sciences, Chennai, 602105, Tamil Nadu, India
- Department of Biosciences, Institute of Biotechnology, Saveetha Institute of Medical and Technical Sciences, Chennai, 602105, Tamil Nadu, India
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Effect of visceral adipose tissue mass on coronary artery disease and heart failure: A Mendelian randomization study. Int J Obes (Lond) 2022; 46:2102-2106. [PMID: 35995978 DOI: 10.1038/s41366-022-01216-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Obesity is associated with coronary artery disease (CAD) and its risk factors in observational studies. This two-sample Mendelian randomization (MR) study investigated the effect of visceral adipose tissue (VAT) mass on coronary artery disease (CAD), myocardial infarction (MI) and heart failure (HF). METHODS Genetic variants (220 SNPs, P < 5 × 10-8) associated with VAT mass were obtained from a genome-wide association study (GWAS) in the UK Biobank. Genetic associations with CAD outcomes including CAD and myocardial infarction (MI) were obtained from the CARDIoGRAMplusC4D 1000 Genomes-based GWAS (including up to 60,801 cases and 123,504 controls) and data on patients with HF were obtained from the HERMES Consortium (47,309 cases and 930,014 controls). The effects of VAT mass on CAD outcomes and HF were estimated using the inverse variance weighted (IVW) method. Sensitivity analysis and multi-variable MR were used to examine the stability of the IVW results. RESULTS Our results showed that genetically predicted higher VAT mass was associated with increased risk of CAD (odds ratio [OR] 1.57, 95% confidence interval [CI], 1.44-1.71; P = 7.62 × 10-24), MI (OR 1.63, 95% CI: 1.48-1.79; P = 3.76 × 10-24) and HF (OR 1.71, 95% CI: 1.60-1.83; P = 1.72 × 10-53). These findings remained significant in the sensitivity analysis and multi-variable MR. CONCLUSION This MR study suggests that genetic determinants of VAT mass are causally associated with CAD, MI and HF.
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Šumarac-Dumanović M, Stamenković-Pejković D, Jeremić D, Dumanović J, Mandić-Marković V, Žarković M, Micić D. Age, Body Mass Index, and Waist-to-Hip Ratio Related Changes in Insulin Secretion and Insulin Sensitivity in Women with Polycystic Ovary Syndrome: Minimal Model Analyses. Int J Endocrinol 2022; 2022:6630498. [PMID: 35646110 PMCID: PMC9132706 DOI: 10.1155/2022/6630498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/21/2022] [Accepted: 04/07/2022] [Indexed: 11/29/2022] Open
Abstract
Insulin resistance is believed to be an integral component of the polycystic ovary syndrome (PCOS). Beta (ß) cell dysfunction is also found in PCOS. In the study, we determined the influence of age, body mass index (BMI), and waist-to-hip ratio (WHR) on insulin response to oral glucose load (OGTT) and on insulin sensitivity (Si) and ß-cell function in young women with PCOS. One hundred fourteen patients with PCOS and 41 controls with normal basal plasma glucose were studied. A 75-g OGTT was performed to determine glucose tolerance and insulin response. Insulin sensitivity and ß-cell function were studied using a modified frequently sampled IV glucose tolerance test (FISGTT) to determine the acute insulin response (AIRG), as well as Si by minimal model analysis. Si was decreased in PCOS women (2.49 0.18 vs. 3.41 ± 0.36, p < 0.05), but no difference in AIRG existed between the PCOS and control group (75.1 ± 4.6 vs. 63.4 ± 4.6, p < 0.05). BMI and WHR correlated negatively with Si (r = -0.43; r = -0.289, p < 0.001, respectively), but not with AIRG (r = 0.116; r = -0.02, p > 0.05, respectively). Increasing age correlated negatively with AIRG (r = -0.285, p < 0.001). There was a significant interaction between disease (PCOS), BMI, and WHR on Si as well as between age and PCOS on AIRG. Thus, patients below the age of 25 with PCOS showed enhanced AIRG (89.5 ± 7.1 vs. 65.1 ± 6.7, p < 0.05) and decreased Si (2.43 ± 0.25 vs. 4.52 ± 0.62, p < 0.05) compared to age-matched controls. In conclusion, these data suggest that not all patients with PCOS have basal and stimulated hyperinsulinemia, insulin resistance, and impaired glucose tolerance. Based on these data in young PCOS subjects, the development of insulin resistance and T2DM may be prevented with appropriate treatment strategies.
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Affiliation(s)
- Mirjana Šumarac-Dumanović
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia
| | - Danica Stamenković-Pejković
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia
| | - Danka Jeremić
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia
| | - Janko Dumanović
- Obstetrics and Gynaecology Clinic Narodni Front, Belgrade, Serbia
| | - Vesna Mandić-Marković
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Obstetrics and Gynaecology Clinic Narodni Front, Belgrade, Serbia
| | - Miloš Žarković
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia
| | - Dragan Micić
- Department of Medical Sciences, Serbian Academy of Sciences and Arts, Belgrade, Serbia
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Greco F, Mallio CA. Artificial intelligence and abdominal adipose tissue analysis: a literature review. Quant Imaging Med Surg 2021; 11:4461-4474. [PMID: 34603998 DOI: 10.21037/qims-21-370] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 06/01/2021] [Indexed: 12/12/2022]
Abstract
Body composition imaging relies on assessment of tissues composition and distribution. Quantitative data provided by body composition imaging analysis have been linked to pathogenesis, risk, and clinical outcomes of a wide spectrum of diseases, including cardiovascular and oncologic. Manual segmentation of imaging data allows to obtain information on abdominal adipose tissue; however, this procedure can be cumbersome and time-consuming. On the other hand, quantitative imaging analysis based on artificial intelligence (AI) has been proposed as a fast and reliable automatic technique for segmentation of abdominal adipose tissue compartments, possibly improving the current standard of care. AI holds the potential to extract quantitative data from computed tomography (CT) and magnetic resonance (MR) images, which in most of the cases are acquired for other purposes. This information is of great importance for physicians dealing with a wide spectrum of diseases, including cardiovascular and oncologic, for the assessment of risk, pathogenesis, clinical outcomes, response to treatments, and complications. In this review we summarize the available evidence on AI algorithms aimed to the segmentation of visceral and subcutaneous adipose tissue compartments on CT and MR images.
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Affiliation(s)
- Federico Greco
- U.O.C. Diagnostica per Immagini Territoriale Aziendale, Cittadella della Salute Azienda Sanitaria Locale di Lecce, Piazza Filippo Bottazzi, Lecce, Italy
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Obesity, Vascular Disease and Frailty in Aging Women with HIV. ACTA ACUST UNITED AC 2021; 3. [PMID: 34368807 PMCID: PMC8345026 DOI: 10.20900/agmr20210014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Women with chronic HIV infection (WWH) living in the United States,
experience a disproportionately high rate of obesity compared to uninfected
populations. Both overweight and obesity, particularly central obesity, are
major contributors to insulin resistance, hypertension, and
dyslipidemia—the major components of metabolic syndromes, including type
2 diabetes, and leading to increased cardiovascular risk, including coronary
heart disease, and cerebrovascular diseases. Notably, declining physical
performance and frailty co-occur with vascular morbidities as well as changes in
bone. These factors tend to exacerbate each other and accelerate the aging
trajectory, leading to poorer quality of life, cognitive impairments, dementia,
and eventually, death. In WWH, persistent HIV infection, sustained treatment for
HIV infection, and concomitant obesity, may accelerate aging-related morbidities
and poorer aging outcomes. Furthermore, health disparities factors common among
some WWH, are independently associated with obesity and higher vascular risk.
The purpose of this review is to describe the constellation of obesity, cardio-
and cerebrovascular diseases, bone health and frailty among aging WWH, a 21st
century emergence.
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Joseph A, Parvathy S, Varma KK. Hyperinsulinemia Induced Altered Insulin Signaling Pathway in Muscle of High Fat- and Carbohydrate-Fed Rats: Effect of Exercise. J Diabetes Res 2021; 2021:5123241. [PMID: 33708999 PMCID: PMC7929694 DOI: 10.1155/2021/5123241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/08/2020] [Accepted: 02/01/2021] [Indexed: 12/18/2022] Open
Abstract
Insulin resistance is a state of impaired responsiveness to insulin action. This condition not only results in deficient glucose uptake but increases the risk for cardiovascular diseases (CVD), stroke, and obesity. The present work investigates the molecular mechanisms of high carbohydrate and fat diet in inducing prediabetic hyperinsulinemia and effect of exercise on InsR signaling events, muscular AChE, and lactate dehydrogenase activity. Adult male Wistar rats were divided into the control (C) diet group, high-carbohydrate diet (HCD) group, high-fat diet (HFD) group, and HCD and HFD groups with exercise (HCD Ex and HFD Ex, respectively). Acetyl choline esterase activity, lactate dehydrogenase activity, total lactate levels, IRS1 phosphorylations, and Glut4 expression patterns were studied in the muscle tissue among these groups. High carbohydrate and fat feeding led to hyperinsulinemic status with reduced acetylcholine esterase (AChE) activity and impaired phosphorylation of IRS1 along with increased lactate concentrations in the muscle. Exercise significantly upregulated phosphoinositide 3 kinase (PI3K) docking site phosphorylation and downregulated the negative IRS1 phosphorylations thereby increasing the glucose transporter (GLUT) expressions and reducing the lactate accumulation. Also, the levels of second messengers like IP3 and cAMP were increased with exercise. Increased second messenger levels induce calcium release thereby activating the downstream pathway promoting the translocation of GLUT4 to the plasma membrane. Our results showed that the metabolic and signaling pathway dysregulations seen during diet-induced hyperinsulinemia, a metabolic condition seen during the early stages in the development of prediabetes, were improved with vigorous physical exercise. Thus, exercise can be considered as an excellent management approach over drug therapy for diabetes and its complications.
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Affiliation(s)
- Anu Joseph
- MIMS Research Foundation, Mankavu P.O., Calicut, Kerala 673007, India
| | - S. Parvathy
- MIMS Research Foundation, Mankavu P.O., Calicut, Kerala 673007, India
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Yang C, Zhang J, Wu T, Zhao K, Wu X, Shi J, Sun W, Kong X. Multi-Omics Analysis to Examine Gene Expression and Metabolites From Multisite Adipose-Derived Mesenchymal Stem Cells. Front Genet 2021; 12:627347. [PMID: 33679891 PMCID: PMC7930907 DOI: 10.3389/fgene.2021.627347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/08/2021] [Indexed: 01/03/2023] Open
Abstract
This study aimed at exploring the gene expression and metabolites among multisite adipose-derived mesenchymal stem cells (ASCs) and investigate the metabolic pathway using a multi-omics analysis. Subcutaneous adipose-derived mesenchymal stem cells (SASCs), perirenal adipose-derived mesenchymal stem cells (PASCs), and epididymal adipose-derived mesenchymal stem cells (EASCs) were isolated from Sprague Dawley rats. RNA and metabolites were extracted and sequenced using transcriptomics and metabolomics analyses, respectively. There were 720 differentially expressed genes (DEGs) in EASCs and 688 DEGs in PASCs compared with SASCs; there were 166 unique DEGs in EASCs, 134 unique DEGs in PASCs, and 554 common DEGs between EASCs and PASCs. Furthermore, there were 226 differential metabolites in EASCs, 255 differential metabolites in PASCs, 83 unique differential metabolites in EASCs, 112 unique differential metabolites in PASCs, and 143 common differential metabolites between EASCs and PASCs. The transcriptomics and metabolomics analyses identified four hub genes, one in EASCs and three in PASCs. There are functional differences among multisite ASCs that may be related to the hub genes Atac2, Rrm1, Rrm2, and Gla. The relevant signaling pathways are the Ras signaling pathway, HIF-1 signaling pathway, and the p53 signaling pathway. In conclusion, compared with SASCs, our multi-omics analysis identified that EASCs with higher Acat2 expression may be more correlated to fat metabolism and insulin resistance, while PASCs with abnormal expression of Rrm1/2 and Gla may be more correlated with some malignant tumors and cardiac-cerebral vascular disease.
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Affiliation(s)
- Chuanxi Yang
- Department of Cardiology, Medical School of Southeast University, Nanjing, China
| | - Jing Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tingting Wu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Kun Zhao
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoguang Wu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Shi
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Sun
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangqing Kong
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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12
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Kim GR, Choi DW, Nam CM, Jang SI, Park EC. Synergistic association of high-sensitivity C-reactive protein and body mass index with insulin resistance in non-diabetic adults. Sci Rep 2020; 10:18417. [PMID: 33116232 PMCID: PMC7595183 DOI: 10.1038/s41598-020-75390-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 09/22/2020] [Indexed: 11/15/2022] Open
Abstract
Epidemiological evidence has indicated that inflammatory markers and obesity are strongly correlated with insulin resistance (IR). However, there is a paucity of studies assessing the complex interaction between elevated hs-CRP and body mass index (BMI), particularly among Asians. This study investigated the additive interaction between hs-CRP and BMI on IR, using cross-sectional data from the 7th Korea National Health and Nutrition Examination Survey (2016–2018). A total of 5706 men and 6707 women aged 20 years or older were evaluated, and a multiple logistic regression analysis was used to assess the association of serum hs-CRP and BMI with IR, as measured by the triglyceride-glucose index (TyG index). Sex-specific median values were used to dichotomise the continuous TyG index variable into insulin-sensitive and IR categories. Biological interaction was evaluated using the Relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI). The joint effects of high hs-CRP and overweight/obesity on IR were greater than would be expected from the effects of the individual exposures alone. Relative to those with low hs-CRP and BMI < 23, having both exposures was related to increased IR with an adjusted OR of 2.97 (95% CI 2.50–3.52) in men and 3.08 (95% CI 2.67–3.56) in women with significant additive interactions. These findings demonstrate that IR prevention strategies that reduce both systematic inflammation and BMI may exceed the expected benefits based on targeting these risk factors separately.
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Affiliation(s)
- Gyu Ri Kim
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea.,Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Dong-Woo Choi
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.,Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea.,Department of Biostatistics, College of Medicine, Yonsei University, Seoul, Korea
| | - Sung-In Jang
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea.,Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea. .,Institute of Health Services Research, Yonsei University, Seoul, Korea.
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13
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Baghbani-Oskouei A, Tohidi M, Hasheminia M, Azizi F, Hadaegh F. Impact of 3-year changes in fasting insulin and insulin resistance indices on incident hypertension: Tehran lipid and glucose study. Nutr Metab (Lond) 2019; 16:76. [PMID: 31728151 PMCID: PMC6842481 DOI: 10.1186/s12986-019-0402-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/18/2019] [Indexed: 12/21/2022] Open
Abstract
Background To examine the association between changes in fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), and insulin-glucose ratio (IGR) levels, over approximately 3 years with incident hypertension. Methods A total of 2814 Iranian participants (1123 men) without hypertension and known diabetes at baseline and the first examination were followed for a median of 6.32 years. The associations between quartiles of changes in fasting insulin and IR indices with incident hypertension were assessed using multivariate Cox proportional hazard regression analyses with first quartile as reference. The models were adjusted for baseline values of insulin or each IR index, and age, sex, smoking, physical activity, educational levels, marital status, history of cardiovascular diseases, baseline levels of systolic and diastolic blood pressures, estimated glomerular filtration rate, triglycerides, total cholesterol, high-density lipoprotein cholesterol, fasting plasma glucose (only for insulin change) and both body mass index (BMI) per se, and its change. Akaike's information criteria (AIC) was applied as indicator for goodness of fit of each predictive model. The discrimination ability of models was calculated using the Harrell's C statistic. Results During the study, 594 incident cases of hypertension (253 men) were identified. The 4th quartile of changes in insulin, HOMA-IR, and IGR showed hazard ratios (95% confidence interval) of 1.31 (1.01-1.69), 1.18 (0.92-1.52), and 1.53 (1.18-1.98) for hypertension, respectively, in fully-adjusted models. Changes in fasting insulin levels and IR indices showed significant increasing trends for incident hypertension, moving from 1st to 4th quartiles (all P-values < 0.05). Focusing on model fitness, no superiority was found between changes in fasting insulin, HOMA-IR, and IGR to predict incident hypertension. The discriminatory powers of changes in fasting insulin and IR indices as assessed by C index were similar (i.e. about 80%). Conclusion Changes in fasting insulin and IR indices were significantly associated with developing hypertension among normotensive population even after considering BMI changes.
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Affiliation(s)
- Aidin Baghbani-Oskouei
- 1Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Tohidi
- 1Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Hasheminia
- 1Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- 2Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- 1Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Dennis PA, Neal JM, Travis E, Watkins LL, Calhoun PS, Dennis MF, Beckham JC. Negative Affect-Related Autonomic Arousal Mediates the Association between Baroreflex Dysfunction and Insulin Resistance in Non-Diabetic Young Adults. J PSYCHOPHYSIOL 2019; 33:243-253. [PMID: 31666757 DOI: 10.1027/0269-8803/a000226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Autonomic dysfunction, in particular under-regulation of heart rate (HR) by the baroreflex, is implicated in development of insulin resistance (IR). According to reactivity hypothesis, sympathetic response to stressors may be more sensitive at predicting IR than baroreceptor sensitivity (BRS), a baseline measure of baroreflex functioning. Using ecological momentary assessment (EMA) of negative affect coupled with minute-to-minute HR and heart-rate variability (HRV) monitoring, we examined whether negative affect (NA)-related autonomic arousal mediates the association of BRS with IR. At baseline, BRS was measured, and fasting serum glucose and insulin levels were collected from 178 young adults (18-39 years old), from which homeostasis model assessment of IR (HOMA-IR) and beta-cell functioning (HOMA %B) were derived. Participants subsequently underwent one day of Holter HR and HRV monitoring while reporting negative affect levels via EMA. Multilevel modeling was used to assess the associations of momentary negative affect with HR and low- (LF) and high-frequency (HF) HRV during the 5-minute intervals following each EMA reading. Structural equation modeling was then used to determine whether individual differences in these associations mediated the association of BRS with IR, measured by HOMA-IR, HOMA %B, and insulin levels. As predicted, BRS was negatively associated with the IR (β = -.17, p = .024). However, NA-related autonomic arousal mediated their association, accounting for 56% of the covariance between BRS and IR. Not only do these results provide support for reactivity hypothesis, they reveal a potential point of intervention in the treatment of affective dysregulation.
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Affiliation(s)
- Paul A Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Julia M Neal
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
| | - Emili Travis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA
| | - Lana L Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Patrick S Calhoun
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA.,Durham Veterans Affairs Center for Health Services Research in Primary Care, Durham, NC, 27705, USA
| | - Michelle F Dennis
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
| | - Jean C Beckham
- Durham Veterans Affairs Medical Center, Durham, NC, 27705, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA.,Veterans Affairs Mid-Atlantic Region Mental Illness Research, Education, and Clinical Center, Durham, NC 27705, USA
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15
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Pereira RO, McFarlane SI. The Role of Brown Adipose Tissue in Cardiovascular Disease Protection: Current Evidence and Future Directions. ACTA ACUST UNITED AC 2019; 4. [PMID: 31650091 PMCID: PMC6812533 DOI: 10.15344/2456-8007/2019/136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Renata O Pereira
- Department of Internal Medicine - Endocrinology and Metabolism, FOE Diabetes Research Center, University of Iowa, Iowa City, IA 52242, USA
| | - Samy I McFarlane
- Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NYC 11203, USA
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16
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Amen OM, Sarker SD, Ghildyal R, Arya A. Endoplasmic Reticulum Stress Activates Unfolded Protein Response Signaling and Mediates Inflammation, Obesity, and Cardiac Dysfunction: Therapeutic and Molecular Approach. Front Pharmacol 2019; 10:977. [PMID: 31551782 PMCID: PMC6747043 DOI: 10.3389/fphar.2019.00977] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/31/2019] [Indexed: 12/25/2022] Open
Abstract
Obesity has been implicated as a risk factor for insulin resistance and cardiovascular diseases (CVDs). Although the association between obesity and CVD is a well-established phenomenon, the precise mechanisms remain incompletely understood. This has led to a relative paucity of therapeutic measures for the prevention and treatment of CVD and associated metabolic disorders. Recent studies have shed light on the pivotal role of prolonged endoplasmic reticulum stress (ERS)-initiated activation of the unfolded protein response (UPR), the ensuing chronic low-grade inflammation, and altered insulin signaling in promoting obesity-compromised cardiovascular system (CVS). In this aspect, potential ways of attenuating ERS-initiated UPR signaling seem a promising avenue for therapeutic interventions. We review intersecting role of obesity-induced ERS, chronic inflammation, insulin resistance, and oxidative stress in the discovery of targeted therapy. Moreover, this review highlights the current progress and strategies on therapeutics being explored in preclinical and clinical research to modulate ERS and UPR signaling.
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Affiliation(s)
- Omar Mohammed Amen
- School of Bioscience, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Malaysia
| | - Satyajit D. Sarker
- Centre for Natural Products Discovery, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Reena Ghildyal
- Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Canberra, Australia
| | - Aditya Arya
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
- Department of Pharmacology and Therapeutics, School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Malaysia
- Malaysian Institute of Pharmaceuticals and Nutraceuticals, Bukit Gambir, Malaysia
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17
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Srinivasan S, Jablonski KA, Knowler WC, Dagogo-Jack S, E. Kahn S, Boyko EJ, Bray GA, Horton ES, Hivert MF, Goldberg R, Chen L, Mercader J, Harden M, Florez JC. A Polygenic Lipodystrophy Genetic Risk Score Characterizes Risk Independent of BMI in the Diabetes Prevention Program. J Endocr Soc 2019; 3:1663-1677. [PMID: 31428720 PMCID: PMC6694040 DOI: 10.1210/js.2019-00069] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/18/2019] [Indexed: 01/24/2023] Open
Abstract
CONTEXT There is substantial heterogeneity in insulin sensitivity, and genetics may suggest possible mechanisms by which common variants influence this trait. OBJECTIVES We aimed to evaluate an 11-variant polygenic lipodystrophy genetic risk score (GRS) for association with anthropometric, glycemic and metabolic traits in the Diabetes Prevention Program (DPP). In secondary analyses, we tested the association of the GRS with cardiovascular risk factors in the DPP. DESIGN In 2713 DPP participants, we evaluated a validated GRS of 11 common variants associated with fasting insulin-based measures of insulin sensitivity discovered through genome-wide association studies that cluster with a metabolic profile of lipodystrophy, conferring high metabolic risk despite low body mass index (BMI). RESULTS At baseline, a higher polygenic lipodystrophy GRS was associated with lower weight, BMI, and waist circumference measurements, but with worse insulin sensitivity index (ISI) values. Despite starting at a lower weight and BMI, a higher GRS was associated with less weight and BMI reduction at one year and less improvement in ISI after adjusting for baseline values but was not associated with diabetes incidence. A higher GRS was also associated with more atherogenic low-density lipoprotein peak-particle-density at baseline but was not associated with coronary artery calcium scores in the Diabetes Prevention Program Outcomes Study. CONCLUSIONS In the DPP, a higher polygenic lipodystrophy GRS for insulin resistance with lower BMI was associated with diminished improvement in insulin sensitivity and potential higher cardiovascular disease risk. This GRS helps characterize insulin resistance in a cohort of individuals at high risk for diabetes, independent of adiposity.
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Affiliation(s)
- Shylaja Srinivasan
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of California at San Francisco, San Francisco, California
| | - Kathleen A Jablonski
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - William C Knowler
- Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
| | - Samuel Dagogo-Jack
- Division of Endocrinology, Diabetes and Metabolism, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Steven E. Kahn
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, Washington
| | - Edward J Boyko
- Division of General Internal Medicine, University of Washington, Seattle, Washington
| | - George A Bray
- Division of Clinical Obesity and Metabolism, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | | | - Marie-France Hivert
- Diabetes Research Center, Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Ronald Goldberg
- Diabetes Research Institute, University of Miami Health System, Miami, Florida
| | - Ling Chen
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard & Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Josep Mercader
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard & Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Maegan Harden
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard & Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Jose C Florez
- Diabetes Research Center, Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard & Massachusetts Institute of Technology, Cambridge, Massachusetts
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18
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Liu AW, Song SO, Hayashi T, Sato KK, Kahn SE, Leonetti DL, Fujimoto WY, Boyko EJ. Change in CT-measured abdominal subcutaneous and visceral but not thigh fat areas predict future insulin sensitivity. Diabetes Res Clin Pract 2019; 154:17-26. [PMID: 31228493 PMCID: PMC6698223 DOI: 10.1016/j.diabres.2019.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 05/31/2019] [Accepted: 06/14/2019] [Indexed: 01/07/2023]
Abstract
AIMS We examined the longitudinal association between change in body composition directly measured by computed tomography (CT) and future insulin sensitivity. METHODS This was a prospective study with 10 years of follow-up with 297 Japanese-American without diabetes. Intra-abdominal fat area (IAFA) and abdominal subcutaneous fat area (SCFA), and thigh SCFA were measured by CT. Insulin sensitivity was calculated by HOMA-IR and the Matsuda index. RESULTS Baseline and change in IAFA were significantly and independently associated with change in HOMA-IR and Matsuda index during follow-up. In multivariate analysis, IAFA and 10-year change in IAFA (Δ IAFA) was significantly and positively associated with 10-year HOMA-IR (p < 0.001) and significantly and negatively associated with 10-year Matsuda index (p < 0.001). The association with Matsuda index though was non-linear and best modeled as a quadratic function (Δ IAFA + Δ IAFA2). No significant associations in multivariate analyses were seen between thigh SCFA and insulin sensitivity or abdominal SCFA and HOMA-IR but an increase in abdominal SCFA was associated with diminished insulin sensitivity measured by the Matsuda index. CONCLUSIONS An increase in visceral adiposity predicts diminished insulin sensitivity over 10 years of follow-up independent of the size of this adipose depot at baseline.
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Affiliation(s)
- Amy W Liu
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Sun Ok Song
- Department of Medicine, University of Washington, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA; Division of Endocrinology and Metabolism, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
| | - Tomoshige Hayashi
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kyoko K Sato
- Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Steven E Kahn
- Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, WA, USA; Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Donna L Leonetti
- Department of Anthropology, University of Washington, Seattle, WA, USA
| | - Wilfred Y Fujimoto
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Edward J Boyko
- Department of Medicine, University of Washington, Seattle, WA, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, WA, USA
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19
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Edgerton DS, Scott M, Farmer B, Williams PE, Madsen P, Kjeldsen T, Brand CL, Fledelius C, Nishimura E, Cherrington AD. Targeting insulin to the liver corrects defects in glucose metabolism caused by peripheral insulin delivery. JCI Insight 2019; 5:126974. [PMID: 30830873 DOI: 10.1172/jci.insight.126974] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Peripheral hyperinsulinemia resulting from subcutaneous insulin injection is associated with metabolic defects which include abnormal glucose metabolism. The first aim of this study was to quantify the impairments in liver and muscle glucose metabolism that occur when insulin is delivered via a peripheral vein compared to when it is given through its endogenous secretory route (the hepatic portal vein) in overnight fasted conscious dogs. The second aim was to determine if peripheral delivery of a hepato-preferential insulin analog could restore the physiologic response to insulin that occurs under meal feeding conditions. This study is the first to show that hepatic glucose uptake correlates with insulin's direct effects on the liver under hyperinsulinemic-hyperglycemic conditions. In addition, glucose uptake was equally divided between the liver and muscle when insulin was infused into the portal vein, but when it was delivered into a peripheral vein the percentage of glucose taken up by muscle was 4-times greater than that going to the liver, with liver glucose uptake being less than half of normal. These defects could not be corrected by adjusting the dose of peripheral insulin. On the other hand, hepatic and non-hepatic glucose metabolism could be fully normalized by a hepato-preferential insulin analog.
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Affiliation(s)
- Dale S Edgerton
- Vanderbilt University School of Medicine, Department of Molecular Physiology and Biophysics, Nashville, Tennessee, USA
| | - Melanie Scott
- Vanderbilt University School of Medicine, Department of Molecular Physiology and Biophysics, Nashville, Tennessee, USA
| | - Ben Farmer
- Vanderbilt University School of Medicine, Department of Molecular Physiology and Biophysics, Nashville, Tennessee, USA
| | - Phillip E Williams
- Vanderbilt University Medical Center, Division of Surgical Research, Nashville, Tennessee, USA
| | - Peter Madsen
- Research and Development, Novo Nordisk A/S, Novo Nordisk Park, Maaleov, Denmark
| | - Thomas Kjeldsen
- Research and Development, Novo Nordisk A/S, Novo Nordisk Park, Maaleov, Denmark
| | - Christian L Brand
- Research and Development, Novo Nordisk A/S, Novo Nordisk Park, Maaleov, Denmark
| | - Christian Fledelius
- Research and Development, Novo Nordisk A/S, Novo Nordisk Park, Maaleov, Denmark
| | - Erica Nishimura
- Research and Development, Novo Nordisk A/S, Novo Nordisk Park, Maaleov, Denmark
| | - Alan D Cherrington
- Vanderbilt University School of Medicine, Department of Molecular Physiology and Biophysics, Nashville, Tennessee, USA
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20
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Siti Hajar MH, Zulkefli S, Juwita S, Norhayati MN, Siti Suhaila MY, Rasool AHG, Harmy MY. Metabolic, inflammatory, and oxidative stress markers in women exposed to secondhand smoke. PeerJ 2018; 6:e5758. [PMID: 30356972 PMCID: PMC6196072 DOI: 10.7717/peerj.5758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/14/2018] [Indexed: 12/20/2022] Open
Abstract
Background Secondhand smoke (SHS) exposure has adverse effects on the cardiovascular system. This study aimed to determine the effects of SHS on the cardiovascular disease biomarkers, namely the metabolic, inflammatory, and oxidative stress markers in healthy adult women. Methods This comparative cross-sectional study was conducted among healthy women. The cases included those women exposed to SHS, and the controls included those women not exposed to SHS. SHS exposure was defined as being exposed to SHS for at least 15 min for 2 days per week. Venous blood was taken to measure the metabolic markers (high molecular weight adiponectin, insulin level, insulin resistance, and nonesterified fatty acids), oxidative stress markers (oxidized low density lipoprotein cholesterol and 8-isoprostane), and inflammatory markers (high-sensitivity C-reactive protein and interleukin-6). A hair nicotine analysis was also performed. An analysis of covariance and a simple linear regression analysis were conducted. Results There were 101 women in the SHS exposure group and 91 women in the non-SHS exposure group. The mean (with standard deviation) of the hair nicotine levels was significantly higher in the SHS exposure group when compared to the non-SHS exposure group [0.22 (0.62) vs. 0.04 (0.11) ng/mg; P = 0.009]. No significant differences were observed in the high molecular weight adiponectin, insulin and insulin resistance, nonesterified fatty acids, 8-isoprostane, oxidized low density lipoprotein cholesterol, interleukin-6, and high-sensitivity C-reactive protein between the two groups. The serum high molecular weight adiponectin was negatively associated with the insulin level and insulin resistance in the women exposed to SHS. However, no significant relationships were seen between the high molecular weight adiponectin and nonesterified fatty acids, 8-isoprostane, oxidized low density lipoprotein cholesterol, high-sensitivity C-reactive protein in the SHS group. Discussion There were no significant differences in the metabolic, oxidative stress, and inflammatory markers between the SHS exposure and non-SHS exposure healthy women. A low serum level of high molecular weight adiponectin was associated with an increased insulin level and resistance in the women exposed to SHS.
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Affiliation(s)
- Mohd Hanaffi Siti Hajar
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Sanip Zulkefli
- Central Research Laboratory, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Shaaban Juwita
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Yusoff Siti Suhaila
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Aida Hanum Ghulam Rasool
- Pharmacology Vascular Laboratory, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mohamed Yusoff Harmy
- Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia
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Observed changes in brown, white, hepatic and pancreatic fat after bariatric surgery: Evaluation with MRI. Eur Radiol 2018; 29:849-856. [PMID: 30062524 DOI: 10.1007/s00330-018-5611-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/29/2018] [Accepted: 06/15/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To study the change in brown and white adipose tissue (BAT and WAT), as well as fat content in the liver and pancreas, in patients with morbid obesity before and after bariatric surgery. METHODS Twelve patients with morbid obesity (F=8, M=4, age: 45.4 years (38.4-51.2), BMI: 35.2 kg/m2 (32.5-38.6)) underwent pre-op MRI at baseline and two post-op scans at 6-month and 12-month intervals after bariatric surgery. Co-registered water, fat, fat-fraction and T2* image series were acquired. Supraclavicular BAT and abdominal WAT were measured using in-house algorithms. Intrahepatic triglyceride (IHTG) was measured using MR spectroscopy and pancreatic fat was measured using a region-of-interest approach. Fat contents were compared between baseline and the first and second 6-month intervals using non-parametric analysis of Friedman's test and Wilcoxon's signed-rank test. Level of significance was selected at p=0.017 (0.05/3). Threshold of non-alcoholic fatty liver disease was set at 5.56%. RESULTS Results indicated that BMI (p=0.005), IHTG (p=0.005), and subcutaneous (p=0.005) and visceral adipose tissues (p=0.005) were significantly reduced 6 months after surgery. Pancreatic fat (p=0.009) was significantly reduced at 12 months. Most reduction became stable between the 6-month and 12-month interval. No significant difference was observed in BAT volume, fat-fraction and T2* values. CONCLUSION The results of this study suggest that bariatric surgery effectively reduced weight, mainly as a result of the reduction of abdominal WAT. Liver and pancreatic fat were deceased below the threshold possibly due to the reduction of free fatty acid. BAT volume, fat-fraction and T2* showed no significant changes, probably because surgery itself might not have altered the metabolic profile of the patients. KEY POINTS • No significant changes were observed in fat-fraction, T2* and volume of brown adipose tissue after bariatric surgery. • Non-alcoholic fatty liver disease was resolved after surgery. • Abdominal white fat and liver fat were significantly reduced 6 months after surgery and become stable between 6 and 12 months while pancreatic fat was significantly reduced between 0 and 12 months.
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22
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Ma E, Fu Y, Garvey WT. Relationship of Circulating miRNAs with Insulin Sensitivity and Associated Metabolic Risk Factors in Humans. Metab Syndr Relat Disord 2018; 16:82-89. [PMID: 29360415 PMCID: PMC5833250 DOI: 10.1089/met.2017.0101] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Insulin resistance disrupts metabolic processes and leads to various chronic disease states such as diabetes and metabolic syndrome (MetS). However, the mechanism linking insulin resistance with cardiometabolic disease pathophysiology is still unclear. One possibility may be through circulating microRNAs (c-miRs), which can alter gene expression in target tissues. Our goal was to assess the relationship of c-miRs with insulin sensitivity, as measured by the gold standard, hyperinsulinemic-euglycemic clamp technique. METHODS Eighty-one nondiabetic, sedentary, and weight-stable patients across a wide range of insulin sensitivities were studied. Measurements were taken for blood pressure, anthropometric data, fasting glucose and lipids, and insulin sensitivity measured by clamp. After an initial screening array to identify candidate miRs in plasma, all samples were assessed for relationships between these c-miRs and insulin sensitivity, as well as associated metabolic factors. RESULTS miR-16 and miR-107 were positively associated with insulin sensitivity (R2 = 0.09, P = 0.0074 and R2 = 0.08, P = 0.0417, respectively) and remained so after adjustment with body mass index (BMI). After adjusting for BMI, miR-33, -150, and -222 were additionally found to be related to insulin sensitivity. Regarding metabolic risk factors, miR-16 was associated with waist circumference (r = -0.25), triglycerides (r = -0.28), and high-density lipoprotein (r = 0.22), while miR-33 was inversely associated with systolic blood pressure (r = -0.29). No significant relationships were found between any candidate c-miRs and BMI, diastolic blood pressure, or fasting glucose. CONCLUSIONS Our results show that relative levels of circulating miR-16, -107, -33, -150, and -222 are associated with insulin sensitivity and metabolic risk factors, and suggest that multiple miRs may act in concert to produce insulin resistance and the clustering of associated traits that comprise the MetS. Therefore, miRs may have potential as novel therapeutic targets or agents in cardiometabolic disease.
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Affiliation(s)
- Elizabeth Ma
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Yuchang Fu
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - W. Timothy Garvey
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama
- The Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
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23
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Son M, Chan CB, Wu J. Egg White Ovotransferrin-Derived ACE Inhibitory Peptide Ameliorates Angiotensin II-Stimulated Insulin Resistance in Skeletal Muscle Cells. Mol Nutr Food Res 2018; 62:1700602. [PMID: 29278298 PMCID: PMC5873282 DOI: 10.1002/mnfr.201700602] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/02/2017] [Indexed: 12/22/2022]
Abstract
SCOPE The renin-angiotensin system (RAS) is a major contributor to the development of insulin resistance and its related complications. Egg white ovotransferrin-derived tripeptides, IRW (Ile-Arg-Trp), IQW (Ile-Gln-Trp), or LKP (Leu-Lys-Pro) are previously identified as the inhibitors of angiotensin-converting enzyme (ACE), a key enzyme in the RAS. This study aims at determining whether these peptides are effective in improving insulin resistance, and their mechanisms of action, in a rat derived skeletal muscle cell line (L6 cells). METHODS AND RESULTS Insulin resistance is induced by treating L6 cells with 1 μm angiotensin II (Ang II) for 24 h. Effects of peptides on glucose uptake are determined using glucose uptake assay, glucose transporter 4 (GLUT4) translocation by immunofluorescence, reactive oxygen species (ROS) by dihydroethidium (DHE) staining, while insulin signaling pathway, Ang II receptor (AT1R or AT2R) levels, and NADPH oxidase activation are measured using Western Blot. Only IRW treatment significantly improves insulin resistance in L6 cells via stimulation of insulin signaling. IRW decreases Ang II-stimulated AT1R expression, ROS formation, and NADPH oxidase activation. CONCLUSIONS Of three ACE inhibitory peptides studied, only IRW improves insulin resistance in L6 cells, at least partially via reduced AT1R expression and its anti-oxidative activity.
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Affiliation(s)
- Myoungjin Son
- Department of AgriculturalFood & Nutritional ScienceUniversity of AlbertaEdmontonAlbertaCanada
| | | | - Jianping Wu
- Department of AgriculturalFood & Nutritional ScienceUniversity of AlbertaEdmontonAlbertaCanada
- Cardiovascular Research CentreUniversity of AlbertaEdmontonAlbertaCanada
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24
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Kamran H, Kupferstein E, Sharma N, Karam JG, Myers AK, Youssef I, Sowers JR, Gustafson DR, Salifu MO, McFarlane SI. Statins and New-Onset Diabetes in Cardiovascular and Kidney Disease Cohorts: A Meta-Analysis. Cardiorenal Med 2018; 8:105-112. [PMID: 29617000 DOI: 10.1159/000485196] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/04/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Statins have long been prescribed for the primary and secondary prevention of cardiovascular disease (CVD) and kidney disease. Their benefits and efficacy are widely accepted in current clinical practice, but like any other therapeutic agents, they have adverse effects. One of the emerging concerns with statin therapy is the development of new-onset diabetes mellitus (NODM), a dreaded risk factor for CVD and kidney disease and widely viewed as CVD equivalent. Accumulating evidence indicates that NODM is a consequence of statin use. METHODS We conducted a meta-analysis of studies reporting on associations between NODM and statin use. Based on strict exclusion criteria, a total of 11 studies were selected. Their data were analyzed using Comprehensive Meta-Analysis® statistical software and reported as odds ratios (OR) with 95% confidence intervals (CI). RESULTS The cumulative fixed effect for use of statin therapy and incident NODM was an OR of 1.61 (95% CI 1.55-1.68, p < 0.001). Our results suggest that statin therapy is associated with NODM, such that there is a small but significant risk of NODM among patients receiving statin for CVD prevention therapy. However, this high-risk population also has other diabetes risk factors (such as obesity and hypertension) contributing to the development of NODM. CONCLUSIONS It is imperative that patients on statin therapy be monitored carefully for NODM. However, it can be argued that the risk of statin therapy is offset by the multitude of cardiovascular and kidney-protective effects provided by such an important and highly effective therapeutic agent.
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Affiliation(s)
- Haroon Kamran
- Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Eric Kupferstein
- Division of Cardiovascular Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Navneet Sharma
- Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Jocelyne G Karam
- Division of Endocrinology, Department of Medicine, Maimonides Medical Center, Brooklyn, New York, USA
| | - Alyson K Myers
- Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Irini Youssef
- Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - James R Sowers
- Division of Endocrinology, Department of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Deborah R Gustafson
- Department of Neurology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.,Neuropsychiatric Epidemiology Unit, University of Gothenburg, Gothenburg, Sweden
| | - Moro O Salifu
- Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Samy I McFarlane
- Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA
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25
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McFarlane SI, Seixas AA, Agyemang C, Jean-Louis G. Effects of Lifestyle Modifications and Dietary Habits on Prevention of Diabetes and Cardiovascular Disease. J Diabetes Res 2018; 2018:2341230. [PMID: 30648114 PMCID: PMC6311884 DOI: 10.1155/2018/2341230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/09/2018] [Indexed: 12/29/2022] Open
Affiliation(s)
- Samy I. McFarlane
- College of Medicine, Department of Medicine, Division of Endocrinology, State University of New York, Downstate Medical Center, Brooklyn, NY, USA
| | - Azizi A. Seixas
- Department of Population Health and Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Charles Agyemang
- Department of Public Health, Amsterdam Public Health (APH) Research Institute, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - Girardin Jean-Louis
- Department of Population Health and Psychiatry, New York University School of Medicine, New York, NY, USA
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26
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The prevalence and association of chronic kidney disease and diabetes in liver cirrhosis using different estimated glomerular filtration rate equation. Oncotarget 2017; 9:2236-2248. [PMID: 29416767 PMCID: PMC5788635 DOI: 10.18632/oncotarget.23368] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/29/2017] [Indexed: 12/13/2022] Open
Abstract
Background Chronic kidney disease (CKD) in cirrhosis is one of the dreaded complications associated with a steep rise in mortality and morbidity, including diabetes. There are limited data on the prevalence of CKD and the association with diabetes in outpatients with cirrhosis. Methodology This is a cross-sectional study of 7,440 adult liver cirrhosis patients enrolled from August 2001 to April 2010 in a medical center. Case control matching by age and sex with 1,967 pairs, and conditional logistic regression for odds of diabetes was analyzed using adjusted model. Results CKD was present in 46.0%, 45.7% and 45.6% of the study population using the MDRD-6, CKD-EPI and MDRD-4 estimated glomerular filtration rate (eGFR) equations, respectively. Using a conditional logistic regression model after adjusting for other risk factors, odds for diabetes increased significantly compared with non-CKD in CKD stage 3 to 5 (stage 3~5) based on MDRD-6–adjusted model, ORs were: stage 3~5, 2.34 (95% CI, 1.78-3.01); MDRD-4–adjusted model, ORs were: stage 3~5, 8.51 (95% CI, 5.63-11.4); CKD-EPI–adjusted model, ORs were: stage 3~5, 8.61 (95% CI, 5.13-13.9). Conclusion In cirrhosis patients, prevalence of diabetes was higher in patients with advanced stage of CKD. For patients with cirrhosis, patients with CKD stages 3~5 defined by MDRD-4, MDRD-6, and CKD-EPI eGFR equations had increased risk for diabetes. More severe cirrhosis, indicated by the Child-Turcott-Pugh classification was also accompanied by an increased risk for diabetes.
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27
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Palacio Rojas M, Prieto C, Bermúdez V, Garicano C, Núñez Nava T, Martínez MS, Salazar J, Rojas E, Pérez A, Marca Vicuña P, González Martínez N, Maldonado Parra S, Hoedebecke K, D’Addosio R, Cano C, Rojas J. Dyslipidemia: Genetics, lipoprotein lipase and HindIII polymorphism. F1000Res 2017; 6:2073. [DOI: 10.12688/f1000research.12938.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 11/20/2022] Open
Abstract
The direct link between lipid metabolism alterations and the increase of cardiovascular risk are well documented. Dyslipidemias, including isolated high LDL-c or mixed dyslipidemia, such as those seen in diabetes (hypertriglyceridemia, high LDL-c or low HDL-c), correlate with a significant risk of cardiovascular and cerebrovascular disease worldwide. This review analyzes the current knowledge concerning the genetic basis of lipid metabolism alterations, emphasizing lipoprotein lipase gene mutations and the HindIII polymorphism, which are associated with decreased levels of triglycerides and LDL-c, as well as higher levels of HDL-c. These patterns would be associated with decreased global morbidity and mortality, providing protection against cardiovascular and cerebrovascular diseases.
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28
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Palacio Rojas M, Prieto C, Bermúdez V, Garicano C, Núñez Nava T, Martínez MS, Salazar J, Rojas E, Pérez A, Marca Vicuña P, González Martínez N, Maldonado Parra S, Hoedebecke K, D'Addosio R, Cano C, Rojas J. Dyslipidemia: Genetics, lipoprotein lipase and HindIII polymorphism. F1000Res 2017; 6:2073. [PMID: 30345000 PMCID: PMC6171722 DOI: 10.12688/f1000research.12938.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2018] [Indexed: 12/21/2022] Open
Abstract
The direct link between lipid metabolism alterations and the increase of cardiovascular risk are well documented. Dyslipidemias, including isolated high LDL-c or mixed dyslipidemia, such as those seen in diabetes (hypertriglyceridemia, high LDL-c or low HDL-c), correlate with a significant risk of cardiovascular and cerebrovascular disease worldwide. This review analyzes the current knowledge concerning the genetic basis of lipid metabolism alterations, emphasizing lipoprotein lipase gene mutations and the HindIII polymorphism, which are associated with decreased levels of triglycerides and LDL-c, as well as higher levels of HDL-c. These patterns would be associated with decreased global morbidity and mortality, providing protection against cardiovascular and cerebrovascular diseases.
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Affiliation(s)
- Marcos Palacio Rojas
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela.,Hospital Básico de Paute, Public Health Ministry, Paute, Ecuador
| | - Carem Prieto
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Valmore Bermúdez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela.,Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Carlos Garicano
- Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar, Cúcuta, Colombia
| | - Trina Núñez Nava
- Hospital Básico de Paute, Public Health Ministry, Paute, Ecuador
| | - María Sofía Martínez
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Edward Rojas
- Department of Medicine, Rutgers University, Newark, NJ, 07103, USA
| | - Arturo Pérez
- Department of Medicine, Rutgers University, Newark, NJ, 07103, USA
| | | | | | | | - Kyle Hoedebecke
- WONCA Polaris - USA, Bangkok, 10500, Thailand.,Yongsan Health Clinic, Seoul, 96205, South Korea
| | - Rosanna D'Addosio
- Department of Public Health, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Clímaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo, Venezuela
| | - Joselyn Rojas
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
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29
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Lee AM, Charlton JR, Carmody JB, Gurka MJ, DeBoer MD. Metabolic risk factors in nondiabetic adolescents with glomerular hyperfiltration. Nephrol Dial Transplant 2017; 32:1517-1524. [PMID: 27312148 PMCID: PMC5837549 DOI: 10.1093/ndt/gfw231] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/04/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In adults, glomerular hyperfiltration is associated with abnormalities related to metabolic syndrome (MetS). We investigated if glomerular hyperfiltration was associated with metabolic abnormalities in US adolescents without diabetes. METHODS We analyzed data from the National Health and Nutrition Examination Survey, a nationally representative sample of US adolescents ages 12-17 years. Estimated glomerular filtration rate (eGFR) was determined using the bedside Schwartz equation; adolescents with hyperfiltration (eGFR >120 mL/min/1.73 m 2 ) were compared to those with normal eGFR (90-120 mL/min/1.73 m 2 ). We calculated mean levels of factors related to MetS, insulin resistance and diabetes risk, adjusting for age, race/ethnicity, sex, socioeconomic status, and BMI z -score. RESULTS Overall, 11.8% of US adolescents had hyperfiltration [95% confidence interval (CI) 10.6-13.0]. Hyperfiltration prevalence varied by race (20.2% in Hispanics versus 9.8% non-Hispanic whites and 7.4% non-Hispanic blacks; P< 0.001). Compared to those with normal eGFR, adolescents with hyperfiltration had higher adjusted mean levels of triglyceride (83 versus 77 mg/dL; P = 0.05), fasting insulin (15.1 versus 12.9; P< 0.001) and homeostatic model assessment of insulin resistance (3.52 versus 3.01; P = 0.001). These differences persisted after adjusting for BMI z- score. Adolescents with hyperfiltration had increased odds for hypertriglyceridemia [odds ratio 1.58 (95% CI 1.11-2.23)]. These relationships varied by racial/ethnic group. CONCLUSIONS Glomerular hyperfiltration is associated with hypertriglyceridemia and increased insulin resistance independent of BMI z- score in a nationally representative sample of US adolescents. Hispanic adolescents are more likely to have hyperfiltration than other racial/ethnic groups. These findings could have significance in evaluations of renal function and MetS in adolescents to identify related risks and target interventions.
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Affiliation(s)
- Arthur M. Lee
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, VA 22908, USA
| | - Jennifer R. Charlton
- Division of Pediatric Nephrology, Department of Pediatrics, University of Virginia, Charlottesville, VA, USA
| | - J. Bryan Carmody
- Division of Pediatric Nephrology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Matthew J. Gurka
- Department ofHealth Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Mark D. DeBoer
- Division of Pediatric Endocrinology, Department of Pediatrics, University of Virginia, Charlottesville, VA 22908, USA
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30
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Matovu N, Matovu FK, Sseguya W, Tushemerirwe F. Association of dietary intake and BMI among newly diagnosed type 2 diabetes patients attending diabetic clinics in Kampala. BMC Nutr 2017; 3:21. [PMID: 32153803 PMCID: PMC7050777 DOI: 10.1186/s40795-017-0141-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 03/01/2017] [Indexed: 11/28/2022] Open
Abstract
Background Dietary intake is a known determinant of body mass index (BMI) among different populations and is therefore a useful component for BMI control. To our knowledge, no study has investigated the usual dietary intake and its association with BMI in type 2 diabetes patients among the Ugandan population. This study aimed to analyse the usual dietary intake of newly diagnosed type 2 diabetes patients and determine the association between the different dietary nutrients and BMI. Methods We conducted a cross sectional study among 200 newly diagnosed type 2 diabetes patients in two major diabetic clinics of Kampala district. Sociodemographic, lifestyle, clinical measurements and dietary intake data were collected using a pretested structured questionnaire and a 24-h dietary recall respectively. Patients were divided according to quintile of nutrient intake. The association between dietary intake and BMI was investigated using multiple linear regression. Results The average energy intake was 1960.2 ± 594.6 kilocalories/day. Carbohydrate, protein and fat contributed 73, 12.6 and 14.4% of the daily energy consumption respectively. We observed an inverse association between protein intake and BMI. Slopes (95% C.I) of average BMI for patients in the respective quintiles were: 0.0, -2.1 (-4.2, -0.06), -4.4 (-6.9, -1.9), -5.6 (-8.2, -3.0), and -7.3 (-10.6, -4.0); ptrend <0.001. In contrast, the findings showed a positive association between carbohydrate intake and BMI. Slopes (95% C.I) of average BMI for patients in the respective quintiles were: 0.0, 3.0 (0.6, 5.4), 3.5 (0.5, 6.4), 5.2 (1.9, 8.6) and 9.7 (5.3, 14.1); ptrend <0.001 after adjusting for sociodemographic, clinical and dietary intake variables. We found no significant association between the dietary intake of fibre, fat, saturated fat, polyunsaturated fat and monounsaturated fat with BMI in the final adjusted model. Conclusion Higher intake of carbohydrate was associated with higher BMI while higher intake of protein was associated with lower BMI.
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Affiliation(s)
- Nicholas Matovu
- 1Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kampala, Uganda
| | - Flavia K Matovu
- 2Department of Epidemiology and Biostatistics, School of Public Health, Makerere University and Makerere University - John Hopkins University Research Collaboration, Kampala, Uganda
| | | | - Florence Tushemerirwe
- 1Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, Kampala, Uganda
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31
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Mangmool S, Denkaew T, Parichatikanond W, Kurose H. β-Adrenergic Receptor and Insulin Resistance in the Heart. Biomol Ther (Seoul) 2017; 25:44-56. [PMID: 28035081 PMCID: PMC5207462 DOI: 10.4062/biomolther.2016.128] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/26/2016] [Accepted: 08/02/2016] [Indexed: 12/24/2022] Open
Abstract
Insulin resistance is characterized by the reduced ability of insulin to stimulate tissue uptake and disposal of glucose including cardiac muscle. These conditions accelerate the progression of heart failure and increase cardiovascular morbidity and mortality in patients with cardiovascular diseases. It is noteworthy that some conditions of insulin resistance are characterized by up-regulation of the sympathetic nervous system, resulting in enhanced stimulation of β-adrenergic receptor (βAR). Overstimulation of βARs leads to the development of heart failure and is associated with the pathogenesis of insulin resistance in the heart. However, pathological consequences of the cross-talk between the βAR and the insulin sensitivity and the mechanism by which βAR overstimulation promotes insulin resistance remain unclear. This review article examines the hypothesis that βARs overstimulation leads to induction of insulin resistance in the heart.
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Affiliation(s)
- Supachoke Mangmool
- Department of Pharmacology, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand.,Center of Excellence for Innovation in Drug Design and Discovery, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
| | - Tananat Denkaew
- Department of Pharmacology, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
| | | | - Hitoshi Kurose
- Department of Pharmacology and Toxicology, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka 812-8582, Japan
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32
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Tan C, Sasagawa Y, Kamo KI, Kukitsu T, Noda S, Ishikawa K, Yamauchi N, Saikawa T, Noro T, Nakamura H, Takahashi F, Sata F, Tada M, Kokai Y. Evaluation of the Japanese Metabolic Syndrome Risk Score (JAMRISC): a newly developed questionnaire used as a screening tool for diagnosing metabolic syndrome and insulin resistance in Japan. Environ Health Prev Med 2016; 21:470-479. [PMID: 27699688 PMCID: PMC5112197 DOI: 10.1007/s12199-016-0568-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 07/29/2016] [Indexed: 01/10/2023] Open
Abstract
Objectives To prevent the onset of lifestyle-related diseases associated with metabolic syndrome (MetS) in Japan, research into the development of a useful screening method is strongly desired. We developed a new screening questionnaire (JAMRISC) utilizing a logistic regression model and evaluated its ability to predict the development of MetS, type 2 diabetes and other lifestyle-related diseases in Japanese populace. Methods JAMRISC questionnaire was sent to 1,850 individuals in Rumoi, a small city in Hokkaido. We received a total of 1,054 valid responses. To maximize the target individuals accurately diagnosed with MetS, logistic regression analysis was used to generate a unique metabolic syndrome score calculation formula as taking into consideration the clinical relevance of each question item as individual coefficients. Results The results of our comparative research utilizing both JAMRISC and Finnish Diabetes Risk Score (FINDRISC) questionnaires revealed the usefulness of JAMRISC for its ability to detect risks for MetS, pre-MetS, diabetes, and pre-diabetes. Study of disease risk detection via JAMRISC questionnaire targeting the 4283 residents of Rumoi indicated a high detection rate for pre-MetS (98.8 %), MetS (94.2 %), pre-diabetes (85.1 %) and type 2 diabetes (94.9 %). In addition, JAMRISC was useful not only as a MetS risk score test, but also as a screening tool for diagnosing insulin resistance. Conclusions JAMRISC questionnaire is a useful instrument for the detection of early risk of not only MetS and type 2 diabetes but also insulin resistance.
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Affiliation(s)
- Ce Tan
- Department of General Medicine, Rumoi Municipal Hospital, 2-16-1 Sinonome, Rumoi, 077-0011, Japan
| | - Yutaka Sasagawa
- Department of General Medicine, Rumoi Municipal Hospital, 2-16-1 Sinonome, Rumoi, 077-0011, Japan.
| | - Ken-Ichi Kamo
- Center for Medical Education, Sapporo Medical University, Sapporo, 060-8556, Japan
| | - Takehiro Kukitsu
- Department of Gastroenterology, Rumoi Municipal Hospital, Rumoi, 077-0011, Japan
| | - Sayaka Noda
- Department of Gastroenterology, Rumoi Municipal Hospital, Rumoi, 077-0011, Japan
| | - Kazuma Ishikawa
- Department of Gastroenterology, Rumoi Municipal Hospital, Rumoi, 077-0011, Japan
| | - Natsumi Yamauchi
- Department of Gastroenterology, Rumoi Municipal Hospital, Rumoi, 077-0011, Japan
| | - Takashi Saikawa
- Department of General Medicine, Rumoi Municipal Hospital, 2-16-1 Sinonome, Rumoi, 077-0011, Japan
| | - Takanori Noro
- Department of General Medicine, Rumoi Municipal Hospital, 2-16-1 Sinonome, Rumoi, 077-0011, Japan
| | - Hajime Nakamura
- Department of Gastroenterology, Rumoi Municipal Hospital, Rumoi, 077-0011, Japan
| | - Fumihiko Takahashi
- Department of Cardiology, Rumoi Municipal Hospital, Rumoi, 077-0011, Japan
| | - Fumihiro Sata
- NPO Rumoi Cohortopia, Rumoi, 077-0028, Japan.,Health Center, Chuo University, Tokyo, 162-8473, Japan
| | - Mitsuhiro Tada
- NPO Rumoi Cohortopia, Rumoi, 077-0028, Japan.,Department of Neurosurgery, Rumoi Municipal Hospital, Rumoi, 077-0011, Japan
| | - Yasuo Kokai
- NPO Rumoi Cohortopia, Rumoi, 077-0028, Japan.,Research Institute for Frontier Medicine, Sapporo Medical University, Sapporo, 060-8556, Japan
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Shin JY, Ha CH. Relationships between blood pressure and health and fitness-related variables in obese women. J Phys Ther Sci 2016; 28:2933-2937. [PMID: 27821965 PMCID: PMC5088156 DOI: 10.1589/jpts.28.2933] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/07/2016] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The present study aimed to separately compare systolic blood pressure and diastolic blood pressure with health and fitness-related variables among Asian obese and normal weight middle-aged women. [Subjects and Methods] The study included 1,201 women aged 30-59 years. The participants were classified into obese and normal weight groups. The blood pressure and health and fitness-related variables of all participants were assessed. [Results] Significant interaction effects were observed for most blood pressure and health and fitness-related variables between the groups. However, significant interaction effects were not observed for standard weight, basal metabolic rate, and heart rate. Blood pressure showed significant positive correlations with weight, body fat, fat weight, core fat, body mass index, and basal metabolic rate in both groups. Systolic blood pressure was significantly correlated with muscular endurance, power, and agility in the obese group and with VO2max and flexibility in the normal weight group. Diastolic blood pressure was significantly correlated with muscular endurance and power in the obese group and with VO2max in the normal weight group. [Conclusion] The relationships between systolic blood pressure and heart rate, muscle endurance, power, and agility are stronger than the relationships between diastolic blood pressure and these variables.
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Affiliation(s)
- Jeong Yeop Shin
- Department of Human Performance and Leisure Studies, North
Carolina A&T State University, USA
| | - Chang Ho Ha
- Department of Human Performance and Leisure Studies, North
Carolina A&T State University, USA
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Yun KJ, Han K, Kim MK, Park YM, Baek KH, Song KH, Kwon HS. Insulin Resistance Distribution and Cut-Off Value in Koreans from the 2008-2010 Korean National Health and Nutrition Examination Survey. PLoS One 2016; 11:e0154593. [PMID: 27128847 PMCID: PMC4851408 DOI: 10.1371/journal.pone.0154593] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 04/16/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We sought to identify the distribution and cut-off value of the 'homeostasis model assessment of insulin resistance' (HOMA-IR) according to gender and menopausal status for metabolic syndrome in Koreans. METHODS Data were from the Korean National Health and Nutrition Examination Survey in 2008-2010. The subjects included adults aged 20 years or older. We excluded participants who had diabetes or fasting serum glucose ≥ 7 mmol/L. Finally, 11,121 subjects (4,911 men, 3,597 premenopausal women, 2,613 postmenopausal women) were enrolled. The modified Adult Treatment Panel III criteria were used to define metabolic syndrome. RESULTS The mean HOMA-IR was 2.11 (2.07-2.15) for men, 2.0 (1.97-2.04) for premenopausal women, and 2.14 (2.2-2.19) for postmenopausal women. The first cut-off values in men, premenopausal women, and postmenopausal women were 2.23 (sensitivity 70.6%, specificity 66.9%), 2.39 (sensitivity 72.3%, specificity 76.4%), and 2.48 (sensitivity 51.9%, specificity 80.2%), respectively. Based on the first HOMA-IR cut-off value, the prevalence of metabolic syndrome was 22.9% in men, 13.7% in premenopausal women, and 51.6% in postmenopausal women. The second cut-off value was around 3.2 in all three groups. Based on the second HOMA-IR cut-off value, the prevalence of metabolic syndrome was 50.8% in men, 42.5% in premenopausal women, and 71.6% in postmenopausal women. CONCLUSION In conclusion, the first cut-off values for HOMA-IR were 2.2-2.5 and the second cut-off value was 3.2 in Korea. The distribution of HOMA-IR showed differences according to gender and menopausal status. When we apply HOMA-IR, we should consider gender, menopausal status, and the prevalence of metabolic syndrome.
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Affiliation(s)
- Kyung-Jin Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, Seoul, Korea
| | - Kyungdo Han
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, Seoul, Korea
| | - Yong-Moon Park
- Department of Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, United States of America
| | - Ki-Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, Seoul, Korea
| | - Ki-Ho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, Seoul, Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary’s Hospital, Seoul, Korea
- * E-mail:
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Sortica DA, Buffon MP, Souza BM, Nicoletto BB, Santer A, Assmann TS, Crispim D, Canani LH. Association between the ENPP1 K121Q polymorphism and risk of diabetic kidney disease: a systematic review and meta-analysis. PLoS One 2015; 10:e0118416. [PMID: 25794151 PMCID: PMC4368055 DOI: 10.1371/journal.pone.0118416] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/16/2015] [Indexed: 01/05/2023] Open
Abstract
The potential association between the K121Q (A/C, rs1044498) polymorphism in the ectonucleotide pyrophosphatase/phosphodiesterase (ENPP1) gene and risk of diabetic kidney disease (DKD) has been investigated. Nevertheless, the effect of this variant on DKD risk is still under debate, and conflicting results have been reported. To this date, no meta-analysis has evaluated the association of the K121Q polymorphism with DKD. This paper describes the first meta-analysis conducted to evaluate whether the ENPP1K121Q polymorphism is associated with DKD. A literature search was conducted to identify all case-control or cross-sectional studies that evaluated associations between the ENPP1K121Q polymorphism and DKD. Pooled odds ratios (OR) and 95% confidence intervals (95% CI) were calculated for allele contrast, additive, dominant and recessive inheritance models. Seven studies were eligible for inclusion in the meta-analysis, providing data on 3571 type 1 or type 2 diabetic patients (1606 cases with DKD and 1965 diabetic controls without this complication). No significant heterogeneity was observed among the studies included in the meta-analysis when assuming different inheritance models (I² < 50% or P > 0.10 for the entire sample and after stratification by ethnicity). Meta-analysis results revealed significant associations between the K121Q polymorphism and risk of DKD in Asians and Europeans when assuming the different inheritance models analyzed. The most powerful association was observed for the additive model (OR = 1.74, 95% CI 1.27-2.38 for the total sample). In conclusion, the present meta-analysis detected a significant association between the ENPP1K121Q polymorphism and increased susceptibility of DKD in European and Asian populations.
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Affiliation(s)
- Denise Alves Sortica
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marjorie Piucco Buffon
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bianca Marmontel Souza
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruna Bellicanta Nicoletto
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Andressa Santer
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Tais Silveira Assmann
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Daisy Crispim
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luis Henrique Canani
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- * E-mail:
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Edgerton DS, Moore MC, Winnick JJ, Scott M, Farmer B, Naver H, Jeppesen CB, Madsen P, Kjeldsen TB, Nishimura E, Brand CL, Cherrington AD. Changes in glucose and fat metabolism in response to the administration of a hepato-preferential insulin analog. Diabetes 2014; 63:3946-54. [PMID: 24947349 PMCID: PMC4392933 DOI: 10.2337/db14-0266] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Endogenous insulin secretion exposes the liver to three times higher insulin concentrations than the rest of the body. Because subcutaneous insulin delivery eliminates this gradient and is associated with metabolic abnormalities, functionally restoring the physiologic gradient may provide therapeutic benefits. The effects of recombinant human insulin (HI) delivered intraportally or peripherally were compared with an acylated insulin model compound (insulin-327) in dogs. During somatostatin and basal portal vein glucagon infusion, insulin was infused portally (PoHI; 1.8 pmol/kg/min; n = 7) or peripherally (PeHI; 1.8 pmol/kg/min; n = 8) and insulin-327 (Pe327; 7.2 pmol/kg/min; n = 5) was infused peripherally. Euglycemia was maintained by glucose infusion. While the effects on liver glucose metabolism were greatest in the PoHI and Pe327 groups, nonhepatic glucose uptake increased most in the PeHI group. Suppression of lipolysis was greater during PeHI than PoHI and was delayed in Pe327 infusion. Thus small increments in portal vein insulin have major consequences on the liver, with little effect on nonhepatic glucose metabolism, whereas insulin delivered peripherally cannot act on the liver without also affecting nonhepatic tissues. Pe327 functionally restored the physiologic portal-arterial gradient and thereby produced hepato-preferential effects.
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Affiliation(s)
- Dale S Edgerton
- Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, TN
| | - Mary C Moore
- Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, TN
| | - Jason J Winnick
- Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, TN
| | - Melanie Scott
- Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, TN
| | - Ben Farmer
- Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, TN
| | | | | | | | | | | | | | - Alan D Cherrington
- Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, TN
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Canepa M, AlGhatrif M, Pestelli G, Kankaria R, Makrogiannis S, Strait JB, Brunelli C, Lakatta EG, Ferrucci L. Impact of central obesity on the estimation of carotid-femoral pulse wave velocity. Am J Hypertens 2014; 27:1209-17. [PMID: 24637912 DOI: 10.1093/ajh/hpu038] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Studies have found that central obesity is associated with higher carotid-femoral pulse wave velocity (PWV). However, traveled distance (TD) measured over the body surface can be substantially overestimated with wider waist circumference (WC). We sought to investigate whether central obesity biases the estimation of PWV and whether this bias explains the association between PWV and different measures of adiposity. METHODS Seven hundred eleven participants (49.5% men) from the Baltimore Longitudinal Study of Aging with PWV, anthropometrics, and quantification of different fat depots by computed tomography and dual x-ray absorptiometry were included. TD and relative PWV were estimated with a tape measure over the body surface or linear distances taken from radiological images, unaffected by obesity. RESULTS A significant association was found between wider WC and a greater difference between the 2 TD measurements and their respective PWV in both sexes (r ≥ 0.34; P < 0.001). This overestimation bias appeared to be generally higher in women than men (0.27 m/sec for each unit increase in WC; P < 0.0001). When TD estimated over the body surface was used to calculate PWV, greater WC, total body fat, subcutaneous fat, and visceral fat were all associated with higher PWV (P < 0.05 for all). However, when PWV was calculated using TD estimated from radiological images or body height, only the association with visceral fat held significant. CONCLUSIONS When TD is measured over the body surface, the role of obesity on PWV is substantially overestimated. After accounting for this bias, PWV was still independently associated with visceral fat but not with other measures of adiposity, confirming its contribution to arterial stiffening.
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Affiliation(s)
| | - Majd AlGhatrif
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute of Aging, National Institutes of Health, Baltimore, Maryland; Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Gabriele Pestelli
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Rohan Kankaria
- Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
| | - Sokratis Makrogiannis
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
| | - James B Strait
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland; Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
| | - Claudio Brunelli
- Department of Internal Medicine, University of Genova, Genova, Italy
| | - Edward G Lakatta
- Laboratory of Cardiovascular Sciences, Human Cardiovascular Studies Unit, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute of Aging, National Institutes of Health, Baltimore, Maryland
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Bendale DS, Karpe PA, Chhabra R, Shete SP, Shah H, Tikoo K. 17-β Oestradiol prevents cardiovascular dysfunction in post-menopausal metabolic syndrome by affecting SIRT1/AMPK/H3 acetylation. Br J Pharmacol 2014; 170:779-95. [PMID: 23826814 DOI: 10.1111/bph.12290] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 06/19/2013] [Accepted: 06/30/2013] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Oestrogen therapy is known to induce cardioprotection in post-menopausal metabolic syndrome (PMS). Hence, we investigated the effect of 17-β oestradiol (E2) on functional responses to angiotensin II and cardiovascular dysfunction in a rat model of PMS. EXPERIMENTAL APPROACH PMS was induced in ovariectomized rats by feeding a high-fat diet for 10 weeks. Isometric tension responses of aortic rings to angiotensin II were recorded using an isometric force transducer. TUNEL assay and immunoblotting was performed to assess apoptosis and protein expression respectively in PMS. KEY RESULTS Endothelial dysfunction in PMS was characterized by enhanced angiotensin II-induced contractile responses and impaired endothelial dependent vasodilatation. This was associated with an increased protein expression of AT1 receptors in the aorta and heart in PMS. PMS induced cardiac apoptosis by activating Bax and PARP protein expression. These changes were associated with a down-regulation in the expression of silent information regulation 2 homologue (SIRT1)/P-AMP-activated PK (AMPK) and increased H3 acetylation in aorta and heart. E2 partially suppressed angiotensin II-induced contractions, restored the protein expression of SIRT1/P-AMPK and suppressed H3 acetylation. The role of SIRT1/AMPK was further highlighted by administration of sirtinol and compound C (ex vivo), which enhanced angiotensin II contractile responses and ablated the protective effect of E2 on PMS. CONCLUSION AND IMPLICATIONS Our results provide novel mechanisms for PMS-induced cardiovascular dysfunction involving SIRT1/AMPK/ histone H3 acetylation, which was prevented by E2. The study suggests that therapies targeting SIRT1/AMPK/epigenetic modifications may be beneficial in reducing the risk of cardiovascular disorders.
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Affiliation(s)
- Dhaval Sharad Bendale
- Laboratory of Chromatin Biology, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Mohali, Punjab, India
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Al-aryahi S, Kamato D, Getachew R, Zheng W, Potocnik SJ, Cohen N, Guidone D, Osman N, Little PJ. Atherogenic, fibrotic and glucose utilising actions of glucokinase activators on vascular endothelium and smooth muscle. Cardiovasc Diabetol 2014; 13:80. [PMID: 24731772 PMCID: PMC4016772 DOI: 10.1186/1475-2840-13-80] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/10/2014] [Indexed: 12/11/2022] Open
Abstract
Background Pharmaceutical interventions for diabetes aim to control glycaemia and to prevent the development of complications, such as cardiovascular diseases. Some anti-hyperglycaemic drugs have been found to have adverse cardiovascular effects in their own right, limiting their therapeutic role. Glucokinase activity in the pancreas is critical in enhancing insulin release in response to hyperglycaemia. Glucokinase activators (GKAs) are novel agents for diabetes which act by enhancing the formation of glucose-6-phosphate leading to increased insulin production and subsequent suppression of blood glucose. Little, however, is known about the direct effects of GKAs on cardiovascular cells. Methods The effect of the GKAs RO28-1675 and Compound A on glucose utilisation in bovine aortic endothelial cells (BAEC) and rat MIN6 was observed by culturing the cells at high and low glucose concentration in the presence and absence of the GKAs and measuring glucose consumption. The effect of RO28-1675 at various concentrations on glucose-dependent signalling in BAEC was observed by measuring Smad2 phosphorylation by Western blotting. The effect of RO28-1675 on TGF-β stimulated proteoglycan synthesis was measured by 35S-SO4 incorporation and assessment of proteoglycan size by SDS-PAGE. The effects of RO28-1675 on TGF-β mediated Smad2C phosphorylation in BAEC was observed by measurement of pSmad2C levels. The direct actions of RO28-1675 on vascular reactivity were observed by measuring arteriole tone and lumen diameter. Results GKAs were demonstrated to increase glucose utilisation in pancreatic but not endothelial cells. Glucose-activated Smad2 phosphorylation was decreased in a dose-dependent fashion in the presence of RO28-1675. No effect of RO28-1675 was observed on TGF-β stimulated proteoglycan production. RO28-1675 caused a modest dilation in arteriole but not contractile sensitivity. Conclusions GKA RO28-1675 did not increase glucose consumption in endothelial cells indicating the absence of glucokinase in those cells. No direct deleterious actions, in terms of atherogenic changes or excessive vasoactive effects were seen on cells or vessels of the cardiovascular system in response to GKAs. If reflected in vivo, these drugs are unlikely to have their use compromised by direct cardiovascular toxicity.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Peter J Little
- Discipline of Pharmacy and Diabetes Complications Group, Health Innovations Research Institute, School of Medical Sciences, RMIT University, Bundoora, VIC 3083, Australia.
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Al-Hwiesh AK, Abdul-Rahman IS, El-Deen MAN, Larbi E, Divino-Filho JC, Al-Mohanna FAA, Gupta KL. Metformin in peritoneal dialysis: a pilot experience. Perit Dial Int 2014; 34:368-75. [PMID: 24584596 DOI: 10.3747/pdi.2013.00048] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE In a number of patients, the antidiabetic drug metformin has been associated with lactic acidosis. Despite the fact that diabetes mellitus is the most common cause of end-stage renal disease (ESRD) and that peritoneal dialysis (PD) is an expanding modality of treatment, little is known about optimal treatment strategies in the large group of PD patients with diabetes. In patients with ESRD, the use of metformin has been limited because of the perceived risk of lactic acidosis or severe hypoglycemia. However, metformin use is likely to be beneficial, and PD might itself be a safeguard against the alleged complications. METHODS Our study involved 35 patients with insulin-dependent type 2 diabetes [median age: 54 years; interquartile range (IQR): 47-59 years] on automated PD (APD) therapy. Patients with additional risk factors for lactic acidosis were excluded. Metformin was introduced at a daily dose in the range 0.5 - 1.0 g. All patients were monitored for glycemic control by blood sugar levels and HbA1c. Plasma lactic acid levels were measured weekly for 4 weeks and then monthly to the end of the study. Plasma and effluent metformin and plasma lactate levels were measured simultaneously. RESULTS In this cohort, the median duration of diabetes was 18 years (IQR: 14 - 21 years), median time on PD was 31 months (IQR: 27 - 36 months), and median HbA1c was 6.8% (IQR: 5.9% - 6.9%). At metformin introduction and at the end of the study, the median anion gap was 11 mmol/L (IQR: 9 - 16 mmol/L) and 12 mmol/L (IQR: 9 - 16 mmol/L; p > 0.05) respectively, median pH was 7.33 (IQR: 7.32 - 7.36) and 7.34 (IQR: 7.32 - 7.36, p > 0.05) respectively, and mean metformin concentration in plasma and peritoneal fluid was 2.57 ± 1.49 mg/L and 2.83 ± 1.7 mg/L respectively. In the group overall, mean lactate was 1.39 ± 0.61 mmol/L, and hyperlactemia (>2 mmol/L to 5 mmol/L) was found in 4 of 525 plasma samples (0.76%), but the patients presented no symptoms. None of the patients registered a plasma lactate level above 5 mmol/L. We observed no correlation between plasma metformin and plasma lactate (r = 0.27). CONCLUSIONS Metformin may be used with caution in APD patients with insulin-dependent type 2 diabetes. Although our study demonstrated the feasibility of metformin use in APD, it was not large enough to demonstrate safety; a large-scale study is needed.
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Affiliation(s)
- Abdulla Khalaf Al-Hwiesh
- Department of Internal Medicine, King Fahd University Hospital, University of Dammam, and Department of Clinical Pharmacology, University of Dammam, Khobar, Saudi Arabia, and Division of Renal Medicine, Clintec, Karolinska Institute, Stockholm, Sweden
| | - Ibrahiem Saeed Abdul-Rahman
- Department of Internal Medicine, King Fahd University Hospital, University of Dammam, and Department of Clinical Pharmacology, University of Dammam, Khobar, Saudi Arabia, and Division of Renal Medicine, Clintec, Karolinska Institute, Stockholm, Sweden
| | - Mohammad Ahmad Nasr El-Deen
- Department of Internal Medicine, King Fahd University Hospital, University of Dammam, and Department of Clinical Pharmacology, University of Dammam, Khobar, Saudi Arabia, and Division of Renal Medicine, Clintec, Karolinska Institute, Stockholm, Sweden
| | - Emmanuel Larbi
- Department of Internal Medicine, King Fahd University Hospital, University of Dammam, and Department of Clinical Pharmacology, University of Dammam, Khobar, Saudi Arabia, and Division of Renal Medicine, Clintec, Karolinska Institute, Stockholm, Sweden
| | - Jose C Divino-Filho
- Department of Internal Medicine, King Fahd University Hospital, University of Dammam, and Department of Clinical Pharmacology, University of Dammam, Khobar, Saudi Arabia, and Division of Renal Medicine, Clintec, Karolinska Institute, Stockholm, Sweden
| | - Fahd Abdul-Aziz Al-Mohanna
- Department of Internal Medicine, King Fahd University Hospital, University of Dammam, and Department of Clinical Pharmacology, University of Dammam, Khobar, Saudi Arabia, and Division of Renal Medicine, Clintec, Karolinska Institute, Stockholm, Sweden
| | - Krishan L Gupta
- Department of Internal Medicine, King Fahd University Hospital, University of Dammam, and Department of Clinical Pharmacology, University of Dammam, Khobar, Saudi Arabia, and Division of Renal Medicine, Clintec, Karolinska Institute, Stockholm, Sweden
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Chiang PPC, Lamoureux EL, Shankar A, Tai ES, Wong TY, Sabanayagam C. Cardio-metabolic risk factors and prehypertension in persons without diabetes, hypertension, and cardiovascular disease. BMC Public Health 2013; 13:730. [PMID: 23919264 PMCID: PMC3751051 DOI: 10.1186/1471-2458-13-730] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 07/26/2013] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore. METHODS We examined data from Chinese (n=1177), Malay (n=774), and Indian (n=985) adults aged 40-80 years who participated in three independent population based studies conducted from 2004-2011 in Singapore who were free of diabetes, hypertension and previous CVD. Prehypertension was defined as systolic blood pressure (BP) 120-139 mm Hg or diastolic BP 80-89 mm Hg. Random blood glucose, glycated haemoglobin (HbA1c), body mass index (BMI), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were examined as indicators of adverse cardiometabolic profile. The association between metabolic variables and prehypertension was examined using logistic regression models adjusting for potential confounders. RESULTS The prevalence of prehypertension was 59.8% (Chinese), 68.9% (Malays) and 57.7% Indians. Higher levels of blood glucose, HbA1c and BMI were significantly associated with prehypertension in all three ethnic groups, odds ratio (95% confidence interval) of prehypertension in Chinese, Malays and Indians were: 1.42 (1.10, 1.83), 1.53 (1.05, 2.24), 1.49 (1.13, 1.98) for high-glucose; 3.50 (1.01, 12.18), 3.72 (1.29, 10.75), 2.79 (1.31, 5.94) for high-HbA1c; 1.86 (1.34, 2.56), 2.96 (2.10, 4.18), 1.68 (1.28, 2.20) for high-BMI. In addition, higher levels of LDL cholesterol in Chinese and higher levels of triglycerides were significantly associated with prehypertension. These associations persisted when metabolic variables were analysed as continuous variables. CONCLUSIONS Higher levels of blood glucose, HbA1c and BMI were associated with prehypertension in all three ethnic groups in Singapore. Screening for prehypertension and lifestyle modifications could potentially reduce the burden of CVD in otherwise healthy Asian adults living in Singapore.
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Affiliation(s)
| | | | | | | | | | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Level 6, 11 Third Hospital Avenue, Singapore 168751, Singapore.
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Abstract
The inexorable increase in the prevalence of obesity is a global health concern, which will result in a concomitant escalation in health-care costs. Obesity-related metabolic syndrome affects approximately 25% of adults and is associated with cardiovascular and renal disease. The heart and kidneys are physiologically interdependent, and the pathological effects of obesity can lead to cardiorenal syndrome and, ultimately, kidney and heart failure. Weight loss can prevent or ameliorate obesity-related cardiorenal syndrome, but long-term maintenance of a healthy weight has been difficult to achieve through lifestyle changes or pharmacotherapy. Bariatric surgery offers both sustained weight loss and favourable metabolic changes, including dramatic improvements in glycaemic control and symptoms of type 2 diabetes mellitus. Procedures such as Roux-en-Y gastric bypass offer immediate multisystemic benefits, including bile flow alteration, reduced gastric size, anatomical gut rearrangement and altered flow of nutrients, vagal manipulation and enteric hormone modulation. In patients with cardiorenal syndrome, bariatric surgery also offers renoprotection and cardioprotection, and attenuates both kidney and heart failure by improving organ perfusion and reversing metabolic dysfunction. However, further research is required to understand how bariatric surgery acts on the cardiorenal axis, and its pioneering role in novel treatments and interventions for cardiorenal disease.
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Yao F, Liu L, Zhang Y, Huang Y, Liu D, Lin H, Liu Y, Fan R, Li C, Deng C. Erectile dysfunction may be the first clinical sign of insulin resistance and endothelial dysfunction in young men. Clin Res Cardiol 2013; 102:645-51. [PMID: 23681359 DOI: 10.1007/s00392-013-0577-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 04/30/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The purpose of this study is to investigate the possible underlying pathogenesis of erectile dysfunction (ED) without well-known etiology in young men under the age of 40 years. METHODS 192 patients and 33 normal controls were enrolled. ED was evaluated by using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Traditional cardiovascular risk factors, hormone levels, and vascular parameters were measured. Insulin resistance (IR) was measured by homeostasis model assessment (HOMA). RESULTS Patients with ED had significantly higher levels of systolic blood pressure (SBP), high-sensitivity C-reactive protein (Hs-CRP), high Insulin resistance index (HOMA-IR) and carotid intima-media thickness (IMT), compared with controls. The brachial artery endothelium-dependent flow-mediated vasodilation (FMD) values were significantly lower in ED patients. By multivariate logistic regression analysis, FMD, SBP, Hs-CRP and HOMA-IR were significantly associated with ED. In receiver-operating characteristic (ROC) analysis, FMD was a significant predictor of ED (area under the curve (AUC) 0.933, p < 0.001). The cutoff value of FMD <10.4 % had sensitivity of 81.3 % and specificity of 100 %. HOMA-IR was also proven to be predictor of ED (AUC of HOMA-IR 0.759, p < 0.001). CONCLUSIONS ED may be the first clinical sign of endothelial dysfunction and a clinical marker of cardiovascular and metabolic diseases. Subclinical endothelial dysfunction and insulin resistance may be the underlying pathogenesis of ED in young patients without well-known etiology. Measurement of FMD, HOMA-IR can improve our ability to predict and treat ED, as well as subclinical cardiovascular disease early in young men.
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Affiliation(s)
- Fengjuan Yao
- Department of Ultrasound, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Chuengsamarn S, Garza AE, Krug AW, Romero JR, Adler GK, Williams GH, Pojoga LH. Direct renin inhibition modulates insulin resistance in caveolin-1-deficient mice. Metabolism 2013; 62:275-81. [PMID: 22954672 PMCID: PMC3518593 DOI: 10.1016/j.metabol.2012.07.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 07/17/2012] [Accepted: 07/18/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To test the hypothesis that aliskiren improves the metabolic phenotype in a genetic mouse model of the metabolic syndrome (the caveolin-1 (cav-1) knock out (KO) mouse). MATERIALS/METHODS Eleven-week-old cav-1 KO and genetically matched wild-type (WT) mice were randomized to three treatment groups: placebo (n=8/group), amlodipine (6 mg/kg/day, n=18/ group), and aliskiren (50 mg/kg/day, n=18/ group). After three weeks of treatment, all treatment groups were assessed for several measures of insulin resistance (fasting insulin and glucose, HOMA-IR, and the response to an intraperitoneal glucose tolerance test (ipGTT)) as well as for triglyceride levels and the blood pressure response to treatment. RESULTS Treatment with aliskiren did not affect the ipGTT response but significantly lowered the HOMA-IR and insulin levels in cav-1 KO mice. However, treatment with amlodipine significantly degraded the ipGTT response, as well as the HOMA-IR and insulin levels in the cav-1 KO mice. Aliskiren also significantly lowered triglyceride levels in the cav-1 KO but not in the WT mice. Moreover, aliskiren treatment had a significantly greater effect on blood pressure readings in the cav-1 KO vs. WT mice, and was marginally more effective than amlodipine. CONCLUSIONS Our results support the hypothesis that aliskiren reduces insulin resistance as indicated by improved HOMA-IR in cav-1 KO mice whereas amlodipine treatment resulted in changes consistent with increased insulin resistance. In addition, aliskiren was substantially more effective in lowering blood pressure in the cav-1 KO mouse model than in WT mice and marginally more effective than amlodipine.
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Affiliation(s)
- Somlak Chuengsamarn
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Endocrinology and Metabolism, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Nakornnayok, Thailand
| | - Amanda E. Garza
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Alexander W. Krug
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jose R. Romero
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Gail K. Adler
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Gordon H. Williams
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Luminita H. Pojoga
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Correspondent Address: Luminita H. Pojoga, PhD Division of Endocrinology, Diabetes and Hypertension Brigham and Women's Hospital 221 Longwood Ave, Boston, MA 02115 Ph. 617-278-0415 Fx. 617-732-5764
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Mahalle NP, Kulkarni MV, Pendse NM, Naik SS. Association of constitutional type of Ayurveda with cardiovascular risk factors, inflammatory markers and insulin resistance. J Ayurveda Integr Med 2012; 3:150-7. [PMID: 23125512 PMCID: PMC3487241 DOI: 10.4103/0975-9476.100186] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 04/20/2012] [Accepted: 06/04/2012] [Indexed: 02/06/2023] Open
Abstract
CONTEXT Ayurveda propounds that diseases manifest from imbalance of doshas. There, have been attempts to indicate biochemical basis of constitutional types described in Ayurveda. AIMS The study was intended to assess the association of constitutional types (Prakriti) with cardiovascular risk factors, inflammatory markers and insulin resistance in subjects with coronary artery disease (CAD). SETTINGS AND DESIGN Hospital based cross sectional study. MATERIALS AND METHODS Three hundred patients with CAD >25 years were studied. Assessment of Prakriti was done by using Ayusoft software. Biochemical parameters, inflammatory markers (hsCRP, TNF-alpha and IL-6) and insulin resistance (HOMA-IR) were measured. STATISTICAL ANALYSIS Was done using EPI INFO, version 3.5.3. RESULTS Mean age of patients was 60.97±12.5 years. Triglyceride, VLDL and LDL was significantly higher (P<0.0001, P<0.0001 and 0.0355, respectively) and HDL cholesterol (P<0.0001) significantly lower in vatta kapha (VK) Prakriti when compared with other constitution type. VK Prakriti was correlated with diabetes mellitus (r=0.169, P=0.003), hypertension (r=0.211, P≤0.0001) and dyslipidemia (r=0.541, P≤0.0001). Inflammatory markers; IL6, TNF alpha, hsCRP and HOMA IR was highest in VK Prakriti. Inflammatory markers were correlated positively with both VK and Kapha group. CONCLUSIONS There is strong relation of risk factors (diabetes, hypertension, dyslipidemia), insulin resistance, and inflammatory markers with Vata Kapha and Kapha Prakriti.
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Affiliation(s)
- Namita P Mahalle
- Department of Pathology, Deenanath Mangeshkar Hospital, Pune, Maharashatra, India
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Abstract
Excess visceral adiposity contributes to inappropriate activation of the renin-angiotensin-aldosterone system despite a state of volume expansion and of salt retention that contributes to subclinical elevations of pro-oxidant mechanisms. These adverse effects are mediated by excess generation of reactive oxygen species (ROS) and diminished antioxidant defense mechanisms. Excess tissue (i.e., skeletal muscle, liver, heart) free oxygen radicals contribute to impairments in the insulin-dependent metabolic signaling pathways that regulate glucose utilization/disposal and systemic insulin sensitivity. The generation of ROS is required for normal cell signaling and physiological responses. It is a loss of redox homeostasis that results in a proinflammatory/profibrotic milieu that promotes impairments in insulin metabolic signaling, reduced endothelial-mediated vasorelaxation, and associated cardiovascular and renal structural and functional abnormalities. These maladaptive processes are increasingly recognized as important in the progression of hypertension in the cardiorenal metabolic phenotype. There is increasing evidence to support a critical role for Ang II signaling through the AT(1)R and aldosterone actions through the MR in conjunction with an altered redox-mediating impaired endothelial, cardiac and renal function in this metabolic phenotype. There are emerging clinical data that indicate that therapies that target the renin angiotensin-aldosterone system (RAAS) also attenuate oxidative stress, and improve endothelial, cardiac and renal functions, which collectively contribute to reductions in hypertension.
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Affiliation(s)
- Adam Whaley-Connell
- Diabetes and Cardiovascular Center, Harry S Truman VA Medical Center and the University of Missouri-Columbia School of Medicine, Columbia, MO 65213, USA.
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Arecoline improves vascular endothelial function in high fructose-fed rats via increasing cystathionine-γ-lyase expression and activating K(ATP) channels. Acta Pharmacol Sin 2012; 33:1023-9. [PMID: 22820911 DOI: 10.1038/aps.2012.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
AIM To investigate the effect of arecoline, a major component of betel nut, on vascular endothelial function in high fructose-fed rats and the potential mechanisms underlying the effect. METHODS Male Wistar rats were fed a high-fructose or control diet for 16 weeks. At the beginning of week 13, the rats were injected ip with low (0.5 mg·kg(-1)·d(-1)), medium (1.0 mg·kg(-1)·d(-1)) or high (5.0 mg·kg(-1)·d(-1)) doses of arecoline for 4 weeks. At the termination of the treatments, blood was collected, fasting blood glucose (FBG) and serum insulin (FSI) levels were measured, and insulin sensitivity index (ISI) was calculated. The thoracic aortas were isolated and aortic rings were prepared for studying ACh-induced endothelium-dependent vasorelaxation (EDVR). The mRNA and protein expression of cystathionine-γ-lyase (CSE) in the thoracic aortas was analyzed using RT-PCR and Western blot analysis, respectively. RESULTS In high fructose-fed rats, the levels of FBG and FSI were remarkably increased, whereas the ISI and the mRNA and protein expression of CSE were significantly decreased. ACh-induced EDVR in the aortic rings from high fructose-fed rats was remarkably reduced. These changes were reversed by treatment with high dose arecoline. Pretreatment of the aortic rings rings from high fructose-fed rats with the CSE inhibitor propargylglycine (10 mmol/L) or the ATP-sensitive potassium (K(ATP)) channel blocker glibenclamide (10 mmol/L) abolished the restoration of ACh-induced EDVR by high dose arecoline. On the contrary, treatment with high dose arecoline significantly impaired ACh-induced EDVR in the aortic rings from control rats, and pretreatment with propargylglycine or glibenclamide did not cause further changes. CONCLUSION Arecoline treatment improves ACh-induced EDVR in high fructose-fed rats, and the potential mechanism of action might be associated with increase of CSE expression and activation of K(ATP) channels by arecoline.
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Boscaro M, Giacchetti G, Ronconi V. Visceral adipose tissue: emerging role of gluco- and mineralocorticoid hormones in the setting of cardiometabolic alterations. Ann N Y Acad Sci 2012; 1264:87-102. [PMID: 22804097 PMCID: PMC3464353 DOI: 10.1111/j.1749-6632.2012.06597.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Several clinical and experimental lines of evidence have highlighted the detrimental effects of visceral adipose tissue excess on cardiometabolic parameters. Besides, recent findings have shown the effects of gluco-and mineralocorticoid hormones on adipose tissue and have also underscored the interplay existing between such adrenal steroids and their respective receptors in the modulation of adipose tissue biology. While the fundamental role played by glucocorticoids on adipocyte differentiation and storage was already well known, the relevance of the mineralocorticoids in the physiology of the adipose organ is of recent acquisition. The local and systemic renin–angiotensin–aldosterone system (RAAS) acting on adipose tissue seems to contribute to the development of the cardiometabolic phenotype so that its modulation can have deep impact on human health. A better understanding of the pathophysiology of the adipose organ is of crucial importance in order to identify possible therapeutic approaches that can avoid the development of such cardiovascular and metabolic sequelae.
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Affiliation(s)
- Marco Boscaro
- Division of Endocrinology, Ospedali Riuniti "Umberto I-G.M. Lancisi-G. Salesi," Università Politecnica delle Marche, Ancona, Italy
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Stavropoulos-Kalinoglou A, Metsios GS, Panoulas VF, Nightingale P, Koutedakis Y, Kitas GD. Anti-tumour necrosis factor alpha therapy improves insulin sensitivity in normal-weight but not in obese patients with rheumatoid arthritis. Arthritis Res Ther 2012; 14:R160. [PMID: 22765047 PMCID: PMC3580552 DOI: 10.1186/ar3900] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 07/05/2012] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Insulin resistance (IR), a risk factor for the development of cardiovascular disease, is common among patients with rheumatoid arthritis (RA). Inflammation, and especially tumour necrosis factor alpha (TNFα), has been associated with IR, and the administration of anti-TNFα agents is suggested to improve insulin sensitivity. However obesity, a potent contributor to IR, may limit the beneficial effects of anti-TNFα medication on IR. The aim of this study is to compare the effects of anti-TNFα therapy on IR between normal-weight and obese patients with RA. METHODS Patients who were normal-weight with IR (N+IR) or obese with IR (O+IR) and had embarked on anti-TNFα treatment, participated. Assessments included body mass index (BMI), insulin sensitivity (Homeostasis Model Assessment of insulin resistance, HOMA and the Quantitative Insulin sensitivity Check Index, QUICKI), and RA disease characteristics before and following six months of anti-TNFα treatment. Their results were compared to matched (for age, gender, BMI, disease duration and smoking status) normal-weight patients without IR (N-IR) and obese without IR (N-IR), respectively. In total, 32 patients were assessed for this study, with 8 in each group. RESULTS Following six months of treatment, disease activity was significantly reduced in all groups (P < 0.05) to a similar extent (P for differences between groups > 0.05 in all cases). In the total population, changes in HOMA (mean reduction at 6 m = -0.2 ± 0.1; P = 0.088) and QUICKI (mean increase at 6 m = 0.03 ± 0.022; P = 0.092) after treatment were not statistically significant, though a trend towards improvement was observed. However, N+IR patients showed a significant decrease in HOMA (mean reduction at 6 m = -0.54 ± 0.2; P = 0.002) and increase in QUICKI (mean increase at 6 m = 0.046 ± 0.02; P = 0.011). These changes were significantly different compared to the other groups (P < 0.05 in all cases). Multivariable analyses showed that the change in Erythrocyte Sedimentation Rate (ESR), and the change in C-Reactive Protein (CRP) associated with the improvement in HOMA (ESR: F₁₋₇ = 5.143, P = 0.019; CRP: F₁₋₇ = 3.122, P = 0.022) and QUICKI (ESR: F₁₋₇ = 3.814, P = 0.021; CRP: F₁₋₇ = 2.67; P = 0.041) only in the N+IR group. CONCLUSIONS Anti-TNFα therapy, through controlling inflammation, seems to improve insulin sensitivity in normal-weight RA patients with insulin resistance, but is not sufficient to achieving the same beneficial effect in obese RA patients with insulin resistance.
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McFarlane SI, Jean-Louis G, Zizi F, Whaley-Connell AT, Ogedegbe O, Makaryus AN, Maraj I. Hypertension in the high-cardiovascular-risk populations. Int J Hypertens 2012; 2011:746369. [PMID: 22778912 PMCID: PMC3388432 DOI: 10.4061/2011/746369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Accepted: 04/01/2012] [Indexed: 11/20/2022] Open
Affiliation(s)
- Samy I McFarlane
- Division of Endocrinology, State University of New York-Downstate Medical Center, Kings County Hospital Center, 450 Clarkson Avenue, Box 50, Brooklyn, NY 11203, USA
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