Translational Metabolic Syndrome Research最新文献

Background

The burden of uncontrolled type-2 diabetes (T2DM) sub-Saharan Africa is high, with an increased risk of developing microvascular and macrovascular complications. We sought to identify predictors of poor diabetes control among Ghanaians with T2DM.

Methods

A cross-sectional study involving 1226 participants with T2DM enrolled at five health facilities in Ghana (2 tertiary, 2 district and 1 rural hospital). Data on demographics, medical history, lifestyle factors, anti-diabetic medications, and treatment adherence were collected. Additional questionnaires on sources of diabetes treatment medications and challenges with accessing these medications were also administered. Glycated hemoglobin was measured and a cut-off value of ≥7.0% used to define poor control. Predictors of diabetes control were assessed using a multivariate logistic regression model.

Key results

The mean ± SD age of study participants was 57 ± 12.1 years, with a female preponderance (77.5%). The mean HbA1C among all study participants was 8.9 ± 4.9% of which 70% had HBA1C >7%. Duration of diabetes diagnosis (aOR = 1.04; 95% CI 1.02–1.06), the absence of the Ghana National Health Insurance Scheme (aOR = 1.41; 95% CI 1.09–1.82) and the number of diabetes medicines (aOR = 1.73; 95% CI 1.45–2.07) were adversely associated with poor glycemic control while male gender (aOR = 0.66; 95% CI 0.49–0.88), increasing age (aOR of 0.97; 95% CI of 0.96–0.98) and dual diagnosis of diabetes and hypertension (aOR = 0.69; 95% CI 0.50–0.95) had positive associations with good glycemic control.

Conclusion

7 out of 10 patients with T2DM in Ghana are poorly controlled. Multidisciplinary interventions that improve patient education, quality of care, access to antidiabetics including insulin, are all needed to avert deaths related to diabetes complications associated with uncontrolled T2DM in Ghana.

This overview of the prevalence of Metabolic Syndrome (MetS) in Iran considers the reports on regional and ethnic variation, international comparisons, and within specific groups, including children, diabetics and women at different stages of their life-course. The reported impact of lifestyle is also discussed. One particular controversy has been the definition of MetS, and this remains a difficulty across ethic groups and in children and adolescents. The changes in the criteria being applied to determine the presence of MetS, also makes trends in prevalence difficult to interpret.

Background

Diabetes, the current epidemic in the present world is the growing concern. Type 2 diabetes mellitus is a consequence of complex interactions among multiple genetic variants and environmental risk factors. This complex disorder is characterized by genetic changes in various adipokine levels.

Methods

In this study, adult population ranging from (30–60 years) with sample size of 400 T2DM cases, 150 MetS cases and 300 controls, among which female: male ratio was 2.3. Samples were taken from the Department of endocrinology SMHS Srinagar. We estimated the correlation of various adipokine levels among T2DM subjects, and we observe association of SNP+276 and +45 polymorphism among T2DM and MetS cases with control groups. Adipokine levels were estimated by ELISA and polymorphism by RFLP-PCR, followed by sequencing.

Results

Our results suggested that adiponectin levels are found to be significantly lower in cases while as leptin and resistin levels were found to be higher in cases than normals. Leptin and resistin were found to be positively correlated whereas they were found to have significant negative correlation with adiponectin. The genotype and allele frequencies for SNP+45 did not differ significantly between the T2DM, MetS cases and control groups. For +276, the results revealed a trend towards an increased risk of T2DM for the SNP+276G allele as compared with the SNP+45T allele in the Kashmiri population. The genotype and allele frequencies of SNP +45 (T/G) in ADIPOQ were not significantly different between both T2DM and MetS cases and controls (P = 0.15 for genotype; P = 0.3 for allele). However, the genotype and allele frequencies of SNP +276 (G/T) of ADIPOQ was significantly found to be associated with the risk of developing diabetes and metabolic syndrome.

Conclusion

The present study revealed that the adiposity or its related complications involving type 2 diabetes mellitus, metabolic syndrome causes significant changes in adipokine levels, also there is a significant association between type 2 diabetes mellitus, metabolic syndrome and polymorphism in SNP+276 (G/T) of ADIPOQ gene which suggests its important role in type 2 diabetes mellitus and metabolic syndrome of Kashmir population.