Endocrine and Metabolic Science最新文献

Glucocorticoid-induced osteoporosis (GIO) is the most common causes of secondary osteoporosis. Several laboratory animals have been employed to model GIO, and multiple routes of administration have been utilized. Prednisolone delivered by pellets implanted subcutaneously has been suggested as a less invasive alternative to daily injections, but how the severity of GIO varies between doses and the efficacy of short-term administration are not entirely elucidated. We investigated the skeletal effects of short-term exposure to glucocorticoid (GC) excess from implantable slow-release prednisolone pellets using two different doses (2.8 and 5.4 mg/kg/d). Forty-eight female Swiss mice were randomly allocated to the following four groups: 1: Baseline, 2: Placebo pellet (PP), 3: GC 5 mg, and 4: GC 10 mg. The study lasted four weeks. The musculoskeletal effects of GC were assessed by DXA, µCT, mechanical testing, dynamic bone histomorphometry, and histological quantification of bone and muscle cells. Both doses of GC significantly reduced bone mineral density, cortical mineralizing surfaces and mineral apposition rate, trabecular osteoid-covered surfaces, and rectus femoris muscle cell cross-sectional area compared with PP. In addition, the high dose of GC significantly reduced mid-diaphyseal bone strength compared with PP. Either dose had only minor impact on trabecular microstructure, while no negative effect was found on mid-diaphyseal cortical thickness. In conclusion, prednisolone pellet-induced short-term GC excess resulted in osteopenia, reduced bone formation indices, and only few dose-dependent differences were found.

Aim: To evaluate the clinical success of a first and longitudinal peer-to-peer support group foot care intervention program in a prospective cohort of persons with diabetes in a disadvantaged population.

Method: A prospective cohort-based study design was implemented using standard protocols. A knowledge, attitude, and practice (KAP) instrument toward foot care was administered to persons with type 2 diabetes mellitus before and after the intervention program was implemented. The KAP instrument achieved very high overall and component Cronbach alpha reliability.

Results: The average age of the patients at the time of the pre-intervention was 57.9 years (SD ± 9.8). Sixty-nine percent are females, 44.5% are natives (I-Taukei) and 55.5% are migrant Indians (Indo-Fijians), and 76.4% completed high school. Univariate analyses reveal a highly statistically significant and clinically meaningful increase in the component KAP scores following the foot care intervention program. Results from multiple regression analyses adjusting for patient demographics and confounders show significant improvements in patients’ KAP toward foot care.

Conclusion: The success and efficacy of this foot care intervention program suggests that other countries with limited resources battling diabetes driven foot care hospitalizations and amputations can implement a similar cost-efficient public health education and awareness model as an initial step. This approach can alleviate the stress on healthcare systems during a pandemic.

The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and its complications are highly contributing to mortality. Compared to oral hypoglycemic agents, reduction in HbA1c is maximum with insulin therapy. Evidence suggests the potential benefits of achieving normoglycemia with early intensive insulin therapy. Despite the high levels of uncontrolled T2DM in Indian patients, the use of insulin remains suboptimal. Initiation of insulin therapy in patients with T2DM is often inappropriately delayed due to physician's barriers. These include physicians’ inadequacy of skill and time required for insulin therapy, perceived complications of insulin therapy and perceived lack of treatment benefit. These barriers can be overcome by physician education and training, using effective patient education methods and tools, and bridging gaps to improve adherence by the patients. Pharmaceutical industry, government health authorities, medical institutions, healthcare professionals and patients can help to overcome the clinical inertia for the initiation and titration of insulin in patients with type 2 diabetes.

Background

. Changes occur in the heart's contractile and metabolic demands during altered thyroid states. The changes may be associated with alterations in the cellular signaling of vascular endothelial growth factors (VEGF) and expressions of heat shock proteins (Hsp).

Aim

. This study examined the effects of thyroid dysfunction on VEGF, hsp70, and hsp 90 concentrations in the heart tissues of dysthyroid rats.

Methods

. Wistar rats were allocated into control, hypothyroid (Carbimazole-treated), and hyperthyroid (Levothyroxine-treated) groups randomly (n=7). Thyroid function test, body weight changes, serum creatinine kinase (CK-MB), cardiac troponin I (cTnI) and troponin T (cTnT), NO, VEGF, Hsp70, and Hsp 90 were determined using standard methods.

Results

. There was a significant increase (P<0.05) in NO, VEGF, Hsp70, and Hsp 90 levels in the hyperthyroid group and reduced expression in the hypothyroid group compared to the control. Carbimazole treatment led to a significant increase in lipid peroxidation and CK-MB level, with a substantial decrease in the superoxide dismutase (SOD) activity in the hypothyroid group.

Conclusion

. Increased expression of Hsp70 and 90 in hyperthyroid rats' heart tissue play essential roles in protecting the heart from oxidative damage and cardiovascular derangements via enhancement of nitric oxide production and apoptosis inhibition by VEGF.

Background

Diabetes is now a global problem and millions of people are suffering all over the world. Reports exist for the allopathic use of turmeric, black pepper, and date palm as an antidiabetic and antioxidant agent.

Aim

The current study was designed to assess the antihyperglycemic, antioxidants and antihyperlipidemic consequences of black pepper (BP), turmeric (T), ajwa pulp (AP), and ajwa seeds (AS) in alloxan-induced diabetic rats.

Methodology

Diabetes was induced by a single intraperitoneal injection of alloxan (150 mg/kg b.w) in rats. They were randomly divided into 11 groups of 18 male and 18 female rats each. Group-1 normal control, group-2 diabetic control, group-3 was administered with glibenclamide (10 mg/kg), group-4 was administered with aqueous extract of BP (50 mg/kg), group-5, 6, 7 were administered with T, AP and AS (500 mg/kg) and group-8, 9, 10, 11 were administered with different combinations of aqueous extract (500 mg/kg) once in a day for eight weeks. The antihyperglycemic potential was determined through biochemical and histological investigations of the experimental animals at the end of the experiment.

Results

The results of the study revealed that treatments improved glucose (229.53 mg/dL), Ghb (7.68%), insulin (13.63 U/L), Tg (95.92 mg/dL), Tc (152.86 mg/dL), HDL (23.22 mg/dL), LDL (110.30 mg/dL), TAC (1.89 mmol/L) and TOS (20.05 μmol/L) in comparison to diabetic control rats after 8 weeks of study period. Histological and immunohistochemical investigation of tissues exhibited severe changes in the pancreas of diabetic rats and treatments modulate these changes; this improvement in cells may explain the antidiabetic effects.

Conclusion

It is concluded that aqueous extract of BP+AS; and BP+T+AP+AS could be promising nutraceutical therapy for diabetes management and its associated complications.

Aim

Diabetic nephropathy (DN) is one of the major life-threatening complications of diabetes and it leads to end-stage renal disease. Altered angiotension converting enzyme and nitric oxide synthase are probably the cause of initiation and the progression of diabetic nephropathy. The present study aims to investigate the effect of ACE ID and NOS3 VNTR gene polymorphisms on the progression of chronic kidney disease among diabetic nephropathy.

Methods

253 DN patients and 104 controls were genotyped for ACE ID and NOS3 VNTR polymorphisms by following PCR-RFLP method. The diabetic nephropathy cases were divided into two groups based on CKD stages: 138 DN cases were at early stage (CKD1 to CKD3) and 115 DN cases were at advanced stage (CKD4 and CKD5). Association χ2 and univariate analysis were performed.

Results

A significant difference was found in genotype frequencies of ACE ID and NOS3 VNTR polymorphisms between the DN patients and the controls. On univariate analysis, the DD genotype of ACE gene was found to have a significant association with the advancement of CKD in DN (OR=0.37; 95 % CI=0.14–0.94; p=0.033).

Conclusions

The results suggest the association of ACE ID and NOS3 VNTR polymorphism with diabetic nephropathy in South Indian population. Furthermore, the present study evidences the association between DD genotype of ACE gene and advancement of CKD progression in DN.

Background: The excessive intake of fructose (FRD) induces insulin resistance (IR)-associated renal impairment. Similarly, the use of estrogen-progestin oral contraceptive therapy (EEL) has been associated with cardiometabolic syndrome, and its non-contraceptive benefits particularly in metabolic pathologies remain inconclusive. Therefore, the present study investigated the effects of EEL on renal metabolic function in rats exposed to FRD.

Methods: Female rats received vehicle (po), EEL (1.0 µg ethinylestradiol+5.0 µg levonorgestrel.), fructose (10%; w/v) and EEL+FRD respectively for 8 weeks. All data were expressed as means ± SEM and significance were accepted at p<0.05.

Results: Data revealed that FRD/EEL caused IR with correspondent increased plasma/renal lipid, decreased glucose-6-dehydrogenase (G6PD), glutathione (GSH) and renal NO/adenosine. FRD but not EEL increased (p<0.05) renal glycogen and decreased (p<0.05) plasma NO/adenosine and pancreatic beta-cell function. These alterations were attenuated when EEL was administered with FRD.

Conclusion: The study demonstrates that FRD causes renal impairments accompanied by deficient NO/adenosine concentration and defective G6PD/GSH-dependent antioxidant defense. The findings also suggest that EEL blots the renal effects of FRD.

Navigating safely towards euglycemia in type 2 diabetes mellitus (T2DM) is a real challenge in the current clinical practice despite availability of a number of glucose-lowering drugs; major barriers are hypoglycemia and weight gain. Sulfonylureas (SUs) have been recommended as one of the most common choice of add-on therapy to metformin (used as first line therapy). They are used extensively in Southeast Asia due to their high efficacy and low cost. However, there have been concerns regarding hypoglycemia, weight gain and cardiovascular safety with SUs. There is a need for an oral molecule that does not cause weight gain, has low risk of causing hypoglycemia, which can be used to navigate safely towards euglycemia with minimal constraints. Literature has shown that gliclazide provides consistent glycemic control with fewer hypoglycemic episodes and has long-term micro- and macrovascular benefits. This expert opinion was developed to highlight the role of SUs, and gliclazide in particular, in navigating effectively and safely towards the desired glycemic control in T2DM.

Background: Understanding diabetes mobile apps functionality is fundamental to diabetes self-management because of the reliance of many patients with diabetes on these apps.

Objectives: The aim of this study is to perform a review of diabetes mobile apps to discover users’ sentiments and qualitatively examine the review comments to understand the perceptions of positive, neutral, and negative sentimental users of the apps.

Method: A total of 2678 user review comments obtained from the google play store were analysed from 47 diabetes mobile apps to understand user sentiments following clinical Self-management Indicators (SMIs) shown in previous research. Pearson correlation analysis was conducted to determine the association between the SMIs present in the apps’ and user review indicators such as rating score, user sentiment and the number of downloads. The users’ review comments were thematically screened using grounded theory to establish the themes to describe their perception of the apps.

Results: After evaluating SMIs such as weight tracking/BMI, sugar level monitoring, diet/Calories management, medication reminder, etc., 74.47% of the apps were found to have Sugar Level Monitoring(SLM) capabilities with 10.64% designed to track weight/BMI. There are 53.19% of the apps that can manage diet/calories and have data storage and security SMIs, however, less than 30% of them provide medication adherence, exercise management, doctor's appointment scheduling, and diabetes information repository. The number of the SMIs included in apps did not influence users’, but the value derived from the functionality of the apps.

Conclusions: Users are satisfied with the apps that are easy to use, setup, provide good analytics for blood sugar monitoring and have uncrowded graphical outputs and user interface. Proper data management and contemporary information about diabetes are among the identified challenges of the apps that were found to crash relentlessly on downloading, uploading, installing, and setup.

Background

Mercury chloride (HgCl₂) is known to cause reproductive dysfunction. The negative effects may be ameliorated with the use of certain antioxidants. Present study focused on impact of D-Ribose-L-Cysteine (DRLC) on mercury chloride-induced testicular toxicity in male rats.

Materials and methods

Forty-eight (48) adult male Sprague-Dawley rats weighing 150-200g randomized into six groups of eight (n=8) rats each. Group A treated with 1mg/Kg body weight (bwt) HgCl₂; Group B received 30mg/Kg bwt of DRLC; Group C received 1mg/Kg bwt of HgCl₂ and 30 mg/Kg bwt of DRLC; Group D received 1mg/Kg bwt of HgCl₂ and 30mg/Kg bwt of Vit. C; Group E received 1mg/Kg bwt of HgCl₂ and 30mg/Kg bwt of DRLC and 30 mg/Kg bwt of Vit. C; Group F served as control given normal saline orally for 8 weeks. Testicular histology, histomorphometry parameters, and other parameters such as sperm, luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (TT), reduced glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT), superoxide dismutase (SOD) and malondialdehyde (MDA) were investigated.

Results

Administration of HgCl₂ disorganized seminiferous epithelium and widened the hypocellular interstitium; significantly decrease the sperm quality, TT, FSH, LH, CAT, GPx, GSH, SOD, and increases the MDA compared to control group. Co-administration of HgCl₂, DRLC and Vit.C decrease the MDA and increase hormonal and antioxidant level; improved sperm quality and restored testicular histopathological alterations.

Conclusion

Intervening action of DRLC therefore, resulted in normal germinal cell layers, suppresses oxidative stress, spermatogenesis and steroidogenesis recovery in HgCl₂ induced testicular toxicity.