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Kovacs A, Bunduc S, Veres DS, Palinkas D, Gagyi EB, Hegyi PJ, Eross B, Mihaly E, Hegyi P, Hosszufalusi N. One third of cases of new-onset diabetic ketosis in adults are associated with ketosis-prone type 2 diabetes-A systematic review and meta-analysis. Diabetes Metab Res Rev 2024; 40:e3743. [PMID: 37888894 DOI: 10.1002/dmrr.3743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 10/28/2023]
Abstract
AIMS Ketosis-prone type 2 diabetes was defined by the World Health Organization in 2019. According to the literature, the diagnosis is based on the presence of ketosis, islet autoantibody negativity and preserved insulin secretion. Our meta-analysis assessed the prevalence and clinical characteristics of ketosis-prone type 2 diabetes among patients hospitalised with diabetic ketoacidosis (DKA) or ketosis. METHODS The systematic search was performed in five main databases as of 15 October 2021 without restrictions. We calculated the pooled prevalence of ketosis-prone type 2 diabetes (exposed group) within the diabetic population under examination, patients with ketoacidosis or ketosis, to identify the clinical characteristics, and we compared it to type 1 diabetes (the comparator group). The random effects model provided pooled estimates as prevalence, odds ratio and mean difference (MD) with 95% confidence intervals. RESULTS Eleven articles were eligible for meta-analysis, thus incorporating 2010 patients of various ethnic backgrounds. Among patients presenting with DKA or ketosis at the onset of diabetes, 35% (95% CI: 24%-49%) had ketosis-prone type 2 diabetes. These patients were older (MD = 11.55 years; 95% CI: 5.5-17.6) and had a significantly higher body mass index (BMI) (MD = 5.48 kg/m2 ; 95% CI: 3.25-7.72) than those with type 1 diabetes. CONCLUSIONS Ketosis-prone type 2 diabetes accounts for one third of DKA or ketosis at the onset of diabetes in adults. These patients are characterised by islet autoantibody negativity and preserved insulin secretion. They are older and have a higher BMI compared with type 1 diabetes. C-peptide and diabetes-related autoantibody measurement is essential to identify this subgroup among patients with ketosis at the onset of diabetes.
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Affiliation(s)
- Adrienn Kovacs
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Stefania Bunduc
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Fundeni Clinical Institute, Bucharest, Romania
| | - Daniel S Veres
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Daniel Palinkas
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Gastroenterology, Military Hospital-State Health Centre, Budapest, Hungary
| | - Endre B Gagyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Selye Janos Doctoral College for Advanced Studies, Semmelweis University, Budapest, Hungary
| | - Peter J Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Balint Eross
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Emese Mihaly
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Peter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nora Hosszufalusi
- Department of Internal Medicine and Hematology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Pethő B, Mátrai Á, Agócs G, Veres DS, Harnos A, Váncsa S, Bánhidy F, Hegyi P, Ács N. Maternal age is highly associated with non-chromosomal congenital anomalies: Analysis of a population-based case-control database. BJOG 2023. [PMID: 37012679 DOI: 10.1111/1471-0528.17461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/05/2023] [Accepted: 03/13/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE The role of maternal age in the development of non-chromosomal congenital anomalies (NCAs) is under debate. Therefore, the primary aim of this study was to identify the age groups at risk for NCAs. The secondary aim was to perform a detailed analysis of the relative frequency of various anomalies. DESIGN National population-based study. SETTING The Hungarian Case-Control Surveillance of Congenital Anomalies (CAs) between 1980 and 2009. POPULATION OR SAMPLE A cohort of 31 128 cases with confirmed NCAs was compared with Hungary's total of 2 808 345 live births. METHODS Clinicians prospectively reported cases after delivery. Data were analysed by non-linear logistic regression. Risk-increasing effect of young and advanced maternal age was determined by each NCA group. MAIN OUTCOME MEASURES These were the total number of NCAs: cleft lip and palate, circulatory, genital, musculoskeletal, digestive, urinary, eye, ear, face, and neck, nervous system, and respiratory system anomalies. RESULTS The occurrence of NCAs in our database was lowest between 23 and 32 years of maternal age at childbirth. The relative risk (RR) of any NCA was 1.2 (95% CI 1.17-1.23) and 1.15 (95% CI 1.11-1.19) in the very young and advanced age groups, respectively. The respective results for the circulatory system were RR = 1.07 (95% CI 1.01-1.13) and RR = 1.33 (95% CI 1.24-1.42); for cleft lip and palate RR = 1.09 (95% CI 1.01-1.19) and RR = 1.45 (95% CI 1.26-1.67); for genital organs RR = 1.15 (95% CI 1.08-1.22) and RR = 1.16 (95% CI 1.04-1.29); for the musculoskeletal system RR = 1.17 (95% CI 1.12-1.23) and RR = 1.29 (95% CI 1.14-1.44); and for the digestive system RR = 1.23 (95% CI 1.14-1.31) and RR = 1.16 (95% CI 1.04-1.29). CONCLUSION Very young and advanced maternal ages are associated with different types of NCAs. Therefore, screening protocols should be adjusted for these risk groups.
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Affiliation(s)
- B Pethő
- Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Á Mátrai
- Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - G Agócs
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - D S Veres
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - A Harnos
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Biostatics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - S Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Institute for Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - F Bánhidy
- Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - P Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Institute for Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - N Ács
- Department of Obstetrics and Gynaecology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Josa V, Ferenczi S, Szalai R, Fuder E, Kuti D, Horvath K, Hegedus N, Kovacs T, Bagamery G, Juhasz B, Winkler Z, Veres DS, Zrubka Z, Mathe D, Baranyai Z. Thrombocytosis and Effects of IL-6 Knock-Out in a Colitis-Associated Cancer Model. Int J Mol Sci 2020; 21:ijms21176218. [PMID: 32867390 PMCID: PMC7504541 DOI: 10.3390/ijms21176218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/17/2020] [Accepted: 08/22/2020] [Indexed: 12/11/2022] Open
Abstract
There is an increasing number of studies showing that thrombocytosis—accompanying a variety of solid tumors including colorectal cancer (CRC)—is associated with shorter survival and earlier development of metastases. The mechanisms of cancer-associated thrombocytosis are not completely understood yet. The aim of our study was to evaluate the role of IL-6 in tumor development and thrombocytosis in mice with inflammation-induced CRC, using a CRISPR/cas9 IL-6 knockout (KO) strain. Adult male FB/Ant mice (n = 39) were divided into four groups: (1) IL-6 KO controls (n = 5); (2) IL-6 KO CRC model group (n = 18); (3) Wild-type (WT) controls (n = 6); and (4) WT CRC model group (n = 10). CRC model animals in (2) and (4) received azoxymethane (AOM)/dextran sodium sulfate (DSS) treatment to induce inflammation-related CRC. Plasma and liver tissues were obtained to determine platelet counts, IL-6 and thrombopoietin-1 (TPO) levels. In 1 WT and 2 IL-6 KO mice in vivo confocal endomicroscopy and 18F-fluorodeoxyglucose (FDG) PET/MRI examinations were performed to evaluate the inflammatory burden and neoplastic transformation. At the end of the study, tumorous foci could be observed macroscopically in both CRC model groups. Platelet counts were significantly elevated in the WT CRC group compared to the IL-6 KO CRC group. TPO levels moved parallelly with platelet counts. In vivo fluorescent microscopy showed signs of disordered and multi-nuclear crypt morphology with increased mucus production in a WT animal, while regular mucosal structure was prominent in the IL-6 KO animals. The WT animal presented more intense and larger colonic FDG uptake than IL-6 KO animals. Our study confirmed thrombocytosis accompanying inflammation-related CRC and the crucial role of IL-6 in this process. Significantly higher platelet counts were found in the WT CRC group compared to both the control group and the IL-6 KO group. Concomitantly, the tumor burden of WT mice was also greater than that of IL-6 KO mice. Our findings are in line with earlier paraneoplastic IL-6 effect suggestions.
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Affiliation(s)
- Valeria Josa
- Jahn Ferenc Del-pesti Korhaz es Rendelointezet, Department of Otorhinolaryngology and Head and Neck Surgery, 1135 Budapest, Hungary
- Correspondence:
| | - Szilamer Ferenczi
- Laboratory of Molecular Neuroendocrinology, Institute of Experimental Medicine, 1083 Budapest, Hungary; (S.F.); (D.K.); (K.H.); (B.J.); (Z.W.)
| | - Rita Szalai
- Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary;
| | - Eniko Fuder
- Department of Pathology, Uzsoki utcai Hospital, 1145 Budapest, Hungary;
| | - Daniel Kuti
- Laboratory of Molecular Neuroendocrinology, Institute of Experimental Medicine, 1083 Budapest, Hungary; (S.F.); (D.K.); (K.H.); (B.J.); (Z.W.)
| | - Krisztina Horvath
- Laboratory of Molecular Neuroendocrinology, Institute of Experimental Medicine, 1083 Budapest, Hungary; (S.F.); (D.K.); (K.H.); (B.J.); (Z.W.)
| | - Nikolett Hegedus
- Department of Biophysics and Radiation Biology, Semmelweis University, 1094 Budapest, Hungary; (N.H.); (D.S.V.); (D.M.)
- CROmed Translational Research Ltd., 1094 Budapest, Hungary
| | - Tibor Kovacs
- Department of Biophysics and Radiation Biology, University of Pannonia, Institute of Radiochemistry and Radioecology, 8200 Veszprém, Hungary;
| | - Gergo Bagamery
- Mediso Medical Imaging Systems Ltd., 1037 Budapest, Hungary;
| | - Balazs Juhasz
- Laboratory of Molecular Neuroendocrinology, Institute of Experimental Medicine, 1083 Budapest, Hungary; (S.F.); (D.K.); (K.H.); (B.J.); (Z.W.)
| | - Zsuzsanna Winkler
- Laboratory of Molecular Neuroendocrinology, Institute of Experimental Medicine, 1083 Budapest, Hungary; (S.F.); (D.K.); (K.H.); (B.J.); (Z.W.)
| | - Daniel S. Veres
- Department of Biophysics and Radiation Biology, Semmelweis University, 1094 Budapest, Hungary; (N.H.); (D.S.V.); (D.M.)
| | - Zsombor Zrubka
- University Research, Innovation and Service Center, University of Óbuda, 1034 Budapest, Hungary;
| | - Domokos Mathe
- Department of Biophysics and Radiation Biology, Semmelweis University, 1094 Budapest, Hungary; (N.H.); (D.S.V.); (D.M.)
- CROmed Translational Research Ltd., 1094 Budapest, Hungary
- Hungarian Center for Excellence in Molecular Medicine, 6723 Szeged, Hungary
| | - Zsolt Baranyai
- 1st Department of Surgery, Semmelweis University, 1082 Budapest, Hungary;
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Lőrincz ÁM, Schütte M, Timár CI, Veres DS, Kittel Á, McLeish KR, Merchant ML, Ligeti E. Functionally and morphologically distinct populations of extracellular vesicles produced by human neutrophilic granulocytes. J Leukoc Biol 2015; 98:583-9. [PMID: 25986013 DOI: 10.1189/jlb.3vma1014-514r] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 03/23/2015] [Indexed: 02/01/2023] Open
Abstract
EVs in the microvesicle size range released during spontaneous death of human neutrophils were characterized and their properties compared with previously described EVs with antibacterial effect (aEVs, generated on specific activation) or produced spontaneously (sEVs). The 3 vesicle populations overlapped in size and in part of the constituent proteins were stained with annexin V and were impermeable to PI. However, none of them produced superoxide. In contrast, remarkable differences were observed in the morphology, abundance of proteins, and antibacterial function. EVs formed spontaneously in 30 min (sEVs) were more similar to EVs released during spontaneous death in 1-3 d than to EVs formed in 30 min on stimulation of opsonin receptors (aEVs). Spontaneously generated EVs had no antibacterial effect despite their large number and protein content. We hypothesized 2 parallel mechanisms: one that proceeds spontaneously and produces EVs without antibacterial effect and another process that is triggered by opsonin receptors and results in differential sorting of proteins into EVs with antibacterial capacity. Our results call attention to the functional and morphologic heterogeneity within the microvesicle/ectosome fraction of EVs.
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Affiliation(s)
- Ákos M Lőrincz
- *Department of Physiology and Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Institute of Experimental Medicine of the Hungarian Academy of Sciences, Budapest, Hungary; and Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Maria Schütte
- *Department of Physiology and Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Institute of Experimental Medicine of the Hungarian Academy of Sciences, Budapest, Hungary; and Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Csaba I Timár
- *Department of Physiology and Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Institute of Experimental Medicine of the Hungarian Academy of Sciences, Budapest, Hungary; and Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Daniel S Veres
- *Department of Physiology and Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Institute of Experimental Medicine of the Hungarian Academy of Sciences, Budapest, Hungary; and Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Ágnes Kittel
- *Department of Physiology and Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Institute of Experimental Medicine of the Hungarian Academy of Sciences, Budapest, Hungary; and Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Kenneth R McLeish
- *Department of Physiology and Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Institute of Experimental Medicine of the Hungarian Academy of Sciences, Budapest, Hungary; and Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Michael L Merchant
- *Department of Physiology and Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Institute of Experimental Medicine of the Hungarian Academy of Sciences, Budapest, Hungary; and Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Erzsébet Ligeti
- *Department of Physiology and Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Institute of Experimental Medicine of the Hungarian Academy of Sciences, Budapest, Hungary; and Department of Medicine, University of Louisville, Louisville, Kentucky, USA
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