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Yong J, Tian J, Zuo H, Cao J, Kong H, Zhao X, Yang X, Zhang H, He Y, Song X. HbA1c is related to microcirculation blood perfusion in patients with coronary microvascular disease using stress perfusion cardiac magnetic resonance: An observational study. Microvasc Res 2023; 147:104493. [PMID: 36738986 DOI: 10.1016/j.mvr.2023.104493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 12/29/2022] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND In coronary microvascular disease (CMD) patients, the incidence of major adverse cardiovascular events (MACEs) in patients with myocardial perfusion reserve index (MPRI) ≤ 1.47 is three times higher than that in MPRI > 1.47. We investigated whether the increase of glycated hemoglobin A1c (HbA1c) could increase the risk of MPRI ≤1.47 in diabetic and non-diabetic patients. METHODS From November 2019, patients with ischemic symptoms but without obstructive coronary disease were screened. Use MPRI measured by stress perfusion cardiac magnetic resonance (CMR) to reflect microcirculation blood perfusion, and MPRI <2.5 were included. The patients were divided into two groups based on MPRI was greater or <1.47. The risk factors for CMD were explored using logistic regression analysis. RESULTS A total of 80 patients with an MPRI of 1.69 ± 0.79 were included. CMD patients with an MPRI of ≤1.47(n = 33) were higher than MPRI of >1.47(n = 47) in age, presence of diabetes mellitus, fasting blood glucose levels and HbA1c levels (P < 0.05). In non-diabetic patients, increased HbA1c was associated with the risk of MPRI≤1.47 (OR = 0.017, 95%CI: 0.050-1.107, P = 0.045). Compared with non-diabetic patients with HbA1c < 6.0, non-diabetic patients with HbA1c ≥ 6.0 increased the risk of MPRI of ≤1.47 (OR = 0.219, 95%CI: 0.069-0.697, P = 0.010). In diabetic patients, HbA1c was not associated with the risk of MPRI of ≤1.47 (OR = 1.043, 95%CI: 0.269, 4.044, P = 0.952). And compared with non-diabetic patients with HbA1c <6.0, diabetic patients with HbA1c <6.0 (OR = 0.917, 95%CI: 0.233-3.610, P = 0.901) or ≥6.0 (OR = 0.326, 95%CI: 0.073-1.446, P = 0.140), the risk of MPRI ≤ 1.47 was not further increased. CONCLUSIONS In non-diabetic patients, elevated HbA1c is related to MPRI≤1.47(a value increased incidence of MACEs). Therefore, in patients with undiagnosed diabetes, early management of glycosylated hemoglobin is very important. TRIAL REGISTRATION This clinical trial has been registered in the Chinese clinical Trial Registry with an identifier: ChiCTR1900025810.
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Affiliation(s)
- JingWen Yong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, China
| | - JinFan Tian
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, China
| | - HuiJuan Zuo
- Department of Community Health Research, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, China
| | - JiaXin Cao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, China
| | - HuiHui Kong
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, China
| | - Xin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, China
| | - XueYao Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, China
| | - HongJia Zhang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, China.
| | - Yi He
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, China
| | - XianTao Song
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, China.
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Radwan E, Belmadani S, Matrougui K. Disrupting Interleukin 12 Improves Microvascular Endothelial Function in Type 2 Diabetes Through ER Stress CHOP and Oxidative Stress Mechanisms. Diabetes Metab Syndr Obes 2022; 15:2633-2642. [PMID: 36065460 PMCID: PMC9440700 DOI: 10.2147/dmso.s369488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/08/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Vascular endothelial dysfunction is well established in type 2 diabetes. Interleukin-12 (IL-12) and endoplasmic reticulum (ER) stress are up-regulated in type 2 diabetic patients and animal models of type 2 diabetes. However, the role and underlying mechanisms of IL-12 and the ER stress CHOP in endothelial dysfunction are not fully understood. METHODS We generated double knockout mice between db-/db- and p40IL-12-/- mice (db-/db-p40-IL-12-/-) and endoplasmic (ER) stress-CHOP-/- mice (db-/db-CHOP-/-). We performed a glucose tolerance test (GTT) to determine the effect of IL-12 and ER stress CHOP on glucose metabolism. We assessed the endothelial function and determined the phosphorylation level of eNOS, Akt, AMPK, and the expression of ER stress (CHOP, BIP), and oxidative stress (Nox2 and Nox4 and NADPH oxidase activity). RESULTS The results showed that GTT was improved in db-/db-p40-IL-12-/- and db-/db-CHOP-/- suggesting IL-12 and CHOP as parts of a mechanism involved in the development of type 2 diabetes. The microvascular endothelial dysfunction in db-/db- mouse is associated with decreased phosphorylated eNOS, Akt, AMPK, and increased CHOP, BIP, Nox2, and Nox4 expressions. Interestingly, disrupting IL-12 and ER stress CHOP in db-/db- mice significantly improved endothelial function, increased survival markers expression and decreased ER and oxidative stress. CONCLUSION Using a genetic approach, these findings provide evidence that IL-12 and ER stress CHOP play a significant role in microvascular endothelial dysfunction in type 2 diabetes.
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Affiliation(s)
- Eman Radwan
- Department of Physiological Sciences, EVMS, Norfolk, VA, 23501, USA
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Asyut, Egypt
| | - Souad Belmadani
- Department of Physiological Sciences, EVMS, Norfolk, VA, 23501, USA
| | - Khalid Matrougui
- Department of Physiological Sciences, EVMS, Norfolk, VA, 23501, USA
- Correspondence: Khalid Matrougui, Department of Physiological Sciences, EVMS, Norfolk, VA, 23501, USA, Tel +1 757-446-5278, Email
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Sørensen MH, Bojer AS, Broadbent DA, Plein S, Madsen PL, Gæde P. Cardiac perfusion, structure, and function in type 2 diabetes mellitus with and without diabetic complications. Eur Heart J Cardiovasc Imaging 2021; 21:887-895. [PMID: 31642902 DOI: 10.1093/ehjci/jez266] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/08/2019] [Accepted: 10/12/2019] [Indexed: 12/28/2022] Open
Abstract
AIMS Coronary microvascular disease (CMD) is a known complication in type 2 diabetes mellitus (T2DM). We examined the relationship between diabetic complications, left ventricular (LV) function and structure and myocardial perfusion reserve (MPR) as indicators of CMD in patients with T2DM and control subjects. METHODS AND RESULTS This was a cross-sectional study of 193 patients with T2DM and 25 controls subjects. Patients were grouped as uncomplicated diabetes (n = 71) and diabetes with complications (albuminuria, retinopathy, and autonomic neuropathy). LV structure, function, adenosine stress, and rest myocardial perfusion were evaluated by cardiovascular magnetic resonance. Echocardiography was used to evaluate diastolic function. Patients with uncomplicated T2DM did not have significantly different LV mass and E/e* but decreased MPR (3.8 ± 1.0 vs. 5.1 ± 1.5, P < 0.05) compared with controls. T2DM patients with albuminuria and retinopathy had decreased MPR (albuminuria: 2.4 ± 0.9 and retinopathy 2.6 ± 0.7 vs. 3.8 ± 1.0, P < 0.05 for both) compared with uncomplicated T2DM patients, along with significantly higher LV mass (149 ± 39 and 147 ± 40 vs. 126 ± 33 g, P < 0.05) and E/e* (8.3 ± 2.8 and 8.1 ± 2.2 vs. 7.0 ± 2.5, P < 0.05). When entered in a multiple regression model, reduced MPR was associated with increasing E/e* and albuminuria and retinopathy were associated with reduced MPR. CONCLUSIONS Patients with uncomplicated T2DM have reduced MPR compared with control subjects, despite equivalent LV mass and E/e*. T2DM patients with albuminuria or retinopathy have reduced MPR and increased LV mass and E/e* compared with patients with uncomplicated T2DM. E/e* and MPR are significantly associated after adjustment for age, hypertension, and LV mass, suggesting a link between CMD and cardiac diastolic function. CLINICAL TRIAL REGISTRATION https://www.clinicaltrials.org. Unique identifier: NCT02684331.
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Affiliation(s)
- Martin Heyn Sørensen
- Department of Cardiology and Endocrinology, Slagelse Hospital, Ingemannsvej 32, 4200 Slagelse, Denmark.,Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - Annemie Stege Bojer
- Department of Cardiology and Endocrinology, Slagelse Hospital, Ingemannsvej 32, 4200 Slagelse, Denmark.,Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
| | - David Andrew Broadbent
- Department of Medical Physics and Engineering, Leeds Teaching Hospitals NHS Trust, Great George St, LS1 3EX, Leeds, UK.,Biomedical Imaging Science Department, University of Leeds, LS2 9JT, Leeds, UK
| | - Sven Plein
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT, Leeds, UK
| | - Per Lav Madsen
- Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Capital Region of Denmark, Borgmester Ib Juels Vej 1, 2730 Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
| | - Peter Gæde
- Department of Cardiology and Endocrinology, Slagelse Hospital, Ingemannsvej 32, 4200 Slagelse, Denmark.,Institute of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
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Chen S, Shen Y, Liu YH, Dai Y, Wu ZM, Wang XQ, Yang CD, Li LY, Liu JM, Zhang LP, Shen WF, Ji R, Lu L, Ding FH. Impact of glycemic control on the association of endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2021; 20:64. [PMID: 33714276 PMCID: PMC7956110 DOI: 10.1186/s12933-021-01257-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/05/2021] [Indexed: 12/16/2022] Open
Abstract
Background We investigated whether glycemic control affects the relation between endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus (T2DM). Methods In 102 type 2 diabetic patients with stable angina, endothelial function was evaluated using brachial artery flow-mediated dilation (FMD) with high-resolution ultrasound, and significant stenosis of major epicardial coronary arteries (≥ 50% diameter narrowing) and degree of coronary atherosclerosis (Gensini score and SYNTAX score) were determined. The status of glycemic control was assessed by blood concentration of glycated hemoglobin (HbA1c). Results The prevalence of significant coronary artery stenosis (67.9% vs. 37.0%, P = 0.002) and degree of coronary atherosclerosis (Gensini score: 48.99 ± 48.88 vs. 15.07 ± 21.03, P < 0.001; SYNTAX score: 15.88 ± 16.36 vs. 7.28 ± 10.54, P = 0.003) were higher and FMD was lower (6.03 ± 2.08% vs. 6.94 ± 2.20%, P = 0.036) in diabetic patients with poor glycemic control (HbA1c ≥ 7.0%; n = 56) compared to those with good glycemic control (HbA1c < 7.0%; n = 46). Multivariate regression analysis revealed that tertile of FMD was an independent determinant of presence of significant coronary artery stenosis (OR = 0.227 95% CI 0.056–0.915, P = 0.037), Gensini score (β = − 0.470, P < 0.001) and SYNTAX score (β = − 0.349, P = 0.004) in diabetic patients with poor glycemic control but not for those with good glycemic control (P > 0.05). Conclusion Poor glycemic control negatively influences the association of endothelial dysfunction and coronary artery disease in T2DM patients.
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Affiliation(s)
- Shuai Chen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Ying Shen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Yong-Hua Liu
- Department of Cardiology, Bao Shan People's Hospital, Baoshan, Yunnan Province, China
| | - Yang Dai
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Zhi-Ming Wu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Xiao-Qun Wang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Chen-Die Yang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Le-Ying Li
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Jing-Meng Liu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Li-Ping Zhang
- Department of Cardiology, Bao Shan People's Hospital, Baoshan, Yunnan Province, China
| | - Wei-Feng Shen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Ri Ji
- Department of Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Lin Lu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China.
| | - Feng-Hua Ding
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China.
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Combination of R-R Interval and Crest Time in Assessing Complexity Using Multiscale Cross-Approximate Entropy in Normal and Diabetic Subjects. ENTROPY 2018; 20:e20070497. [PMID: 33265587 PMCID: PMC7513023 DOI: 10.3390/e20070497] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/16/2018] [Accepted: 06/22/2018] [Indexed: 12/17/2022]
Abstract
The present study aimed at testing the hypothesis that application of multiscale cross-approximate entropy (MCAE) analysis in the study of nonlinear coupling behavior of two synchronized time series of different natures [i.e., R-R interval (RRI) and crest time (CT, the time interval from foot to peakof a pulse wave)] could yield information on complexity related to diabetes-associated vascular changes. Signals of a single waveform parameter (i.e., CT) from photoplethysmography and RRI from electrocardiogram were simultaneously acquired within a period of one thousand cardiac cycles for the computation of different multiscale entropy indices from healthy young adults (n = 22) (Group 1), upper-middle aged non-diabetic subjects (n = 34) (Group 2) and diabetic patients (n = 34) (Group 3). The demographic (i.e., age), anthropometric (i.e., body height, body weight, waist circumference, body-mass index), hemodynamic (i.e., systolic and diastolic blood pressures), and serum biochemical (i.e., high- and low-density lipoprotein cholesterol, total cholesterol, and triglyceride) parameters were compared with different multiscale entropy indices including small- and large-scale multiscale entropy indices for CT and RRI [MEISS(CT), MEILS(CT), MEISS(RRI), MEILS(RRI), respectively] as well as small- and large-scale multiscale cross-approximate entropy indices [MCEISS, MCEILS, respectively]. The results demonstrated that both MEILS(RRI) and MCEILS significantly differentiated between Group 2 and Group 3 (all p < 0.017). Multivariate linear regression analysis showed significant associations of MEILS(RRI) and MCEILS(RRI,CT) with age and glycated hemoglobin level (all p < 0.017). The findings highlight the successful application of a novel multiscale cross-approximate entropy index in non-invasively identifying diabetes-associated subtle changes in vascular functional integrity, which is of clinical importance in preventive medicine.
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Potier L, Chequer R, Roussel R, Mohammedi K, Sismail S, Hartemann A, Amouyal C, Marre M, Le Guludec D, Hyafil F. Relationship between cardiac microvascular dysfunction measured with 82Rubidium-PET and albuminuria in patients with diabetes mellitus. Cardiovasc Diabetol 2018; 17:11. [PMID: 29325551 PMCID: PMC5763541 DOI: 10.1186/s12933-017-0652-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 12/23/2017] [Indexed: 12/14/2022] Open
Abstract
Background Albuminuria is of one the strongest predictors of cardiovascular disease (CVD) in diabetes. Diabetes is associated with cardiac microvascular dysfunction (CMD), a powerful, independent prognostic factor for cardiac mortality. The aim of this study was to evaluate the relationship between CMD and microvascular complications in patients without known CVD. Methods In this monocentric study, myocardial flow reserve (MFR) was measured with cardiac 82Rubidium positron emission tomography (Rb-PET) in 311 patients referred to nuclear medicine department of Bichat University Hospital for screening of coronary artery disease from 2012 to 2014. Patients with hemodynamically relevant stenosis on coronary angiography or myocardial ischemia on Rb-PET were excluded. Among patients with diabetes, MFR values were compared according to the presence of retinopathy and albuminuria. Results Overall, 175 patients (118 with type 2 diabetes) were included. MFR was significantly lower in patients with diabetes compared with those without diabetes (2.6 ± 1.1 vs. 3.3 ± 1.7; p < 0.005). In patients with diabetes, MFR decreased progressively in relation to albumin urinary excretion (normoalbuminuria: 2.9 ± 1.1, microalbuminuria: 2.3 ± 1.0, macroalbuminuria: 1.8 ± 0.7; p < 0.0001). MFR was not significantly different in patients with vs. without retinopathy (2.4 ± 1.0 vs. 2.7 ± 1.1, p = 0.07). Microalbuminuria and macroalbuminuria remained strongly associated with impaired MFR after multiple adjustments [odds ratio 2.6 (95% CI 1.1–8.4) and 5.3 (95% CI 1.2–44.7), respectively]. This association was confirmed when analyses were restricted to patients with low levels of coronary calcifications on computed tomography. Conclusions Impaired MFR was more frequent in patients with diabetes and was strongly associated with the degree of albuminuria suggesting that CMD and albuminuria might share common mechanisms. Electronic supplementary material The online version of this article (10.1186/s12933-017-0652-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louis Potier
- Department of Diabetology, Endocrinology and Nutrition, DHU-FIRE, HUPNVS, AP-HP, Paris, France. .,Paris Diderot-Sorbonne Paris Cité University, Paris, France. .,Centre de Recherche des Cordeliers, INSERM, U-1138, Paris, France.
| | - Renata Chequer
- Department of Nuclear Medicine, DHU-FIRE, HUPNVS, AP-HP, Paris, France
| | - Ronan Roussel
- Department of Diabetology, Endocrinology and Nutrition, DHU-FIRE, HUPNVS, AP-HP, Paris, France.,Paris Diderot-Sorbonne Paris Cité University, Paris, France.,Centre de Recherche des Cordeliers, INSERM, U-1138, Paris, France
| | - Kamel Mohammedi
- Department of Diabetology, Endocrinology and Nutrition, DHU-FIRE, HUPNVS, AP-HP, Paris, France.,Paris Diderot-Sorbonne Paris Cité University, Paris, France.,Centre de Recherche des Cordeliers, INSERM, U-1138, Paris, France
| | - Souad Sismail
- Department of Diabetology, Endocrinology and Nutrition, DHU-FIRE, HUPNVS, AP-HP, Paris, France
| | - Agnès Hartemann
- Department of Diabetology-Metabolism, Pitié-Salpêtrière-Charles Foix Hospital, AP-HP, Paris, France.,Pierre and Marie Curie University (UPMC), Sorbonne University, Paris, France.,INSERM U-1166, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Chloé Amouyal
- Department of Diabetology-Metabolism, Pitié-Salpêtrière-Charles Foix Hospital, AP-HP, Paris, France.,Pierre and Marie Curie University (UPMC), Sorbonne University, Paris, France.,INSERM U-1166, Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Michel Marre
- Department of Diabetology, Endocrinology and Nutrition, DHU-FIRE, HUPNVS, AP-HP, Paris, France.,Paris Diderot-Sorbonne Paris Cité University, Paris, France.,Centre de Recherche des Cordeliers, INSERM, U-1138, Paris, France
| | - Dominique Le Guludec
- Paris Diderot-Sorbonne Paris Cité University, Paris, France.,Department of Nuclear Medicine, DHU-FIRE, HUPNVS, AP-HP, Paris, France.,INSERM, U-1148, Paris, France
| | - Fabien Hyafil
- Paris Diderot-Sorbonne Paris Cité University, Paris, France.,Department of Nuclear Medicine, DHU-FIRE, HUPNVS, AP-HP, Paris, France.,INSERM, U-1148, Paris, France
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Chen X, Su T, Chen Y, He Y, Liu Y, Xu Y, Wei Y, Li J, He R. d-Ribose as a Contributor to Glycated Haemoglobin. EBioMedicine 2017; 25:143-153. [PMID: 29033370 PMCID: PMC5704047 DOI: 10.1016/j.ebiom.2017.10.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/28/2017] [Accepted: 10/02/2017] [Indexed: 12/19/2022] Open
Abstract
Glycated haemoglobin (HbA1c) is the most important marker of hyperglycaemia in diabetes mellitus. We show that d-ribose reacts with haemoglobin, thus yielding HbA1c. Using mass spectrometry, we detected glycation of haemoglobin with d-ribose produces 10 carboxylmethyllysines (CMLs). The first-order rate constant of fructosamine formation for d-ribose was approximately 60 times higher than that for d-glucose at the initial stage. Zucker Diabetic Fatty (ZDF) rat, a common model for type 2 diabetes mellitus (T2DM), had high levels of d-ribose and HbA1c, accompanied by a decrease of transketolase (TK) in the liver. The administration of benfotiamine, an activator of TK, significantly decreased d-ribose followed by a decline in HbA1c. In clinical investigation, T2DM patients with high HbA1c had a high level of urine d-ribose, though the level of their urine d-glucose was low. That is, d-ribose contributes to HbA1c, which prompts future studies to further explore whether d-ribose plays a role in the pathophysiological mechanism of T2DM.
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Affiliation(s)
- Xixi Chen
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Tao Su
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Yao Chen
- Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yingge He
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Ying Liu
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Yong Xu
- Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Yan Wei
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, University of Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Mental Health, Institute of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China.
| | - Juan Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Rongqiao He
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, University of Chinese Academy of Sciences, Beijing 100101, China; CAS Key Laboratory of Mental Health, Institute of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China; Alzheimer's Disease Center, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China.
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How Low to Go With Glucose, Cholesterol, and Blood Pressure in Primary Prevention of CVD. J Am Coll Cardiol 2017; 70:2171-2185. [DOI: 10.1016/j.jacc.2017.09.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/22/2017] [Accepted: 09/01/2017] [Indexed: 12/22/2022]
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von Scholten BJ, Rosendahl A, Hasbak P, Bergholdt R, Kjaer A, Rossing P, Hansen TW. Impaired coronary microcirculation in type 2 diabetic patients is associated with elevated circulating regulatory T cells and reduced number of IL-21R⁺ T cells. Cardiovasc Diabetol 2016; 15:67. [PMID: 27095356 PMCID: PMC4837587 DOI: 10.1186/s12933-016-0378-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 03/25/2016] [Indexed: 01/24/2023] Open
Abstract
Background Low-grade systemic inflammation is considered to participate in the progression of type 2 diabetes (T2D) and in diabetic complications. Methods To determine if circulating leukocytes were abnormally regulated in T2D patients, 8-color flow-cytometry (FACS) analysis was performed in a cross-sectional study of 37 T2D patients and 16 controls. Data obtained from the FACS analysis were compared to coronary flow reserve (CFR), assessed by Rb82-PET-imaging, to uncover inflammatory signatures associated with impaired CFR. Results Presence of T2D was associated with T cell attenuation characterized by reduced overall T cell, Th17, IL-21R+, Treg’s and TLR4+ T cells, while the monocyte population showed enhanced TLR4 expression. Further, our data revealed reduced M1-like CD11c expression in T2D which was associated with impaired CFR. In contrast, we show, for the first time in T2D, increased TLR4 expression on CD8 T cells, increased Treg cell number and Treg maturation and reduced IL-21R expression on CD8 T cells to be functionally associated with impaired CFR. Conclusions Our demonstration that HbA1c inversely correlates to several T cell populations suggests that T cells may play disease modulating roles in T2D. Further, the novel association between impaired CFR and regulatory T cells and IL-21R+ T cells imply an intricate balance in maintaining tissue homeostasis in vascular diabetic complications. Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0378-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bernt Johan von Scholten
- Department of Diabetic Complications, Steno Diabetes Center, Niels Steensens Vej 1, 2820, Gentofte, Denmark.
| | - Alexander Rosendahl
- Diabetes Complications Research, Novo Nordisk A/S, Måløv, Denmark.,Department of New Haemophilia, Novo Nordisk A/S, Gentofte, Denmark.,Baxalta Inc, Medical Affairs, Tobaksvej 2, 2860, Søborg, Denmark
| | - Philip Hasbak
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Copenhagen, Denmark
| | - Regine Bergholdt
- Diabetes Complications Research, Novo Nordisk A/S, Måløv, Denmark
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Copenhagen, Denmark
| | - Peter Rossing
- Department of Diabetic Complications, Steno Diabetes Center, Niels Steensens Vej 1, 2820, Gentofte, Denmark.,University of Copenhagen, Copenhagen, Denmark.,Aarhus University Denmark, Aarhus, Denmark
| | - Tine W Hansen
- Department of Diabetic Complications, Steno Diabetes Center, Niels Steensens Vej 1, 2820, Gentofte, Denmark
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