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Xiao Y, Lanz B, Lim SI, Tkáč I, Xin L. Improved reproducibility of γ-aminobutyric acid measurement from short-echo-time proton MR spectroscopy by linewidth-matched basis sets in LCModel. NMR Biomed 2024; 37:e5056. [PMID: 37839823 DOI: 10.1002/nbm.5056] [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] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023]
Abstract
γ-Aminobutyric acid (GABA), as the primary inhibitory neurotransmitter, is extremely important for maintaining healthy brain function, and deviations from GABA homeostasis are related to various brain diseases. Short-echo-time (short-TE) proton MR spectroscopy (1 H-MRS) has been employed to measure GABA concentration from various human brain regions at high magnetic fields. The aim of this study was to investigate the effect of spectral linewidth on GABA quantification and explore the application of an optimized basis-set preparation approach using a spectral-linewidth-matched (LM) basis set in LCModel to improve the reproducibility of GABA quantification from short-TE 1 H-MRS. In contrast to the fixed-linewidth basis-set approach, the LM basis-set preparation approach, where all metabolite basis spectra were simulated with a linewidth 4 Hz narrower than that of water, showed a smaller standard deviation of estimated GABA concentration from synthetic spectra with varying linewidths and lineshapes. The test-retest reproducibility was assessed by the mean within-subject coefficient of variation, which improved from 19.2% to 12.0% in the thalamus, from 27.9% to 14.9% in the motor cortex, and from 9.7% to 2.8% in the medial prefrontal cortex using LM basis sets at 7 T. We conclude that spectral linewidth has a large effect on GABA quantification from short-TE 1 H-MRS data and that using LM basis sets in LCModel can improve the reproducibility of GABA quantification.
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Affiliation(s)
- Ying Xiao
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
- Animal Imaging and Technology, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Bernard Lanz
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
- Animal Imaging and Technology, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Song-I Lim
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
- Animal Imaging and Technology, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Ivan Tkáč
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lijing Xin
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
- Animal Imaging and Technology, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Tkáč I, Xie T, Shah N, Larson S, Dubinsky JM, Gomez-Pastor R, McLoughlin HS, Orr HT, Eberly LE, Öz G. Regional sex differences in neurochemical profiles of healthy mice measured by magnetic resonance spectroscopy at 9.4 tesla. Front Neurosci 2023; 17:1278828. [PMID: 37954878 PMCID: PMC10634209 DOI: 10.3389/fnins.2023.1278828] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/03/2023] [Indexed: 11/14/2023] Open
Abstract
Objective To determine sex differences in the neurochemical concentrations measured by in vivo proton magnetic resonance spectroscopy (1H MRS) of healthy mice on a genetic background commonly used for neurodegenerative disease models. Methods 1H MRS data collected from wild type mice with C57BL/6 or related genetic backgrounds in seven prior studies were used in this retrospective analysis. To be included, data had to be collected at 9.4 tesla magnetic field using advanced 1H MRS protocols, with isoflurane anesthesia and similar animal handling protocols, and a similar number of datasets from male and female mice had to be available for the brain regions analyzed. Overall, 155 spectra from female mice and 166 spectra from male mice (321 in total), collected from six brain regions (brainstem, cerebellum, cortex, hippocampus, hypothalamus, and striatum) at various ages were included. Results Concentrations of taurine, total creatine (creatine + phosphocreatine), ascorbate, glucose and glutamate were consistently higher in male vs. female mice in most brain regions. Striatum was an exception with similar total creatine in male and female mice. The sex difference pattern in the hypothalamus was notably different from other regions. Interaction between sex and age was significant for total creatine and taurine in the cerebellum and hippocampus. Conclusion Sex differences in regional neurochemical levels are small but significant and age-dependent, with consistent male-female differences across most brain regions. The neuroendocrine region hypothalamus displays a different pattern of sex differences in neurochemical levels. Differences in energy metabolism and cellular density may underlie the differences, with higher metabolic rates in females and higher osmoregulatory and antioxidant capacity in males.
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Affiliation(s)
- Ivan Tkáč
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States
| | - Tiankai Xie
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Nitya Shah
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Sarah Larson
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States
| | - Janet M. Dubinsky
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
| | - Rocio Gomez-Pastor
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
| | | | - Harry T. Orr
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Lynn E. Eberly
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, United States
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Mužik R, Knapčoková V, Saal B, Tkáč I. Effect of a Disease Management Program on the Adherence to Guideline-Recommended HbA1c Monitoring in Patients with Diabetes in Slovakia. Diabetes Ther 2023; 14:1685-1694. [PMID: 37477855 PMCID: PMC10499705 DOI: 10.1007/s13300-023-01447-9] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION Glycated hemoglobin (HbA1c) is a crucial marker of glucose control that is widely utilized in the management of diabetes mellitus. The aim of this study was to evaluate the effect of a diabetes management program (DMP) offered by a health insurance company, together with the effects of other factors associated with patient and physician characteristics, on the frequency of HbA1c testing in outpatient diabetes clinics in Slovakia. METHODS A retrospective analysis was conducted to compare the frequency of HbA1c measurements in patients under the care of physicians participating in the DMP with those who did not, spanning the years 2015 to 2019. In 2019, a total of 74,384 patients with diabetes were included in the analysis, of which 52% were men and 48% were women, with an average age of 64.1 years. RESULTS At the end of the study period, the average annual number of HbA1c measurements was significantly higher in patients treated by physicians participating in the DMP than in patients treated by physicians who were not (2.50 vs. 1.91 per year, respectively; P < 0.001). There was a substantial increase in HbA1c testing at least twice yearly in both groups, but the growth rate was greater in the group with DMP-engaged diabetologists (14.3%) compared to the diabetes specialists who were not involved in the DMP (5.1%). In the multivariate analysis, participation in the DMP was correlated with an increase in HbA1c tests per year by 0.7. CONCLUSIONS Physician participation in a DMP was found to significantly increase the number of HbA1c tests ordered by physicians, potentially leading to improved glycemic control.
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Affiliation(s)
- Roman Mužik
- DÔVERA Health Insurance Company, Einsteinova 25, 85101, Bratislava, Slovakia.
| | - Veronika Knapčoková
- DÔVERA Health Insurance Company, Einsteinova 25, 85101, Bratislava, Slovakia
| | - Beáta Saal
- DÔVERA Health Insurance Company, Einsteinova 25, 85101, Bratislava, Slovakia
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, P.J. Šafárik University-L. Pasteur University Hospital, Košice, Slovakia
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Rašiová M, Koščo M, Moščovič M, Pavlíková V, Habalová V, Židzik J, Tormová Z, Hudák M, Bavoľárová M, Perečinský S, Dekanová L, Tkáč I. Factors associated with all-cause mortality following endovascular abdominal aortic aneurysm repair. VASA 2023; 52:325-331. [PMID: 37350324 DOI: 10.1024/0301-1526/a001081] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Background: Knowledge of factors that influence all-cause mortality after endovascular abdominal aortic aneurysm repair (EVAR) could improve therapeutic strategies post-EVAR and thus patient prognosis. Our study aimed to evaluate the association between sociodemographic information, comorbidities, laboratory parameters, treatment, selected anatomical and genetic factors and all-cause mortality post-EVAR. Patients and methods: We reviewed all patients who had undergone elective EVAR for non-ruptured abdominal aortic aneurysm (AAA) between January 2010 and December 2019. AAA size (maximum diameter and volume) was measured using CT-angiography. Sac expansion was defined as at least 5 mm increase, sac regression as at least 5 mm decrease in the sac diameter determined at 36±3 months post-EVAR in relation to pre-EVAR AAA diameter. Adjustments were performed for age, hypertension, diabetes mellitus, dyslipidaemia, sex, smoking, number of lumbar arteries, patency of inferior mesenteric artery and number of reinterventions post-EVAR. Results: One hundred and sixty-two patients (150 men, 12 women) with a mean age of 72.6±7.3 years were included in the analysis. Pre-EVAR AAA diameter (HR 1.07; 95% CI 1.03 - 1.12; p=0.001), pre-EVAR AAA volume (HR 1.01; 95% CI 1.002 - 1.011; p=0.008), post-EVAR sac diameter (HR 1.06; 95% CI 1.03 - 1.10; p=0.000), post-EVAR sac volume (HR 1.01; 95% CI 1.002 - 1.011; p=0.006) and anticoagulation therapy (HR 2.46; 95% CI 1.18 - 5.14; p=0.019) were associated with higher mortality in multivariate analysis. Sac regression (HR 0.42; 95% CI 0.22 - 0.82; p=0.011), and treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) (HR 0.71; 95% CI 0.36 - 0.97; p=0.047) were associated with lower mortality. Conclusions: Greater pre- and post-EVAR diameter and volume, failure of sac regression and anticoagulation were associated with higher mortality post-EVAR. Reduced mortality was observed in patients treated with ACE inhibitors or ARBs, and in patients with AAA sac regression.
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Affiliation(s)
- Mária Rašiová
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Martin Koščo
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Matej Moščovič
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Veronika Pavlíková
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Viera Habalová
- Department of Medicine Biology, Faculty of Medicine, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Jozef Židzik
- Department of Medicine Biology, Faculty of Medicine, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Zuzana Tormová
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Marek Hudák
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Marta Bavoľárová
- Department of Cardiology, Štefan Kukura Hospital, Michalovce, Slovakia
| | - Slavomír Perečinský
- Department of Occupational Medicine and Clinical Toxicology, Faculty of Medicine, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Lucia Dekanová
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, University of Pavol Jozef Šafárik, Košice, Slovakia
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, University of Pavol Jozef Šafárik, Košice, Slovakia
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Bednářová A, Habalová V, Tkáč I. BDNF rs962369 Is Associated with Major Depressive Disorder. Biomedicines 2023; 11:2243. [PMID: 37626739 PMCID: PMC10452342 DOI: 10.3390/biomedicines11082243] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/30/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
This study enrolled 291 patients diagnosed with depression and schizophrenia (F32, F33, and F20 according to ICD-10) and 227 ethnicity-matched control subjects. We analyzed the distribution of BDNF rs6265 and BDNF rs962369 genotypes, finding no significant associations between these and schizophrenia. We revealed a significant increase in the risk of single-episode major depression disorder (MDD) for rs962369 minor allele homozygotes (CC vs. TT+TC), an association that persisted after adjusting for age and sex (OR 3.47; 95% CI 1.36-8.85; p = 0.009). Furthermore, rs962369 genotype was significantly associated with an increased risk of recurrent MDD in a log-additive model (OR per C-allele 1.65; 95% CI 1.11-2.45; p = 0.013). A comparative analysis between MDD subtypes and between MDD subtypes and schizophrenia showed no significant differences for BDNF rs6265. Notably, the frequency of minor allele C of BDNF rs962369 varied across subgroups, with the highest frequency in patients with recurrent MDD (0.32) and the lowest in schizophrenia patients (0.20). The presence of genotypes with at least one minor allele C was significantly higher in the recurrent MDD patient group compared to the schizophrenia group. In conclusion, the BDNF rs962369 variant was associated with MDD but not with schizophrenia.
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Affiliation(s)
- Aneta Bednářová
- 2nd Department of Psychiatry, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, 041 90 Kosice, Slovakia
| | - Viera Habalová
- Department of Medical Biology, Faculty of Medicine, Pavol Jozef Safarik University, 040 11 Kosice, Slovakia;
| | - Ivan Tkáč
- 4th Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, 041 90 Kosice, Slovakia;
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Stančáková Yaluri A, Tkáč I, Tokarčíková K, Kozelová Z, Rašiová M, Javorský M, Kozárová M. Decreased 25-Hydroxy Vitamin D Level Is Associated with All-Cause Mortality in Patients with Type 2 Diabetes at High Cardiovascular Risk. Metabolites 2023; 13:887. [PMID: 37623831 PMCID: PMC10456820 DOI: 10.3390/metabo13080887] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Cardiovascular diseases are among the leading causes of morbidity and mortality, particularly in individuals with type 2 diabetes. There is a need for new biomarkers to improve the prediction of cardiovascular events and overall mortality. We investigated the association of selected atherosclerosis related biomarkers, specifically osteoprotegerin (OPG), 25-hydroxy-vitamin D (25(OH)D), C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), and asymmetric dimethylarginine (ADMA), with the occurrence of any cardiovascular event or all-cause mortality (primary outcome) during a 5.6-year follow-up of 190 patients with type 2 diabetes. Data were analyzed using logistic regression to adjust for baseline cardiovascular status and cardiovascular risk factors. The primary outcome occurred in 89 participants (46.8%) during the study. When analyzed individually, 25(OH)D, CRP, and LBP significantly predicted the primary outcome in multivariable models. However, in a model that included all biomarkers, only a decreased level of 25(OH)D remained a significant predictor of the primary outcome. Moreover, the level of 25(OH)D significantly predicted all-cause mortality: a reduction of 10 ng/mL was associated with a two-fold increase in all-cause mortality. Our study thus demonstrates that vitamin D deficiency was the strongest factor associated with the primary outcome and all-cause mortality after a 5.6-year follow-up in patients with type 2 diabetes at high cardiovascular risk.
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Affiliation(s)
- Alena Stančáková Yaluri
- Department of Internal Medicine 4, Faculty of Medicine, P. J. Šafárik University and L. Pasteur University Hospital, 04190 Košice, Slovakia; (A.S.Y.); (K.T.); (Z.K.); (M.J.)
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, P. J. Šafárik University and L. Pasteur University Hospital, 04190 Košice, Slovakia; (A.S.Y.); (K.T.); (Z.K.); (M.J.)
| | - Katarína Tokarčíková
- Department of Internal Medicine 4, Faculty of Medicine, P. J. Šafárik University and L. Pasteur University Hospital, 04190 Košice, Slovakia; (A.S.Y.); (K.T.); (Z.K.); (M.J.)
| | - Zuzana Kozelová
- Department of Internal Medicine 4, Faculty of Medicine, P. J. Šafárik University and L. Pasteur University Hospital, 04190 Košice, Slovakia; (A.S.Y.); (K.T.); (Z.K.); (M.J.)
| | - Mária Rašiová
- Department of Angiology, Faculty of Medicine, P. J. Šafárik University and East Slovak Institute of Cardiovascular Disease, 04011 Košice, Slovakia;
| | - Martin Javorský
- Department of Internal Medicine 4, Faculty of Medicine, P. J. Šafárik University and L. Pasteur University Hospital, 04190 Košice, Slovakia; (A.S.Y.); (K.T.); (Z.K.); (M.J.)
| | - Miriam Kozárová
- Department of Internal Medicine 4, Faculty of Medicine, P. J. Šafárik University and L. Pasteur University Hospital, 04190 Košice, Slovakia; (A.S.Y.); (K.T.); (Z.K.); (M.J.)
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Martinka E, Dravecká I, Tkáč I. Switching from Multiple Insulin Injections to a Fixed Combination of Degludec and Liraglutide in Patients with Type 2 Diabetes Mellitus: Results from the Simplify Study After 6 Months. Diabetes Ther 2023:10.1007/s13300-023-01435-z. [PMID: 37402960 PMCID: PMC10363096 DOI: 10.1007/s13300-023-01435-z] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/12/2023] [Indexed: 07/06/2023] Open
Abstract
INTRODUCTION This study aimed to evaluate the effectiveness and safety of switching from basal bolus insulin treatment (BBIT) to a fixed combination of insulin degludec and liraglutide (IDegLira) in patients with type 2 diabetes mellitus (T2DM) who had preserved insulin secretion but inadequate glucose control. The study also aimed to assess the feasibility of implementing this therapeutic approach in common clinical practice settings. METHODS This was a non-randomized, open-label, multicenter, prospective, single-arm study involving 234 patients with T2DM who were receiving BBIT. Inclusion criteria were duration of diabetes mellitus > 60 months, stable total daily dose of insulin (TDDI) ranging from > 20 to < 70 IU/day (approx. > 0.3 to < 0.7 IU/kg body weight/day), C-peptide levels > 10% above the lower limit, HbA1c levels > 7% and < 10% (Diabetes Control and Complications Trial), and body mass index > 25 kg/m2. The primary endpoints were changes in glycated hemoglobin (HbA1c) and body weight at week 28 after treatment switching. Secondary endpoints included changes in the 7-point glycemic profile, hypoglycemia frequency, blood pressure, blood lipids, liver enzymes, insulin dose, and a patient questionnaire focusing on treatment satisfaction, concerns and impact on daily activities. A subgroup of 55 patients underwent continuous glucose monitoring (CGM) with the evaluation of CGM-derived parameters, such as time in range (TIR), time above range (TAR), time below range (TBR), hypoglycemia, and glucose variability. RESULTS A significant decrease in HbA1c (8.6% vs. 7.6%; p < 0.0001) and body weight (97.8 vs. 94.0 kg; p < 0.0001) was observed at week 28 after treatment switching. Significant improvements were also seen in all measurements of the 7-point glycemic profile (p < 0.0001), reduction in the number of hypoglycemia episodes per patient, and the proportion of patients with at least one hypoglycemia event (p < 0.001). Furthermore, there was a significant decrease in daily insulin dose (55.6 vs. 32.7 IU/day; p < 0.0001), as well as improvements in blood pressure, blood lipids, and liver enzymes (gamma glutamyl transferase and alanine aminotransferase). The subgroup of patients who underwent CGM showed a significant increase in TIR (57.9% vs. 69.0%; p < 0.01) and a decrease in TAR (40.1% vs. 28.8%; p < 0.01), while TBR, hypoglycemia (number of episodes per patient and proportion of patients), and glucose variability did not change significantly. CONCLUSION The results of this study suggest that switching from BBIT to IDegLira in patients with T2DM and preserved insulin secretion can simplify treatment without compromising glycemic control. The switch to IDegLira was associated with significant improvements in various glucose control parameters, including HbA1c, glycemic profile, hypoglycemia, insulin doses, and CGM-derived parameters TIR and TAR. Additionally, it led to significant reductions in body weight, blood pressure, lipid profile, and liver enzyme levels. Switching to IDegLira may be considered a safe and beneficial approach in clinical practice settings, offering metabolic and individual advantages.
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Affiliation(s)
- Emil Martinka
- National Institute of Endocrinology and Diabetology, Ľubochňa, Slovakia.
| | - Ingrid Dravecká
- Department of Internal Medicine 1, Faculty of Medicine, P.J. Šafárik University-L. Pasteur University Hospital, Košice, Slovakia
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, P.J. Šafárik University-L. Pasteur University Hospital, Košice, Slovakia
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Satrom KM, Rao RB, Tkáč I. Neonatal hyperbilirubinemia differentially alters the neurochemical profiles of the developing cerebellum and hippocampus in a preterm Gunn rat model. NMR Biomed 2023:e4946. [PMID: 37009906 DOI: 10.1002/nbm.4946] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 06/19/2023]
Abstract
Neonatal hyperbilirubinemia (NHB) can lead to brain injury in newborn infants by affecting specific regions including the cerebellum and hippocampus. Extremely preterm infants are more vulnerable to bilirubin neurotoxicity, but the mechanism and extent of injury is not well understood. A preterm version of the Gunn rat model was utilized to investigate severe preterm NHB. Homozygous/jaundiced Gunn rat pups were injected (i.p.) on postnatal day (P) 5 with sulfadimethoxine, which increases serum free bilirubin capable of crossing the blood-brain barrier and causing brain injury. The neurochemical profiles of the cerebellum and hippocampus were determined using in vivo 1 H MRS at 9.4 T on P30 and compared with those of heterozygous/non-jaundiced control rats. Transcript expression of related genes was determined by real-time quantitative PCR. MRI revealed significant morphological changes in the cerebellum of jaundiced rats. The concentrations of myo-inositol (+54%), glucose (+51%), N-acetylaspartylglutamate (+21%), and the sum of glycerophosphocholine and phosphocholine (+17%) were significantly higher in the cerebellum of the jaundiced group compared with the control group. Despite the lack of morphologic changes in the hippocampus, the concentration of myo-inositol (+9%) was higher and the concentrations of creatine (-8%) and of total creatine (-3%) were lower in the jaundiced group. In the hippocampus, expression of calcium/calmodulin dependent protein kinase II alpha (Camk2a), glucose transporter 1 (Glut1), and Glut3 transcripts were downregulated in the jaundiced group. In the cerebellum, glial fibrillary acidic protein (Gfap), myelin basic protein (Mbp), and Glut1 transcript expression was upregulated in the jaundiced group. These results indicate osmotic imbalance, gliosis, and changes in energy utilization and myelination, and demonstrate that preterm NHB critically affects brain development in a region-specific manner, with the cerebellum more severely impacted than the hippocampus.
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Affiliation(s)
- Katherine M Satrom
- Department of Pediatrics, Division of Neonatology, University of Minnesota, Minneapolis, MN, USA
| | - Raghavendra B Rao
- Department of Pediatrics, Division of Neonatology, University of Minnesota, Minneapolis, MN, USA
| | - Ivan Tkáč
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
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Rašiová M, Koščo M, Moščovič M, Habalová V, Židzik J, Tormová Z, Bavoľárová M, Perečinský S, Hudák M, Kočan L, Tkáč I. Positive association between calcium channel blocker treatment and persistent type II endoleak. INT ANGIOL 2022; 41:277-284. [PMID: 35373941 DOI: 10.23736/s0392-9590.22.04847-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Type II endoleaks are the most common complication occuring after endovascular abdominal aortic aneurysm repair (EVAR). The aim of our study was to evaluate the impact of persistent type II endoleak on sac dynamics post-EVAR, and to study the association between non-anatomical factors including polymorphisms associated with abdominal aortic aneurysm (AAA) and persistent type II endoleak. METHODS The cohort comprises of 210 patients undergoing EVAR between January, 2010 and December, 2018. A persistent type II endoleak was defined as any type II endoleak lasting longer than six months and included also a type II endoleak diagnosed after six months or more post-EVAR during the 36-month follow-up period confirmed with CT-angiography. Anteroposterior AAA maximum diameter and AAA volume were measured pre-EVAR and 36 months post-EVAR using CT-angiographic pictures. Sac progression was defined as at least 5 mm increase, sac regression as at least 5 mm decrease in the sac diameter in relation to the preprocedural diameter. Sociodemographic information, comorbidities, treatment, laboratory parameters, selected anatomical and genetic factors were all analysed to determine their impact on persistent type II endoleak. The adjustments included age, hypertension, diabetes mellitus, dyslipidaemia, sex, smoking in multivariate analyses. When postprocedural diameter and volume were evaluated, adjustments included also preprocedural diameter/volume. RESULTS After exclusion, 178 pacients with mean age 72.4±7.60 years remained for analysis. Persistent type II endoleak was found in 27.5% of patients (n=49) and 2.94-times increased risk of sac progression in multivariate analysis (p=0.033). In multivariate analysis, AAA diameter in patients with persistent type II endoleak was 4.31 mm greater than in patients without (B=4.31; p=0.014); and its presence was also associated with 22.0 cm³ greater sac volume (B=22.0; p=0.034) compared to patients without persistent type II endoleak. Treatment with calcium channel blockers increased risk of persistent type II endoleak 2.11-times in multivariate analysis (OR 2.11; 95% CI 1.05-4.25; p=0.037). No association between persistent type II endoleak and selected polymorphisms associated with AAA and other observed factors was found. CONCLUSIONS Risk of persistent type II endoleak was more than doubled in patients taking calcium channel blockers. Patients with persistent type II endoleak had greater anteroposterior sac diameter and sac volume compared to patients without persistent type II endoleak.
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Affiliation(s)
- Mária Rašiová
- Department of Angiology, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Šafárik University, Košice, Slovakia -
| | - Martin Koščo
- Department of Angiology, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Matej Moščovič
- Department of Angiology, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Viera Habalová
- Department of Medicine Biology, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Jozef Židzik
- Department of Medicine Biology, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Zuzana Tormová
- Department of Angiology, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Marta Bavoľárová
- Department of Cardiology, Štefan Kukura Hospital, Michalovce, Slovakia
| | - Slavomír Perečinský
- Department of Occupational Medicine and Clinical Toxicology, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Marek Hudák
- Department of Angiology, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Ladislav Kočan
- Department of Anaesthesiology and Intensive Medicine, East Slovak Institute of Cardiovascular Diseases, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, Šafárik University, Košice, Slovakia
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10
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Simicic D, Rackayova V, Xin L, Tkáč I, Borbath T, Starcuk Z, Starcukova J, Lanz B, Cudalbu C. In vivo macromolecule signals in rat brain 1 H-MR spectra at 9.4T: Parametrization, spline baseline estimation, and T 2 relaxation times. Magn Reson Med 2021; 86:2384-2401. [PMID: 34268821 PMCID: PMC8596437 DOI: 10.1002/mrm.28910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/25/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Reliable detection and fitting of macromolecules (MM) are crucial for accurate quantification of brain short-echo time (TE) 1 H-MR spectra. An experimentally acquired single MM spectrum is commonly used. Higher spectral resolution at ultra-high field (UHF) led to increased interest in using a parametrized MM spectrum together with flexible spline baselines to address unpredicted spectroscopic components. Herein, we aimed to: (1) implement an advanced methodological approach for post-processing, fitting, and parametrization of 9.4T rat brain MM spectra; (2) assess the concomitant impact of the LCModel baseline and MM model (ie, single vs parametrized); and (3) estimate the apparent T2 relaxation times for seven MM components. METHODS A single inversion recovery sequence combined with advanced AMARES prior knowledge was used to eliminate the metabolite residuals, fit, and parametrize 10 MM components directly from 9.4T rat brain in vivo 1 H-MR spectra at different TEs. Monte Carlo simulations were also used to assess the concomitant influence of parametrized MM and DKNTMN parameter in LCModel. RESULTS A very stiff baseline (DKNTMN ≥ 1 ppm) in combination with a single MM spectrum led to deviations in metabolite concentrations. For some metabolites the parametrized MM showed deviations from the ground truth for all DKNTMN values. Adding prior knowledge on parametrized MM improved MM and metabolite quantification. The apparent T2 ranged between 12 and 24 ms for seven MM peaks. CONCLUSION Moderate flexibility in the spline baseline was required for reliable quantification of real/experimental spectra based on in vivo and Monte Carlo data. Prior knowledge on parametrized MM improved MM and metabolite quantification.
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Affiliation(s)
- Dunja Simicic
- CIBM Center for Biomedical Imaging, Switzerland.,Animal Imaging and Technology, EPFL, Lausanne, Switzerland.,Laboratory for functional and metabolic imaging (LIFMET), EPFL, Lausanne, Switzerland
| | - Veronika Rackayova
- CIBM Center for Biomedical Imaging, Switzerland.,Animal Imaging and Technology, EPFL, Lausanne, Switzerland
| | - Lijing Xin
- CIBM Center for Biomedical Imaging, Switzerland.,Animal Imaging and Technology, EPFL, Lausanne, Switzerland
| | - Ivan Tkáč
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tamas Borbath
- High-Field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.,Faculty of Science, University of Tübingen, Tübingen, Germany
| | - Zenon Starcuk
- Institute of Scientific Instruments, Czech Academy of Sciences, Brno, Czech Republic
| | - Jana Starcukova
- Institute of Scientific Instruments, Czech Academy of Sciences, Brno, Czech Republic
| | - Bernard Lanz
- Laboratory for functional and metabolic imaging (LIFMET), EPFL, Lausanne, Switzerland
| | - Cristina Cudalbu
- CIBM Center for Biomedical Imaging, Switzerland.,Animal Imaging and Technology, EPFL, Lausanne, Switzerland
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11
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Cudalbu C, Behar KL, Bhattacharyya PK, Bogner W, Borbath T, de Graaf RA, Gruetter R, Henning A, Juchem C, Kreis R, Lee P, Lei H, Marjańska M, Mekle R, Murali-Manohar S, Považan M, Rackayová V, Simicic D, Slotboom J, Soher BJ, Starčuk Z, Starčuková J, Tkáč I, Williams S, Wilson M, Wright AM, Xin L, Mlynárik V. Contribution of macromolecules to brain 1 H MR spectra: Experts' consensus recommendations. NMR Biomed 2021; 34:e4393. [PMID: 33236818 PMCID: PMC10072289 DOI: 10.1002/nbm.4393] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 05/08/2023]
Abstract
Proton MR spectra of the brain, especially those measured at short and intermediate echo times, contain signals from mobile macromolecules (MM). A description of the main MM is provided in this consensus paper. These broad peaks of MM underlie the narrower peaks of metabolites and often complicate their quantification but they also may have potential importance as biomarkers in specific diseases. Thus, separation of broad MM signals from low molecular weight metabolites enables accurate determination of metabolite concentrations and is of primary interest in many studies. Other studies attempt to understand the origin of the MM spectrum, to decompose it into individual spectral regions or peaks and to use the components of the MM spectrum as markers of various physiological or pathological conditions in biomedical research or clinical practice. The aim of this consensus paper is to provide an overview and some recommendations on how to handle the MM signals in different types of studies together with a list of open issues in the field, which are all summarized at the end of the paper.
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Affiliation(s)
- Cristina Cudalbu
- Center for Biomedical Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Vaud, Switzerland
| | - Kevin L Behar
- Magnetic Resonance Research Center and Department of Psychiatry, Yale University, New Haven, Connecticut, USA
| | | | - Wolfgang Bogner
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - Tamas Borbath
- High-Field Magnetic Resonance, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany
- Faculty of Science, Eberhard-Karls Universität Tübingen, Tübingen, Germany
| | - Robin A de Graaf
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut, USA
| | - Rolf Gruetter
- Laboratory for Functional and Metabolic Imaging, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Anke Henning
- High-Field Magnetic Resonance, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, Germany
| | - Christoph Juchem
- Departments of Biomedical Engineering and Radiology, Columbia University, New York, USA
| | - Roland Kreis
- Departments of Radiology and Biomedical Research, University of Bern, Bern, Switzerland
| | - Phil Lee
- Department of Radiology, Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hongxia Lei
- Center for Biomedical Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Vaud, Switzerland
| | - Małgorzata Marjańska
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ralf Mekle
- Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Saipavitra Murali-Manohar
- High-Field Magnetic Resonance, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany
- Faculty of Science, Eberhard-Karls Universität Tübingen, Tübingen, Germany
| | - Michal Považan
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Veronika Rackayová
- Center for Biomedical Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Vaud, Switzerland
- Laboratory for Functional and Metabolic Imaging, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Dunja Simicic
- Center for Biomedical Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Vaud, Switzerland
- Laboratory for Functional and Metabolic Imaging, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Johannes Slotboom
- University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern and Inselspital, Bern, Switzerland
| | - Brian J Soher
- Center for Advanced MR Development, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Zenon Starčuk
- Czech Academy of Sciences, Institute of Scientific Instruments, Brno, Czech Republic
| | - Jana Starčuková
- Czech Academy of Sciences, Institute of Scientific Instruments, Brno, Czech Republic
| | - Ivan Tkáč
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stephen Williams
- Division of Informatics, Imaging and Data Science, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Martin Wilson
- Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, UK
| | - Andrew Martin Wright
- High-Field Magnetic Resonance, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany
- IMPRS for Cognitive and Systems Neuroscience, Eberhard-Karls Universität Tübingen, Tübingen, Germany
| | - Lijing Xin
- Center for Biomedical Imaging, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Vaud, Switzerland
| | - Vladimír Mlynárik
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
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12
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Tkáč I, Deelchand D, Dreher W, Hetherington H, Kreis R, Kumaragamage C, Považan M, Spielman DM, Strasser B, de Graaf RA. Water and lipid suppression techniques for advanced 1 H MRS and MRSI of the human brain: Experts' consensus recommendations. NMR Biomed 2021; 34:e4459. [PMID: 33327042 PMCID: PMC8569948 DOI: 10.1002/nbm.4459] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 11/23/2020] [Indexed: 05/09/2023]
Abstract
The neurochemical information provided by proton magnetic resonance spectroscopy (MRS) or MR spectroscopic imaging (MRSI) can be severely compromised if strong signals originating from brain water and extracranial lipids are not properly suppressed. The authors of this paper present an overview of advanced water/lipid-suppression techniques and describe their advantages and disadvantages. Moreover, they provide recommendations for choosing the most appropriate techniques for proper use. Methods of water signal handling are primarily focused on the VAPOR technique and on MRS without water suppression (metabolite cycling). The section on lipid-suppression methods in MRSI is divided into three parts. First, lipid-suppression techniques that can be implemented on most clinical MR scanners (volume preselection, outer-volume suppression, selective lipid suppression) are described. Second, lipid-suppression techniques utilizing the combination of k-space filtering, high spatial resolutions and lipid regularization are presented. Finally, three promising new lipid-suppression techniques, which require special hardware (a multi-channel transmit system for dynamic B1+ shimming, a dedicated second-order gradient system or an outer volume crusher coil) are introduced.
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Affiliation(s)
- Ivan Tkáč
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Dinesh Deelchand
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Wolfgang Dreher
- Department of Chemistry, In vivo-MR Group, University Bremen, Bremen, Germany
| | - Hoby Hetherington
- Department of Radiology Magnetic Resonance Research Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roland Kreis
- Departments of Radiology and Biomedical Research, University Bern, Bern, Switzerland
| | - Chathura Kumaragamage
- Department of Radiology and Biomedical Imaging, Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
| | - Michal Považan
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel M. Spielman
- Department of Radiology, Stanford University, Stanford, California, CA, USA
| | - Bernhard Strasser
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Department of Radiology, Boston, MA, USA
| | - Robin A. de Graaf
- Department of Radiology and Biomedical Imaging, Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
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13
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Lin A, Andronesi O, Bogner W, Choi I, Coello E, Cudalbu C, Juchem C, Kemp GJ, Kreis R, Krššák M, Lee P, Maudsley AA, Meyerspeer M, Mlynarik V, Near J, Öz G, Peek AL, Puts NA, Ratai E, Tkáč I, Mullins PG. Minimum Reporting Standards for in vivo Magnetic Resonance Spectroscopy (MRSinMRS): Experts' consensus recommendations. NMR Biomed 2021; 34:e4484. [PMID: 33559967 PMCID: PMC8647919 DOI: 10.1002/nbm.4484] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 11/24/2020] [Accepted: 01/12/2021] [Indexed: 05/08/2023]
Abstract
The translation of MRS to clinical practice has been impeded by the lack of technical standardization. There are multiple methods of acquisition, post-processing, and analysis whose details greatly impact the interpretation of the results. These details are often not fully reported, making it difficult to assess MRS studies on a standardized basis. This hampers the reviewing of manuscripts, limits the reproducibility of study results, and complicates meta-analysis of the literature. In this paper a consensus group of MRS experts provides minimum guidelines for the reporting of MRS methods and results, including the standardized description of MRS hardware, data acquisition, analysis, and quality assessment. This consensus statement describes each of these requirements in detail and includes a checklist to assist authors and journal reviewers and to provide a practical way for journal editors to ensure that MRS studies are reported in full.
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Affiliation(s)
- Alexander Lin
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Ovidiu Andronesi
- Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
| | - In‐Young Choi
- Department of Neurology, Hoglund Biomedical Imaging CenterUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Eduardo Coello
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Cristina Cudalbu
- Center for Biomedical Imaging (CIBM), Ecole Polytechnique Fédérale de LausanneLausanneSwitzerland
| | - Christoph Juchem
- Departments of Biomedical Engineering and RadiologyColumbia UniversityNew YorkNew YorkUSA
| | - Graham J. Kemp
- Department of Musculoskeletal and Ageing Science and Liverpool Magnetic Resonance Imaging Centre (LiMRIC)University of LiverpoolLiverpoolUK
| | - Roland Kreis
- Departments of Radiology and Biomedical ResearchUniversity of BernBernSwitzerland
| | - Martin Krššák
- Department of Medicine III and Department of Biomedical Imaging and Image guided TherapyMedical University of ViennaViennaAustria
| | - Phil Lee
- Department of Radiology, Hoglund Biomedical Imaging CenterUniversity of Kansas Medical CenterKansas CityKansasUSA
| | | | - Martin Meyerspeer
- High Field MR Center, Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
| | - Vladamir Mlynarik
- Magnetic Resonance Centre of Excellence. Medical University of ViennaViennaAustria
| | - Jamie Near
- Brain Imaging Centre, Douglas Research Centre, Department of PsychiatryMcGill UniversityMontrealQuebecCanada
| | - Gülin Öz
- Center for Magnetic Resonance Research, Department of RadiologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Aimie L. Peek
- Faculty of Health SciencesUniversity of SydneySydneyAustralia
| | - Nicolaas A. Puts
- Department of Forensic and Neurodevelopmental SciencesSackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King's College LondonLondonUK
| | - Eva‐Maria Ratai
- A.A. Martinos Center for Biomedical Imaging, Neuroradiology Division, Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Ivan Tkáč
- Faculty of Health SciencesUniversity of SydneySydneyAustralia
| | - Paul G. Mullins
- Bangor Imaging Unit, School of PsychologyBangor UniversityBangorGwyneddUK
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14
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Tkáč I, Benneyworth MA, Nichols-Meade T, Steuer EL, Larson SN, Metzger GJ, Uğurbil K. Long-term behavioral effects observed in mice chronically exposed to static ultra-high magnetic fields. Magn Reson Med 2021; 86:1544-1559. [PMID: 33821502 DOI: 10.1002/mrm.28799] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 10/20/2020] [Revised: 02/11/2021] [Accepted: 03/19/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE The primary goal of this study was to investigate whether chronic exposures to ultra-high B0 fields can induce long-term cognitive, behavioral, or biological changes in C57BL/6 mice. METHODS C57BL/6 mice were chronically exposed to 10.5-T or 16.4-T magnetic fields (3-h exposures, two exposure sessions per week, 4 or 8 weeks of exposure). In vivo single-voxel 1 H magnetic resonance spectroscopy was used to investigate possible neurochemical changes in the hippocampus. In addition, a battery of behavioral tests, including the Morris water-maze, balance-beam, rotarod, and fear-conditioning tests, were used to examine long-term changes induced by B0 exposures. RESULTS Hippocampal neurochemical profile, cognitive, and basic motor functions were not impaired by chronic magnetic field exposures. However, the balance-beam-walking test and the Morris water-maze testing revealed B0 -induced changes in motor coordination and balance. The tight-circling locomotor behavior during Morris water-maze tests was found as the most sensitive factor indexing B0 -induced changes. Long-term behavioral changes were observed days or even weeks subsequent to the last B0 exposure at 16.4 T but not at 10.5 T. Fast motion of mice in and out of the 16.4-T magnet was not sufficient to induce such changes. CONCLUSION Observed results suggest that the chronic exposure to a magnetic field as high as 16.4 T may result in long-term impairment of the vestibular system in mice. Although observation of mice may not directly translate to humans, nevertheless, they indicate that studies focused on human safety at very high magnetic fields are necessary.
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Affiliation(s)
- Ivan Tkáč
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Michael A Benneyworth
- Mouse Behavioral Core, Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tessa Nichols-Meade
- Mouse Behavioral Core, Department of Neuroscience, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elizabeth L Steuer
- N Bud Grossman Center for Memory Research & Care, Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sarah N Larson
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gregory J Metzger
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kâmil Uğurbil
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
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15
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Rašiová M, Habalová V, Židzik J, Koščo M, Farkašová Ľ, Moščovič M, Hudák M, Javorský M, Tkáč I. An association between rs7635818 polymorphism located on chromosome 3p12.3 and the presence of abdominal aortic aneurysm. Physiol Res 2021; 70:193-201. [PMID: 33676387 DOI: 10.33549/physiolres.934624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The association between gene variant rs7635818 located on chromosome 3p12.3 and abdominal aortic aneurysm (AAA) was not unambiguously determined by the results of genome-wide association studies. The aim of our study was to examine this possible association in the Slovak population, with respect to the presence and severity of AAA.A cross-sectional study was conducted between August 2016 and March 2020. The study included 329 participans, 166 AAA patients and a control group of 163 subjects without confirmed AAA with comparable distribution of genders. The anteroposterior diameter of the abdominal aorta was determined by duplex ultrasonography. AAA was defined as subrenal aortic diameter ≥ 30 mm. DNA samples were genotyped using real-time polymerase chain reaction and subsequent high-resolution melting analysis in presence of unlabelled probe. Genetic models studying the possible association were adjusted to age, sex, smoking, arterial hypertension, diabetes mellitus, creatinine and body mass index (BMI) in multivariate analysis. In the additive model, presence of each C-allele of rs7635818 polymorphism was associated with an almost 50 % increase in probability of developing AAA (OR 1.49; 95 % CI 1.06-2.08; p=0.020). Compared to GG homozygotes, CC homozygotes had more than two times higher risk of developing AAA (OR 2.23; 95 % CI 1.14-4.39; p=0.020). The risk of AAA was also in the recessive model higher for CC homozygotes compared to G-allele carriers (GC/GG) (OR 1.79; 95 % CI 1.01-3.19; p=0.047).The abdominal aortic diameter in CC homozygotes of the rs7635818 polymorphism was 7.66 mm greater compared to GG homozygotes (42.5±22.0 mm vs 34.8±21.3 mm; p=0.022) and 5.88 mm greater compared to G-allele carriers (GC/GG) (42.5±22.0 mm vs 36.6±21.0 mm; p=0.04) in univariate analysis. C-allele variant in rs7635818 G>C polymorphism is associated with a higher probability of developing AAA in the Slovak population.
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Affiliation(s)
- M Rašiová
- Faculty of Medicine, Department of Angiology, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Košice, Slovak Republic.
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16
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Kreis R, Boer V, Choi I, Cudalbu C, de Graaf RA, Gasparovic C, Heerschap A, Krššák M, Lanz B, Maudsley AA, Meyerspeer M, Near J, Öz G, Posse S, Slotboom J, Terpstra M, Tkáč I, Wilson M, Bogner W. Terminology and concepts for the characterization of in vivo MR spectroscopy methods and MR spectra: Background and experts' consensus recommendations. NMR Biomed 2020; 34:e4347. [PMID: 32808407 PMCID: PMC7887137 DOI: 10.1002/nbm.4347] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 05/04/2023]
Abstract
With a 40-year history of use for in vivo studies, the terminology used to describe the methodology and results of magnetic resonance spectroscopy (MRS) has grown substantially and is not consistent in many aspects. Given the platform offered by this special issue on advanced MRS methodology, the authors decided to describe many of the implicated terms, to pinpoint differences in their meanings and to suggest specific uses or definitions. This work covers terms used to describe all aspects of MRS, starting from the description of the MR signal and its theoretical basis to acquisition methods, processing and to quantification procedures, as well as terms involved in describing results, for example, those used with regard to aspects of quality, reproducibility or indications of error. The descriptions of the meanings of such terms emerge from the descriptions of the basic concepts involved in MRS methods and examinations. This paper also includes specific suggestions for future use of terms where multiple conventions have emerged or coexisted in the past.
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Affiliation(s)
- Roland Kreis
- Department of Radiology, Neuroradiology, and Nuclear Medicine and Department of Biomedical ResearchUniversity BernBernSwitzerland
| | - Vincent Boer
- Danish Research Centre for Magnetic Resonance, Funktions‐ og Billeddiagnostisk EnhedCopenhagen University Hospital HvidovreHvidovreDenmark
| | - In‐Young Choi
- Department of Neurology, Hoglund Brain Imaging CenterUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Cristina Cudalbu
- Centre d'Imagerie Biomedicale (CIBM)Ecole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
| | - Robin A. de Graaf
- Department of Radiology and Biomedical Imaging & Department of Biomedical EngineeringYale UniversityNew HavenConnecticutUSA
| | | | - Arend Heerschap
- Department of Radiology and Nuclear MedicineRadboud University Medical CenterNijmegenThe Netherlands
| | - Martin Krššák
- Division of Endocrinology and Metabolism, Department of Internal Medicine III & High Field MR Centre, Department of Biomedical Imaging and Image guided TherapyMedical University of ViennaViennaAustria
| | - Bernard Lanz
- Laboratory of Functional and Metabolic Imaging (LIFMET)Ecole Polytechnique Fédérale de LausanneLausanneSwitzerland
- Sir Peter Mansfield Imaging Centre, School of MedicineUniversity of NottinghamNottinghamUK
| | - Andrew A. Maudsley
- Department of Radiology, Miller School of MedicineUniversity of MiamiMiamiFloridaUSA
| | - Martin Meyerspeer
- Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
- High Field MR CenterMedical University of ViennaViennaAustria
| | - Jamie Near
- Douglas Mental Health University Institute and Department of PsychiatryMcGill UniversityMontrealCanada
| | - Gülin Öz
- Center for Magnetic Resonance Research, Department of RadiologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Stefan Posse
- Department of NeurologyUniversity of New Mexico School of MedicineAlbuquerqueNew MexicoUSA
| | - Johannes Slotboom
- Department of Radiology, Neuroradiology, and Nuclear MedicineUniversity Hospital BernBernSwitzerland
| | - Melissa Terpstra
- Center for Magnetic Resonance Research, Department of RadiologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Ivan Tkáč
- Center for Magnetic Resonance Research, Department of RadiologyUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Martin Wilson
- Centre for Human Brain Health and School of PsychologyUniversity of BirminghamBirminghamUK
| | - Wolfgang Bogner
- High Field MR Center, Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaViennaAustria
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17
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Űrgeová A, Javorský M, Klimčáková L, Židzik J, Šalagovič J, Hubáček JA, Doubravová P, Gotthardová I, Kvapil M, Pelikánová T, Tkáč I, Yaluri AS. Genetic variants associated with glycemic response to treatment with dipeptidylpeptidase 4 inhibitors. Pharmacogenomics 2020; 21:317-323. [PMID: 32308134 DOI: 10.2217/pgs-2019-0147] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Aim: We examined associations of eight SNPs in/near seven candidate genes with glycemic response to 6 month treatment with DPP4 inhibitors. Patients & methods: 206 patients with type 2 diabetes (116 men and 90 women) were treated with sitagliptin or vildagliptin (both 100 mg/day) in combination with metformin or metformin/sulphonylurea over 6 months, and the reduction in glycated hemoglobin (HbA1c) was measured. Results: Rs6923761 in GLP1R was significantly associated with a reduction in HbA1c (adjusted p = 0.006). Homozygotes for the minor A allele had smaller reduction in HbA1c by 0.4% (4 mmol/mol) than the G allele carriers (p = 0.016). Conclusion: The missense variant rs6923761 in the GLP1R gene was associated with a smaller glycemic response to 6 month gliptin therapy in diabetic patients of central European origin.
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Affiliation(s)
- Anna Űrgeová
- Pavol Jozef Šafárik University, Faculty of Medicine, Košice, Slovakia
- Louis. Pasteur University Hospital, Košice, Slovakia
| | - Martin Javorský
- Pavol Jozef Šafárik University, Faculty of Medicine, Košice, Slovakia
- Louis. Pasteur University Hospital, Košice, Slovakia
| | - Lucia Klimčáková
- Pavol Jozef Šafárik University, Faculty of Medicine, Košice, Slovakia
| | - Jozef Židzik
- Pavol Jozef Šafárik University, Faculty of Medicine, Košice, Slovakia
| | - Ján Šalagovič
- Pavol Jozef Šafárik University, Faculty of Medicine, Košice, Slovakia
| | | | - Pavlina Doubravová
- Faculty Hospital in Motol, Department of Medicine, Prague, Czech Republic
| | - Ivana Gotthardová
- Pavol Jozef Šafárik University, Faculty of Medicine, Košice, Slovakia
- Louis. Pasteur University Hospital, Košice, Slovakia
| | - Milan Kvapil
- Charles University, Faculty of Medicine 2, Prague, Czech Republic
- Faculty Hospital in Motol, Department of Medicine, Prague, Czech Republic
| | - Terezie Pelikánová
- Institute for Clinical & Experimental Medicine, Diabetes Centre, Prague, Czech Republic
| | - Ivan Tkáč
- Pavol Jozef Šafárik University, Faculty of Medicine, Košice, Slovakia
- Louis. Pasteur University Hospital, Košice, Slovakia
| | - Alena Stančáková Yaluri
- Pavol Jozef Šafárik University, Faculty of Medicine, Košice, Slovakia
- Louis. Pasteur University Hospital, Košice, Slovakia
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18
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Öz G, Deelchand DK, Wijnen JP, Mlynárik V, Xin L, Mekle R, Noeske R, Scheenen TWJ, Tkáč I. Advanced single voxel 1 H magnetic resonance spectroscopy techniques in humans: Experts' consensus recommendations. NMR Biomed 2020; 34:e4236. [PMID: 31922301 PMCID: PMC7347431 DOI: 10.1002/nbm.4236] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 10/29/2019] [Accepted: 11/07/2019] [Indexed: 05/06/2023]
Abstract
Conventional proton MRS has been successfully utilized to noninvasively assess tissue biochemistry in conditions that result in large changes in metabolite levels. For more challenging applications, namely, in conditions which result in subtle metabolite changes, the limitations of vendor-provided MRS protocols are increasingly recognized, especially when used at high fields (≥3 T) where chemical shift displacement errors, B0 and B1 inhomogeneities and limitations in the transmit B1 field become prominent. To overcome the limitations of conventional MRS protocols at 3 and 7 T, the use of advanced MRS methodology, including pulse sequences and adjustment procedures, is recommended. Specifically, the semiadiabatic LASER sequence is recommended when TE values of 25-30 ms are acceptable, and the semiadiabatic SPECIAL sequence is suggested as an alternative when shorter TE values are critical. The magnetic field B0 homogeneity should be optimized and RF pulses should be calibrated for each voxel. Unsuppressed water signal should be acquired for eddy current correction and preferably also for metabolite quantification. Metabolite and water data should be saved in single shots to facilitate phase and frequency alignment and to exclude motion-corrupted shots. Final averaged spectra should be evaluated for SNR, linewidth, water suppression efficiency and the presence of unwanted coherences. Spectra that do not fit predefined quality criteria should be excluded from further analysis. Commercially available tools to acquire all data in consistent anatomical locations are recommended for voxel prescriptions, in particular in longitudinal studies. To enable the larger MRS community to take advantage of these advanced methods, a list of resources for these advanced protocols on the major clinical platforms is provided. Finally, a set of recommendations are provided for vendors to enable development of advanced MRS on standard platforms, including implementation of advanced localization sequences, tools for quality assurance on the scanner, and tools for prospective volume tracking and dynamic linear shim corrections.
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Affiliation(s)
- Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, United States
| | - Dinesh K. Deelchand
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, United States
| | - Jannie P. Wijnen
- High field MR Research group, Department of Radiology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Vladimír Mlynárik
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Lijing Xin
- Animal Imaging and Technology Core (AIT), Center for Biomedical Imaging (CIBM), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Ralf Mekle
- Center for Stroke Research Berlin (CSB), Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Tom W. J. Scheenen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- Erwin L Hahn Institute for Magnetic Resonance Imaging, UNESCO World Cultural Heritage Zollverein, Essen, Germany
| | - Ivan Tkáč
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, United States
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19
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Gröhn H, Gillick BT, Tkáč I, Bednařík P, Mascali D, Deelchand DK, Michaeli S, Meekins GD, Leffler-McCabe MJ, MacKinnon CD, Eberly LE, Mangia S. Influence of Repetitive Transcranial Magnetic Stimulation on Human Neurochemistry and Functional Connectivity: A Pilot MRI/MRS Study at 7 T. Front Neurosci 2019; 13:1260. [PMID: 31827419 PMCID: PMC6890551 DOI: 10.3389/fnins.2019.01260] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/06/2019] [Indexed: 12/13/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method commonly used in the disciplines of neuroscience, neurology, and neuropsychiatry to examine or modulate brain function. Low frequency rTMS (e.g., 1 Hz) is associated with a net suppression of cortical excitability, whereas higher frequencies (e.g., 5 Hz) purportedly increase excitability. Magnetic resonance spectroscopy (MRS) and resting-state functional MRI (rsfMRI) allow investigation of neurochemistry and functional connectivity, respectively, and can assess the influence of rTMS in these domains. This pilot study investigated the effects of rTMS on the primary motor cortex using pre and post MRS and rsfMRI assessments at 7 T. Seven right-handed males (age 27 ± 7 y.o.) underwent single-voxel MRS and rsfMRI before and about 30-min after rTMS was administered outside the scanner for 20-min over the primary motor cortex of the left (dominant) hemisphere. All participants received 1-Hz rTMS; one participant additionally received 5-Hz rTMS in a separate session. Concentrations of 17 neurochemicals were quantified in left and right motor cortices. Connectivity metrics included fractional amplitude of low-frequency fluctuations (fALFF) and regional homogeneity (ReHo) of both motor cortices, strength of related brain networks, and inter-hemispheric connectivity. The group-analysis revealed few trends (i.e., uncorrected for multiple comparisons), including a mean increase in the concentration of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) after the inhibitory rTMS protocol as compared to baseline in the stimulated (left) motor cortex (+8%, p = 0.043), along with a slight increase of total creatine (+2%, p = 0.018), and decrease of aspartate (-18%, p = 0.016). Additionally, GABA tended to decrease in the contralateral hemisphere (-6%, p = 0.033). No other changes of metabolite concentrations were found. Whereas functional connectivity outcomes did not exhibit trends of significant changes induced by rTMS, the percent changes of few connectivity metrics in both hemispheres were negatively correlated with GABA changes in the contralateral hemisphere. While studies in larger cohorts are needed to confirm these preliminary findings, our results indicate the safety and feasibility of detecting changes in key metabolites associated with neurotransmission after a single 1-Hz rTMS session, establishing the construct for future exploration of the neurochemical, and connectivity mechanisms of cortical responses to neuromodulation.
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Affiliation(s)
- Heidi Gröhn
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Bernadette T Gillick
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Ivan Tkáč
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Petr Bednařík
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States.,Department of Biomedical Imaging and Image-guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, Austria
| | - Daniele Mascali
- Museo Storico della Fisica e Centro Studi e Ricerche "Enrico Fermi", Rome, Italy
| | - Dinesh K Deelchand
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Shalom Michaeli
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Gregg D Meekins
- Department of Neurology, University of Minnesota, Minneapolis, MN, United States
| | | | - Colum D MacKinnon
- Department of Neurology, University of Minnesota, Minneapolis, MN, United States
| | - Lynn E Eberly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Silvia Mangia
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
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20
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Paraničová I, Habalová V, Klimčáková L, Trojová I, Židzik J, Tkáč I, Tkáčová R, Joppa P. Association of JAG1 gene polymorphism with systemic blood pressure in patients with obstructive sleep apnea: a prospective cohort study. Croat Med J 2019. [PMID: 31686456 PMCID: PMC6852136 DOI: 10.3325/cmj.2019.60.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aim To assess the effects of single nucleotide polymorphisms (SNPs) on blood pressure control in patients with obstructive sleep apnea (OSA). Methods This prospective observational cohort study, conducted between 2004 and 2014, examined the associations of SNPs of JAG1, GUCY1A3-GUCY1B3, SH2B3, and NPR3-C5orf23 genes with systolic and diastolic blood pressure (SBP, DBP) in 1179 adults evaluated for OSA with overnight polysomnography. Genotyping was performed by unlabeled probe melting analysis. Results The patients were predominantly male (69.6%, mean age 52 ± 11 years, apnea-hypopnea index 34 ± 31 episodes/h). Only JAG1 genotype was associated with SBP and DBP: compared with AA homozygotes, G allele carriers (pooled GG and AG genotype) had significantly higher morning SBP (132 ± 19 vs 129 ± 18 mm Hg; P = 0.009) and morning and evening DBP (85 ± 11 vs 83 ± 10 mm Hg, P = 0.004; 86 ± 10 vs 84 ± 10 mm Hg, P = 0.012, respectively); the differences remained significant after the correction for multiple SNPs testing. In multivariate analyses, oxygen desaturation index and JAG1 genotype independently predicted morning SBP (P = 0.001, P = 0.003, respectively) and DBP (P < 0.001, P = 0.005, respectively), and evening SBP (P = 0.019, P = 0.048, respectively) and DBP (P = 0.018, P = 0.018, respectively). Conclusion This is the first replication study of the SNPs recently linked to arterial hypertension in general population by genome-wide association studies. Our findings suggest that JAG1 genotype is related to blood pressure control in OSA: G allele was associated with higher morning and evening SBP and DBP.
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21
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Rašiová M, Farkašová Ľ, Koščo M, Moščovič M, Špak Ľ, Petrášová D, Tkáč I. Positive association between abdominal aortic diameter and serum collagen XVIII levels. INT ANGIOL 2019; 38:410-417. [PMID: 31566319 DOI: 10.23736/s0392-9590.19.04222-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The identification of abdominal aortic aneurysm (AAA) biomarker offers a perspective to determine disease progress and rupture risk. The aim of our study was to evaluate the association between selected circulating biomarkers and diameter of abdominal aorta. METHODS One hundred and two patients (88 men and 14 women) with mean age 70.0±8.7 years were included in a single center cross-sectional study conducted between February 2016 and October, 2018. AAA was defined as subrenal aortic dilatation ≥3 cm. Serum biomarker concentrations (insulin-like growth factor-1, peroxiredoxin-1, collagen IV, collagen XVIII) were measured by an enzyme-linked immunosorbent assay (ELISA). Adjustments including variables with different baseline distribution at univariate level with P<0.1 (age, body mass index, coronary artery disease, fibrinogen) were performed in multivariate models. RESULTS Higher collagen XVIII was found in AAA patients in comparison with the control group of patients (39.5 vs. 25.0 ng/mL; P=0.002). Diameter of abdominal aorta was positively associated with collagen XVIII levels in univariate (B=0.16; P=0.004), and in multivariate analysis (B=0.14; P=0.027), i.e. increase in collagen XVIII by 1 ng/mL corresponded to an increase in abdominal aortic diameter by 0.14 mm. Patients with serum collagen XVIII levels in the third tertile (˃47 ng/mL) had 4.23 times higher risk of AAA compared to patients with collagen XVIII levels in the first and second tertiles (OR 4.23; 95% CI 1.42-11.6; P=0.020). No association was found between other examined biomarkers and abdominal aortic diameter. CONCLUSIONS Diameter of abdominal aorta was positively associated with serum collagen XVIII level.
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Affiliation(s)
- Mária Rašiová
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Košice, Slovakia - .,Department of Internal Medicine 4, Faculty of Medicine, Šafárik University, Košice, Slovakia -
| | - Ľudmila Farkašová
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Košice, Slovakia
| | - Martin Koščo
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Košice, Slovakia
| | - Matej Moščovič
- Department of Angiology, Faculty of Medicine, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Košice, Slovakia
| | - Ľubomír Špak
- Department of Interventional Angiology, Štefan Kukura Hospital, Michalovce, Slovakia
| | - Darina Petrášová
- Laboratory of Research Biomodels, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, Šafárik University, Košice, Slovakia
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22
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Schernthaner G, Karasik A, Abraitienė A, Ametov AS, Gaàl Z, Gumprecht J, Janež A, Kaser S, Lalić K, Mankovsky BN, Moshkovich E, Past M, Prázný M, Radulian G, Smirčić Duvnjak L, Tkáč I, Trušinskis K. Evidence from routine clinical practice: EMPRISE provides a new perspective on CVOTs. Cardiovasc Diabetol 2019; 18:115. [PMID: 31472683 PMCID: PMC6717330 DOI: 10.1186/s12933-019-0920-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 08/21/2019] [Indexed: 12/28/2022] Open
Abstract
EMPA-REG OUTCOME is recognised by international guidelines as a landmark study that showed a significant cardioprotective benefit with empagliflozin in patients with type 2 diabetes (T2D) and cardiovascular disease. To assess the impact of empagliflozin in routine clinical practice, the ongoing EMPRISE study is collecting real-world evidence to compare effectiveness, safety and health economic outcomes between empagliflozin and DPP-4 inhibitors. A planned interim analysis of EMPRISE was recently published, confirming a substantial reduction in hospitalisation for heart failure with empagliflozin across a diverse patient population. In this commentary article, we discuss the new data in the context of current evidence and clinical guidelines, as clinicians experienced in managing cardiovascular risk in patients with T2D. We also look forward to what future insights EMPRISE may offer, as evidence is accumulated over the next years to complement the important findings of EMPA-REG OUTCOME.
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Affiliation(s)
| | - Avraham Karasik
- Sheba Medical Center and Tel Aviv University, Tel Aviv, Israel.
| | - Agnė Abraitienė
- Clinic of Internal Diseases, Family Medicine and Oncology, Institute of Medicine, Faculty of Medicine, Vilnius University Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
| | - Alexander S Ametov
- Russian Medical Academy for Continuous Professional Education, Ministry of Education of the Russian Federation, Moscow, Russia
| | - Zsolt Gaàl
- Department of Medicine, András Jósa Teaching Hospital, Nyíregyháza, Hungary
| | | | - Andrej Janež
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre, Ljubljana, Slovenia
| | - Susanne Kaser
- Department of Internal Medicine I and CD Laboratory for Metabolic Crosstalk, Medical University of Innsbruck, Innsbruck, Tirol, Austria
| | - Katarina Lalić
- Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Evgeny Moshkovich
- Diabetes and Endocrinology Clinic, Clalit Medical Services, Ramat Gan, Israel
| | - Marju Past
- Estonian Diabetes Center, Tallinn, Estonia
| | - Martin Prázný
- 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Gabriela Radulian
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Lea Smirčić Duvnjak
- School of Medicine, University of Zagreb, Vuk Vrhovac University Clinic-UH Merkur, Zagreb, Croatia
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, Safarik University in Košice, Košice, Slovakia
| | - Kārlis Trušinskis
- Latvian Center of Cardiology, Stradiņš Clinical University Hospital, Rīga Stradiņš University, Riga, Latvia
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23
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Wilson M, Andronesi O, Barker PB, Bartha R, Bizzi A, Bolan PJ, Brindle KM, Choi IY, Cudalbu C, Dydak U, Emir UE, Gonzalez RG, Gruber S, Gruetter R, Gupta RK, Heerschap A, Henning A, Hetherington HP, Huppi PS, Hurd RE, Kantarci K, Kauppinen RA, Klomp DWJ, Kreis R, Kruiskamp MJ, Leach MO, Lin AP, Luijten PR, Marjańska M, Maudsley AA, Meyerhoff DJ, Mountford CE, Mullins PG, Murdoch JB, Nelson SJ, Noeske R, Öz G, Pan JW, Peet AC, Poptani H, Posse S, Ratai EM, Salibi N, Scheenen TWJ, Smith ICP, Soher BJ, Tkáč I, Vigneron DB, Howe FA. Methodological consensus on clinical proton MRS of the brain: Review and recommendations. Magn Reson Med 2019; 82:527-550. [PMID: 30919510 PMCID: PMC7179569 DOI: 10.1002/mrm.27742] [Citation(s) in RCA: 226] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 02/01/2019] [Accepted: 02/25/2019] [Indexed: 12/14/2022]
Abstract
Proton MRS (1 H MRS) provides noninvasive, quantitative metabolite profiles of tissue and has been shown to aid the clinical management of several brain diseases. Although most modern clinical MR scanners support MRS capabilities, routine use is largely restricted to specialized centers with good access to MR research support. Widespread adoption has been slow for several reasons, and technical challenges toward obtaining reliable good-quality results have been identified as a contributing factor. Considerable progress has been made by the research community to address many of these challenges, and in this paper a consensus is presented on deficiencies in widely available MRS methodology and validated improvements that are currently in routine use at several clinical research institutions. In particular, the localization error for the PRESS localization sequence was found to be unacceptably high at 3 T, and use of the semi-adiabatic localization by adiabatic selective refocusing sequence is a recommended solution. Incorporation of simulated metabolite basis sets into analysis routines is recommended for reliably capturing the full spectral detail available from short TE acquisitions. In addition, the importance of achieving a highly homogenous static magnetic field (B0 ) in the acquisition region is emphasized, and the limitations of current methods and hardware are discussed. Most recommendations require only software improvements, greatly enhancing the capabilities of clinical MRS on existing hardware. Implementation of these recommendations should strengthen current clinical applications and advance progress toward developing and validating new MRS biomarkers for clinical use.
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Affiliation(s)
- Martin Wilson
- Centre for Human Brain Health and School of Psychology, University of Birmingham, Birmingham, England
| | - Ovidiu Andronesi
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Peter B Barker
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert Bartha
- Robarts Research Institute, University of Western Ontario, London, Canada
| | - Alberto Bizzi
- U.O. Neuroradiologia, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Patrick J Bolan
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Kevin M Brindle
- Department of Biochemistry, University of Cambridge, Cambridge, England
| | - In-Young Choi
- Department of Neurology, Hoglund Brain Imaging Center, University of Kansas Medical Center, Kansas City, Kansas
| | - Cristina Cudalbu
- Center for Biomedical Imaging, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Ulrike Dydak
- School of Health Sciences, Purdue University, West Lafayette, Indiana
| | - Uzay E Emir
- School of Health Sciences, Purdue University, West Lafayette, Indiana
| | - Ramon G Gonzalez
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Stephan Gruber
- High Field MR Center, Department of Biomedical imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Rolf Gruetter
- Laboratory for Functional and Metabolic Imaging, Center for Biomedical Imaging, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | - Rakesh K Gupta
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Arend Heerschap
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Anke Henning
- Max Planck Institute for Biological Cybernetics, Tuebingen, Germany
| | | | - Petra S Huppi
- Department of Pediatrics, University of Geneva, Geneva, Switzerland
| | - Ralph E Hurd
- Stanford Radiological Sciences Lab, Stanford, California
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Risto A Kauppinen
- School of Psychological Science, University of Bristol, Bristol, England
| | | | - Roland Kreis
- Departments of Radiology and Biomedical Research, University of Bern, Bern, Switzerland
| | | | - Martin O Leach
- CRUK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden Hospital, London, England
| | - Alexander P Lin
- Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard University Medical School, Boston, Massachusetts
| | | | - Małgorzata Marjańska
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | | | - Dieter J Meyerhoff
- DVA Medical Center and Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | | | - Paul G Mullins
- Bangor Imaging Unit, School of Psychology, Bangor University, Bangor, Wales
| | | | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | | | - Gülin Öz
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Julie W Pan
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Andrew C Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, England
| | - Harish Poptani
- Centre for Preclinical Imaging, Institute of Translational Medicine, University of Liverpool, Liverpool, England
| | - Stefan Posse
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico
| | - Eva-Maria Ratai
- Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nouha Salibi
- MR R&D, Siemens Healthineers, Malvern, Pennsylvania
| | - Tom W J Scheenen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Brian J Soher
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Ivan Tkáč
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - Daniel B Vigneron
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California
| | - Franklyn A Howe
- Molecular and Clinical Sciences, St George's University of London, London, England
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Rašiová M, Koščo M, Špak Ľ, Moščovič M, Židzik J, Slabá E, Habalová V, Farkašová Ľ, Hudák M, Tkáč I. Higher preprocedural fibrinogen levels are associated with aneurysm sac regression after EVAR. VASA 2019; 48:347-354. [DOI: 10.1024/0301-1526/a000783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Summary. Background: The aim of our study was to determine the diameter of the aneurysm sac 24 months after endovascular abdominal aortic aneurysm repair (EVAR); to identify factors associated with sac regression, and to determine the impact of sac regression on all-cause mortality during long-term follow-up. Patients and methods: We conducted a retrospective review of prospectively collected data from patients treated with EVAR between January, 2010 and July, 2016. Sac regression was defined as at least 5 mm decrease in aneurysm diameter in relation to the preprocedural diameter seen on computed tomography angiography. Sociodemographic information, comorbidities, treatment, laboratory parameters, selected anatomical and genetic factors were all analysed to determine their impact on sac regression. Results: During the study period, 124 patients with mean age of 71.2 ± 7.2 years met the inclusion criteria. Sac regression was found in 45.2% of patients. Higher preprocedural fibrinogen was found in patients with sac regression in comparison with patients with stable sac or sac expansion (3.84 g/l vs 3.47 g/l; p = 0.028). In multivariate analysis after adjustment for age, hypertension, sex, smoking, dyslipidaemia, volume and percentage of intraluminal thrombus higher fibrinogen was associated with an increased probability of sac regression (OR 2.47; 95% CI 1.29–4.72; p = 0.006). Persistent type II endoleak was associated with significantly lower probability of sac regression in univariate and multivariate analysis after adjustment for age, hypertension, sex, smoking and dyslipidaemia (OR 0.26; 95% CI 0.10–0.66; p = 0.004). Higher age was a significant predictor of sac regression in multivariate analysis after adjustment for hypertension, sex, smoking and dyslipidaemia (OR 1.07; 95% CI 1.02–1.14; p = 0.012). No difference was found between patient subgroups with and without sac regression in all-cause mortality during follow-up. Conclusions: Higher preprocedural fibrinogen, absence of persistent type II endoleak and higher age were predictive factors of aneurysm sac regression post-EVAR.
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Affiliation(s)
- Mária Rašiová
- Faculty of Medicine, Angiology Clinic, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Slovakia
- Faculty of Medicine, Department of Internal Medicine 4, Šafárik University, Slovakia
| | - Martin Koščo
- Faculty of Medicine, Angiology Clinic, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Slovakia
| | - Ľubomír Špak
- Department of Interventional Angiology, Štefan Kukura Hospital, Michalovce, Slovakia
| | - Matej Moščovič
- Faculty of Medicine, Angiology Clinic, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Slovakia
| | - Jozef Židzik
- Faculty of Medicine, Department of Medicine Biology, Šafárik University, Slovakia
| | - Eva Slabá
- Faculty of Medicine, Department of Medicine Biology, Šafárik University, Slovakia
| | - Viera Habalová
- Faculty of Medicine, Department of Medicine Biology, Šafárik University, Slovakia
| | - Ľudmila Farkašová
- Faculty of Medicine, Angiology Clinic, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Slovakia
| | - Marek Hudák
- Faculty of Medicine, Angiology Clinic, East Slovak Institute of Cardiovascular Diseases, Šafárik University, Slovakia
| | - Ivan Tkáč
- Faculty of Medicine, Department of Internal Medicine 4, Šafárik University, Slovakia
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25
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Bednařík P, Tkáč I, Giove F, Eberly LE, Deelchand DK, Barreto FR, Mangia S. Neurochemical responses to chromatic and achromatic stimuli in the human visual cortex. J Cereb Blood Flow Metab 2018; 38:347-359. [PMID: 28273721 PMCID: PMC5951013 DOI: 10.1177/0271678x17695291] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the present study, we aimed at determining the metabolic responses of the human visual cortex during the presentation of chromatic and achromatic stimuli, known to preferentially activate two separate clusters of neuronal populations (called "blobs" and "interblobs") with distinct sensitivity to color or luminance features. Since blobs and interblobs have different cytochrome-oxidase (COX) content and micro-vascularization level (i.e., different capacities for glucose oxidation), different functional metabolic responses during chromatic vs. achromatic stimuli may be expected. The stimuli were optimized to evoke a similar load of neuronal activation as measured by the bold oxygenation level dependent (BOLD) contrast. Metabolic responses were assessed using functional 1H MRS at 7 T in 12 subjects. During both chromatic and achromatic stimuli, we observed the typical increases in glutamate and lactate concentration, and decreases in aspartate and glucose concentration, that are indicative of increased glucose oxidation. However, within the detection sensitivity limits, we did not observe any difference between metabolic responses elicited by chromatic and achromatic stimuli. We conclude that the higher energy demands of activated blobs and interblobs are supported by similar increases in oxidative metabolism despite the different capacities of these neuronal populations.
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Affiliation(s)
- Petr Bednařík
- 1 Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA.,2 Division of Endocrinology and Diabetes, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.,3 CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Ivan Tkáč
- 1 Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Federico Giove
- 4 MARBILab, Museo storico della fisica e Centro di studi e ricerche Enrico Fermi, Rome, Italy.,5 Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Lynn E Eberly
- 6 Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Dinesh K Deelchand
- 1 Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Felipe R Barreto
- 7 Physics Department, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Silvia Mangia
- 1 Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
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26
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Demková K, Kozárová M, Malachovská Z, Javorský M, Tkáč I. Osteoprotegerin concentration is associated with the presence and severity of peripheral arterial disease in type 2 diabetes mellitus. VASA 2018; 47:131-135. [PMID: 29313442 DOI: 10.1024/0301-1526/a000682] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Osteoprotegerin plays a role in the development of several bone diseases. In addition, osteoprotegerin may contribute to the development of vascular disease. Little is known about the association between serum osteoprotegerin levels and the presence or severity of peripheral arterial disease (PAD). The aim of this study was to examine the association between serum osteoprotegerin levels and both the presence as well as the severity of lower extremity arterial disease in patients with type 2 diabetes (T2DM). PATIENTS AND METHODS The study included 165 consecutive patients with T2DM (57 % males, mean age 65.0 ± 0.7 years). PAD was diagnosed by measurement of the toe-brachial index (TBI). Serum osteoprotegerin was measured using ELISA. RESULTS The mean osteoprotegerin level was significantly higher in patients with PAD in comparison to patients without PAD (18.2 ± 1.0 vs. 13.1 ± 2.0 pmol/L, p = 0.014). Significant univariate correlations between TBI and osteoprotegerin level (r = -0.308; p < 0.001), age, body mass index, and HDL cholesterol were observed. In the multivariate linear regression analysis, serum osteoprotegerin (β = -0.005; p = 0.020), higher age, and male gender were significant predictors of TBI. When 25(OH) vitamin D was introduced into the mentioned model, OPG was no longer a significant predictor of TBI and was replaced in the model with vitamin D (β = 0.009, p = 0.001). This finding suggests a role of OPG as a mediator of the effects of 25(OH) vitamin D. CONCLUSIONS Serum osteoprotegerin level is significantly associated with both the presence and severity of PAD in patients with T2D. Osteoprotegerin might be a biomarker for the presence of atherosclerotic disease in patients with T2DM.
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Affiliation(s)
| | | | - Zuzana Malachovská
- 1 Department of Internal Medicine, Pavol Jozef Šafárik University, Faculty of Medicine, Louis Pasteur University Hospital, Košice, Slovakia
| | - Martin Javorský
- 1 Department of Internal Medicine, Pavol Jozef Šafárik University, Faculty of Medicine, Louis Pasteur University Hospital, Košice, Slovakia
| | - Ivan Tkáč
- 1 Department of Internal Medicine, Pavol Jozef Šafárik University, Faculty of Medicine, Louis Pasteur University Hospital, Košice, Slovakia
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27
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Martinka E, Uličiansky V, Mokáň M, Tkáč I, Galajda P, Dókušová S, Schroner Z. [A consensual therapeutic recommendation for type 2 diabetes mellitus by the Slovak Diabetes Society (2018)]. Vnitr Lek 2018; 64:405-426. [PMID: 29791176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Type 2 diabetes mellitus is a heterogeneous medical condition involving multiple pathophysiological mechanisms. Its successful treatment requires an individualized approach and frequently combined therapy with utilizing its effect on multiple levels. Current possibilities enable the employment of such procedures to an incomparably greater extent than before. The effects of different classes of oral antidiabetic drugs on the reduction of glycemia and HbA1c is mutually comparable. However differences are observed in the proportions of patients who met the required criteria, regarding the increase in weight, incidence of hypoglycemia as well as the effect on cardiovascular, renal or oncologic morbidity and mortality, and severity of specific adverse effects, potential risks and contraindications. The presented text provides the reader with the information about the Consensual therapeutic algorithm for the treatment of type 2 diabetes mellitus in compliance with SPC, the ADA/EASD amended indicative limitations and recommendations, formulated by the Committee of the Slovak Diabetes Society.Key words: biguanides - gliflozins - gliptins - glitazones - GLP-1-receptor agonists - insulin - sulfonylurea.
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28
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Gotthardová I, Javorský M, Klimčáková L, Kvapil M, Schroner Z, Kozárová M, Malachovská Z, Ürgeová A, Židzik J, Tkáč I. KCNQ1 gene polymorphism is associated with glycaemic response to treatment with DPP-4 inhibitors. Diabetes Res Clin Pract 2017. [PMID: 28624668 DOI: 10.1016/j.diabres.2017.05.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIMS Only afew gene variants were associated with the response to dipeptidylpeptidase-4 inhibitors (DPP4I). KCNQ1 gene variants were previously related both to type 2 diabetes (T2D) and incretin effect. We hypothesized that T2D related KCNQ1 variants would be associated with smaller glucose-lowering effect of DDP4I. METHODS We performed a retrospective study in 137 Caucasian subjects with T2D who were followed for 6months after initiation of DPP4I treatment. Genotyping for KCNQ1 rs163184 and rs151290 was performed using PCR-HRMA and PCR-RFLP methods, respectively. The main clinical outcome was reduction in HbA1c (ΔHbA1c) after 6-month DPP4I treatment. RESULTS KCNQ1 rs163184 T>G variant was associated with the response to DPP4I treatment in genetic additive model (β=-0.30, p=0.022). For each G allele in the rs163184 genotype, we observed a 0.3% (3.3mmol/mol) less reduction in HbA1c during treatment with a DPP4I. Both the GG homozygotes and G-allele carriers had significantly smaller HbA1c reduction in comparison with the TT homozygotes. CONCLUSIONS KCNQ1 rs163184 T>G variant was associated with a reduced glycaemic response to DPP4I. The difference of 0.6% (6.5mmol/mol) in HbA1c reduction between the TT and GG homozygotes might be of clinical significance if replicated in further studies.
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Affiliation(s)
- Ivana Gotthardová
- P.J. Šafárik University, Faculty of Medicine, Košice, Slovakia; L. Pasteur University Hospital, Košice, Slovakia
| | - Martin Javorský
- P.J. Šafárik University, Faculty of Medicine, Košice, Slovakia; L. Pasteur University Hospital, Košice, Slovakia
| | | | - Milan Kvapil
- Charles University, Faculty of Medicine 2, Praha, Czech Republic; Faculty Hospital in Motol, Praha, Czech Republic
| | | | - Miriam Kozárová
- P.J. Šafárik University, Faculty of Medicine, Košice, Slovakia; L. Pasteur University Hospital, Košice, Slovakia
| | - Zuzana Malachovská
- P.J. Šafárik University, Faculty of Medicine, Košice, Slovakia; L. Pasteur University Hospital, Košice, Slovakia
| | - Anna Ürgeová
- P.J. Šafárik University, Faculty of Medicine, Košice, Slovakia; L. Pasteur University Hospital, Košice, Slovakia
| | - Jozef Židzik
- P.J. Šafárik University, Faculty of Medicine, Košice, Slovakia
| | - Ivan Tkáč
- P.J. Šafárik University, Faculty of Medicine, Košice, Slovakia; L. Pasteur University Hospital, Košice, Slovakia.
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29
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Dujic T, Zhou K, Yee SW, van Leeuwen N, de Keyser CE, Javorský M, Goswami S, Zaharenko L, Hougaard Christensen MM, Out M, Tavendale R, Kubo M, Hedderson MM, van der Heijden AA, Klimčáková L, Pirags V, Kooy A, Brøsen K, Klovins J, Semiz S, Tkáč I, Stricker BH, Palmer C, 't Hart LM, Giacomini KM, Pearson ER. Variants in Pharmacokinetic Transporters and Glycemic Response to Metformin: A Metgen Meta-Analysis. Clin Pharmacol Ther 2017; 101:763-772. [PMID: 27859023 PMCID: PMC5425333 DOI: 10.1002/cpt.567] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 09/26/2016] [Accepted: 11/06/2016] [Indexed: 12/25/2022]
Abstract
Therapeutic response to metformin, a first-line drug for type 2 diabetes (T2D), is highly variable, in part likely due to genetic factors. To date, metformin pharmacogenetic studies have mainly focused on the impact of variants in metformin transporter genes, with inconsistent results. To clarify the significance of these variants in glycemic response to metformin in T2D, we performed a large-scale meta-analysis across the cohorts of the Metformin Genetics Consortium (MetGen). Nine candidate polymorphisms in five transporter genes (organic cation transporter [OCT]1, OCT2, multidrug and toxin extrusion transporter [MATE]1, MATE2-K, and OCTN1) were analyzed in up to 7,968 individuals. None of the variants showed a significant effect on metformin response in the primary analysis, or in the exploratory secondary analyses, when patients were stratified according to possible confounding genotypes or prescribed a daily dose of metformin. Our results suggest that candidate transporter gene variants have little contribution to variability in glycemic response to metformin in T2D.
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Affiliation(s)
- T Dujic
- Department of Biochemistry and Clinical Analysis, Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - K Zhou
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - S W Yee
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California, USA
| | - N van Leeuwen
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - C E de Keyser
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Inspectorate of Healthcare, Utrecht, The Netherlands
| | - M Javorský
- Department of Internal Medicine 4, Faculty of Medicine, Šafárik University, Košice, Slovakia.,Pasteur University Hospital, Košice, Slovakia
| | - S Goswami
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California, USA
| | - L Zaharenko
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | - M Out
- Treant Zorggroep, Location Bethesda, Hoogeveen, The Netherlands.,Bethesda Diabetes Research Centre, Hoogeveen, The Netherlands
| | - R Tavendale
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - M Kubo
- Core for Genomic Medicine, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - M M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - A A van der Heijden
- Department of General Practice, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - L Klimčáková
- Department of Medical Biology, Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - V Pirags
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - A Kooy
- Treant Zorggroep, Location Bethesda, Hoogeveen, The Netherlands.,Bethesda Diabetes Research Centre, Hoogeveen, The Netherlands
| | - K Brøsen
- Department of Public Health, Clinical Pharmacology and Pharmacy, University of Southern Denmark, Odense, Denmark
| | - J Klovins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - S Semiz
- Department of Biochemistry and Clinical Analysis, Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,International University of Sarajevo, Faculty of Engineering and Natural Sciences, Sarajevo, Bosnia and Herzegovina
| | - I Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, Šafárik University, Košice, Slovakia.,Pasteur University Hospital, Košice, Slovakia
| | - B H Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Inspectorate of Healthcare, Utrecht, The Netherlands.,Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Cna Palmer
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - L M 't Hart
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - K M Giacomini
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California, USA.,Institute for Human Genetics, University of California, San Francisco, San Francisco, California, USA
| | - E R Pearson
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, UK
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30
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Tkáč I, Raz I. Combined Analysis of Three Large Interventional Trials With Gliptins Indicates Increased Incidence of Acute Pancreatitis in Patients With Type 2 Diabetes. Diabetes Care 2017; 40:284-286. [PMID: 27659407 DOI: 10.2337/dc15-1707] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 12/29/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Data on the possible relationship of gliptin treatment with the incidence of acute pancreatitis have been controversial. The aim of the current study was to combine data on the incidence of acute pancreatitis from three large randomized controlled trials. RESEARCH DESIGN AND METHODS Three trials designed to test cardiovascular safety and efficacy of add-on treatment with a gliptin were included in the analysis, as follows: SAVOR-TIMI 53 (saxagliptin), EXAMINE (alogliptin), and TECOS (sitagliptin). The trials included 18,238 gliptin-treated patients and 18,157 placebo-treated patients. Data were combined using a random-effects model meta-analysis. RESULTS The incidence of acute pancreatitis was significantly increased in the gliptin-treated patients when compared with the control groups (odds ratio 1.79 [95% CI 1.13-2.82], P = 0.013). The difference in the absolute risk was small (0.13%). CONCLUSIONS Treatment with gliptins significantly increased the risk for acute pancreatitis in a combined analysis of three large controlled randomized trials.
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Affiliation(s)
- Ivan Tkáč
- Department of Internal Medicine 4, Šafárik University, and Faculty of Medicine, Louis Pasteur University Hospital, Košice, Slovakia
| | - Itamar Raz
- Diabetes Unit, Department of Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel
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Zaharenko L, Kalnina I, Geldnere K, Konrade I, Grinberga S, Židzik J, Javorský M, Lejnieks A, Nikitina-Zake L, Fridmanis D, Peculis R, Radovica-Spalvina I, Hartmane D, Pugovics O, Tkáč I, Klimčáková L, Pīrāgs V, Klovins J. Single nucleotide polymorphisms in the intergenic region between metformin transporter OCT2 and OCT3 coding genes are associated with short-term response to metformin monotherapy in type 2 diabetes mellitus patients. Eur J Endocrinol 2016; 175:531-540. [PMID: 27609360 DOI: 10.1530/eje-16-0347] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 08/31/2016] [Accepted: 09/08/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVES High variability in clinical response to metformin is often observed in type 2 diabetes (T2D) patients, and it highlights the need for identification of genetic components affecting the efficiency of metformin therapy. Aim of this observational study is to evaluate the role of tagSNPs (tagging single nucleotide polymorphisms) from genomic regions coding for six metformin transporter genes with respect to the short-term efficiency. DESIGN 102 tagSNPs in 6 genes coding for metformin transporters were genotyped in the group of 102 T2D patients treated with metformin for 3 months. METHODS Most significant hits were analyzed in the group of 131 T2D patients from Slovakia. Pharmacokinetic study in 25 healthy nondiabetic volunteers was conducted to investigate the effects of identified polymorphisms. RESULTS In the discovery group of 102 patients, minor alleles of rs3119309, rs7757336 and rs2481030 were significantly nominally associated with metformin inefficiency (P = 1.9 × 10-6 to 8.1 × 10-6). Effects of rs2481030 and rs7757336 did not replicate in the group of 131 T2DM patients from Slovakia alone, whereas rs7757336 was significantly associated with a reduced metformin response in combined group. In pharmacokinetic study, group of individuals harboring risk alleles of rs7757336 and rs2481030 displayed significantly reduced AUC∞ of metformin in plasma. CONCLUSIONS For the first time, we have identified an association between the lack of metformin response and SNPs rs3119309 and rs7757336 located in the 5' flanking region of the genes coding for Organic cation transporter 2 and rs2481030 located in the 5' flanking region of Organic cation transporter 3 that was supported by the results of a pharmacokinetic study on 25 healthy volunteers.
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Affiliation(s)
| | - Ineta Kalnina
- Latvian Biomedical Research and Study CentreRiga, Latvia
| | - Kristine Geldnere
- Pauls Stradins Clinical University HospitalRiga, Latvia
- Faculty of MedicineUniversity of Latvia, Riga, Latvia
| | - Ilze Konrade
- Riga East Clinical University HospitalRiga, Latvia
- Riga Stradins UniversityRiga, Latvia
| | | | - Jozef Židzik
- Faculty of MedicineP. J. Šafárik University, Košice, Slovakia
| | - Martin Javorský
- Faculty of MedicineP. J. Šafárik University, Košice, Slovakia
| | - Aivars Lejnieks
- Riga East Clinical University HospitalRiga, Latvia
- Riga Stradins UniversityRiga, Latvia
| | | | | | - Raitis Peculis
- Latvian Biomedical Research and Study CentreRiga, Latvia
| | | | | | | | - Ivan Tkáč
- Faculty of MedicineP. J. Šafárik University, Košice, Slovakia
| | | | - Valdis Pīrāgs
- Pauls Stradins Clinical University HospitalRiga, Latvia
- Faculty of MedicineUniversity of Latvia, Riga, Latvia
| | - Janis Klovins
- Latvian Biomedical Research and Study CentreRiga, Latvia
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Abstract
Proton nuclear magnetic resonance spectroscopy of biofluids has become one of the key techniques for metabolic profiling and phenotyping. This technique has been widely used in a number of epidemiological studies and in a variety of health disorders. However, its utilization in brain disorders is limited due to the blood-brain barrier, which not only protects the brain from unwanted substances in the blood, but also substantially limits the potential of finding biomarkers for neurological disorders in serum. This review article focuses on the potential of localized in vivo proton magnetic resonance spectroscopy (1H-MRS) for non-invasive neurochemical profiling in the human brain. First, methodological aspects of 1H-MRS (data acquisition, processing and metabolite quantification) that are essential for reliable non-invasive neurochemical profiling are described. Second, the power of 1H-MRS-based neurochemical profiling is demonstrated using some examples of its application in neuroscience and neurology. Finally, the authors present their vision and propose necessary steps to establish 1H-MRS as a method suitable for large-scale neurochemical profiling in epidemiological research.
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Affiliation(s)
- Jessica McKay
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Ivan Tkáč
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
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33
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Xin L, Tkáč I. A practical guide to in vivo proton magnetic resonance spectroscopy at high magnetic fields. Anal Biochem 2016; 529:30-39. [PMID: 27773654 DOI: 10.1016/j.ab.2016.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 08/13/2016] [Revised: 10/03/2016] [Accepted: 10/19/2016] [Indexed: 12/26/2022]
Abstract
Localized proton magnetic resonance spectroscopy (1H-MRS) is a noninvasive tool for measuring in vivo neurochemical information in animal and human brains. With the increase of magnetic field strength, whereas localized 1H-MRS benefits from higher sensitivity and spectral dispersion, it is challenged by increased spatial inhomogeneity of the B0 and B1 fields, larger chemical shift displacement error, and shortened T2 relaxation times of metabolites. Advanced localized 1H-MRS methodologies developed for high magnetic fields have shown promising results and allow the measurement of neurochemical profiles with up to 19 brain metabolites, including less-abundant metabolites, such as glutathione, glycine, γ-aminobutyric acid and ascorbate. To provide a practical guide for conducting in vivo1H-MRS studies at high magnetic field strength, we reviewed various essential technical aspects from data acquisition (hardware requirements, B1 and B0 inhomogeneity, water suppression, localization sequences and acquisition strategies) to data processing (frequency and phase correction, spectral quality control, spectral fitting and concentration referencing). Additionally, we proposed guidelines for choosing the most appropriate data acquisition and processing approaches to maximize the achievable neurochemical information.
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Affiliation(s)
- Lijing Xin
- Animal Imaging and Technology Core (AIT), Center for Biomedical Imaging (CIBM), Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
| | - Ivan Tkáč
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA.
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34
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Javorský M, Gotthardová I, Klimčáková L, Kvapil M, Židzik J, Schroner Z, Doubravová P, Gala I, Dravecká I, Tkáč I. A missense variant in GLP1R gene is associated with the glycaemic response to treatment with gliptins. Diabetes Obes Metab 2016; 18:941-4. [PMID: 27160388 DOI: 10.1111/dom.12682] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 04/27/2016] [Accepted: 05/01/2016] [Indexed: 12/25/2022]
Abstract
Gliptins act by increasing endogenous incretin levels. Glucagon-like peptide-1 receptor (GLP1R) and glucose-dependent insulinotropic peptide receptor (GIPR) are their indirect drug targets. Variants of GLP1R and GIPR have previously been associated with the incretin effect. The aim of the present pilot study was to examine associations of the GLP1R and GIPR gene variants with the glycaemic response to gliptins. A total of 140 consecutive patients with type 2 diabetes were followed-up 6 months after initiation of gliptin treatment. GLP1R rs6923761 (Gly168Ser) and GIPR rs10423928 genotyping was performed using real-time PCR, with subsequent high-resolution melting analysis. The main study outcome was reduction in glycated haemoglobin (HbA1c) after treatment. GLP1R Gly168Ser variant was significantly associated with reduction in HbA1c in an additive model (β = -0.33, p = 0.011). The mean reduction in HbA1c in Ser/Ser homozygotes was significantly lower compared with Gly-allele carriers [0.12 ± 0.23% vs. 0.80 ± 0.09% (1.3 ± 2.5 mmol/mol vs. 8.7 ± 1.0 mmol/mol); p = 0.008]. In conclusion, GLP1R missense variant was associated with a reduced response to gliptin treatment. The genotype-related effect size of ∼0.7% (8 mmol/mol) is equal to an average effect of gliptin treatment and makes this variant a candidate for use in precision medicine.
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Affiliation(s)
- M Javorský
- Faculty of Medicine, Department of Internal Medicine 4, Šafárik University, Košice, Slovakia
- Department of Internal Medicine 4, Pasteur University Hospital, Košice, Slovakia
| | - I Gotthardová
- Faculty of Medicine, Department of Internal Medicine 4, Šafárik University, Košice, Slovakia
- Department of Internal Medicine 4, Pasteur University Hospital, Košice, Slovakia
| | - L Klimčáková
- Faculty of Medicine, Department of Internal Medicine 4, Šafárik University, Košice, Slovakia
- Faculty of Medicine, Department of Medicine Biology, Šafárik University, Košice, Slovakia
| | - M Kvapil
- Faculty of Medicine 2, Department of Medicine, Charles University, Praha, Czech Republic
- Faculty Hospital in Motol, Department of Medicine, Praha, Czech Republic
| | - J Židzik
- Faculty of Medicine, Department of Internal Medicine 4, Šafárik University, Košice, Slovakia
| | - Z Schroner
- Department of Internal Medicine 4, Pasteur University Hospital, Košice, Slovakia
| | - P Doubravová
- Faculty Hospital in Motol, Department of Medicine, Praha, Czech Republic
| | - I Gala
- Department of Internal Medicine 4, Pasteur University Hospital, Košice, Slovakia
| | - I Dravecká
- Faculty of Medicine, Department of Internal Medicine 4, Šafárik University, Košice, Slovakia
- Department of Internal Medicine 4, Pasteur University Hospital, Košice, Slovakia
| | - I Tkáč
- Faculty of Medicine, Department of Internal Medicine 4, Šafárik University, Košice, Slovakia
- Department of Internal Medicine 4, Pasteur University Hospital, Košice, Slovakia
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Zhou K, Yee SW, Seiser EL, van Leeuwen N, Tavendale R, Bennett AJ, Groves CJ, Coleman RL, van der Heijden AA, Beulens JW, de Keyser CE, Zaharenko L, Rotroff DM, Out M, Jablonski KA, Chen L, Javorský M, Židzik J, Levin AM, Williams LK, Dujic T, Semiz S, Kubo M, Chien HC, Maeda S, Witte JS, Wu L, Tkáč I, Kooy A, van Schaik RHN, Stehouwer CDA, Logie L, Sutherland C, Klovins J, Pirags V, Hofman A, Stricker BH, Motsinger-Reif AA, Wagner MJ, Innocenti F, 't Hart LM, Holman RR, McCarthy MI, Hedderson MM, Palmer CNA, Florez JC, Giacomini KM, Pearson ER. Variation in the glucose transporter gene SLC2A2 is associated with glycemic response to metformin. Nat Genet 2016; 48:1055-1059. [PMID: 27500523 PMCID: PMC5007158 DOI: 10.1038/ng.3632] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/30/2016] [Indexed: 02/06/2023]
Abstract
Metformin is the first-line antidiabetic drug with over 100 million users worldwide, yet its mechanism of action remains unclear1. Here the Metformin Genetics (MetGen) Consortium reports a three-stage genome wide association study (GWAS), consisting of 13,123 participants of different ancestries. The C-allele of rs8192675 in the intron of SLC2A2, which encodes the facilitated glucose transporter GLUT2, was associated with a 0.17% (p=6.6x10-14) greater metformin induced HbA1c reduction in 10,577 participants of European ancestry. rs8192675 is the top cis-eQTL for SLC2A2 in 1,226 human liver samples, suggesting a key role for hepatic GLUT2 in regulation of metformin action. In obese individuals C-allele homozygotes at rs8192675 had a 0.33% (3.6mmol/mol) greater absolute HbA1c reduction than T-allele homozygotes.This is about half the effect seen with the addition of a DPP-4 inhibitor, and equates to a dose difference of 550mg of metformin, suggesting rs8192675 as a potential biomarker for stratified medicine.
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Affiliation(s)
- Kaixin Zhou
- School of Medicine, University of Dundee, Dundee, UK
| | - Sook Wah Yee
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Eric L Seiser
- Division of Pharmacotherapy and Experimental Therapeutics, Center for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Nienke van Leeuwen
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Amanda J Bennett
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Christopher J Groves
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Ruth L Coleman
- Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Amber A van der Heijden
- Department of General Practice, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Joline W Beulens
- Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Linda Zaharenko
- Latvian Genome Data Base (LGDB), Riga, Latvia.,Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Daniel M Rotroff
- Bioinformatics Research Center, North Carolina State University, Raleigh, North Carolina, USA.,Department of Statistics, North Carolina State University, Raleigh, North Carolina, USA
| | - Mattijs Out
- Treant Zorggroep, Location Bethesda, Hoogeveen, the Netherlands.,Bethesda Diabetes Research Centre, Hoogeveen, the Netherlands
| | | | - Ling Chen
- Diabetes Unit and Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Jozef Židzik
- Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Albert M Levin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan, USA
| | - L Keoki Williams
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan, USA.,Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA
| | - Tanja Dujic
- School of Medicine, University of Dundee, Dundee, UK.,Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Sabina Semiz
- Faculty of Pharmacy, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.,Faculty of Engineering and Natural Sciences, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan
| | - Huan-Chieh Chien
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Shiro Maeda
- Department of Advanced Genomic and Laboratory Medicine, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan.,Division of Clinical Laboratory and Blood Transfusion, University of the Ryukyus Hospital, Nishihara, Japan
| | - John S Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA.,Institute for Human Genetics, University of California, San Francisco, San Francisco, California, USA.,Department of Urology, University of California, San Francisco, San Francisco, California, USA.,UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, California, USA
| | - Longyang Wu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Ivan Tkáč
- Faculty of Medicine, Šafárik University, Košice, Slovakia
| | - Adriaan Kooy
- Treant Zorggroep, Location Bethesda, Hoogeveen, the Netherlands.,Bethesda Diabetes Research Centre, Hoogeveen, the Netherlands
| | - Ron H N van Schaik
- Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Lisa Logie
- School of Medicine, University of Dundee, Dundee, UK
| | | | | | | | | | - Janis Klovins
- Latvian Genome Data Base (LGDB), Riga, Latvia.,Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Valdis Pirags
- Latvian Biomedical Research and Study Centre, Riga, Latvia.,Faculty of Medicine, University of Latvia, Riga, Latvia.,Department of Endocrinology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.,Inspectorate of Healthcare, Heerlen, the Netherlands
| | - Alison A Motsinger-Reif
- Bioinformatics Research Center, North Carolina State University, Raleigh, North Carolina, USA
| | - Michael J Wagner
- Center for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Federico Innocenti
- Division of Pharmacotherapy and Experimental Therapeutics, Center for Pharmacogenomics and Individualized Therapy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Leen M 't Hart
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Epidemiology and Biostatistics, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.,Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rury R Holman
- Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Mark I McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK.,Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.,Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK
| | - Monique M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | | | - Jose C Florez
- Diabetes Unit and Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA.,Program in Metabolism, Broad Institute, Cambridge, Massachusetts, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Kathleen M Giacomini
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California, USA.,Institute for Human Genetics, University of California, San Francisco, San Francisco, California, USA
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Abstract
Incretin effect enhancers are drugs used in the treatment of Type 2 diabetes and include GLP-1 receptor agonists and dipeptidyl peptidase-4 inhibitors (gliptins). Variants in several genes were shown to be involved in the physiology of incretin secretion. Only two gene variants have evidence also from pharmacogenetic studies. TCF7L2 rs7903146 C>T and CTRB1/2 rs7202877 T>G minor allele carriers were both associated with a smaller reduction in HbA1c after gliptin treatment when compared with major allele carriers. After replication in further studies, these observations could be of clinical significance in helping to identify patients with potentially lower or higher response to gliptin treatment.
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Affiliation(s)
- Ivan Tkáč
- Department of Internal Medicine 4, Šafárik University, Faculty of Medicine, Rastislavova 43, 041 90 Košice, Slovakia.,Department of Internal Medicine 4, Pasteur University Hospital, Košice, Slovakia
| | - Ivana Gotthardová
- Department of Internal Medicine 4, Šafárik University, Faculty of Medicine, Rastislavova 43, 041 90 Košice, Slovakia.,Department of Internal Medicine 4, Pasteur University Hospital, Košice, Slovakia
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Tkáč I. [Pharmacogenetics of oral antidiabetic treatment]. Vnitr Lek 2016; 62:186-188. [PMID: 27180666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pharmacogenetics is the study of how genes (individual genotypes) affect a persons response to drugs. At present, recommendations made about the treatment of some monogenic forms of diabetes are based on genetic diagnostics. The first studies in the field of pharmacogenetics of oral antidiabetics have now been published which have identified associations of individual genetic variants with response to treatment. The response to sulfonylurea derivatives was significantly associated with the variants KCNJ11/ABCC8, TCF7L2 and CYP2C9. The response to metformin treatment was associated with the genetic variants ATM and SLC47A1. The response to treatment with glitazones was associated with the genetic variant PPARG. The therapeutic response to the treatment with gliptins was associated with the genetic variants TCF7L2 and CTRB1/2. It may be expected that in the near future pharmacogenetic knowledge will also be used within personalized treatment of type 2 diabetes.
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Češka R, Tkáč I. [Estimating the prevalence of potential drug interactions in patients treated with 5 and more drugs in the Czech Republic and Slovac Repuplic]. Vnitr Lek 2016; 62:514-520. [PMID: 27627072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Polypragmasy is currently a growing phenomenon, leading to an increased risk of drug interactions. Empirical data to document this trend can only be obtained through a field survey, which, however, is missing in both Czechia and Slovakia. Therefore an international, multicentre, observational, non-interventional study "Estimating the prevalence of potential drug interactions in patients treated with 5 and more drugs in the Czech Republic and Slovakia" was conducted, with the primary aim to identify the prevalence of potential drug-drug interactions in the conditions of routine clinical practice. The patients aged 18 years or more and treated with 5 and more drugs simultaneously were recruited from 21 September 2013 onward in 4 consecutive quarters, each patient maximally once in a single quarter. The participating sites consisted of general practitioners and outpatient specialist clinics (1 040 physicians altogether), chosen to match the structure of medical specialties as well as to cover the entire territory of the respective country. The data was evaluated with descriptive statistical methods. The level of health risk associated with drug-drug interactions has been expressed by an Interaction Index, a measure developed to estimate the probability of critical risk of drug-drug interaction The prevalence of prescriptions with Interaction index 12, i.e. exposing patients to adverse effects, was significantly influenced mainly by the amount of drugs prescribed and their profile in relation to the risk of interactions; on the other hand, age or gender did not play an important role. The identified seasonal variations in the prevalence of interactions can be explained by additional medication associated with seasonal illnesses. KEY WORDS drug interactions - interaction index - polypharmacy.
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Abstract
The introduction of several new drug groups into the treatment of type 2 diabetes in the past few decades leads to an increased requirement for an individualized treatment approach. A personalized treatment is important from the point of view of both efficacy and safety. Recent guidelines are based mainly on entirely phenotypic characteristics such as diabetes duration, presence of macrovascular complications, or risk of hypoglycemia with the use of individual drugs. So far, genetic knowledge is used to guide treatment in the monogenic forms of diabetes. With the accumulating pharmacogenetic evidence in type 2 diabetes, there are reasonable expectations that genetics might help in the adjustment of drug doses to reduce severe side effects, as well as to make better therapeutic choices among the drugs available for the treatment of diabetes.
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Affiliation(s)
- Ivan Tkáč
- Department of Internal Medicine 4, P. J. Šafárik University, Faculty of Medicine, L. Pasteur University Hospital, Rastislavova 43, 041 90, Košice, Slovakia,
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Maliszewski-Hall AM, Alexander M, Tkáč I, Öz G, Rao R. Differential Effects of Intrauterine Growth Restriction on the Regional Neurochemical Profile of the Developing Rat Brain. Neurochem Res 2015; 42:133-140. [PMID: 25972040 DOI: 10.1007/s11064-015-1609-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/23/2015] [Revised: 05/05/2015] [Accepted: 05/07/2015] [Indexed: 11/24/2022]
Abstract
Intrauterine growth restricted (IUGR) infants are at increased risk for neurodevelopmental deficits that suggest the hippocampus and cerebral cortex may be particularly vulnerable. Evaluate regional neurochemical profiles in IUGR and normally grown (NG) 7-day old rat pups using in vivo 1H magnetic resonance (MR) spectroscopy at 9.4 T. IUGR was induced via bilateral uterine artery ligation at gestational day 19 in pregnant Sprague-Dawley dams. MR spectra were obtained from the cerebral cortex, hippocampus and striatum at P7 in IUGR (N = 12) and NG (N = 13) rats. In the cortex, IUGR resulted in lower concentrations of phosphocreatine, glutathione, taurine, total choline, total creatine (P < 0.01) and [glutamate]/[glutamine] ratio (P < 0.05). Lower taurine concentrations were observed in the hippocampus (P < 0.01) and striatum (P < 0.05). IUGR differentially affects the neurochemical profile of the P7 rat brain regions. Persistent neurochemical changes may lead to cortex-based long-term neurodevelopmental deficits in human IUGR infants.
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Affiliation(s)
- Anne M Maliszewski-Hall
- Division of Neonatology, Department of Pediatrics, University of Minnesota, 420 Delaware Street SE, Suite 13-227, MMC 391, Minneapolis, MN, 55455, USA.
| | - Michelle Alexander
- Division of Neonatology, Department of Pediatrics, University of Minnesota, 420 Delaware Street SE, Suite 13-227, MMC 391, Minneapolis, MN, 55455, USA
| | - Ivan Tkáč
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Gülin Öz
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Raghavendra Rao
- Division of Neonatology, Department of Pediatrics, University of Minnesota, 420 Delaware Street SE, Suite 13-227, MMC 391, Minneapolis, MN, 55455, USA
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41
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Bednařík P, Tkáč I, Giove F, DiNuzzo M, Deelchand DK, Emir UE, Eberly LE, Mangia S. Neurochemical and BOLD responses during neuronal activation measured in the human visual cortex at 7 Tesla. J Cereb Blood Flow Metab 2015; 35:601-10. [PMID: 25564236 PMCID: PMC4420878 DOI: 10.1038/jcbfm.2014.233] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/27/2014] [Accepted: 12/01/2014] [Indexed: 01/24/2023]
Abstract
Several laboratories have consistently reported small concentration changes in lactate, glutamate, aspartate, and glucose in the human cortex during prolonged stimuli. However, whether such changes correlate with blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) signals have not been determined. The present study aimed at characterizing the relationship between metabolite concentrations and BOLD-fMRI signals during a block-designed paradigm of visual stimulation. Functional magnetic resonance spectroscopy (fMRS) and fMRI data were acquired from 12 volunteers. A short echo-time semi-LASER localization sequence optimized for 7 Tesla was used to achieve full signal-intensity MRS data. The group analysis confirmed that during stimulation lactate and glutamate increased by 0.26 ± 0.06 μmol/g (~30%) and 0.28 ± 0.03 μmol/g (~3%), respectively, while aspartate and glucose decreased by 0.20 ± 0.04 μmol/g (~5%) and 0.19 ± 0.03 μmol/g (~16%), respectively. The single-subject analysis revealed that BOLD-fMRI signals were positively correlated with glutamate and lactate concentration changes. The results show a linear relationship between metabolic and BOLD responses in the presence of strong excitatory sensory inputs, and support the notion that increased functional energy demands are sustained by oxidative metabolism. In addition, BOLD signals were inversely correlated with baseline γ-aminobutyric acid concentration. Finally, we discussed the critical importance of taking into account linewidth effects on metabolite quantification in fMRS paradigms.
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Affiliation(s)
- Petr Bednařík
- 1] Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA [2] Division of Endocrinology, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA [3] Multimodal and Functional Neuroimaging Research Group, CEITEC-Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Ivan Tkáč
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Federico Giove
- 1] MARBILab, Museo storico della fisica e Centro di studi e ricerche Enrico Fermi, Rome, Italy [2] Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Mauro DiNuzzo
- 1] MARBILab, Museo storico della fisica e Centro di studi e ricerche Enrico Fermi, Rome, Italy [2] Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Dinesh K Deelchand
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Uzay E Emir
- FMRIB Centre, University of Oxford, Oxford, UK
| | - Lynn E Eberly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Silvia Mangia
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
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Tkáč I, Javorský M, Klimčáková L, Židzik J, Gaľa I, Babjaková E, Schroner Z, Štolfová M, Hermanová H, Habalová V. A pharmacogenetic association between a variation in calpain 10 (CAPN10) gene and the response to metformin treatment in patients with type 2 diabetes. Eur J Clin Pharmacol 2014; 71:59-63. [PMID: 25327507 DOI: 10.1007/s00228-014-1774-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/13/2014] [Indexed: 12/26/2022]
Abstract
PURPOSE The aim of the present study was to investigate possible associations of the single-nucleotide variants in six genes encoding the key molecules mediating the metformin pharmacodynamic effect with the response to treatment with metformin in patients with type 2 diabetes. METHODS One hundred forty-eight drug-naïve patients with type 2 diabetes were included in the study. PRKAA1 rs249429, STK11 rs741765, PCK1 rs4810083, PPARGC1A rs10213440, HNF1A rs11086926, and CAPN10 rs3792269 variants were genotyped. The outcomes of the study were treatment success defined by achieving HbA1c <7 % and absolute reduction in HbAlc after 6-month metformin therapy. The relationships between genotypes and outcomes were evaluated in multivariate logistic and linear models. The level of statistical significance after Bonferroni correction was predefined as p<0.0083. RESULTS The minor G-allele of CAPN10 rs3792269 A>G polymorphism was significantly associated with less treatment success with an odds ratio of 0.27 (95 % CI 0.12-0.62, p=0.002) per variant allele. When the reduction in HbA1c was analyzed as a quantitative trait, G-allele was nominally associated with a smaller reduction in HbA1c (per allele β=-0.26, 95 % CI -0.50 to -0.02, p=0.032). The reduction in HbA1c in minor allele carriers (24 % of study population) was smaller by 0.3 % in comparison with the major allele homozygotes. CONCLUSIONS The present study provides the first observation of an association between a variant in CAPN10 gene and the response to metformin therapy in patients with type 2 diabetes. This observation needs to be replicated in further studies in different populations.
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Affiliation(s)
- Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, P. J. Šafárik University, Rastislavova 43, 04190, Košice, Slovakia,
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Tkáč I. [Personalized therapy for diabetes in retrospect and prospect]. Vnitr Lek 2014; 60:797-800. [PMID: 25294772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In recent years, the term "personalized medicine" has been increasingly mentioned in relation to the endeavours to tailor the pharmaceutical as well as regimen therapy to the needs and requirements of individual patients. The personalization of antidiabetic treatment has undergone a dramatic advancement in relation to the expansion of knowledge about diabetes. From the empirical it moved forward to the phenotypic level which made it possible to differentiate between individual types of diabetes. The pathogenetic personalization which began to be used within Type 2 diabetes in the 1960s, was based on the assumption that while insulin resistance predominates in some patients, others are mainly affected by insulin secretion deficit. Biostatistics-personalized medicine (evidence based medicine) gathered evidence based on which metformin was included in recommendations on the therapy for Type 2 diabetes as a first-line drug. Although randomized studies during the first decade of the 21st century did not prove superiority of any other treatment modality as an adjunctive therapy used with metformin, they brought with them individualization of the goals of glycemic con-trol. At present, personalization is heading towards the pharmacogenetic level that will enable in the near future individualized therapy in terms of choice of first-, second- and third-line drugs depending on the panel of key gene polymorphisms which characterize sensitivity of an individual to specific antidiabetics. Finally, the "tailor-maded therapy" should be chosen based on a synthesis of pathogenetic, biostatistic and pharmacogenetic knowledge that will reflect the translation of results of the basic biomedical research into the clinical practice.Key words: evidence based medicine - pathogenesis - personalized therapy - pharmacogenetics - type 2 diabetes.
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Abstract
A plethora of magnetic resonance (MR) techniques developed in the last two decades provide unique and noninvasive measurement capabilities for studies of basic brain function and brain diseases in humans. Animal model experiments have been an indispensible part of this development. MR imaging and spectroscopy measurements have been employed in animal models, either by themselves or in combination with complementary and often invasive techniques, to enlighten us about the information content of such MR methods and/or verify observations made in the human brain. They have also been employed, with or independently of human efforts, to examine mechanisms underlying pathological developments in the brain, exploiting the wealth of animal models available for such studies. In this endeavor, the desire to push for ever-higher spatial and/or spectral resolution, better signal-to-noise ratio, and unique image contrast has inevitably led to the introduction of increasingly higher magnetic fields. As a result, today, animal model studies are starting to be conducted at magnetic fields ranging from ~ 11 to 17 Tesla, significantly enhancing the armamentarium of tools available for the probing brain function and brain pathologies.
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Affiliation(s)
- Gülin Öz
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
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Öz G, Alger JR, Barker PB, Bartha R, Bizzi A, Boesch C, Bolan PJ, Brindle KM, Cudalbu C, Dinçer A, Dydak U, Emir UE, Frahm J, González RG, Gruber S, Gruetter R, Gupta RK, Heerschap A, Henning A, Hetherington HP, Howe FA, Hüppi PS, Hurd RE, Kantarci K, Klomp DWJ, Kreis R, Kruiskamp MJ, Leach MO, Lin AP, Luijten PR, Marjańska M, Maudsley AA, Meyerhoff DJ, Mountford CE, Nelson SJ, Pamir MN, Pan JW, Peet AC, Poptani H, Posse S, Pouwels PJW, Ratai EM, Ross BD, Scheenen TWJ, Schuster C, Smith ICP, Soher BJ, Tkáč I, Vigneron DB, Kauppinen RA. Clinical proton MR spectroscopy in central nervous system disorders. Radiology 2014; 270:658-79. [PMID: 24568703 PMCID: PMC4263653 DOI: 10.1148/radiol.13130531] [Citation(s) in RCA: 411] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A large body of published work shows that proton (hydrogen 1 [(1)H]) magnetic resonance (MR) spectroscopy has evolved from a research tool into a clinical neuroimaging modality. Herein, the authors present a summary of brain disorders in which MR spectroscopy has an impact on patient management, together with a critical consideration of common data acquisition and processing procedures. The article documents the impact of (1)H MR spectroscopy in the clinical evaluation of disorders of the central nervous system. The clinical usefulness of (1)H MR spectroscopy has been established for brain neoplasms, neonatal and pediatric disorders (hypoxia-ischemia, inherited metabolic diseases, and traumatic brain injury), demyelinating disorders, and infectious brain lesions. The growing list of disorders for which (1)H MR spectroscopy may contribute to patient management extends to neurodegenerative diseases, epilepsy, and stroke. To facilitate expanded clinical acceptance and standardization of MR spectroscopy methodology, guidelines are provided for data acquisition and analysis, quality assessment, and interpretation. Finally, the authors offer recommendations to expedite the use of robust MR spectroscopy methodology in the clinical setting, including incorporation of technical advances on clinical units.
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Affiliation(s)
- Gülin Öz
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Jeffry R. Alger
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Peter B. Barker
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Robert Bartha
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Alberto Bizzi
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Chris Boesch
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Patrick J. Bolan
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Kevin M. Brindle
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Cristina Cudalbu
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Alp Dinçer
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Ulrike Dydak
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Uzay E. Emir
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Jens Frahm
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Ramón Gilberto González
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Stephan Gruber
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Rolf Gruetter
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Rakesh K. Gupta
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Arend Heerschap
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Anke Henning
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Hoby P. Hetherington
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Franklyn A. Howe
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Petra S. Hüppi
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Ralph E. Hurd
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Kejal Kantarci
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Dennis W. J. Klomp
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Roland Kreis
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Marijn J. Kruiskamp
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Martin O. Leach
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Alexander P. Lin
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Peter R. Luijten
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Małgorzata Marjańska
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Andrew A. Maudsley
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Dieter J. Meyerhoff
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Carolyn E. Mountford
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Sarah J. Nelson
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - M. Necmettin Pamir
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Jullie W. Pan
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Andrew C. Peet
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Harish Poptani
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Stefan Posse
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Petra J. W. Pouwels
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Eva-Maria Ratai
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Brian D. Ross
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Tom W. J. Scheenen
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Christian Schuster
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Ian C. P. Smith
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Brian J. Soher
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Ivan Tkáč
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
| | - Daniel B. Vigneron
- From the Center for Magnetic Resonance Research, University of Minnesota,
2021 6th St SE, Minneapolis, MN 55455 (G.O.)
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Tkáč I, Klimčáková L, Javorský M, Fabianová M, Schroner Z, Hermanová H, Babjaková E, Tkáčová R. Pharmacogenomic association between a variant in SLC47A1 gene and therapeutic response to metformin in type 2 diabetes. Diabetes Obes Metab 2013; 15:189-91. [PMID: 22882994 DOI: 10.1111/j.1463-1326.2012.01691.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 07/20/2012] [Accepted: 08/06/2012] [Indexed: 11/28/2022]
Abstract
Pharmacogenetic studies revealed that variants in genes related to the pharmacokinetics of metformin were associated with glucose-lowering effect of metformin. The aim of this study was to investigate possible associations of the variants in genes encoding organic cationic transporters-solute carrier family 22, members A1, A2 (SLC22A1, SLC22A2) and solute carrier family 47, member A1 (SLC47A1) with response to metformin in type 2 diabetes. One hundred forty-eight drug-naive patients with type 2 diabetes were included in the study. Genotyping for SLC22A1 rs622342, SLC22A2 rs316019 and SLC47A1 rs2289669 variants was performed using real-time PCR with subsequent melting-curve analysis. SLC47A1 rs2289669 genotype was significantly associated with the reduction in haemoglobin A1c (HbA1c) after 6 months. Twenty percentage of patients with diabetes that are homozygous for A-allele of SLC47A1 had twofold reduction in HbA1c in comparison with the patients carrying G-allele (GG + GA: 0.55 ± 0.09% vs. AA: 1.10 ± 0.18%, p = 0.018). In conclusion, the results of this study might have in future practical implication in personalised treatment of patients with type 2 diabetes.
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Affiliation(s)
- I Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, Šafárik University, Košice, Slovakia.
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Javorský M, Babjaková E, Klimčáková L, Schroner Z, Židzik J, Štolfová M, Šalagovič J, Tkáč I. Association between TCF7L2 Genotype and Glycemic Control in Diabetic Patients Treated with Gliclazide. Int J Endocrinol 2013; 2013:374858. [PMID: 23509454 PMCID: PMC3590634 DOI: 10.1155/2013/374858] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 01/20/2013] [Indexed: 12/25/2022] Open
Abstract
Previous studies showed associations between variants in TCF7L2 gene and the therapeutic response to sulfonylureas. All sulfonylureas stimulate insulin secretion by the closure of ATP-sensitive potassium (KATP) channel. The aim of the present study was to compare TCF7L2 genotype specific effect of gliclazide binding to KATP channel A-site (Group 1) with sulfonylureas binding to AB-site (Group 2). A total of 101 patients were treated with sulfonylureas for 6 months as an add-on therapy to the previous metformin treatment. TCF7L2 rs7903146 C/T genotype was identified by real-time PCR with subsequent melting curve analysis. Analyses using the dominant genetic model showed significantly higher effect of gliclazide in the CC genotype group in comparison with combined CT + TT genotype group (1.32 ± 0.15% versus 0.73 ± 0.11%, P (adj) = 0.005). No significant difference in ΔHbA1c between the patients with CC genotype and the T-allele carriers was observed in Group 2. In the multivariate analysis, only the TCF7L2 genotype (P = 0.006) and the baseline HbA1c (P < 0.001) were significant predictors of ΔHbA1c. After introducing an interaction term between the TCF7L2 genotype and the sulfonylurea type into multivariate model, the interaction became a significant predictor (P = 0.023) of ΔHbA1c. The results indicate significantly higher difference in ΔHbA1c among the TCF7L2 genotypes in patients treated with gliclazide than in patients treated with glimepiride, glibenclamide, or glipizide.
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Affiliation(s)
- Martin Javorský
- Department of Internal Medicine 4, Faculty of Medicine, L. Pasteur University Hospital, P. J. Šafárik University in Košice, 041 90 Košice, Slovakia
| | - Eva Babjaková
- Department of Internal Medicine 4, Faculty of Medicine, L. Pasteur University Hospital, P. J. Šafárik University in Košice, 041 90 Košice, Slovakia
| | - Lucia Klimčáková
- Department of Medical Biology, Faculty of Medicine, P. J. Šafárik University in Košice, 040 66 Košice, Slovakia
| | - Zbynek Schroner
- Department of Internal Medicine 4, Faculty of Medicine, L. Pasteur University Hospital, P. J. Šafárik University in Košice, 041 90 Košice, Slovakia
| | - Jozef Židzik
- Department of Medical Biology, Faculty of Medicine, P. J. Šafárik University in Košice, 040 66 Košice, Slovakia
| | - Mária Štolfová
- Department of Internal Medicine 4, Faculty of Medicine, L. Pasteur University Hospital, P. J. Šafárik University in Košice, 041 90 Košice, Slovakia
| | - Ján Šalagovič
- Department of Medical Biology, Faculty of Medicine, P. J. Šafárik University in Košice, 040 66 Košice, Slovakia
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, L. Pasteur University Hospital, P. J. Šafárik University in Košice, 041 90 Košice, Slovakia
- *Ivan Tkáč:
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Abstract
Oral antidiabetic drugs (OADs) are used for more than a half-century in the treatment of type 2 diabetes. Only in the last five years, intensive research has been conducted in the pharmacogenetics of these drugs based mainly on the retrospective register studies, but only a handful of associations detected in these studies were replicated. The gene variants in CYP2C9, ABCC8/KCNJ11, and TCF7L2 were associated with the effect of sulfonylureas. CYP2C9 encodes sulfonylurea metabolizing cytochrome P450 isoenzyme 2C9, ABCC8 and KCNJ11 genes encode proteins constituting ATP-sensitive K(+) channel which is a therapeutic target for sulfonylureas, and TCF7L2 is a gene with the strongest association with type 2 diabetes. SLC22A1, SLC47A1, and ATM gene variants were repeatedly associated with the response to metformin. SLC22A1 and SLC47A1 encode metformin transporters OCT1 and MATE1, respectively. The function of a gene variant near ATM gene identified by a genome-wide association study is not elucidated so far. The first variant associated with the response to gliptins is a polymorphism in the proximity of CTRB1/2 gene which encodes chymotrypsinogen. Establishment of diabetes pharmacogenetics consortia and reduction in costs of genomics might lead to some significant clinical breakthroughs in this field in a near future.
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Affiliation(s)
- Matthijs L. Becker
- Department of Epidemiology, Erasmus MC, 3015 CE Rotterdam, The Netherlands
- Pharmacy Foundation of Haarlem Hospitals, 2035 RC Haarlem, The Netherlands
| | - Ewan R. Pearson
- Medical Research Institute, University of Dundee, Dundee DD1 9SY, UK
| | - Ivan Tkáč
- Department of Internal Medicine 4, Faculty of Medicine, P. J. Šafárik University, 041 80 Košice, Slovakia
- Department of Internal Medicine 4, L. Pasteur University Hospital, Rastislavova 43, 041 90 Košice, Slovakia
- *Ivan Tkáč:
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Tkáč I. Replication of the association of gene variant near ATM and response to metformin. Pharmacogenomics 2012; 13:1331-1332. [PMID: 23130369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- Ivan Tkáč
- Department of Internal Medicine 4, L. Pasteur University Hospital, P. J. Šafárik University, Košice, Slovakia.
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Affiliation(s)
- Ivan Tkáč
- Department of Internal Medicine 4, L. Pasteur University Hospital, P. J. Šafárik University, Košice, Slovakia
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