Hasil untuk "Diseases of the endocrine glands. Clinical endocrinology"

Daniel Tancredi, Marian Rewers, Nicole Glaser et al.

Introduction Diabetic ketoacidosis (DKA) occurs frequently in children with type 1 diabetes (T1D). The inflammatory response to DKA may play a role in complications, but the inflammatory pattern is not well characterized. We aimed to describe the inflammatory profile during and after DKA.Research design and methods We evaluated inflammatory mediators (cytokines, chemokines, growth factors, and matrix metalloproteinases) using multiplex immunoassays in children (1) hospitalized with acute DKA (6–8 hours after beginning treatment, (n=15), (2) seen in the outpatient diabetes clinic 2–5 days after DKA (n=14), (3) hospitalized with new-onset T1D without DKA <24 hours after beginning insulin (n=9), and (4) referred to the outpatient diabetes clinic for new-onset T1D without DKA 2–5 days after beginning insulin (n=14). Children with chronic T1D and glycated hemoglobin <8.0% (n=59) undergoing routine phlebotomy served as a reference group.Results Compared with the reference group, children with acute DKA had significant alterations in interleukin 1 (IL-1) receptor antagonist (IL-1RA), IL-6, IL-8, IL-10, IL-18, chemokine C-X-C motif ligand (CXCL) 5, CXCL10, chemokine C-C motif ligand (CCL) 27, tumor necrosis factor-related apoptosis-inducing ligand, granulocyte colony-stimulating factor, tissue inhibitor of metalloproteinase 2 (TIMP-2), TIMP-4, matrix metalloproteinase 2 (MMP-2), MMP-3, MMP-7, MMP-9, and MMP-10. MMP-3, MMP-10, TIMP-1, and IL-1RA were also elevated 2–5 days after DKA (false discovery rate-adjusted p<0.10 for all). MMP-2 and MMP-9 levels were altered in children with new-onset T1D without DKA <24 hours after starting insulin, but no significant inflammatory changes were found in new-onset T1D 2–5 days after starting insulin.Conclusions DKA causes a unique inflammatory pattern distinct from inflammatory changes in acute hyperglycemia or T1D-related autoimmunity. Alterations in MMPs and their tissue inhibitors play a dominant role in this inflammatory profile.

Jia Ming Low, Abhishek Gupta, Rachel Toh et al.

ABSTRACT Background Vertical transmission of microbes from a mother's gut to their offspring plays a crucial role in the genesis of the early life gut microbiome. Gestational Diabetes Mellitus (GDM) is the commonest metabolic disorder during pregnancy, which has adverse short‐ and long‐term effects on both maternal and infant health. We aimed to capture the GDM‐associated biosignatures in infants' gut microbiome from birth to the first 6 weeks of life. Methods 53 GDM mother‐infant dyads and 16 healthy mother‐infant dyads were recruited. We performed targeted 16S rRNA gene amplicon sequencing on stool samples. Various statistical analyses were performed to understand the changes in the microbiome profile of infants and identify GDM‐associated bacterial biomarkers in mothers and their transfer to infants. Results GDM altered the gut microbiome of pregnant women as compared to healthy counterparts (PERMANOVA, p.adjusted < 0.05), with predominance of bacterial members associated with insulin resistance, proinflammatory conditions, and other metabolic processes. Infants born to GDM mothers have distinctive early life microbiome (meconium and six weeks stools) compared to infants born to control mothers (PERMANOVA, p.adjusted < 0.05). We also identified the presence of various GDM‐associated microbial signatures such as Blautia and Collinsella in both meconium and one‐month‐old stool samples of infants born to GDM mothers. Conclusion This study provides a better understanding of the impact of GDM on the seeding of a specific set of microbes during the early life colonization event in the infant gut that increases the risk of inflammatory and metabolic diseases in the future.

Yekta Rameshi, Simin Dashti‐Khavidaki, Soghra Rabizadeh et al.

ABSTRACT Introduction Liver transplantation is associated with various metabolic disorders. Peri‐transplant hyperglycemia is among the most frequent metabolic disorders among liver transplant recipients. Hyperglycemia following liver transplantation can increase the risk of post‐transplant complications, potentially impacting both graft and recipient outcomes. Several studies have compared intensive with standard blood glucose control strategies in liver transplant recipients. However, a comprehensive protocol for managing peri‐transplant hyperglycemia remains elusive. This review aimed to synthesise existing literature on the mechanisms, associated factors, and consequences of hyperglycemia after liver transplantation, and to provide recommendations for managing hyperglycemia in this patient population. Method PubMed, Scopus, and UpToDate databases and American Diabetes Association guidelines were searched without time limitations until February 2025. Results Peri‐liver transplant hyperglycemia can be attributed to several factors, including post‐reperfusion hepatocyte injury, insulin resistance stemming from underlying liver disease, surgical stress, and the use of immunosuppressive drugs. Various factors associated with peri‐transplant hyperglycemia can be categorised into pre‐transplant recipient factors, intraoperative factors, and donor‐related factors. Research has shown that inadequate glycemic control during the peri‐transplant period may have detrimental effects on post‐transplant outcomes, including an increased incidence of infections, graft rejection, acute kidney injury, prolonged hospital stays, and higher overall mortality. Conclusion The suggestions presented in this article, which consider the recipient's medical history and clinical conditions, can serve as a framework for healthcare providers to manage peri‐liver transplant hyperglycemia effectively.

Tom R. Kurzawinski

Yutong Chen, Yi Ding, Shanliang Jin et al.

PurposeThis research aimed to assess the correlation between the Adjusted Body Shape Index (ABSI) and the presence of abdominal aortic calcification (AAC) among middle-aged and older American adults.MethodsEmploying a cross-sectional design, this study analyzed data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES), focusing on 3077 participants aged 40 and above. AAC detection was conducted using dual-energy X-ray absorptiometry (DXA). ABSI was determined based on waist circumference (WC), weight, and height data. The association between ABSI and AAC was examined through multiple linear regression, smoothed curve analysis, threshold effect evaluation, subgroup analysis, and interaction testing.ResultsThe study encompassed 3077 individuals aged 40 and above. Findings indicated a noteworthy positive relationship between ABSI and AAC when adjusting various covariates. Analysis of threshold effects identified a K-point at 0.0908, showing no significant effect to its left but a significant effect to its right. Further, subgroup and interaction analyses highlighted the ABSI-AAC connection specifically within different age groups and among individuals with diabetes.ConclusionHigher ABSI was correlated with higher AAC score.

Kyungdo Han, Mee Kyoung Kim

Background : High body weight variability (BWV) is associated with many metabolic and cardiovascular diseases in adults. The study was designed to explore the baseline characteristics associated with high BWV. Methods : Using a nationally representative database from the Korean National Health Insurance system, 77,424 individuals who underwent five health examinations between 2009 and 2013 were enrolled. BWV was calculated using the body weight recorded at each examination, and the clinical and demographic characteristics associated with high BWV were investigated. High BWV was defined as the highest quartile of coefficient variation in body weight. Results : Subjects with high BWV were younger, more commonly female, less likely to have a high income, and more likely to be a current smoker. Young people under the age of 40 years were more than twice as likely to have high BWV compared with those over 65 years (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.88 to 2.50). The incidence of high BWV was higher in female than in male (OR, 1.67; 95% CI, 1.59 to 1.76). Male with the lowest income had a 1.9-fold higher risk of high BWV compared to male with the highest income (OR, 1.97; 95% CI, 1.81 to 2.13). A high BWV in female was associated with heavy alcohol intake (OR, 1.50; 95% CI, 1.17 to 1.91) and current smoking (OR, 1.97; 95% CI, 1.67 to 2.33). Conclusion : Young people, female, low income, and unhealthy behaviors were independently associated with high BWV. Further research is needed on the mechanisms linking high BWV to detrimental health outcomes.

Shunfan Yang, Guoliang Wang, Nanfang Li et al.

Abstract Background The use of transcatheter adrenal ablation as an alternative treatment for primary aldosteronism (PA) patients remains a subject of debate, with outcomes varying widely across existing studies. This meta-analysis aims to evaluate the results of adrenal ablation and estimate the effectiveness and safety of this therapeutic approach. Methods A comprehensive search was conducted across PubMed, Embase, and Cochrane Library databases for studies published up to October 2022. Outcomes analyzed included the combined clinical success rate, biochemical success rate, and complication rate, which were assessed using a random-effects model. Results Five studies, comprising 234 PA patients, were included in the analysis. The combined clinical success rate was 74% (95% CI: 69%-79%), and the biochemical success rate was 74% (95% CI: 53%-95%). Subgroup analysis revealed that the combined clinical success rate from Unilateral PA (72%, 95% CI: 46%-98%) was similar to the rate from Unilateral + Bilateral (73%, 95% CI: 52.0%-94.0%), while the clinical success rate of the PASO subgroup (78%, 95% CI: 66.0%-89.0%) was higher than the rate of other criteria (51%, 95% CI: 40.0%-63.0%). The combined complication rates were as follows: mild fever, 23% (95% CI: 12%-33%); back pain, 84% (95% CI: 77%-91%); and pleural effusion, 9% (95% CI: 0%-18%). All complications resolved within one week following the procedure. No late complications or ablation-related deaths were reported. Conclusions Transcatheter adrenal ablation for PA patients is safe and demonstrates a relatively high clinical success rate. Presently, this approach is suitable for PA patients who are unwilling to undergo surgery or receive long-term mineralocorticoid receptor antagonist (MRA) treatment. Systematic Review registration INPLASY, identifier 2022110076

Jordan S. Sherwood, Jagdeesh Ullal, Katherine Kutney et al.

Antoine Tabarin

Hongtu Hu, Wei Liang, Zongwei Zhang et al.

Background. Perirenal fat (PRF) has multiple effects on the kidney through its physical structure and adipocytokine-secreting ability. The present study explored the relationship between PRF thickness and the onset and progression of albuminuria in patients with diabetes. Methods. In the cross-sectional analysis, we screened 959 patients from 8764 subjects with type 2 diabetes mellitus (T2DM) who met the inclusion criteria and measured their perirenal fat thickness (PFT) using color Doppler ultrasound. A group of laboratory indexes were included in the analysis models. In a longitudinal study, a total of 218 patients with a baseline UACR <30 mg/g were included in the follow-up study. Results. In a cross-sectional analysis, patients with diabetes and higher PFT presented with higher albuminuria. Multiple logistic regression analysis indicated that PFT was an independent risk factor for the degree of albuminuria in patients with T2DM (odds ratio = 4.186, 95%CI: 2.290–7.653, P < 0.001). In a longitudinal study, 218 albuminuria-free patients with T2DM at the baseline were followed up for a mean of 12.3 months. Based on the cutoff value from the ROC diagnostic test in the cross-sectional study, patients were divided into two groups: higher PFT (H-PFT) and lower PFT (L-PFT). Kaplan–Meier survival curve analysis showed that H-PFT was associated with a higher incidence of albuminuria than L-PFT (log-rank test, χ2 = 4.522, P = 0.033). Cox regression analysis showed that PFT was a risk factor for the earlier onset of albuminuria (hazard ratio 2.83, 95% CI: 1.34–4.88, P < 0.001). Conclusions. PRF evaluated by color Doppler ultrasound is an easy and reliable tool for predicting the onset and progression of albuminuria in patients with T2DM.

Chao Wang, Chao Wang, Chao Wang et al.

Glaucoma is the leading cause of irreversible blindness. The progressive degeneration of retinal ganglion cells (RGCs) is the major characteristic of glaucoma. Even though the control of intraocular pressure could delay the loss of RGCs, current clinical treatments cannot protect them directly. The overactivation of N-methyl-D-aspartic acid (NMDA) receptors by excess glutamate (Glu) is among the important mechanisms of RGC death in glaucoma progression. Melatonin (MT) is an indole neuroendocrine hormone mainly secreted by the pineal gland. This study aimed to investigate the therapeutic effect of MT on glutamate excitotoxicity of mouse RGCs and R28 cells. The Glu-induced R28 cell excitotoxicity model and NMDA-induced retinal injury model were established. MT was applied to R28 cells and the vitreous cavity of mice by intravitreal injection. Cell counting kit-8 assay and propidium iodide/Hoechst were performed to evaluate cell viability. Reactive oxygen species and glutathione synthesis assays were used to detect the oxidative stress state of R28 cells. Retina immunofluorescence and hematoxylin and eosin staining were applied to assess RGC counts and retinal structure. Flash visual-evoked potential was performed to evaluate visual function in mice. RNA sequencing of the retina was performed to explore the underlying mechanisms of MT protection. Our results found that MT treatment could successfully protect R28 cells from Glu excitotoxicity and decrease reactive oxygen species. Also, MT rescued RGCs from NMDA-induced injury and protected visual function in mice. This study enriches the indications of MT in the treatment of glaucoma, providing practical research ideas for its comprehensive prevention and treatment.

Fatemeh Fallah, Morteza Alijanpour, Soraya Khafri et al.

Abstract Background This study aimed to evaluate the effect of Neuromuscular Electrical Stimulation (NMES) on serum glucose level in children and adolescents with type-1 diabetes. Methods This before-after, single-group, clinical trial was conducted on 29 patients with type-1 diabetes mellitus with the age range of 7–18 years. The patients underwent NMES in two 20-minute phases on the quadriceps and hamstrings muscles, three sessions per week for a period of 8 weeks. Fasting Blood Sugar (FBS), measured in two ways, by glucometer and laboratory testing, was considered as the primary outcome and the glycated hemoglobin (HbA1c) and the total daily dose (TDD) of insulin were measured as the secondary outcomes. The laboratory FBS and HbA1c were measured 1 day before the intervention (as a baseline value) and then 2 and 6 weeks after the last session of intervention. FBS by glucometer and total daily dose of insulin were recorded daily from 2 weeks before the intervention to the last day of the intervention and consequently, the weekly average of these variables was calculated and used for statistical analysis. Results The serum level of FBS (measured by glucometer) and the total daily dose of insulin reduced significantly 2 weeks after beginning of intervention. The laboratory serum level of FBS decreased significantly in the second week after the end of intervention compared to the baseline values. Although the HbA1c level decreased at follow-up period (2 and 6 weeks after the intervention), it was not significant. Conclusion It seems that 8 weeks of NMES has beneficial effects on the reduction of FBS and TDD of insulin therefore, it could be suggested as the contributory treatment in management of children and adolescents with type-1 diabetes. Trial registration The study was registered at https://fa.irct.ir/user/trial/51739/view (IRCT20100523003998N1) in date of 25/10/2020.

Reshma Aziz Merchant, Michael Wong Wai Kit, Jia Yi Lim et al.

Objective: To investigate the association of normal BMI with central obesity (CO), high BMI with CO, high BMI without CO, and normal BMI without CO, with function and cognition in older adults. Methods: Cross-sectional study involving 754 participants ≥ 65 years. Data collected include demographics, cognition, and physical measurements. Results: Females had a higher prevalence of high BMI with CO and a lower prevalence of high BMI without CO than males (61.0% vs 44.6% and 4.6% vs 15.0%, respectively). Within gender, CO groups, regardless of BMI, had lower mini-mental state examination (MMSE), handgrip strength (HGS), and longer timed-up-and-go (TUG) scores. Overall, the high BMI without CO group had the highest MMSE scores, HGS, and shortest TUG. Amongst males, HGS was significantly lower in the normal BMI with CO group (B −3.28, 95% CI −6.32 to −0.23, P = 0.04). CO, regardless of normal/high BMI, had significantly lon ger TUG time (B 2.65, 95% CI 0.45 to 4.84, P = 0.02; B 1.07, 95% CI 0.25 to 1.88, P = 0.01, respectively) than normal BMI without CO group. CO was associated with lower MMSE scores in both genders but significant only in males with normal BMI and CO (B −1.60, 95% CI −3.15 to −0.06, P = 0.04). Conclusion: CO may be a better predictor of obesity and adverse outcomes in older adults. High BMI without CO was associated with better outcomes especially in males but require further validation. Prospective longitudinal studies are needed to ascertain the impact of BMI and/or CO on function, cognition, mortality, and gender diff erences.

Olaf M. Dekkers

Olaf M. Dekkers

Hirotaka Watada, Masanari Shiramoto, Shin Irie et al.

Abstract Aims/Introduction Pancreatic β‐cell dysfunction contributes to type 2 diabetes mellitus progression. Drugs that improve insulin secretion might be a valuable treatment approach. The present study aimed to evaluate the effect of the G protein‐coupled receptor 119 agonist DS‐8500a on insulin secretory capacity in Japanese type 2 diabetes mellitus patients. Materials and Methods This single‐center, 4‐week, randomized, double‐blind, cross‐over study enrolled 21 Japanese drug‐naïve type 2 diabetes mellitus patients aged ≥20 years with glycated hemoglobin ≥7.0 and <9.0% (NCT02669732, JapicCTI 163126). Patients received 75 mg of DS‐8500a or a placebo orally daily for 4 weeks in a random order. A combined euglycemic‐hyperinsulinemic and hyperglycemic clamp test was carried out to assess insulin secretion and insulin sensitivity before and after each 4‐week treatment period. Primary end‐points were first‐phase insulin secretion (insulin area under the curve [AUC]180–190 min and C‐peptide AUC180–190 min during the clamp test) and second‐phase insulin secretion (insulin AUC190–300 min and C‐peptide AUC190–300 min). Insulin sensitivity (M and M/I values), disposition index and changes in lipid profile were also assessed. Results DS‐8500a significantly increased first‐ and second‐phase insulin AUC (P = 0.0011, P = 0.0112) and C‐peptide AUC (P = 0.0012, P < 0.0001) compared with the placebo. At day 28, M and M/I values were comparable with those of the placebo, whereas the disposition index for insulin and C‐peptide was significantly increased (P = 0.0108, P = 0.0002). Total cholesterol, low‐density lipoprotein cholesterol and triglyceride concentrations were significantly reduced, and high‐density lipoprotein cholesterol concentrations were significantly increased compared with the placebo. No significant treatment‐emergent adverse events occurred. Conclusion DS‐8500a enhanced insulin secretory capacity, but not insulin sensitivity.

María Altamira, Analía Álvarez, javier Bringa et al.

Introduction: patients with diabetes mellitus type 1 (DM1) have a higher risk of cardiovascular disease (CVD). There are studies in which it was observed that in patients with DM1, CVD appears at younger ages, compared with the general population. The association of vascular anomalies and atherosclerosis is very frequent in DM1, being the detection of thickening of the carotid intima media a useful method to perform the diagnosis of subclinical atherosclerotic disease. Objectives: to perform early detection of subclinical CVD, to know if there is a direct correlation between DM1 and various risk factors in order to establish early therapeutic measures

Alexandre G. Oliveira, Alexandre G. Oliveira, Tiago G. Araújo et al.

In obesity, insulin resistance (IR) and diabetes, there are proteins and hormones that may lead to the discovery of promising biomarkers and treatments for these metabolic disorders. For example, these molecules may impair the insulin signaling pathway or provide protection against IR. Thus, identifying proteins that are upregulated in IR states is relevant to the diagnosis and treatment of the associated disorders. It is becoming clear that hepatocyte growth factor (HGF) is an important component of the pathophysiology of IR, with increased levels in most common IR conditions, including obesity. HGF has a role in the metabolic flux of glucose in different insulin sensitive cell types; plays a key role in β-cell homeostasis; and is capable of modulating the inflammatory response. In this review, we discuss how, and to what extent HGF contributes to IR and diabetes pathophysiology, as well as its role in cancer which is more prevalent in obesity and diabetes. Based on the current literature and knowledge, it is clear that HGF plays a central role in these metabolic disorders. Thus, HGF levels could be employed as a biomarker for disease status/progression, and HGF/c-Met signaling pathway modulators could effectively regulate IR and treat diabetes.

Walter Arancio, Valeria Carina, Giuseppe Pizzolanti et al.

It has been suggested that cancer stem cells (CSC) may play a central role in oncogenesis, especially in undifferentiated tumours. Anaplastic thyroid carcinoma (ATC) has characteristics suggestive of a tumour enriched in CSC. Previous studies suggested that the stem cell factor SOX2 has a preeminent hierarchical role in determining the characteristics of stem cells in SW1736 ATC cell line. In detail, silencing SOX2 in SW1736 is able to suppress the expression of the stem markers analysed, strongly sensitizing the line to treatment with chemotherapeutic agents. Therefore, in order to further investigate the role of SOX2 in ATC, a competing endogenous RNA (ceRNA) analysis was conducted in order to isolate new functional partners of SOX2. Among the interactors, of particular interest are genes involved in the biogenesis of miRNAs (DICER1, RNASEN, and EIF2C2), in the control cell cycle (TP53, CCND1), and in mitochondrial activity (COX8A). The data suggest that stemness, microRNA biogenesis and functions, p53 regulatory network, cyclin D1, and cell cycle control, together with mitochondrial activity, might be coregulated.