1.Myeloperoxidase Is Associated with Insulin Resistance and Inflammation in Overweight Subjects with First-Degree Relatives with Type 2 Diabetes Mellitus.
Anel GOMEZ GARCIA ; Mireya Rivera RODRIGUEZ ; Carlos GOMEZ ALONSO ; Daysi Yazmin Rodriguez OCHOA ; Cleto ALVAREZ AGUILAR
Diabetes & Metabolism Journal 2015;39(1):59-65
BACKGROUND: Family history of type 2 diabetes mellitus (T2DM) is one of risk factors for that in future a subject can develop diabetes. Insulin resistance (IR) is important in the pathogenesis of T2DM. There is evidence that oxidative stress plays an important role in the etiology and/or progression of diabetes. Myeloperoxidase (MPO) participates in developing of inflammation. The objective was to investigate if MPO is associated with IR and inflammation in individuals with first-degree relatives of T2DM. METHODS: Cross-sectional study in 84 overweight individuals with family history of T2DM divided in two groups according to IR, group with IR (homeostasis model assessment [HOMA] > or =2.5; n=43) and control group (CG; HOMA <2.5; n=41). Complete clinical history and a venous blood sample were collected for measuring glucose and lipids profile, insulin, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), MPO, glutathione reductase (GRd), glutathione peroxidase, and superoxide dismutase. RESULTS: MPO, TNF-alpha, and IL-6 were higher in patients with IR than in CG (MPO: 308.35 [190.85 to 445.42] vs. 177.35 [104.50 to 279.85], P=0.0001; TNF-alpha: 13.46 [10.58 to 18.88] vs. 9.39 [7.53 to 11.25], P=0.0001; IL-6: 32.93 [24.93 to 38.27] vs. 15.60 [12.93 to 26.27]; P=0.0001, respectively). MPO was associated with IR (rho de Spearman=0.362, P=0.001). In the analysis of lineal regression, MPO predicts IR (beta, 0.263; t, 2.520; P=0.014). In the univariate analysis, MPO had an odds ratio of 9.880 for risk of IR (95% confidence interval, 2.647 to 36.879). CONCLUSION: MPO had relation with IR and inflammation parameters in overweight subjects with first-degree relatives of T2DM. We need studies on a casual relationship and molecular mechanisms among the increased serum MPO levels, inflammation markers, and IR.
Cross-Sectional Studies
;
Diabetes Mellitus, Type 2*
;
Glucose
;
Glutathione Peroxidase
;
Glutathione Reductase
;
Humans
;
Inflammation*
;
Insulin
;
Insulin Resistance*
;
Interleukin-6
;
Odds Ratio
;
Overweight*
;
Oxidative Stress
;
Peroxidase*
;
Risk Factors
;
Superoxide Dismutase
;
Tumor Necrosis Factor-alpha
2.Hexane Extract of Orthosiphon stamineus Induces Insulin Expression and Prevents Glucotoxicity in INS-1 Cells.
Hae Jung LEE ; Yoon Jung CHOI ; So Young PARK ; Jong Yeon KIM ; Kyu Chang WON ; Jong Keun SON ; Yong Woon KIM
Diabetes & Metabolism Journal 2015;39(1):51-58
BACKGROUND: Hyperglycemia, a characteristic feature of diabetes, induces glucotoxicity in pancreatic beta-cells, resulting in further impairment of insulin secretion and worsening glycemic control. Thus, preservation of insulin secretory capacity is essential for the management of type 2 diabetes. In this study, we evaluated the ability of an Orthosiphon stamineus (OS) extract to prevent glucotoxicity in insulin-producing cells. METHODS: We measured insulin mRNA expression and glucose-stimulated insulin secretion (GSIS) in OS-treated INS-1 cells after exposure to a high glucose (HG; 30 mM) concentration. RESULTS: The hexane extract of OS elevated mRNA expression of insulin as well as pancreatic and duodenal homeobox-1 of INS-1 cells in a dose-dependent manner. The hexane OS extract also increased the levels of phosphorylated phosphatidylinositol 3-kinase (PI3K) in a concentration-dependent manner. Additionally, Akt phosphorylation was elevated by treatment with 100 and 200 micromol of the hexane OS extract. Three days of HG exposure suppressed insulin mRNA expression and GSIS; these expressions were restored by treatment with the hexane OS extract. HG elevated peroxide levels in the INS-1 cells. These levels were unaffected by OS treatment under both normal and hyperglycemic conditions. CONCLUSION: Our results suggested that the hexane extract of OS elevates insulin mRNA expression and prevents glucotoxicity induced by a 3-day treatment with HG. This was associated with the activation of PI-3K and Akt.
Glucose
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Hyperglycemia
;
Insulin*
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Orthosiphon*
;
Phosphatidylinositol 3-Kinase
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Phosphatidylinositol 3-Kinases
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Phosphorylation
;
RNA, Messenger
3.Intravitreal Ranibizumab for Subfoveal Choroidal Neovascularization from Age-Related Macular Degeneration with Combined Severe Diabetic Retinopathy.
So Young HAN ; Jeong Hun BAE ; Jaeryung OH ; Hyeong Gon YU ; Su Jeong SONG
Diabetes & Metabolism Journal 2015;39(1):46-50
BACKGROUND: To evaluate the efficacy of intravitreal ranibizumab for subfoveal choroidal neovascularization (CNV) from age-related macular degeneration (AMD) with combined severe diabetic retinopathy (DR). METHODS: This retrospective, interventional case series included eleven patients (mean age, 70.09 years; range, 54 to 83 years) with at least severe non-proliferative DR and subfoveal CNV secondary to AMD. Each subject was treated with intravitreal injections of 0.5 mg ranibizumab. The primary outcomes included change in best-corrected visual acuity and central subfield thickness (CST) on optical coherence tomography (OCT). RESULTS: The mean follow-up time was 16.7+/-14 months (range, 6 to 31 months). Mean visual acuity improved from 1.21+/-0.80 logarithm of the minimum angle of resolution (logMAR) to 1.0+/-0.6 logMAR (P=0.107), 0.95+/-0.62 logMAR (P=0.044), 1.10+/-0.68 logMAR (P=0.296), and 1.13+/-0.66 logMAR (P=0.838) at 1, 3, 6, and 12 months after injection, respectively. Eight patients (72.7%) gained or maintained vision (mean 0.32 logMAR), whereas three patients (27.3%) lost more than one line of vision (mean 0.51 logMAR). The mean OCT CST was 343.9+/-134.6 microm at baseline, and the mean CST at 1, 3, 6, 12 months after the injection was 367.8+/-172.1 (P=0.864), 346.2+/-246.2 (P=0.857), 342+/-194.1 (P=0.551), and 294.2+/-108.3 microm (P=0.621), respectively. CONCLUSION: Intravitreal ranibizumab injection can be considered to be a therapy for the stabilization of subfoveal CNV secondary to AMD with combined severe DR. However, these patients might exhibit limited visual improvement after treatment.
Choroidal Neovascularization*
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Diabetic Retinopathy*
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Follow-Up Studies
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Humans
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Intravitreal Injections
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Macular Degeneration*
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Retrospective Studies
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Tomography, Optical Coherence
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Visual Acuity
;
Ranibizumab
4.Appendicular Skeletal Muscle Mass and Insulin Resistance in an Elderly Korean Population: The Korean Social Life, Health and Aging Project-Health Examination Cohort.
Seung Won LEE ; Yoosik YOUM ; Won Joon LEE ; Wungrak CHOI ; Sang Hui CHU ; Yeong Ran PARK ; Hyeon Chang KIM
Diabetes & Metabolism Journal 2015;39(1):37-45
BACKGROUND: Increasing evidence supports an association between age-related loss of muscle mass and insulin resistance. However, the association has not been fully investigated in the general population. Thus, we investigated the association between appendicular skeletal muscle mass (ASM) and insulin resistance in an elderly Korean population. METHODS: This cross-sectional study included 158 men (mean age, 71.8) and 241 women (mean age, 70.6) from the Korean Social Life, Health and Aging Project, which started in 2011. In this study, ASM was measured by bioelectrical impedance analysis and was analyzed in three forms: ASM (kg), ASM/height2 (kg/m2), and ASM/weight (%). The homeostasis model assessment of insulin resistance (HOMA-IR) was used as a measure of insulin resistance. The relationships between the ASM values and the HOMA-IR were investigated by multiple linear regression models. RESULTS: The HOMA-IR was positively associated with ASM (beta=0.43, P<0.0001) and ASM/height2 (beta=0.36, P<0.0001) when adjusted for sex and age. However, after additional adjustment for body weight, HOMA-IR was inversely associated with ASM (beta=-0.43, P<0.001) and ASM/height2 (beta=-0.30, P=0.001). Adjustment for other potential confounders did not change these associations. Conversely, HOMA-IR was consistently and inversely associated with ASM/weight before and after adjustment for other potential confounders. CONCLUSION: Our results support the idea that lower skeletal muscle mass is independently associated with insulin resistance in older adults. When evaluating sarcopenia or muscle-related conditions in older adults, their whole body sizes also need to be considered.
Adult
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Aged*
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Aging*
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Body Size
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Body Weight
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Cohort Studies*
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Cross-Sectional Studies
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Electric Impedance
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Female
;
Homeostasis
;
Humans
;
Insulin Resistance*
;
Korea
;
Linear Models
;
Male
;
Muscle, Skeletal*
;
Sarcopenia
5.Subjective Assessment of Diabetes Self-Care Correlates with Perceived Glycemic Control but not with Actual Glycemic Control.
Jung Hun OHN ; Ju Hee LEE ; Eun Shil HONG ; Bo Kyung KOO ; Sang Wan KIM ; Ka Hee YI ; Min Kyong MOON
Diabetes & Metabolism Journal 2015;39(1):31-36
BACKGROUND: We investigated whether patients' perceived glycemic control and self-reported diabetes self-care correlated with their actual glycemic control. METHODS: A survey was administered among patients with diabetes mellitus at an outpatient clinic with structured self-report questionnaires regarding perceived glycemic control and diabetes self-management. Actual glycemic control was defined as a change in glycated hemoglobin (A1C) or fasting plasma glucose (FPG) since the last clinic visit. RESULTS: Patients who perceived their glycemic control as "improved" actually showed a mild but significant decrease in the mean A1C (-0.1%, P=0.02), and those who perceived glycemic control as "aggravated" had a significant increase in the mean FPG (10.5 mg/dL or 0.59 mmol/L, P=0.04) compared to the "stationary" group. However, one-half of patients falsely predicted their actual glycemic control status. Subjective assessment of diabetes self-care efforts, such as adherence to a diet regimen or physical activity, correlated positively with perceived glycemic control but showed no association with actual glycemic control. CONCLUSION: Patients should be encouraged to assess and monitor diabetes self-care more objectively to motivate behavioral modifications and improve their actual glycemic control.
Ambulatory Care
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Ambulatory Care Facilities
;
Blood Glucose
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Diabetes Mellitus
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Diet
;
Fasting
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Hemoglobin A, Glycosylated
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Humans
;
Motor Activity
;
Self Care*
;
Surveys and Questionnaires
7.The Optimal Cutoff Value of Glycated Hemoglobin for Detection of Diabetic Retinopathy.
Diabetes & Metabolism Journal 2015;39(1):16-26
With standardization of measurement of glycated hemoglobin (A1C), the International Expert Committee Report in 2009 and the American Diabetes Association in 2010 recommended incorporating A1C > or =6.5% into the previous diagnostic criteria using fasting plasma glucose and/or 2-hour plasma glucose. Whereas the association of A1C with cardiovascular diseases and other diabetic microvascular complications was linear without evidence of a distinct threshold, several studies suggested a threshold value for A1C in diabetic retinopathy (DR). In studies about the optimal cutoff value for A1C in DR, the A1C values range from 5.2% to 7.8%. There are several possible reasons why these values for DR differ so widely (differences in the definition and/or methods for DR, variation in statistical methods, differences in study population, differences in exclusion criteria, and difference in methods for measuring A1C). With these wide variations in the study method, drawing a conclusive cutoff value for A1C in DR is impossible. In published studies, the cutoff values for moderate or severe DR were higher than those for any or mild DR (6.4% to 7.0% vs. 5.5% to 6.5%).
Blood Glucose
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Cardiovascular Diseases
;
Diabetes Mellitus
;
Diabetic Retinopathy*
;
Fasting
;
Hemoglobin A, Glycosylated*
8.Hepatokines as a Link between Obesity and Cardiovascular Diseases.
Diabetes & Metabolism Journal 2015;39(1):10-15
Non-alcoholic fatty liver disease, which is considered a hepatic manifestation of metabolic syndrome, independently increases the risks of developing cardiovascular disease (CVD) and type 2 diabetes mellitus. Recent emerging evidence suggests that a group of predominantly liver-derived proteins called hepatokines directly affect the progression of atherosclerosis by modulating endothelial dysfunction and infiltration of inflammatory cells into vessel walls. Here, we summarize the role of the representative hepatokines fibroblast growth factor 21, fetuin-A, and selenoprotein P in the progression of CVD.
alpha-2-HS-Glycoprotein
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Atherosclerosis
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Cardiovascular Diseases*
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Diabetes Mellitus, Type 2
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Fatty Liver
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Fibroblast Growth Factors
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Obesity*
;
Selenoprotein P
9.Pancreatic alpha-Cell Dysfunction in Type 2 Diabetes: Old Kids on the Block.
Diabetes & Metabolism Journal 2015;39(1):1-9
Type 2 diabetes (T2D) has been known as 'bi-hormonal disorder' since decades ago, the role of glucagon from alpha-cell has languished whereas beta-cell taking center stage. Recently, numerous findings indicate that the defects of glucagon secretion get involve with development and exacerbation of hyperglycemia in T2D. Aberrant alpha-cell responses exhibit both fasting and postprandial states: hyperglucagonemia contributes to fasting hyperglycemia caused by inappropriate hepatic glucose production, and to postprandial hyperglycemia owing to blunted alpha-cell suppression. During hypoglycemia, insufficient counter-regulation response is also observed in advanced T2D. Though many debates still remained for exact mechanisms behind the dysregulation of alpha-cell in T2D, it is clear that the blockade of glucagon receptor or suppression of glucagon secretion from alpha-cell would be novel therapeutic targets for control of hyperglycemia. Whereas there have not been remarkable advances in developing new class of drugs, currently available glucagon-like peptide-1 and dipeptidyl peptidase-IV inhibitors could be options for treatment of hyperglucagonemia. In this review, we focus on alpha-cell dysfunction and therapeutic potentials of targeting alpha-cell in T2D.
Diabetes Mellitus, Type 2
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Fasting
;
Glucagon
;
Glucagon-Like Peptide 1
;
Glucagon-Secreting Cells
;
Glucose
;
Hyperglycemia
;
Hypoglycemia
;
Insulin
;
Insulin-Secreting Cells
;
Receptors, Glucagon
10.Retrospective Analysis on the Efficacy, Safety and Treatment Failure Group of Sitagliptin for Mean 10-Month Duration.
Won Jun KIM ; Cheol Young PARK ; Eun Haeng JEONG ; Jeong Youn SEO ; Ji Soo SEOL ; Se Eun PARK ; Eun Jung RHEE ; Won Young LEE ; Ki Won OH ; Sung Woo PARK ; Sun Woo KIM
Diabetes & Metabolism Journal 2011;35(3):290-297
BACKGROUND: To investigate the clinical results of sitagliptin (SITA) and the characteristics of the treatment failure group or of low responders to SITA. METHODS: A retrospective study of type 2 diabetic patients reviewed 99 cases, including 12 treatment failure cases, who stopped SITA because of worsening patients' condition, and 87 cases, who continued treatment over five visits (total 9.9+/-10.1 months) after receiving the prescription of SITA from December 2008 to June 2009. Subjects were classified as five groups administered SITA as an initial combination with metformin (MET), add-on to metformin or sulfonylurea, and switching from sulfonylurea or thiazolidinedione. The changes in HbA1c level from the first to last visit (DeltaHbA1c) in treatment maintenance group were subanalyzed. RESULTS: The HbA1c level was significantly reduced in four groups, including initial coadministration of SITA with metformin (DeltaHbA1c=-1.1%, P<0.001), add-on to MET (DeltaHbA1c=-0.6%, P=0.017), add-on to sulfonylurea (DeltaHbA1c=-0.5%, P<0.001), and switching from thiazolidinedione (DeltaHbA1c=-0.3%, P=0.013). SITA was noninferior to sulfonlyurea (DeltaHbA1c=-0.2%, P=0.63). There was no significant adverse effect. The treatment failure group had a longer diabeties duration (P=0.008), higher HbA1c (P=0.001) and fasting plasma glucose (P=0.003) compared to the maintenance group. Subanalysis on the tertiles of DeltaHbA1c showed that low-response to SITA (tertile 1) was associated with a longer diabetes duration (P=0.009) and lower HbA1c (P<0.001). CONCLUSION: SITA was effective and safe for use in Korean type 2 diabetic patients. However, its clinical responses and long-term benefit-harm profile is yet to be established.
Diabetes Mellitus, Type 2
;
Fasting
;
Glucose
;
Humans
;
Metformin
;
Plasma
;
Prescriptions
;
Pyrazines
;
Retrospective Studies
;
Thiazolidinediones
;
Treatment Failure
;
Treatment Outcome
;
Triazoles
;
Sitagliptin Phosphate