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Arif M, Nigoskar S, Verma MK. Adiponectin and HbA1c levels among Indian patients with diabetes mellitus. Bioinformation 2024; 20:202-207. [PMID: 38497075 PMCID: PMC10941768 DOI: 10.6026/973206300200202] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Adiponectin is closely related to glucose metabolism and newly diagnosed type 2 diabetes mellitus (T2DM), and other kinds of diabetes linked to the risk of T2DM. Therefore, it is of interest to report the correlation between adiponectin levels and glycosylated hemoglobin (HbA1c) as a diagnostic marker of T2DM and healthy control. Total 210 participants were included of IPD & OPD healthy controls with glycosylated hemoglobin levels under 6% were included. Blood samples, collected using sterile clot activator or plain vials, were stored at -20°C. The biomarker score that comprised significant differences in age, gender distribution, and metabolic indicators are seen between the diabetes (n=105) and control (n=105) groups. Increase in both Adiponectin and HbA1c% Mean±SD (6.86±0.23, p<0.0001; 22.71±2.01; p<0.0001) is indicative of deteriorating glycaemic control and an accompanying rise in inflammatory response. Positively correlate adiponectin levels with HbA1c levels (r2=0.398; p<0.0001), suggesting a link between inflammatory response and glucose control. Lower adiponectin levels are statistically associated with diabetes. Diabetes and adiponectin were negatively correlated and positive linear relationship between HbA1c and adiponectin levels. Adiponectin may be a significant factor useful in understanding the pathophysiology; they are likely to be straight forward instruments for predicting future risk of diabetes.
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Affiliation(s)
- Mohammad Arif
- Department of Biochemistry, Index Medical College & Research Center Indore, Madhya Pradesh, India
| | - Shreya Nigoskar
- Department of Biochemistry, Index Medical College & Research Center Indore, Madhya Pradesh, India
| | - Manish Kumar Verma
- Department of Biochemistry, Rajashri Dashrath Autonomous State Medical College Ayodhya, U.P, India
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Chillo O, Mzokolo I, Peter E, Malindisa E, Thabit H, Tungu A, Njelekela M, Balandya E. Type 2 Diabetes Mellitus in Tanzania. A Narrative Review of Epidemiology and Disease Trend. Curr Diabetes Rev 2024; 20:CDR-EPUB-136941. [PMID: 38173215 DOI: 10.2174/0115733998267513231208100124] [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: 06/28/2023] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION The prevalence of type 2 diabetes is on a rapid rise in Tanzania, driven by lifestyle modifications, nutritional changes, and increased obesity rates. This article reviews the epidemiology, and disease trends of type 2 diabetes in Tanzania and explores the economic implications and challenges in care, including policy, education, and healthcare systems. METHODOLOGY The study employs a narrative literature review from research articles, local healthcare reports, surveys, and public health records. It evaluates the economic impacts, healthcare capabilities, and patient behaviors in managing type 2 diabetes in Tanzania. RESULTS The economic burden of diabetes in Tanzania is increasing due to direct healthcare costs, lost productivity, and reduced quality of life, placing significant pressure on the already resourcelimited healthcare system. Treatment dropout rates are alarmingly high, and healthcare providers' knowledge of diabetes is insufficient. Insulin and metformin availability are critically low. Cultural norms and dietary habits pose substantial barriers to effective disease management. CONCLUSION The growing prevalence of type 2 diabetes in Tanzania presents a significant public health crisis, necessitating comprehensive strategies for prevention, early detection, and effective disease management. Priorities should include enhancing healthcare infrastructure, increasing public investment, improving healthcare education, and tackling socio-cultural barriers to disease management.
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Affiliation(s)
- Omary Chillo
- Department of Physiology, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Irene Mzokolo
- Department of Physiology, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Elizabeth Peter
- Department of Physiology, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Physiology, School of Medicine, Kilimanjaro Christian Medical College, Kilimanjaro, Tanzania
| | - Eva Malindisa
- Department of Physiology, School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Hassan Thabit
- Department of Physiology, School of Medicine, State University of Zanzibar, Zanzibar, Tanzania
| | - Alexander Tungu
- Department of Physiology, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Marina Njelekela
- Department of Physiology, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Emmanuel Balandya
- Department of Physiology, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Elshoeibi AM, Akomolafe A, Al-Khulaifi A, Metwally O, Al-Khayarin R, Al Abiad AR, Al-Naemi L, Chivese T, Farooqui H. The Association Between Short Sleep Duration and Metabolic Syndrome: A Case-Control Study. Diabetes Metab Syndr Obes 2023; 16:4157-4167. [PMID: 38146450 PMCID: PMC10749399 DOI: 10.2147/dmso.s438054] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/28/2023] [Indexed: 12/27/2023] Open
Abstract
Purpose Short sleep duration and quality are increasingly common in the Middle East and North Africa (MENA) region and has been linked to metabolic syndrome, which increases the risk of cardiovascular disease and diabetes. This study aimed to examine the link between short sleep duration and metabolic syndrome. Patients and Methods We conducted a case-control study using data from Qatar Biobank, with 1000 participants categorized into two groups: less than 7 hours of sleep (n=500) and 7 or more hours of sleep (n=500). Metabolic syndrome was defined using WHO criteria, and logistic regression analysis adjusted for age and gender. Results There was a higher proportion of individuals with MetS in the short sleep duration group compared to the normal sleep duration group (22.8% vs 15.8%, respectively). The multivariable regression showed that short sleep duration was associated with metabolic syndrome (OR 1.91, 95% CI: 1.14-3.20, P=0.014) and having 1-2 components of metabolic syndrome (OR 1.91, 95% CI: 1.14-3.20, P=0.014), particularly in males (OR: 2.30, 95% CI: 1.07-4.94, P=0.032). Being overweight (OR 2.17, 95% CI: 1.30-3.63, P=0.003) was also associated with a shorter sleep duration. BMI was identified as the main contributor to the association between short sleep duration and metabolic syndrome, while diabetes played a minor role. Conclusion Short sleep duration was associated with metabolic syndrome in Qatar, particularly in males.
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Affiliation(s)
| | - Aishat Akomolafe
- College of Medicine, QU Health, Qatar University, Doha, 2713, Qatar
| | | | - Omar Metwally
- College of Medicine, QU Health, Qatar University, Doha, 2713, Qatar
| | | | | | - Latifa Al-Naemi
- College of Medicine, QU Health, Qatar University, Doha, 2713, Qatar
| | - Tawanda Chivese
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, 2713, Qatar
| | - Habib Farooqui
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, 2713, Qatar
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Pandya S, Savaliya C, Thummar K, Gothwad A, Panchabhai T, Nagore D. Validation of standardized polyherbal formulation in the management of type 2 diabetes mellitus: A randomized, double-blind, placebo-controlled trial. J Diabetes Metab Disord 2023; 22:495-506. [PMID: 37255810 PMCID: PMC10225382 DOI: 10.1007/s40200-022-01171-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 12/05/2022] [Indexed: 06/01/2023]
Abstract
Background Diabetes is prevalent globally; India stands amongst the first two countries with the highest percentage of adults aged 20-79 years with diabetes in 2021. Anti-diabetic agents and insulin offer profound side effects. Phytoconstituents regulate blood sugar, improve health status and reduce dependency on anti-diabetic medications. This research aims to generate clinical evidence of Diabetic Support Product (GP/PROD/2021/001) in the treatment of type 2 diabetes. Trial design A randomized, double-blind, placebo-controlled clinical trial was conducted on 150 individuals with type 2 diabetes mellitus. Subjects were divided into two parallel groups and given either GP/PROD/2021/001 or a placebo tablet; 2 tablets twice a day after meals for 90 days. Methods Interventions were adjuvant to the standard medication. The research objectives were to evaluate changes in fasting and post-meal plasma glucose and HbA1c in patients with type 2 diabetes. Results In 90 days, GP/PROD/2021/001 group showed a substantial improvement in all key biochemical markers-HbA1c, FBS, and PPBS when compared to the placebo group. A reduced HOMA-IR score suggests reduced insulin resistance. Quality of life improved in GP/PROD/2021/001 group than placebo. On day 90, there was a significant decrease in HbA1c levels in GP/PROD/2021/001 (23.51%) group than placebo (6.21%). The test group reduced their dependency on conventional antidiabetic medication and insulin. Conclusion It can be concluded from the study that the advanced diabetic support formula (GP/PROD/2021/001) is a safer and more effective option as an adjuvant in the management of diabetes from newly diagnosed to chronic diabetic patients. Trial registration CTRI/2022/01/039179 [Registered on: 05/01/2022] Trial Registered Prospectively.
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Affiliation(s)
- Shridhar Pandya
- Gplife Healthcare Pvt Ltd, 705‑706, Orbit‑ 1 Building, Punagam‑Saroli Rd, Near RRTM Market, 395010 Surat, India
| | - Chetan Savaliya
- Gplife Healthcare Pvt Ltd, 705‑706, Orbit‑ 1 Building, Punagam‑Saroli Rd, Near RRTM Market, 395010 Surat, India
| | - Kamlesh Thummar
- Gplife Healthcare Pvt Ltd, 705‑706, Orbit‑ 1 Building, Punagam‑Saroli Rd, Near RRTM Market, 395010 Surat, India
| | - Amol Gothwad
- Lokmanya Medical Research Centre Lokmanya Hospital, Floor 4, OPD 1, 314/B Telco Road, Chinchwad, Pune, 411033 Maharashtra India
| | - Tanuja Panchabhai
- Atharv Multispecialty Research Center, Krishna Chowk, Kirti Nagar, New Sanghavi, Pune, 411027 Maharashtra India
| | - Dheeraj Nagore
- Mprex Healthcare Pvt Ltd, 501, Crossroads Building, Bhumkar Chowk, Wakad, Pune, 411057 India
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Bukhari I, Iqbal F, Thorne RF. Editorial: Relationship between gestational and neonatal diabetes mellitus. Front Endocrinol (Lausanne) 2022; 13:1060147. [PMID: 36313786 PMCID: PMC9616566 DOI: 10.3389/fendo.2022.1060147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ihtisham Bukhari
- Translational Research Institute, Henan Provincial and Zhengzhou City Key Laboratory of Non-coding RNA and Cancer Metabolism, Henan International Joint Laboratory of Non-coding RNA and Metabolism in Cancer, Henan Provincial People’s Hospital, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Helicobacter pylori, Microbiota and Gastrointestinal Cancer, Marshall Medical Research Center, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Furhan Iqbal
- Institute of Zoology, Bahauddin Zakariya University, Multan, Pakistan
- *Correspondence: Furhan Iqbal, ; Rick Francis Thorne,
| | - Rick Francis Thorne
- Translational Research Institute, Henan Provincial and Zhengzhou City Key Laboratory of Non-coding RNA and Cancer Metabolism, Henan International Joint Laboratory of Non-coding RNA and Metabolism in Cancer, Henan Provincial People’s Hospital, Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
- School of Environmental and Life Sciences, University of Newcastle, Callaghan, NSW, Australia
- *Correspondence: Furhan Iqbal, ; Rick Francis Thorne,
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Jess T, Jensen BW, Andersson M, Villumsen M, Allin KH. Inflammatory Bowel Diseases Increase Risk of Type 2 Diabetes in a Nationwide Cohort Study. Clin Gastroenterol Hepatol 2020; 18:881-888.e1. [PMID: 31394285 DOI: 10.1016/j.cgh.2019.07.052] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 01/23/2019] [Revised: 06/17/2019] [Accepted: 07/25/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The intestine regulates glucose homeostasis, but it is not clear whether chronic intestinal inflammation affects risk for type 2 diabetes. We investigated the long-term risk of type 2 diabetes in patients with inflammatory bowel diseases (IBD) in a nationwide cohort study in Denmark. METHODS In a nationwide population-based cohort of 6,028,844 persons in Denmark, we compared data from individuals with a diagnosis of IBD (Crohn's disease [CD] or ulcerative colitis UC]) with data from individuals from the general population from 1977 through 2014. Persons with type 2 diabetes were identified in the National Patient Register. Risk is presented as standardized incidence ratios (SIR) with 95% CIs. RESULTS During 736,072 person-years of follow-up, 3436 patients with IBD developed type 2 diabetes vs 2224 expected (SIR, 1.54; 95% CI, 1.49-1.60). The risk was significantly increased in patients with UC (SIR, 1.54; 95% CI, 1.48-1.60), in patients with CD (SIR, 1.57; 95% CI, 1.47-1.67), in women (SIR, 1.51; 95% CI, 1.44-1.59), and in men (SIR, 1.57; 95% CI, 1.50-1.65). The risk was highest the first year after a diagnosis of IBD (SIR, 4.48; 95% CI, 4.16-4.83), but remained increased for 20 or more years following the diagnosis (SIR, 1.26; 95% CI, 1.16-1.38). The increased risk could not be accounted for by frequency of health care contacts or corticosteroid exposure. Patients who received a diagnosis of IBD from 2003 through 2014 (SIR, 1.79; 95% CI, 1.67-1.91) had a significantly higher risk of type 2 diabetes than patients who received a diagnosis of IBD from 1977 through 1988 (SIR, 1.47; 95% CI, 1.39-1.56) or 1989 through 2002 (SIR, 1.48; 95% CI, 1.41-1.56) (P < .001). CONCLUSIONS In a population-based cohort study, we found an increased risk of type 2 diabetes in patients with UC or CD, with highest risk estimates from 2003 through 2014, compared with earlier years. Studies are needed to determine the effects of IBD treatment on risk of type 2 diabetes.
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Affiliation(s)
- Tine Jess
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Department of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark.
| | - Britt W Jensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Mikael Andersson
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark
| | - Marie Villumsen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
| | - Kristine H Allin
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen N, Denmark
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Zani C, Magoni M, Speziani F, Leonardi L, Orizio G, Scarcella C, Gaia A, Donato F. Polychlorinated biphenyl serum levels, thyroid hormones and endocrine and metabolic diseases in people living in a highly polluted area in North Italy: A population-based study. Heliyon 2019; 5:e01870. [PMID: 31194120 PMCID: PMC6551472 DOI: 10.1016/j.heliyon.2019.e01870] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 04/01/2019] [Revised: 05/23/2019] [Accepted: 05/29/2019] [Indexed: 01/19/2023] Open
Abstract
Polychlorinated biphenyls (PCBs) are persistent organic pollutants produced until the 1980s, which they are still present worldwide. They have been associated with metabolic and endocrine diseases and hypertension in humans, but definite evidence is lacking. A chemical factory producing PCBs caused a heavy pollution in an urban area in Northern Italy. We aimed to evaluate present PCBs serum levels according to demographic and lifestyle variables and their associations with endocrine and metabolic diseases and hypertension in the resident general population. A random sample of 816 adults aged 20–79 years (mean ± SD: 49.1 ± 16.5 years) was enrolled in a cross-sectional population-based study. The participants provided a fasting blood sample for laboratory analysis and were face-to-face interviewed about the presence of chronic diseases. The serum level of total PCBs was computed as the sum of 33 PCB congeners. The median serum level of lipid-adjusted total PCBs was 435.2 and 95th centile was 2154.9 ng/g lipid. Medium and high chlorinated PCBs with immunotoxic and endocrine disrupting activity contributed most to total PCB serum levels, particularly PCBs 138, 153, 170, 180 and 194. The serum levels of total PCBs and of PCB functional groups were positively associated with age and negatively with female gender, education, smoking habit and BMI, and not associated with serum levels of thyroid hormones and TSH and glycaemia and with presence of endocrine diseases, diabetes and hypertension by multivariable analysis. Subgroup analyses according to gender, age and BMI provided similar results. In conclusion, this study shows a long-term persistence of past exposure to PCBs and does not support the hypothesis of an association between PCB exposure and prevalence of endocrine and metabolic diseases and hypertension.
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Affiliation(s)
- Claudia Zani
- Department of Medical and Surgical Specialties Radiological Sciences and Public Health, Unit of Epidemiology, Hygiene and Public Health, University of Brescia, Italy
| | | | | | | | - Grazia Orizio
- ATS Brescia (Brescia Health Protection Agency), Italy
| | | | - Alice Gaia
- Department of Medical and Surgical Specialties Radiological Sciences and Public Health, Institute of Occupational Health and Industrial Hygiene, University of Brescia, Italy
| | - Francesco Donato
- Department of Medical and Surgical Specialties Radiological Sciences and Public Health, Unit of Epidemiology, Hygiene and Public Health, University of Brescia, Italy
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Furman JL, Soyombo A, Czysz AH, Jha MK, Carmody TJ, Mason BL, Scherer PE, Trivedi MH. Adiponectin Moderates Antidepressant Treatment Outcome in the Combining Medications to Enhance Depression Outcomes Randomized Clinical Trial. ACTA ACUST UNITED AC 2018; 9-10:1-7. [PMID: 30859144 DOI: 10.1016/j.pmip.2018.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 12/13/2022]
Abstract
Background Major depressive disorder (MDD) is often comorbid with metabolic diseases such as obesity, cardiovascular disease, and type 2 diabetes. A potential link between these disorders is adiponectin, an adipocyte-derived circulating hormone with insulin-sensitizing, anti-inflammatory, and neuroplasticity effects. Reductions in plasma levels of adiponectin have been reported in both humans with depression and in the chronic-defeat mouse model of depression. However, the predictive value of adiponectin for treatment response to depression has not been determined. Methods We investigated the potential predictive effect of baseline adiponectin levels in patients who provided plasma and were undergoing one of three pharmacological treatments (escitalopram monotherapy; escitalopram plus bupropion; and venlafaxine plus mirtazapine) in the Combining Medications to Enhance Depression Outcomes clinical trial (n=160). Specifically, we assessed whether adiponectin moderates-that is, differentially predicts-treatment response among the treatment arms. Improvements with treatment were assessed using change in the clinician-rated 30-item Inventory of Depressive Symptomatology (IDS-C) from baseline through week 12. Moderator effects were tested using separate pairwise repeated measures mixed-effects models with a treatment-arm-by-adiponectin interaction. Results Baseline adiponectin levels moderated treatment outcome between two combination therapies. Specifically, low adiponectin predicted better response to escitalopram plus bupropion compared to venlafaxine plus mirtazapine, whereas high adiponectin predicted better response to venlafaxine plus mirtazapine compared to escitalopram plus bupropion (F=4.84, p=0.03). Adiponectin levels did not correlate with baseline depression severity (r=-0.03, p=.59). Conclusions Antidepressant selection for patients with MDD can be personalized using pre-treatment blood-based biomarkers, such as adiponectin, thereby improving treatment outcomes.
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Affiliation(s)
- Jennifer L Furman
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Abigail Soyombo
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Andrew H Czysz
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Manish K Jha
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Thomas J Carmody
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Brittany L Mason
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
| | - Philipp E Scherer
- Departments of Internal Medicine and Cell Biology, Touchstone Diabetes Center University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, Texas, 75390-9119, USA
| | - Madhukar H Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, UT Southwestern Medical Center, 6363 Forest Park Rd, Ste BL13.408, Dallas, TX, 75390-9119, USA
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Sharaiha RZ, Kumta NA, Saumoy M, Desai AP, Sarkisian AM, Benevenuto A, Tyberg A, Kumar R, Igel L, Verna EC, Schwartz R, Frissora C, Shukla A, Aronne LJ, Kahaleh M. Endoscopic Sleeve Gastroplasty Significantly Reduces Body Mass Index and Metabolic Complications in Obese Patients. Clin Gastroenterol Hepatol 2017; 15:504-510. [PMID: 28017845 DOI: 10.1016/j.cgh.2016.12.012] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [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: 08/02/2016] [Revised: 12/11/2016] [Accepted: 12/12/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Endoscopic sleeve gastroplasty (ESG) is an incisionless, minimally invasive bariatric procedure that reduces the length and width of the gastric cavity to facilitate weight loss. We performed a prospective study to evaluate the effects of ESG on total body weight loss and obesity-related comorbidities. METHODS We collected data from 91 consecutive patients (mean age, 43.86 ± 11.26 years; 68% female) undergoing ESG from August 2013 through March 2016. All patients had a body mass index (BMI) greater than 30 kg/m2 and had failed noninvasive weight-loss measures or had a BMI greater than 40 kg/m2 and were not considered as surgical candidates or refused surgery. All procedures were performed with a cap-based flexible endoscopic suturing system to facilitate a triangular pattern of sutures to imbricate the greater curvature of the stomach. Patients were evaluated after 6 months (n = 73), 12 months (n = 53), and 24 months (n = 12) for anthropometric features (BMI, weight, waist circumference, blood pressure) and underwent serologic (hemoglobin A1c), lipid panel, serum triglycerides, and liver function tests. The primary outcomes were total body weight loss at 6, 12, and 24 months. Secondary outcomes were the effects of ESG on metabolic factors (blood pressure, diabetes, hyperlipidemia, steatohepatitis) and safety. RESULTS The patients' mean BMI before the procedure was 40.7 ± 7.0 kg/m2. Patients had lost 14.4% of their total body weight at 6 months (80% follow-up rate), 17.6% at 12 months (76% follow-up rate), and 20.9% at 24 months (66% follow-up rate) after ESG. At 12 months after ESG, patients had statistically significant reductions in levels of hemoglobin A1c (P = .01), systolic blood pressure (P = .02), waist circumference (P < .001), alanine aminotransferase (P < .001), and serum triglycerides (P = .02). However, there was no significant change in low-density lipoprotein after vs before ESG (P = .79). There was one serious adverse event (1.1%) (perigastric leak) that occurred that was managed non-operatively. CONCLUSIONS ESG is a minimally invasive and effective endoscopic weight loss intervention. In addition to sustained total body weight loss up to 24 months, ESG reduced markers of hypertension, diabetes, and hypertriglyceridemia.
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Affiliation(s)
- Reem Z Sharaiha
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York.
| | - Nikhil A Kumta
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Monica Saumoy
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Amit P Desai
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Alex M Sarkisian
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Andrea Benevenuto
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Amy Tyberg
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Rekha Kumar
- Department of Endocrinology, Weill Cornell Medicine, New York, New York
| | - Leon Igel
- Department of Endocrinology, Weill Cornell Medicine, New York, New York
| | - Elizabeth C Verna
- Department of Gastroenterology, Columbia University Medical Center, New York, New York
| | - Robert Schwartz
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Christina Frissora
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
| | - Alpana Shukla
- Department of Endocrinology, Weill Cornell Medicine, New York, New York
| | - Louis J Aronne
- Department of Endocrinology, Weill Cornell Medicine, New York, New York
| | - Michel Kahaleh
- Department of Gastroenterology, Weill Cornell Medicine, New York, New York
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Allu PKR, Chirasani VR, Ghosh D, Mani A, Bera AK, Maji SK, Senapati S, Mullasari AS, Mahapatra NR. Naturally occurring variants of the dysglycemic peptide pancreastatin: differential potencies for multiple cellular functions and structure-function correlation. J Biol Chem 2014; 289:4455-69. [PMID: 24338022 PMCID: PMC3924307 DOI: 10.1074/jbc.m113.520916] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 12/08/2013] [Indexed: 12/16/2022] Open
Abstract
Pancreastatin (PST), a chromogranin A-derived peptide, is a potent physiological inhibitor of glucose-induced insulin secretion. PST also triggers glycogenolysis in liver and reduces glucose uptake in adipocytes and hepatocytes. Here, we probed for genetic variations in PST sequence and identified two variants within its functionally important carboxyl terminus domain: E287K and G297S. To understand functional implications of these amino acid substitutions, we tested the effects of wild-type (PST-WT), PST-287K, and PST-297S peptides on various cellular processes/events. The rank order of efficacy to inhibit insulin-stimulated glucose uptake was: PST-297S > PST-287K > PST-WT. The PST peptides also displayed the same order of efficacy for enhancing intracellular nitric oxide and Ca(2+) levels in various cell types. In addition, PST peptides activated gluconeogenic genes in the following order: PST-297S ≈ PST-287K > PST-WT. Consistent with these in vitro results, the common PST variant allele Ser-297 was associated with significantly higher (by ∼17 mg/dl, as compared with the wild-type Gly-297 allele) plasma glucose level in our study population (n = 410). Molecular modeling and molecular dynamics simulations predicted the following rank order of α-helical content: PST-297S > PST-287K > PST-WT. Corroboratively, circular dichroism analysis of PST peptides revealed significant differences in global structures (e.g. the order of propensity to form α-helix was: PST-297S ≈ PST-287K > PST-WT). This study provides a molecular basis for enhanced potencies/efficacies of human PST variants (likely to occur in ∼300 million people worldwide) and has quantitative implications for inter-individual variations in glucose/insulin homeostasis.
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Affiliation(s)
- Prasanna K. R. Allu
- From the Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036
| | - Venkat R. Chirasani
- From the Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036
| | - Dhiman Ghosh
- the Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, and
| | - Anitha Mani
- From the Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036
| | - Amal K. Bera
- From the Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036
| | - Samir K. Maji
- the Department of Biosciences and Bioengineering, Indian Institute of Technology Bombay, Mumbai 400076, and
| | - Sanjib Senapati
- From the Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036
| | - Ajit S. Mullasari
- the Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai 600037, India
| | - Nitish R. Mahapatra
- From the Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036
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Weiss KH, Thurik F, Gotthardt DN, Schäfer M, Teufel U, Wiegand F, Merle U, Ferenci-Foerster D, Maieron A, Stauber R, Zoller H, Schmidt HH, Reuner U, Hefter H, Trocello JM, Houwen RHJ, Ferenci P, Stremmel W. Efficacy and safety of oral chelators in treatment of patients with Wilson disease. Clin Gastroenterol Hepatol 2013; 11:1028-35.e1-2. [PMID: 23542331 DOI: 10.1016/j.cgh.2013.03.012] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [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: 02/13/2013] [Accepted: 03/04/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Wilson disease is a genetic copper storage disorder that causes hepatic and neurologic symptoms. Chelating agents (D-penicillamine, trientine) are used as first-line therapies for symptomatic patients, but there are few data from large cohorts. We assessed the safety of D-penicillamine and trientine therapy and outcomes of patients with Wilson disease. METHODS We performed a retrospective analysis of data on 380 patients with Wilson disease from tertiary care centers in Germany and Austria, and 25 additional patients from the EUROWILSON registry. Chelator-based treatment regimens were analyzed for their effect on neurologic and hepatic symptoms and for adverse events that led to discontinuation of therapy (Kaplan-Meier estimation; data were collected for a mean of 13.3 y after therapy began). RESULTS Changes in medication were common, resulting in analysis of 471 chelator monotherapies (326 patients receiving D-penicillamine and 141 receiving trientine). Nine of 326 patients treated with D-penicillamine and 3 of 141 patients given trientine underwent liver transplantation. Adverse events leading to discontinuation of treatment were more frequent among those receiving D-penicillamine than trientine (P = .039). Forty-eight months after therapy, hepatic deterioration was reported in only 4 of 333 patients treated initially with a chelating agent. Hepatic improvements were observed in more than 90%, and neurologic improvements were observed in more than 55%, of therapy-naive patients, and values did not differ significantly between treatments. However, neurologic deterioration was observed less frequently in patients given D-penicillamine first (6 of 295) than those given trientine first (4 of 38; P = .018). CONCLUSIONS Chelating agents are effective therapies for most patients with Wilson disease; D-penicillamine and trientine produce comparable outcomes, although D-penicillamine had a higher rate of adverse events. Few patients receiving chelation therapy had neurologic deterioration, which occurred more frequently in patients who received trientine.
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Affiliation(s)
- Karl Heinz Weiss
- Department of Gastroenterology, University Hospital Heidelberg, Heidelberg, Germany.
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12
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Sheikhmoonesi F, Shafaat A, Moarefian S, Zaman T. Affective disorder as the first manifestation of methylmalonic acidemia: a case report. Iran J Pediatr 2013; 23:245-6. [PMID: 23724196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 06/27/2012] [Indexed: 11/12/2022]
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