International Journal of Diabetes in Developing Countries最新文献

Objective

This cross-sectional study was planned to evaluate the relationship between serum nesfatin-1 levels, glucose regulation and anthropometric measurements of individuals who had undergone sleeve gastrectomy.

Methods

A total of 40 participants aged between 19 and 64 years with a body mass index (BMI) greater than 30 kg/m² who underwent sleeve gastrectomy participated in the study. Before and 1 month after the surgery, serum nesfatin-1, fasting insulin levels, anthropometric measurements and biochemical parameters were assessed.

Results

Serum nesfatin-1 levels significantly decreased 4 weeks after the surgery (108.3 ± 58.35 pg/mL versus 74.6 ± 40.12 pg/mL: p = 0.003). Serum insulin levels (µIU/ml) showed a similar decrease (p < 0.001). Change in serum nesfatin-1 levels significantly correlated with change in BMI and body fat mass (p = 0.009, p = 0.007, respectively). Furthermore, serum nesfatin-1 levels significantly correlated with total cholesterol levels (p = 0.037). However, despite the significant decreases in both nesfatin-1 levels and glucose regulation markers, no correlation was found between them. The significant decrease observed in post-operative serum nesfatin-1 levels was found to be correlated with anthropometric measurements.

Conclusions

This finding highlights the anorexigenic effects of nesfatin-1, and therefore, nesfatin-1 may be an effective factor in obesity treatment and diabetes.

Objective

Type 2 diabetes mellitus (T2DM) seriously affects human life and health. The aim of this study is to investigate the molecular mechanisms underlying the pathogenesis of T2DM through functional studies of pancreatic β-cell line in vitro.

Methods

In this study, a high-glucose- and high-fat-induced model of Min6 cells was constructed, and their cellular functions and insulin secretion levels were detected. Transcriptome sequencing and differentially expressed genes (DEGs) screening and identification were eventually performed.

Results

We successfully constructed a T2DM model of high-fat- and high-glucose-treated Min6 cells and found that their migration rate, survival rate, and insulin secretion capacity were reduced. Through transcriptome sequencing and bioinformatics analysis, we finally selected the glutathione S-transferase A2 (Gsta2) and neuropilin-2 (Nrp2) genes. After overexpressing Nrp2, we found that PARP1 protein levels were elevated and apoptotic pathways were activated. Cell viability and survival were significantly reduced, apoptosis was increased, and insulin secretion capacity was reduced. Overexpression of Gsta2 significantly increased the apoptosis of Min6 cells, but no increase in Nrp2 expression was observed.

Conclusions

The results suggest that Nrp2 regulates apoptosis in Min6 cells and that there may be a link between this molecule and pathological apoptosis of pancreatic β-cells in T2DM patients. However, Gsta2 was not found to be an upstream regulator of Nrp2 in our cell line. Therefore, Gsta2 regulation of apoptosis in Min6 cells may be achieved through other apoptotic pathways.

Objective

Dysfunction of cardiac autonomic control (CAC) in people with type 2 diabetes mellitus (T2DM) is a predictor of cardiovascular disease mortality. The purpose of this study was to systematically review the literature on the effects of aerobic exercise training on CAC in people with T2DM.

Methods

Electronic databases (MEDLINE, Scopus, and Web of Science) were systematically searched to retrieve relevant evidence from inception to April 2021. Studies investigating the effect of aerobic training on CAC assessed by heart rate variability, baroreflex sensitivity, and heart rate recovery were included in the review. Two authors independently assessed trial quality using the PEDro scale & extracted the following data: study design and participant characteristics, intervention protocol, outcome measures, & major findings of the study.

Results

Ten studies enrolling 651 subjects met the eligibility criteria. Out of the 10 studies, only 4 were randomized controlled trials (RCTs). Eight out of ten studies showed a positive change in cardiac autonomic function. PEDro was used for quality and characteristic assessment which revealed fair-quality evidence. Six studies showed a high risk of bias according to the Cochrane risk of bias tool.

Conclusion

Evidence from this systematic review suggests that aerobic training may positively influence CAC in people with T2DM. However, further large-scale, robust RCTs are required.

Objective

To evaluate the interaction between the NLRP3 inflammasome and superoxide dismutase-2 (SOD2) to provide an insight into the complex host response in periodontitis patients with type 2 diabetes mellitus (T2DM), who have an inherent upregulation of inflammatory cytokines and reactive oxygen species (ROS).

Methods

Gingival tissues were collected from 51 patients divided into three groups: group 1, systemically and periodontally healthy; group 2, systemically healthy with periodontitis; and group 3, periodontitis with T2DM. Immunohistochemistry was performed to evaluate the expression of the NLRP3 inflammasome and SOD2 in terms of mean percentage, intensity and staining intensity distribution (SID).

Results

The mean percentage levels of NLRP3 and SOD2 expression were statistically significantly higher in group 3 (49.16 ± 6.45% and 48.22 ± 11.66%, respectively) when compared to groups 2 and 1 (p < 0.001). While the groups with periodontitis with or without T2DM had statistically significant differences in these variables, the highest expression was found in the periodontitis patient group with T2DM (p < 0.001). NLRP3 and SOD2 mean percentages were positively correlated in groups 1 and 2 but were negatively correlated in group 3.

Conclusion

NLRP3 inflammasome is significantly upregulated in periodontitis patients with T2DM. The negative correlation between SOD2 and NLRP3 in periodontitis patients with T2DM probably indicates insufficient endogenous SOD2 to effectively counteract the excessive oxidative burden and inflammatory state, thereby compounding periodontal destruction in cohorts with T2DM. Further, NLRP3 and SOD2 can be used as biomarkers of periodontal disease progression in periodontitis cohorts modified by DM.

Background

Diabetes mellitus is an etiological factor of tinea pedis (TP) which can increase the risk of diabetes-related foot complications. There is scarce research investigating the epidemiology of TP among patients with diabetes and this study contributed to filling this gap.

Objective

To identify the prevalence and the associated factors of TP among patients with diabetes in Jordan.

Methods

A total of 375 patients with diabetes were recruited in a cross-sectional study at the National Centre for Diabetes, Endocrinology and Genetics in Amman, Jordan. TP was examined by a specimen culture and microscopic study. Several independent variables were collected, including sociodemographic, clinical, and foot self-care variables. Multivariant logistic regression was conducted to test independent factors associated with the prevalence of TP.

Results

Positive TP was present in 211 participants with a prevalence of 56.3%. Multiple logistic regression resulted in four significant associated factors; being highly educated (β = 1.69, p = 0.03), presence of onychomycosis (β = 4.48, p < 0.01), wearing socks as a daily habit (β = 2.30, p < 0.01), and frequency of feet washing (1–2 timesday) (β = 2.54, p = 0.04).

Conclusion

Patients with diabetes in Jordan have a high prevalence of TP. Factors including educational level, onychomycosis infection, and self-care activities (i.e., socks wearing habits and foot hygiene) were found to be associated with the prevalence of TP.

Objective

During an oral glucose tolerance test (OGTT), typically fasting plasma glucose is lower than 2-h postprandial plasma glucose. However, postprandial plasma glucose (PPG) levels lower than fasting plasma glucose (FPG) levels may also occur. This study aims to describe the prevalence, clinical characteristics and contributing risk factors for PPG ≤ FPG in a large diverse Chinese population.

Methods

We conducted a cross-sectional analysis of baseline data from a nationwide cohort study conducted in China. In addition to sociodemographic and anthropometric data collection, individuals had OGTT and blood chemistry tests. We determined the prevalence of PPG ≤ FPG (‘Low Post Load’ group) and PPG > FPG (‘High Post Load’ group) and used logistic regression to evaluate the association of risk factors with the occurrence of Low Post Load.

Results

The prevalence of Low Post Load was 26.04% (n = 3773) and High Post Load was 73.96% (n = 10,714). Low Post Load was found to be related to younger age, male, lower BMI, lower blood pressure, higher HDL cholesterol levels and lower triglycerides levels. Compared with participants in the High Post Load group, participants in Low Post Load group had lower PPG (4.59 ± 0.83 mmol/L vs 7.15 ± 1.41 mmol/L) and HbA1c (5.30 ± 0.43% vs 5.39 ± 0.45%). People in Low Post Load group were more likely to have hypoglycaemic episodes (2.12% vs 0.01%) and impaired fasting glucose (12.30% vs 4.81%) compared with people with High Post Load, all p < 0.001.

Conclusions

We found a high prevalence of people with Low Post Load glucose (26.04%) in a Chinese population cohort. The relationship between Low Post Load and the progression to or protection from diabetes and related complications and future incidence of cardiovascular disease needs further exploration in longitudinal analyses.

Background

Association between liver cirrhosis (LC) and glucose intolerance has been known since long. Many studies in the past have attempted to explore the correlation of glucose metabolism disorders (GMD) with the severity of LC with mixed results (some favouring i.e. higher prevalence of GMD in more severe LC; others negating). This study was conducted to shed further light on the significance of this association.

Objective

This study has been carried out with the aim of studying the correlation between GMD and the severity of LC, as determined by the Child-Turcotte-Pughe (CTP) score.

Methods

100 patients with LC admitted in medical wards were studied and tested with fasting plasma glucose (FPG), 2 h post-75 g oral glucose load plasma glucose (PPG), glycosylated haemoglobin (HbA1c) and fasting plasma insulin. They were categorized based on the severity of LC into CTP A, B or C class and then patients belonging to different classes were compared for the presence of GMD and insulin resistance (IR).

Conclusion

Out of 100 patients, 6, 21 and 73 were respectively found as falling under CTP class A, B and C of LC. The frequency of diabetes mellitus (DM) was found to progressively increase with worsening grade of cirrhosis (17%-A, 24%-B and 27%-C), however this was not significant (p value 0.82). The p values for IR, GMD (pre-diabetes or DM), pre-diabetes (pre-DM) were 0.629, 0.382 and 0.189 respectively. To conclude, development of GMD and IR may be independent of the severity of LC. However more studies may be required to further study this association.

Objective

To estimate the effect of the total cerebral small vessel disease score in the functional outcome and recurrence of cerebral infarction in patients with type 2 diabetes.

Methods

A comparative study was used to review the initial cerebral infarction cases of patients with type 2 diabetes undergoing cranial MRI during 2016–2019, follow up their recovery for 3 months, and count the events of cerebral infarction recurrence within 24 months. MRI with lacunes, enlarged perivascular space (EPVS), cerebral microbleeds (CMBs), and white matter hyperintensities (WMHs) were defined as cerebral small vessel disease (CSVD). Chi-square tests, t-tests, rank-sum tests, and Logistic regression were used for the statistical analysis.

Results

A total of 208 patients were included in the analyses. Mean age was 65.2 ± 11.8 years, and 62% were men. The distribution of the total SVD score from 0 to 4 was 26.9%, 23.6%, 26.4%, 16.3%, and 6.7%. Multivariate Logistic regression showed that the cumulative CSVD score was independently associated with poor outcome 3 months after cerebral infarction (OR:2.193, 95% CI:1.673–2.875) and recurrence within 2 years (OR:2.715, 95% CI: 1.363–2.979). Lacunes, CMBs, WMHs but not EPVS were associated with the modified Rankin Scale (mRS) scores at 3 months after cerebral infarction, Lacunes was associated with recurrence within 2 years. However, the impact of each CSVD marker on functional outcome and stroke recurrence was smaller than that of the total CSVD score.

Conclusion

Cumulative CSVD burden exert important influences on the functional outcome and recurrence of cerebral infarction in patients with type 2 diabetes.

Background

The metabolic syndrome consists of a combination of metabolic abnormalities and genetic predisposition that both contribute significantly to its development. Numerous studies have established a strong association between single nucleotide polymorphisms (SNPs) of the rs7903146 variant in the TCF7L2 gene and the metabolic syndrome (MetS) as well as type 2 diabetes.

Objective

The aim of this study was to assess the impact of rs7903146 on MetS and its components.

Methods

For this cross-sectional study, 325 individuals aged 25 to 86 who were selected from the baseline data of the Ahvaz cohort study were examined. Body mass index, blood pressure, fasting blood glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured following standard protocols. MetS subjects were identified based on the National Cholesterol Education Program guidelines. Genotyping was conducted using the PCR-RFLP method.

Results

Our findings revealed that individuals with the CT genotype of rs7903146 had an increased risk of MetS (OR 2.24; 95% CI, 1.26–3.98; p < 0.006). This genotype was also found to be associated with a higher risk of hypertension and low HDL cholesterol (p < 0.05). Moreover, plasma triglyceride levels were slightly higher in individuals with TT and CT genotypes, although not significantly so (p = 0.06).

Conclusion

In conclusion, the CT genotype of the TCF7L2 rs7903146 polymorphism exhibited higher odds for MetS. While lifestyle factors and other genes are also implicated in MetS, our findings suggest that studying TCF7L2 polymorphisms in high-risk groups could contribute to the development of genotype-specific prevention or treatment strategies. However, further research is required to validate these results.

Background

Glucokinase-maturity onset diabetes of the young (GCK-MODY) is a form of monogenic diabetes that is caused by heterozygous inactivating mutations in GCK gene. The management of GCK-MODY during pregnancy is challenging, as pharmacological treatment dose could not alter glycaemia in GCK-MODY in longitudinal studies and noninvasive antenatal fetal GCK genotyping is unavailable.

Case presentation

Here, we report a case of GCK-MODY with pregnancy. The patient was 41 years old. She was diagnosed with GCK-MODY at 10 weeks of gestation. At 22 weeks and 6 days of gestation, she underwent amniocentesis due to her advanced age and genetic testing confirmed that the fetus was a heterozygous mutation carrier. We described the characteristics of blood glucose fluctuation, insulin responsiveness, hypoglycemic risk, fetal development, and pregnancy outcome before and after fetus genetic testing during her entire pregnancy. Until now, there were no studies describing insulin titration and blood glucose fluctuations during pregnancy in patients with GCK-MODY.

Conclusion

Our case indicted that insulin therapy during pregnancy is effective in GCK-MODY. Careful dietary modifications, individualized insulin titration and specialized diabetes education can reduce the risk of hypoglycemia and improve gestational outcome in GCK-MODY with pregnancy.