Endocrine and Metabolic Science最新文献

Objective

Gestational Diabetes Mellitus (GDM) is one of the most common complications of pregnancy and becoming an increasing health problem worldwide. The rate of GDM is increasing in Asian countries including Bangladesh. This study is aimed at investigating the association between the rs12255372 (G/T) polymorphism of the TCF7L2 gene with GDM.

Method

To carry out the present research, 63 GDM pregnant women and 60 control pregnant women were randomly selected from the city Chattogram, Bangladesh. During the study data was collected between gestational weeks of 24–28. PCR-RFLP was used for genotyping the rs12253372 (G/T) and for genotype analysis Hardy-Weinberg equation (Hardy, 1908) was applied.

Results

The fasting and 2-hour plasma glucose level was significantly higher in GDM than the control. Moreover, in the case of family history women with GDM showed higher percentage in first degree relatives (60.31 %) compared to that of control (38.33 %). The frequency of mutant allele T in GDM is 26.2 % which was however not significant. TT genotype was found only in one subject with GDM. However, the percentage of risk allele GT is higher in GDM (49.2 %) compared to that of NGT (35 %).

Conclusions

In our pilot study, we did not find an association between rs12255372 (G/T) polymorphism of TCF7L2 gene and GDM. Studying in a broader group may help to find a conclusive result.

Aims

Sleep duration and quality are increasingly recognized as potential contributors to cardiovascular disease risk, with serum lipids playing a crucial role in this relationship. However, the results regarding this association have been inconsistent across different ethnic groups. This study aims to investigate this association in an Iranian elderly population.

Methods

Totally 1392 people 60 to 69 years old were included in this study. Sleep duration and quality were assessed by the Pittsburgh sleep quality index (PSQI). Logistic and linear regression models were employed to determine the association of sleep duration and quality with serum lipid levels; moreover, the effects of other potential confounders were also controlled.

Findings

Most of the participants had low sleep quality (70.47 %), which was more notable in males (80.08 %), compared to females (59.15 %), and most of the participants slept 6–7 h per day (42.2 %). No association was observed between sleep quality and serum lipid levels including HDL (OR = 1.12; P = 0.871), LDL (OR = 0.80; P = 0.451), total cholesterol (OR = 0.89; P = 0.702) and triglyceride (OR = 1.13; P: 0.477). As well as, no association between sleep duration and LDL; (β = 0.35; P = 0.094), total cholesterol (β = 0.02; P = 0.918), triglycerides (β = −0.02; P = 0.846), and HDL (β = −0.06; P = 0.534).

Conclusion

In the elderly population, poor sleep quality is typical, particularly among males. Sleep quality and duration were not associated with serum lipid profiles, including TG, TC, LDL, and HDL.

Along with the rising incidence of diabetes, the prevalence of diabetic retinopathy (DR) is quickly growing across the world. The incidence of DR complications is high, and many people are not detected until they have complications and visual impairment, causing many difficulties for the treatment process. Aims: The goal of this cross-sectional was to investigate the clinical and subclinical features of Vietnamese diabetic retinopathy patients. Methods: DR was diagnosed using International Clinical Diabetic Retinopathy scale. Complete clinical information (Age, sex, weight, height, history of hypertension and diabetes mellitus, smoking, alcohol), subclinical information (Glucose, urea, creatinine, HbA1c, uric acid, cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol blood levels, Complete blood count) were collected. Results: The research enrolled 140 type 2 diabetic patients (70 in each group: DR and no DR). DR patients had significantly higher age, RBC, Hb, eGFR, uric acid, and creatinine blood levels than patients without DR. A duration of diabetes mellitus of over 15 years was associated with an 8.319-fold increased risk of DR. In conclusion, age, RBC, Hb, eGFR, uric acid, creatinine blood levels and duration of diabetes mellitus over 15 years are risk factors for DR.

Aims/objectives

Although considerable effort, both experimental and theoretical, has been directed towards understanding the relationship between the HPA axis and weight regulation, no true consensus exists in the literature as to the nature of the relationship. The aim of this study was to explore potential correlations between BMI and measures of cortisol and cortisol metabolites using dried urine and saliva sampling in a large sample of individuals with BMIs ranging from underweight to obese.

Materials and methods

A cohort of patients with data available from urinary and/or salivary measures of cortisol and cortisol metabolites who met inclusion criteria was extracted from the database of a commercial clinical laboratory. Pearson correlation coefficients were used to determine associations between variables; Student's t-test and one-way ANOVA were used to examine differences between groups, and the Jonckheere-Terpstra trend test was used to assess for trends by BMI category. A multivariable linear regression model was created to determine which variables explained the largest amounts of variance in BMI.

Results

A significant correlation was observed between the urinary cortisol metabolites and BMI (P < 0.0001). In addition, cortisol metabolites were associated with changes in BMI over time. No significant correlation was observed between urinary free cortisol and BMI, and correlations observed between BMI and other variables, with the exception of age, were either weak or not statistically significant.

Conclusions

The data presented in this study suggest that cortisol metabolism is a key component of weight regulation and that cortisol metabolite concentrations may potentially serve as informative biomarkers to characterize the relationship between the HPA axis and changes in BMI. The implications of this affect both clinical practice and the research and development of both prevention and treatment strategies aimed at either decreasing or increasing BMI.

Background

Hyperuricemia in dyslipidemic patients has been addressed as a potential risk factor for cardiovascular disease, because of its association with atherosclerosis and elevated oxidative stress. Hence, the main objective of the present study was to evaluate the effect of statins on blood uric acid level in patients being treated for dyslipidemia at a tertiary care hospital.

Methods

The study comprised 120 patients with dyslipidemia who were treated at UCMS-TH's outpatient medicine department over a six-month period from December 2022 to May 2023. Participants who met the inclusion criteria for this interventional longitudinal study had their serum uric acid and lipid parameters measured at the start of the study and again after 6 weeks of statin therapy. Using a dependent t-test, we compared the effects of statin on uric acid reduction in the serum.

Results

Statin significantly reduced serum uric acid levels from 6.36 ± 1.02 mg/dL baseline to 5.12 ± 0.43 mg/dL (P < 0.001) after 6 weeks of treatment. The lipid markers LDL-C, TG, TC, and VLDL were all lowered, whereas the HDL level was raised (P < 0.05) after 6 weeks of statin medication.

Conclusion

Because of the association between elevated serum uric acid levels and an increased risk of cardiovascular disease, statins like atorvastatin may be prescribed to dyslipidemic individuals at high risk for cardiovascular mortality due to hyperuricemia.

Background

Diabetes is a common condition that often requires increasing intensity of glucose lowering regimens. We describe the population trends in the intensity of regimens, and associations of achieved HbA1c and treatment persistence.

Methods

We performed an episode-based analysis of the EXTEND-45 dataset, assessing trends in glucose lowering therapy and the associated outcomes of HbA1c and treatment persistence. Trends from 2009 to 2014 were assessed for each intensity level of a glucose lowering therapy regimen, according to the year prescribed. Episodes were defined as the length of time that an individual adhered to a regimen through ongoing prescription, and this was used as to define persistence. Mean HbA1c were calculated for each episode. Persistence and HbA1c were compared across the different regimens of treatment intensity.

Results

The intensity of glucose lowering therapy remained stable over time with around one third of episodes utilising a single glucose lowering agent. Mean HbA1c was higher for insulin-based treatment (mean 7.9 % SD = 1.3 %), and lowest for episodes of no glucose lowering treatment (mean 6.3 % (SD = 0.8 %). Around half of participants achieved glycemic targets of 7 %. While there was considerable variation in persistence, the median persistence was around 3 months (94 days, IQR 51–201 days).

Conclusions

Therapeutic intensity for diabetes has remained stable over 9 years. Whilst there was considerable variability in persistence with glucose lowering regimens, the mean duration of all regimens was less than a year. Requirement for higher intensity treatment with insulin was related to poorer glycemic control.

Introduction

Diabetes mellitus (DM) is considered as a group of metabolic diseases with a global distribution and severe complications. It is caused by insulin deficiency, which with time leads to development of pathological changes in the cardiovascular, respiratory, and other systems. Several studies have shown some features and the connection of structural changes of the lungs with DM, however very little is known regarding ultrastructural changes of type 2 alveolocytes (AT2).

Materials and methods

The study involved 24 white non-linear male laboratory rats which were divided into two groups (experimental and intact). The experimental group was further divided into two subgroups depending on the duration of study: the first group with hyperglycemia for 30 days, and the second with hyperglycemia for 60 days. For the experimental modeling of hyperglycemia, the rats were injected once subcutaneously with solution of alloxan monohydrate hyperglycemia.

Results

AT2 of the intact group had a high degree of differentiation with plates of high electron density. In AT2 of rats with hyperglycemia for 30 days, there were signs of vacuolation, mass accumulation of primary and secondary lysosomes, and lamellar bodies were grouped as conglomerates. In AT2 of the rats with 60 days of hyperglycemia, nuclei with scalloped contour, karyoplasmic outgrowths and intussusception, and condensation of heterochromatin were observed.

Conclusion

Under conditions of experimental chronic hyperglycemia, proliferation and destruction of AT2 are observed, which is the morphological basis for the violation of surfactant synthesis and immunocompetent properties in lung tissues of young rats.

Introduction

Diabetic wounds are highly susceptible to a range of pathogens, particularly bacteria, due to the immunocompromised state of diabetic patients. Although diabetic wound isolates are typically polymicrobial, S. aureus is the most common bacteria found in such isolates.

Objective

The objectives of this study were to identify the different bacterial isolates present in each sample of diabetic foot ulcers, determine the minimum inhibitory concentration of the identified bacterial strains to various antibiotics, and identify the genes responsible for drug resistance in multidrug-resistant bacterial strains.

Materials and methods

A cross-sectional prospective study was conducted at the Endocrinology Unit, Hayatabad Medical Complex, Peshawar, Pakistan, from November 2019 to March 2020. A total of n = 140 samples from diabetic foot ulcers were aseptically collected and evaluated for their sensitivity to antibacterial drugs commonly used in the study area. The samples were inoculated into various media and cultured, and biochemical and molecular analyses were conducted according to the Clinical Laboratory Institute Guidelines.

Results

A total of 122 bacterial isolates were obtained out of a total of 144. The results of antibiotics susceptibility testing showed that gram-positive isolates were more resistant to penicillin G (93.18 %), but exhibited sensitivity to vancomycin (100 %) and linezolid (LZD) (95 %). Gram-negative isolates were found to be 100 % resistant to penicillin, such as amoxicillin (AMC), and sulphonamides, such as sulphamethoxazole/trimethoprim (SXT) groups of antibiotics. A total of 36 (29.50 %) multidrug-resistant (MDR) isolates were identified. MDR isolates exhibited good sensitivity to meronem (MEM), i.e. 97 %, and were highly resistant to sulphamethoxazole/trimethoprim and clindamycin, i.e. 100 %.

Conclusion

Gram-positive isolates were resistant to penicillin G (93.18 %) but sensitive to vancomycin (100 %) and linezolid (95 %). Gram-negative isolates were resistant to penicillin and sulphonamides. Among the isolates, 29.50 % were multidrug-resistant (MDR), with high resistance to sulphamethoxazole/trimethoprim and clindamycin but good sensitivity to meronem (97 %).

Two sentence summary

This study highlights the emerging problem that world is facing right now in the form of antimicrobial resistance.

Our study showed increased antimicrobial resistance in wounds of diabetic foot ulcers.

Introduction

Insulin pumps serve as alternative insulin delivery methods with physiological similarity to the normal pancreas. The MiniMed 780G device is an advanced closed-loop hybrid system. Recent real-life studies have allowed reaching a higher percentage of time in range (TIR) (70 to 180 mg/dL). Being an emerging technology, it is of the utmost value to report on the early experience of use of this device.

Methods

This was an observational, descriptive, cross-sectional study that included patients older than 18 years with types 1 diabetes mellitus and other types switched to a Medtronic 780G insulin pump. Baseline clinical and glycemic control variables and those after 4 weeks of using the SmartGuard mode were evaluated.

Results

Thirty-nine patients (mean age, 33 years) were analyzed, 95 % of whom had type 1 diabetes with an average disease duration of 17 years. The values for time below range (TBR) <54 mg/dL, TBR <70 mg/dL, TIR, time above range (TAR) >180 mg/dL, and TAR >250 mg/dL were 0 %, 3 %, 72 %, 21 %, and 3 %, respectively, at baseline and 1 %, 2 %, 79 %, 14 %, and 2 %, respectively, after the intervention. The changes in TIR varied based on prior therapy: multiple daily injections of insulin, 13 % improvement; MiniMed Paradigm Veo/MiniMed 640G, 6 % improvement; and MiniMed 670G, −4 % improvement.

Conclusion

In conclusion, the application of a hybrid closed-loop system allowed for better glycemic control based on international standards. The average percentage improvement in TIR was lower than that in other studies and was dependent on the previous method of insulin administration, achieving lower performance with the migration from recent technologies such as the Minimed 670G.

Asthenospermia is a common cause of male infertility refers to semen samples with spermatozoa that move slowly or immotile. Recent research has implicated oxidative stress-induced ferroptosis in asthenospermia's pathophysiology. Peroxiredoxins are important players in the antioxidant defense to protect cells against oxidative stress. However, some aspects of the antioxidant response necessary for male fertility are not well understood. This case-control study aimed to elucidate the role of peroxiredoxins in regulating oxidative stress in male fertility via their correlation with ferroptosis. It included 90 fertile and 90 asthenospermic subfertile males from Hilla City, Iraq. Total peroxiredoxin activity, peroxiredoxin-6 level, and peroxiredoxin-4 level were measured alongside the ferroptosis biomarkers glutathione peroxidase-4, malondialdehyde, and the reduced/oxidized protein thiol ratio. Infertile males had significantly higher oxidized thiol and malondialdehyde levels than fertile males (p < 0.05). Total peroxiredoxin activities, peroxiredoxin-6 levels, peroxiredoxin-4 levels, glutathione peroxidase-4 levels, and reduced/oxidized protein thiol ratios were significantly lower in infertile males than in fertile males (p < 0.05). Therefore, peroxiredoxin activity and level correlate with reduced/oxidized protein thiol ratio. They are inversely associated with ferroptosis and directly associated with semen quality. These findings suggest that peroxiredoxins are crucial in preventing ferroptosis and have potential implications for treating asthenospermia.