-
Journal of Family Medicine and Primary... May 2024Diabetes mellitus is associated with carbohydrate, lipid and protein metabolism abnormalities. Uncontrolled hyperglycaemia can result in dysfunction of various organs...
BACKGROUND
Diabetes mellitus is associated with carbohydrate, lipid and protein metabolism abnormalities. Uncontrolled hyperglycaemia can result in dysfunction of various organs such as eyes, kidneys, nerves, and heart and blood vessels leading to long-term complications like nephropathy, neuropathy, retinopathy, stroke and ischaemia. The main objective of the study was to identify critical factors in Type 2 diabetes mellitus (Type 2 DM) with metabolic syndrome (mets) compared with Type 2 DM without mets and their association in the development of Type 2 DM to Type 2 DM with mets and cardiovascular complications. This can aid in improving the clinical management and the consequences of the disease.
MATERIALS AND METHODS
The present study was conducted in the Department of Biochemistry, a tertiary care centre in Northern India. All patients who were aged between 35 and 65 years of age were enrolled. Enrolled subjects were divided into three groups, Group I: 50 healthy people; Group II: 50 Type 2 DM without mets; and Group III: 50 Type 2 DM with mets. These patients were subjected to Anthropometric and biochemical parameter assessment.
RESULTS
On comparing Group III with control and Group II significant difference was observed in these parameters, that is, elevated TGs ( = 0.001), reduced high-density lipoprotein (HDL) level ( = 0.001), elevated high-sensitivity C-reactive protein (hs-CRP) (0.011), high serum insulin fasting ( = 0.010), weight ( = 0.021), waist circumference ( = 0.001) and BMI ( = 0.001). In the control group, head circumference was significantly lower compared to Group II ( = 0.001) and Group III ( = 0.001).
CONCLUSION
On the basis of observed observation, it has been suggested that low enzymatic activity with poor glycaemic control may further progress Type 2 DM into Type 2 DM with metabolic syndrome and cardiovascular complications. High hs-CRP concentration and high fasting insulin can be independent predictor of cardiovascular complications.
PubMed: 38948574
DOI: 10.4103/jfmpc.jfmpc_852_23 -
Frontiers in Endocrinology 2024Diabetic retinopathy (DR) stands as a prevalent complication in the eye resulting from diabetes mellitus, predominantly associated with high blood sugar levels and... (Review)
Review
Diabetic retinopathy (DR) stands as a prevalent complication in the eye resulting from diabetes mellitus, predominantly associated with high blood sugar levels and hypertension as individuals age. DR is a severe microvascular complication of both type I and type II diabetes mellitus and the leading cause of vision impairment. The critical approach to combatting and halting the advancement of DR lies in effectively managing blood glucose and blood pressure levels in diabetic patients; however, this is seldom achieved. Both human and animal studies have revealed the intricate nature of this condition involving various cell types and molecules. Aside from photocoagulation, the sole therapy targeting VEGF molecules in the retina to prevent abnormal blood vessel growth is intravitreal anti-VEGF therapy. However, a substantial portion of cases, approximately 30-40%, do not respond to this treatment. This review explores distinctive pathophysiological phenomena of DR and identifiable cell types and molecules that could be targeted to mitigate the chronic changes occurring in the retina due to diabetes mellitus. Addressing the significant research gap in this domain is imperative to broaden the treatment options available for managing DR effectively.
Topics: Humans; Diabetic Retinopathy; Animals; Molecular Targeted Therapy; Cell- and Tissue-Based Therapy; Vascular Endothelial Growth Factor A
PubMed: 38948520
DOI: 10.3389/fendo.2024.1416668 -
Frontiers in Endocrinology 2024The concept of the gut-retinal axis proposed by previous scholars primarily focused on the relationship between intestinal microbiota and retinal diseases, and few...
Mendelian randomization study and mediation analysis about the relation of inflammatory bowel disease and diabetic retinopathy: the further exploration of gut-retina axis.
BACKGROUND
The concept of the gut-retinal axis proposed by previous scholars primarily focused on the relationship between intestinal microbiota and retinal diseases, and few further expanded the relationship between intestinal diseases and retinal diseases. To further substantiate the concept of the gut-retinal axis, we analyzed inflammatory bowel disease (IBD) and diabetic retinopathy (DR) using Mendelian randomization (MR), and use mediation analysis to further explore the potential substances that influence this causal relationship.
METHODS
The genome-wide association study's (GWAS) summary statistics for genetic variations were utilized in a Mendelian randomization (MR) investigation. GWAS data on IBD (including ulcerative colitis (UC), Crohn's disease (CD), and IBD) for non-Finnish Europeans (NFE) were sourced from published articles. In contrast, data on DR (including DR and diabetic maculopathy (DMP)) were obtained from FinnGen R9. The causal relationship has been investigated using inverse variance weighted (IVW), MR-Egger, and weighted median and sensitivity analysis was applied to verify the stability of the results. In addition, we applied mediation analysis to investigate whether circulating inflammatory proteins and plasma lipids played a mediating role, and calculated its effect ratio.
RESULTS
The causal relationship between IBD and DR was discovered by employing the inverse variance weighted (IVW) method and weighted median method. In forward MR, UC was significantly associated with lower risk of DR (IVW: OR=0.874; 95%CI= 0.835-0.916; P value= 1.28E-08) (Weighted median: OR=0.893; 95%CI= 0.837-0.954; P value= 7.40E-04). In reverse MR, it was shown that DR (IVW: OR=0.870; 95%CI= 0.828-0.914; P value= 2.79E-08)(Weighted median: OR=0.857; 95%CI= 0.801-0.916; P value= 6.40E-06) and DMP (IVW: OR=0.900; 95%CI= 0.865-0.937; P value= 3.34E-07)(Weighted median: OR=0.882; 95%CI= 0.841-0.924; P value= 1.82E-07) could reduce the risk of CD. What's more, DR is associated with a lower risk of IBD according to genetic prediction (IVW: OR=0.922; 95%CI= 0.873-0.972; P value= 0.002) (Weighted median: OR=0.924; 95%CI= 0.861-0.992; P value= 0.029). Fibroblast growth factor 21 (FGF21), phosphatidylcholine (PC), and triacylglycerol (TG) serve as mediators in these relationships.
CONCLUSIONS
Our research offers novel insights and sources for investigating the gut-retina axis in the genetic relationship between IBD and DR. We discover four mediators and more about the association between the intestine and retinal disorders and provide more evidence for the gut-retinal axis theory.
Topics: Humans; Mendelian Randomization Analysis; Diabetic Retinopathy; Genome-Wide Association Study; Inflammatory Bowel Diseases; Mediation Analysis; Retina; Polymorphism, Single Nucleotide; Gastrointestinal Microbiome
PubMed: 38948518
DOI: 10.3389/fendo.2024.1382777 -
Frontiers in Endocrinology 2024Ectopic ACTH syndrome (EAS) remains one of the most demanding diagnostic and therapeutic challenges for endocrinologists. Thymic neuroendocrine tumors account for 5%-10%...
Ectopic ACTH syndrome (EAS) remains one of the most demanding diagnostic and therapeutic challenges for endocrinologists. Thymic neuroendocrine tumors account for 5%-10% of all EAS cases. We report a unique case of a 31-year-old woman with severe EAS caused by primary metastatic combined large-cell neuroendocrine carcinoma and atypical carcinoid of the thymus. The patient presented with severe hypercortisolemia, which was successfully controlled with continuous etomidate infusion. Complex imaging initially failed to detect thymic lesion; however, it revealed a large, inhomogeneous, metabolically active left adrenal mass infiltrating the diaphragm, suspected of primary disease origin. The patient underwent unilateral adrenalectomy, which resulted in hypercortisolemia resolve. The pathology report showed an adenoma with adrenal infarction and necrosis. The thymic tumor was eventually revealed a few weeks later on follow-up imaging studies. Due to local invasion and rapid progression, only partial resection of the thymic tumor was possible, and the patient was started on radio- and chemotherapy.
Topics: Humans; Female; Adult; Thymus Neoplasms; Cushing Syndrome; Carcinoma, Neuroendocrine; Adrenal Gland Neoplasms; ACTH Syndrome, Ectopic; Adrenalectomy; Neoplasms, Multiple Primary
PubMed: 38948516
DOI: 10.3389/fendo.2024.1399930 -
Frontiers in Pharmacology 2024Heart failure and cognitive impairment emerge as public health problems that need to be addressed due to the aging global population. The conditions that often coexist... (Review)
Review
Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors, anti-diabetic drugs in heart failure and cognitive impairment: potential mechanisms of the protective effects.
Heart failure and cognitive impairment emerge as public health problems that need to be addressed due to the aging global population. The conditions that often coexist are strongly related to advancing age and multimorbidity. Epidemiological evidence indicates that cardiovascular disease and neurodegenerative processes shares similar aspects, in term of prevalence, age distribution, and mortality. Type 2 diabetes increasingly represents a risk factor associated not only to cardiometabolic pathologies but also to neurological conditions. The pathophysiological features of type 2 diabetes and its metabolic complications (hyperglycemia, hyperinsulinemia, and insulin resistance) play a crucial role in the development and progression of both heart failure and cognitive dysfunction. This connection has opened to a potential new strategy, in which new classes of anti-diabetic medications, such as glucagon-like peptide-1 receptor (GLP-1R) agonists and sodium-glucose cotransporter 2 (SGLT2) inhibitors, are able to reduce the overall risk of cardiovascular events and neuronal damage, showing additional protective effects beyond glycemic control. The pleiotropic effects of GLP-1R agonists and SGLT2 inhibitors have been extensively investigated. They exert direct and indirect cardioprotective and neuroprotective actions, by reducing inflammation, oxidative stress, ions overload, and restoring insulin signaling. Nonetheless, the specificity of pathways and their contribution has not been fully elucidated, and this underlines the urgency for more comprehensive research.
PubMed: 38948473
DOI: 10.3389/fphar.2024.1422740 -
PeerJ 2024Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with systemic implications, potentially affecting musculoskeletal health. This study aimed to assess...
BACKGROUND
Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with systemic implications, potentially affecting musculoskeletal health. This study aimed to assess shoulder muscle strength and joint repositioning accuracy in individuals with T2DM, exploring potential correlations and shedding light on the musculoskeletal consequences of the condition. The objectives were two-fold: (1) to assess and compare shoulder strength and joint repositioning accuracy between individuals with T2DM and asymptomatic counterparts, and (2) to examine the correlation between shoulder strength and joint repositioning accuracy in individuals with T2DM.
METHODS
A cross-sectional study enrolled 172 participants using the convenience sampling method, including 86 individuals with T2DM and an age-matched asymptomatic group ( = 86). Shoulder strength was assessed using a handheld dynamometer, while joint repositioning accuracy was evaluated with an electronic digital inclinometer.
RESULTS
Individuals with T2DM exhibited reduced shoulder muscle strength compared to asymptomatic individuals ( < 0.001). Additionally, joint repositioning accuracy was significantly lower in the T2DM group ( < 0.001). Negative correlations were observed between shoulder strength and joint repositioning accuracy in various directions (ranging from -0.29 to -0.46, < 0.001), indicating that higher muscle strength was associated with improved joint repositioning accuracy in individuals with T2DM.
CONCLUSION
This study highlights the significant impact of T2DM on shoulder muscle strength and joint repositioning accuracy. Reduced strength and impaired accuracy are evident in individuals with T2DM, emphasizing the importance of addressing musculoskeletal aspects in diabetes management. The negative correlations suggest that enhancing shoulder muscle strength may lead to improved joint repositioning accuracy, potentially contributing to enhanced physical functioning in this population.
Topics: Humans; Diabetes Mellitus, Type 2; Male; Cross-Sectional Studies; Female; Middle Aged; Muscle Weakness; Muscle Strength; Shoulder; Proprioception; Shoulder Joint; Aged; Adult; Range of Motion, Articular
PubMed: 38948217
DOI: 10.7717/peerj.17630 -
Clinical Interventions in Aging 2024Serum trace elements and oxidative stress factors are related to diabetic microvascular complications. The study was to investigate the complex relationship between...
Malondialdehyde and Zinc May Relate to Severity of Microvascular Complications in Diabetes: A Preliminary Study on Older Adults with Type 2 Diabetes Mellitus in Northeast China.
BACKGROUND
Serum trace elements and oxidative stress factors are related to diabetic microvascular complications. The study was to investigate the complex relationship between trace elements, oxidative stress factors, and the severity of microvascular complications of diabetes in older adults.
METHODS
The present study included patients with or without type 2 diabetes, and blood glucose, blood lipids, trace elements (iron, magnesium, zinc), oxidative stress factors (malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC)) were evaluated. Risk factors for the severity of diabetic microvascular complications in older adults with diabetes were also estimated.
RESULTS
There were statistically significant differences in fasting blood glucose (FBG), triglycerides (TG), low density lipoprotein (LDL), glycated hemoglobin (HbAlc), MDA, NO, SOD, T-AOC, magnesium, and zinc between the two groups (). Iron (r = 0.147, r = 0.180, r = 0.193, ) was positively correlated with zinc, SOD and T-AOC. Iron was negatively correlated with MDA (r = -0.146, ). Magnesium was positively correlated with SOD (r = 0.147, ). Zinc (r = 0.616, r = 0.575, ) was positively correlated with SOD and T-AOC. Zinc (r =-0.636, r=-0.616, ) was positively correlated with MDA and negatively correlated with NO. The course of disease (18.653, [5.726; 60.764], ), FBG (1.265, [1.059; 1.511], ), HbAlc (1.545, [1.431; 1.680], P <0.01), MDA (2.989, [1.900; 4.702], ) were risk factor for the severity of diabetic microvascular complications. Zinc (0.680, [0.503; 0.919], ) and SOD (0.820, [0.698; 0.964], ) were protective factors for the severity of diabetic microvascular complications.
CONCLUSION
Serum trace elements are related to oxidative stress levels in older adults with type 2 diabetes. The more stable trace element in older adults with diabetes, the lower the oxidative stress and the fewer microvascular complications of diabetes.
Topics: Humans; Diabetes Mellitus, Type 2; Male; Female; Aged; Zinc; China; Oxidative Stress; Malondialdehyde; Superoxide Dismutase; Middle Aged; Blood Glucose; Risk Factors; Diabetic Angiopathies; Glycated Hemoglobin; Nitric Oxide; Antioxidants; Magnesium; Lipids; Trace Elements; Severity of Illness Index
PubMed: 38948168
DOI: 10.2147/CIA.S464615 -
Theranostics 2024Current treatments for ocular angiogenesis primarily focus on blocking the activity of vascular endothelial growth factor (VEGF), but unfavorable side effects and...
Current treatments for ocular angiogenesis primarily focus on blocking the activity of vascular endothelial growth factor (VEGF), but unfavorable side effects and unsatisfactory efficacy remain issues. The identification of novel targets for anti-angiogenic treatment is still needed. We investigated the role of tsRNA-1599 in ocular angiogenesis using endothelial cells, a streptozotocin (STZ)-induced diabetic model, a laser-induced choroidal neovascularization model, and an oxygen-induced retinopathy model. CCK-8 assays, EdU assays, transwell assays, and matrigel assays were performed to assess the role of tsRNA-1599 in endothelial cells. Retinal digestion assays, Isolectin B4 (IB4) staining, and choroidal sprouting assays were conducted to evaluate the role of tsRNA-1599 in ocular angiogenesis. Transcriptomic analysis, metabolic analysis, RNA pull-down assays, and mass spectrometry were utilized to elucidate the mechanism underlying angiogenic effects mediated by tsRNA-1599. tsRNA-1599 expression was up-regulated in experimental ocular angiogenesis models and endothelial cells in response to angiogenic stress. Silencing of tsRNA-1599 suppressed angiogenic effects in endothelial cells and inhibited pathological ocular angiogenesis . Mechanistically, tsRNA-1599 exhibited little effect on VEGF signaling but could cause reduced glycolysis and NAD/NADH production in endothelial cells by regulating the expression of HK2 gene through interacting with YBX1, thus affecting endothelial effects. Targeting glycolytic reprogramming of endothelial cells by a tRNA-derived small RNA represents an exploitable therapeutic approach for ocular neovascular diseases.
Topics: Animals; Glycolysis; Mice; Endothelial Cells; Choroidal Neovascularization; Humans; Y-Box-Binding Protein 1; Angiogenesis Inhibitors; Hexokinase; Diabetes Mellitus, Experimental; Mice, Inbred C57BL; Male; Disease Models, Animal; Neovascularization, Pathologic; Vascular Endothelial Growth Factor A; Diabetic Retinopathy; Human Umbilical Vein Endothelial Cells; RNA, Small Untranslated
PubMed: 38948065
DOI: 10.7150/thno.96946 -
World Journal of Clinical Pediatrics Jun 2024Over the past 20 years, the incidence and prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents have increased, particularly in racial and ethnic... (Review)
Review
Over the past 20 years, the incidence and prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents have increased, particularly in racial and ethnic minorities. Despite the rise in T2DM in children and adolescents, the pathophysiology and progression of disease in this population are not clearly understood. Youth-onset T2DM has a more adverse clinical course than is seen in those who develop T2DM in adulthood or those with T1DM. Furthermore, the available therapeutic options are more limited for children and adolescents with T2DM compared to adult patients, mostly due to the challenges of implementing clinical trials. A better understanding of the mechanisms underlying the de-velopment and aggressive disease phenotype of T2DM in youth is important to finding effective prevention and management strategies. This review highlights the key evidence about T2DM in children and adolescents and its current burden and challenges both in clinical care and research activities.
PubMed: 38947996
DOI: 10.5409/wjcp.v13.i2.91587 -
World Journal of Clinical Pediatrics Jun 2024Prediabetes in children and adolescents is on the rise which has drawn significant attention over the past decade. It is an early warning sign of the underlying...
Prediabetes in children and adolescents is on the rise which has drawn significant attention over the past decade. It is an early warning sign of the underlying pathophysiological changes which in due course of time might compound into type II diabetes mellitus. The incidence of prediabetes in adolescents ranges from 4%-23% which is alarmingly high and requires active intervention from the system. We have discussed early identification of high-risk patients, prompt screening and active intervention to manage this growing problem.
PubMed: 38947990
DOI: 10.5409/wjcp.v13.i2.92127