Body Mass Index In Diabetic Patients Research Articles

The Differences of TNF-α Levels and BMI in Diabetic Patients with Pulmonary Tuberculosis After Intensive Phase of Tuberculosis Treatment

Abstract. Introduction. Diabetes Melitus (DM) can cause complications, such as pulmonary tuberculosis (TB). Metabolic disorders are thought to be related to Tumor Necrosis Factor-α (TNF-α) metabolism, adipocytokines secreted by macrophages, which inhibit insulin transduction, has anti-mycobacterial activity, however, also negatively affect pathological TB process. This study aims to determine differences in TNF-α levels and Body Mass Index (BMI) in DM with pulmonary TB after intensive phase of antituberculosis treatment. Method. This prospective comparative analytical study with one-group pretest-posttest design, conducted during August 2019-September 2019 in outpatient of Type 2 DM with pulmonary TB at USU Hospital, Madani Medan Hospital, Teladan Health Center and Laboratory of Haji Adam Malik Medan after approval from the Health Research Ethics Commission. Data were analyzed after normality test, then mean difference and correlation test by using the SPPS program where p <0.05 was considered significant. Results. This study showed an increase BMI, and decrease of fasting blood glucose, 2-hour post-prandial blood glucose, HbA1C and TNFα levels before and after intensive phase of antituberculosis treatment (p = 0,000; p = 0,000; p = 0,000; p = 0,000). Conclusion. There was a significant increase of BMI and decrease of TNFα level after intensive phase of antituberculosis treatment.

Clinically relevant factors associated with quantitative optical coherence tomography angiography metrics in deep capillary plexus in patients with diabetes

BackgroundTo test clinically relevant factors associated with quantitative artifact-free deep capillary plexus (DCP) metrics in patients with diabetes mellitus (DM).Methods563 eligible eyes (221 with no diabetic retinopathy [DR], 135 with mild DR, 130 with moderate DR, and 77 with severe DR) from 334 subjects underwent optical coherence tomography-angiography (OCT-A) with a swept-source OCT (Triton DRI-OCT, Topcon, Inc., Tokyo, Japan). Strict criteria were applied to exclude from analysis those DCP images with artifacts and of poor quality, including projection artifacts, motion artifacts, blurriness, signal loss, B-scan segmentation error, or low-quality score. A customized MATLAB program was then used to quantify DCP morphology from the artifact-free DCP images by calculating three metrics: foveal avascular zone (FAZ), vessel density (VD), and fractal dimension (FD).Results166 (29.5%) eyes were excluded after quality control, leaving in the analysis 397 eyes (170 with no DR, 101 with mild DR, 90 with moderate DR, 36 with severe DR) from 250 subjects. In the multiple regression models, larger FAZ area was associated with more severe DR (β = 0.687; p = 0.037), shorter axial length (AL) (β = − 0.171; p = 0.003), thinner subfoveal choroid thickness (β = − 0.122; p = 0.031), and lower body mass index (BMI) (β = − 0.090; p = 0.047). Lower VD was associated with more severe DR (β = − 0.842; p = 0.001), shorter AL (β = 0.107; p = 0.039), and poorer visual acuity (VA) (β = − 0.133; p = 0.021). Lower FD was associated with more severe DR (β = − 0.891; p < 0.001) and with older age (β = − 0.142; p = 0.004).ConclusionsQuantitative artifact-free DCP metrics are associated with VA, DR severity, AL, subfoveal choroidal thickness, age, and BMI in diabetic patients. The effects of ocular and systemic factors should be considered for meaningful interpretations of DCP changes in DM patients.

EXPRESSION OF IRISIN AND ITS RELATION WITH ANTHROPOMETRIC AND BIOCHEMICAL PARAMETERS IN DIABETES MELLITUS TYPE II PATIENTS

AimTo evaluate the gene expression of irisin in patients with type 2 diabetes mellitus (DM2) and its possible involvement in the metabolic changes and obesity in this pathophysiological situation.MethodsPatients anthropometric data were obtained, as well as samples of blood were collected in the clinic of specialties from Faculty of Medicine of ABC. A list of healthy individuals CT (n=14) and DM2 patients (n=16) diagnosed for less than 10 years was obtained. The criteria for the diagnosis of DM2 were the one used by the American Diabetes Association (ADA). Volunteers filled in terms of consent, and all of them were greater than or equal to 21 years old. After collection, it was evaluated complete hemogram and biochemical parameters: glucose and glycated hemoglobin (A1C). The expression of molecular biomarker irisin in peripheral blood leukocytes was performed by RT‐qPCR technique. Results were expressed as mean ± standard deviation (SD) and analyzed by the program GraphPad Prism® 6.0, using the Student's t‐test and Mann‐Whitney test. As for the analyzes of correlation, it was done the Spearman correlation test. The significance level was 5% (descriptive value *p&lt;0.05).ResultsThe mean age of the patients studied was 51±15 years for the CT group (n=14) and 64±10 years for the DM2 (n=16). As for the biochemical parameters, the following results were obtained: glucose (CT 92±13, n=14 DM2 versus 143±40 mg/dL, n=16 *p&lt;0.05); A1C (CT 5.6±0.5, n=14 DM2 versus 7.1±1.6%, n=16 *p&lt;0.05); irisin gene expression in peripheral blood was obtained by the formula 2^‐ΔCT and values found in CT group were 8.506e‐006±1.412e‐005, n=6. The ones found in DM2 group were 0.02288± 0.08050 n=14, p=0.06. The correlation test between the expression of irisin versus Body Mass Index (BMI) in DM2 was r=0.5221, p=0.06. There was no correlation between the glucose levels and A1C with irisin expression.ConclusionDespite the preliminary findings, the data showed a tendency toward a positive correlation between the expression of irisin and BMI in diabetic patients. These data suggest that irisin is associated to possible changes in adiposity which happen in obesity associated to DM2.Support or Funding InformationFinancial Support: CAPES, CNPq.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

VitaminD deficiency and hypertension in type 2 diabetic Iraqi patients

Objective Vitamin D3 deficiency has been defined as serum 25-hydroxyvitamin D3[25-(OH)D3] levels below 30 ng/ml and it is common among patients with type 2 diabetes mellitus (T2DM). Laboratory studies indicate that 1,25-(OH)D3 suppresses renin expression and vascular smooth muscle cells proliferation, then decreases blood pressure. The aim of the present study is to demonstrate the association between 25-(OH)D3 level and the risk of blood pressure, and its relation with T2DM and body mass index (BMI).Method This study was conducted at Al-Hussein Medical City/Al-Hussein Teaching Hospital, Karbala, Iraq. All samples, 30 apparently healthy subjects as control, N = 30 and 90 patients (equal number of male and female) with T2DM [50 obese with hypertension (G1) and 40 non-obese without hypertension (G2)], were randomly selected from diabetic patients who had attended the diabetic consultation unit from November 2012 to June 2013 with age ranged between 23 and 75 years. Measurement of 25-(OH)D3, fasting blood glucose, triglyceride, total cholesterol and high-density lipoprotein cholesterol (HDL-C) levels in addition to blood pressure and BMI were calculated in all samples.Results The results showed that serum 25-(OH)D3 was significantly decreased in G1 and G2 groups (16.8 ± 8.8 ng/ml, 19.5 ± 9.7 ng/ml, respectively), compared with control group (36.0 ± 9.4 ng/ml) at P &lt; 0.001, and 68% of female vs. 57% of male underwent this deficiency. Also 25-(OH)D3 had negative correlation with blood pressure, fasting blood sugar, triglycerides and BMI in diabetic patients in G1 at P &lt; 0.0001 and it had positive significant correlation with HDL-C in G1 and G2 groups.Conclusion It can be concluded that T2DM, systolic and diastolic blood pressure levels correlates significantly with lower concentration of 25-(OH)D3, which suggested that clinical experiences should be taking into account the protective effect of vitamin D in decrease hypertension, which reflects risk factors in diabetic patients with hypertension that leads to metabolic syndrome and then to cardiovascular diseases.

The relationship between serum 25-hydroxy vitamin D concentration and obesity in type 2 diabetic patients and healthy subjects

BackgroundBoth obesity and type 2 diabetes are associated with hypovitaminosis D. The aims of this study were to investigate the association of serum 25-hydroxy vitamin D (25(OH) D) and parathyroid hormone (PTH) concentration with body mass index (BMI) in type 2 diabetic patients compared to control subjects and their predicting role in obesity.MethodsThis cross-sectional study was conducted on 200 subjects (100 type 2 diabetics and 100 healthy controls). Concentration of 25(OH) D, calcium, phosphorous, parathyroid hormone (PTH), fasting blood glucose, HbA1c, serum insulin, homeostasis model assessment of insulin resistance (HOMA-IR) was determined in the fasting samples. Anthropometric measurements including body mass index (BMI) were also measured.ResultsEighty-five percent of type 2 diabetics and 79% of healthy subjects were suffering from vitamin D deficiency or insufficiency. Serum concentration of 25(OH) D (22.08 ± 15.20 ng/ml) (r = −0.11, P = 0.04) and calcium (8.94 ± 0.59 mg/dl) (r = −2.25, P = 0.04) has significant statistically with BMI in type 2 diabetic patients. Serum concentration of PTH has non-significantly associated with BMI in diabetic patients and healthy subjects.ConclusionSerum levels of vitamin D inversely and PTH positively are associated with BMI after adjusted for age, gender and serum calcium in both type 2 diabetic patients and healthy subjects. These associations were statistically significant for serum concentration of vitamin D and calcium only in diabetic patients. So the status of vitamin D is considered as an important factor in type 2 diabetic patients.

Further Investigation of the Negative Association between Hypertension and Peripheral Neuropathy in the Elderly: An Oklahoma Physicians Resource/Research Network (OKPRN) Study

In a previous cross-sectional study of age-associated peripheral neuropathy (AAPN), we found that a history of hypertension was protective. The purpose of this study, conducted in the same cohort, was to investigate further this association in the same subjects and in a comparison group of older subjects with diabetes mellitus. Baseline data from 584 subjects involved in a longitudinal study of primary care patients 65 years of age and older, with no history of 10 medical conditions known to cause peripheral neuropathy, were analyzed for associations between peripheral neuropathy by examination and history of hypertension, number of antihypertensive medications, systolic blood pressure, diastolic blood pressure, pulse pressure, and orthostatic hypotension. In addition, we examined associations between neuropathy at baseline and use of specific classes of antihypertensive medications and non-steroidal anti-inflammatory agents (NSAIDs) in year 3. The analyses were repeated in 110 subjects with diabetes mellitus. History of hypertension, but not the other hypertension-related variables, was negatively associated (OR, 0.60; 95% CI: 0.40 to 0.90) with AAPN after controlling for age and body mass index (BMI). In 287 subjects evaluated in the 3rd year of the study, beta-blocking agents (OR, 3.56; 95% CI: 1.58 to 8.03) and NSAIDs (OR, 2.65; 95% CI: 1.37 to 5.10) were positively associated with AAPN. In subjects with diabetes mellitus, a history of hypertension was again protective, but current pulse pressure (OR, 1.03; 95% CI: 1.00 to 1.05) was a positive predictor of peripheral neuropathy. There were interesting interactions between pulse pressure and military service and pulse pressure and BMI in diabetic patients. The negative association between hypertension and AAPN remains unexplained. The positive association between pulse pressure and neuropathy in diabetic subjects supports findings from previous studies and suggests that AAPN and the neuropathy of diabetes may be distinct entities. The incidental finding of an association between NSAIDs and AAPN is concerning and should be investigated further.

Body Mass Index Negatively Influences Glycated Albumin, but not Glycated Hemoglobin, in Diabetic Patients

Measurement of serum glycated albumin (GA) is accepted as an alternative method to evaluate chronic glycemic control in diabetic patients in whom measurement of HbA 1c is inadequate for some reason. Although GA levels are known to be influenced by serum albumin turnover besides glycemia, little is known about the physiological and pathological conditions affecting GA levels. This study was aimed to prove the effects of body mass index (BMI) on GA measurement in diabetic patients. We studied 209 patients with type 2 diabetes mellitus whose HbA 1c levels had been stable for at least the past three months. In the study patients HbA 1c and GA levels were found to be correlated to one another. Fasting plasma glucose (FPG) was significantly correlated with HbA 1c and GA. BMI showed a significant negative correlation with GA levels, whereas there was no correlation of BMI with HbA 1c levels. Multivariate regression analyses revealed that only FPG was positively correlated with HbA 1c, while FPG was positively and BMI was negatively correlated with GA. Only BMI was negatively correlated with the ratio of GA to HbA 1c. These results clearly demonstrate that GA levels are negatively influenced by BMI in diabetic patients.

Tyrosine phosphatase 1B and leptin receptor genes and their interaction in type 2 diabetes.

The association between three tyrosine phosphatase 1B (PTP1B) gene polymorphisms and type 2 diabetes was examined by comparing the prevalence rates of these polymorphisms in type 2 diabetic patients and healthy control subjects. Furthermore, the association of the polymorphisms and PTP1B and leptin receptor (LepR) gene-gene interactions with complications of type 2 diabetes were examined in type 2 diabetic patients. A total of 257 Finnish patients with type 2 diabetes and 285 nondiabetic subjects were screened. Single nucleotide polymorphisms were determined using polymerase chain reaction and restriction enzymes. The diagnosis of coronary heart disease was based on clinical and ECG criteria. The prevalences of cerebrovascular and peripheral vascular diseases were assessed on the basis of clinical criteria. Laboratory analyses were carried out in the hospital laboratory. We did not find any differences in the genotype distributions or allele frequencies of IVS6 + G82A and Pro387Leu polymorphisms between the type 2 diabetics and controls. There were differences in the genotype frequencies of the Pro303Pro (C981T)-polymorphism between the two studied groups (P = 0,018); there were eight T981T subjects in the control population but none amongst the type 2 diabetics. However, there were no differences in the allele frequencies. In addition, significant associations between the IVS6 + G82A polymorphism and body mass index (BMI), albuminuria, glycohaemoglobin A1 (GHBA1) and hypertension in type 2 diabetic patients (P = 0,026-0,031) were observed. Pro387Leu and Pro303Pro did not associate with risk factors or diabetic complications. We also found a gene-gene interaction effect between PTP1B and the LepR gene with the genotype combination IVS6 + A82A and Arg223Arg having the highest BMI compared with the other genotype combinations (P = 0.0043 for trend). The interaction between these two polymorphisms explained 3% of the variation in BMI in diabetic patients when the other covariates were taken into account. We conclude that the PTP1B IVS6 + G82A polymorphism was associated with BMI, albuminuria, GHBA1 and hypertension in type 2 diabetic patients. The 981T/T-genotype of the Pro303Pro- polymorphism might have some protective role against the development of type 2 diabetes. The interaction effects between the PTP1B IVS6 + A82A and LepR Arg223Arg genotypes influenced BMI, explaining 3% of its variation. A synergistic effect of PTP1B and LepR variants on the leptin signalling may be involved.

Selective beta-cell loss and alpha-cell expansion in patients with type 2 diabetes mellitus in Korea.

In the presence of obesity, beta-cell mass needs to be increased to compensate for the accompanying demands and maintain euglycemia. However, in Korea, the majority of type 2 diabetic patients are nonobese. We determined the absolute masses, relative volumes, and ratio of alpha- and beta-cell in the pancreas and islets in normal and diabetic Korean subjects to correlate these findings with the clinical characteristics. Whole pancreases procured from organ donors were divided into 24 parts (control 1, n = 9). Tissue was also obtained by surgical resection after 35 partial pancreatectomies: in 25 diabetic patients, 10 age- and body mass index (BMI)-matched patients of benign or malignant pancreatic tumor without diabetes mellitus (DM) (control 2). Morphometric quantifications were performed. In control 1, the relative volume of beta-cells was 2.1 +/- 0.9%, and the total beta-cell mass was 1.3 +/- 0.3 g. The relative volume of beta-cells was found to be variable (control 1, 2.1 +/- 0.9%; control 2, 1.9 +/- 0.7%; DM, 1.4 +/- 1.0%; P < 0.05 DM vs. control 1 and 2) and showed good correlation with BMI (control 1, r(2) = 0.64; DM, r(2) = 0.55; all subjects, r(2) = 0.38; P < 0.05). Notably, in type 2 diabetic patients, the ratio of alpha-cell area to beta-cell area in the islet was higher than in control 1 and 2 (0.81 +/- 0.4 vs. 0.29 +/- 0.2, 0.20 +/- 0.1, P < 0.05). Additionally, significant alpha-cell expansion and a decreased beta-cell fraction were predominantly observed in larger islets (islet area, >6415 micro m(2); P < 0.05) in control 1 and diabetic patients. The relative volume of beta-cell was found to be correlated with BMI in diabetic patients and normal organ donors. Moreover, decreased beta-cell but increased alpha-cell proportion in the islets suggests for a selective beta-cell loss in the pathogenesis of Korean type 2 diabetes.