Markers Of Type 2 Diabetes Mellitus Research Articles

Examining the associations between testosterone and biomarkers as men age.

Testosterone concentrations in men decline with advancing age. However, the cause of the decline is yet to be fully elucidated. Therefore, the aims of this study were to examine the associations between chronic diseases such as obesity and type 2 diabetes mellitus (T2DM) with total testosterone (TT) and sex hormone-binding globulin (SHBG), using a large nationally-representative data set (National Health and Nutrition Examination Survey; NHANES). NHANES is a cross-sectional survey, physical examination, and laboratory evaluation of a nationally-representative sample of a non-institutionalized United States population. Male participants aged ≥18 years during the NHANES 2013-2014 and NHANES 2015-2016 survey periods were selected for this analysis. The analysis included the following data: body mass index (BMI), oral glucose tolerance test (OGTT), homeostatic model assessment of insulin resistance (HOMA-IR), insulin, glucose, and age. An overweight or obese condition was significantly inversely associated with TT and SHBG, even after adjusting for other variables. Several variables associated with T2DM (OGTT, HOMA-IR, insulin, and glucose) were also inversely associated with TT; however, only the associations between OGTT and insulin with TT remained significant after adjusting for the other variables. Insulin and HOMA-IR levels were significantly inversely associated with SHBG; however, only the association between SHBG and pre-diabetic HOMA-IR levels remained significant after adjusting for the other variables. OGTT became significantly associated with SHBG after adjusting for the other variables. Age was significantly inversely associated with TT, but positively associated with SHBG, even after adjusting for other variables. The results of the present study, which is the largest to date, indicate that a marker of obesity, BMI, and some markers of T2DM are both independently and significantly inversely associated with TT and SHBG.

Determination of microbial metagenomic markers of Type 2 Diabetes Mellitus (T2DM) in patients visiting South C Health Centre in Nairobi Kenya

Disturbances in the gut microbiota have been associated with the onset and progression of Type 2 Diabetes Mellitus (T2DM). This study aims to the determination of Microbial Metagenomic Markers of Type 2 Diabetes Mellitus (T2DM) in Patients Visiting South C Health Centre in Nairobi Kenya. The study adopted three basic objectives, namely, types and abundance of Bacteria Colonizing the Gut of T2DM, Pre-Diabetic, and Non-Diabetic Patients Visiting South C Health Centre, T2DM metagenomics markers based on the identified genera and abundances of bacteria and correlation between metagenomic markers of T2DM, prediabetes and non-diabetic subjects and their clinical manifestations. The data used was collected from South C Medical Center in Nairobi, Kenya. The total target population was 79 persons in a cross-sectional metagenomic study which profiled the types and abundances of gut bacteria in 33 T2DM and 13 prediabetic Kenyan volunteers and compare these with the profiles of 33 Kenyans without diabetes. Postprandial random blood sugar (RBS) measurements were used to group the participants. Fecal samples were collected and subjected to 16S V5-V6 rRNA gene sequencing. Reads were analyzed using MOTHUR v. 1.39.1 and the SILVA reference dataset. Alpha and beta diversity and tests of significance were calculated using the MOTHUR Software. Samples from all the groups showed marked dysbiosis characterized by the high abundance of proteobacteria, low levels of bacteroidetes, and a high F/B ratio. The T2DM group had high levels of Firmicutes and Actinobacteria compared to the non-diabetic and prediabetic groups. Putative metagenomic markers of T2DM identified include elevated levels of Firmicutes and Actinobacteria, elevated F/B ratio, and high alpha diversity in T2DM (Chao 1 -value: 0.019888; [Kruskal-Wallis] statistic: 7.8353) and significant abundance of Escherichia shigella (p value=0.000588, FDR=0.004706). It was suggested that high levels of Escherichia Shigella in T2DM patients contribute to the progression of T2DM disease through the production of bacterial endotoxins leading to chronic systemic inflammation. High levels of opportunistic pathogens such as Escherichia Shigella, and Kluyvera in the T2DM group support the observation that monitoring the gut microbiome may be a useful strategy in monitoring and managing bacterial infections in the diabetic people.

Association of Serum Urotensin-II Levels with Insulin Resistance and Endothelin-I in Type-II Diabetes Mellitus Patients

Urotensin-II (UII), a pluripotent vasoactive cyclic peptide, exhibits the progression of cardiovascular diseases and the glucose metabolic disorder of insulin resistance. Type 2 Diabetes Mellitus (T2DM) is entirely associated with insulin resistance. This study aimed to demonstrate the association of UII with insulin resistance in diabetic and non-diabetic subjects. A total of 73 male and female subjects aged 40-60 years were recruited in this case-control study. They included 35 non- diabetic subjects with a body mass index of (BMI) ≤ 25 and 38 patients with Diabetes Mellitus and BMI ≥ 25. UII levels were assessed beside other vasoactive and clinical parameters. The results revealed that patients with T2DM had elevated UII and Endothelin-I (ET-I) levels, along with positive correlations with the insulin-resistance marker of Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), blood pressure (BP), fasting blood glucose (FBG), hemoglobin A1c (HbA1C), and asymmetric dimethylarginine (ADMA). Results from stepwise multiple regressions indicated that UII correlated positively with the increases in the levels of serum cholesterol, ET-I, urea, ADMA, and FBG. This study concludes that the increase in UII level has a positive relation with insulin-resistance and the increase in ET-I level. However, UII could inhibit glucose-induced insulin secretion and, hence, can be utilized as a marker for T2DM and its complications through inflammatory microangiopathy.

Assessment of Salivary Adipokines Resistin, Visfatin, and Ghrelin as Type 2 Diabetes Mellitus Biomarkers.

Type 2 diabetes mellitus (T2DM) is emerging as a metabolic epidemic worldwide. Pathologically, dysregulation of many biological pathways precedes hyperglycemia and the clinical diagnosis of T2DM. Changing trajectories along the process of T2DM development necessitates frequent measurement of biomarkers for early identification of at-risk individuals and successful prevention. Increase in circulating inflammatory adipokines has been suggested as predictive of T2DM. Human saliva is an easily accessible biospecimen amenable for painless frequent collection and possesses nearly 50% of serum proteome. In this study, we measured the adipokines resistin, visfatin, TNF-α, and ghrelin as markers for T2DM in unstimulated whole saliva (UWS) using specific assay kits. Resistin and visfatin concentrations were significantly higher in T2DM saliva. Although the concentration of acylated or unacylated ghrelin was lower in diabetic saliva, the decrease was not significant. Since resistin and visfatin are biomarkers integral to T2DM pathology, their salivary assessments may receive clinical acceptance.

Association of abdominal obesity, hypertriglyceridemia, and hypertriglyceridemic waist phenotype with hypertension and type 2 diabetes mellitus

The present study tested the hypothesis that simple variables, such as waist circumference, hypertriglyceridemia (eTG), and hypertriglyceridemic waist (eTGWC) phenotype could be used as screening tools for the identification of those at high risk in hypertension (HT) and type 2 diabetes mellitus (T2DM). Based on data from our health survey, check of 4206 participants (997 men and 3209 women) were 420 (42.1 %) and 2394 (74.6 %) AO men and women, 370 (37.1 %) and 1340 (41.8 %) eTG men and women, and 236 (23.7 %) and 1131 (35.2 %) eTGWC men and women. We demonstrated that AO, eTG, and eTGWC phenotype associated with increased risk of HT and T2DM. In men, the largest area under curve (AUC) of the receiver operating characteristic (ROC) curves demonstrated that AO was the best marker for HT and eTG was the best marker for T2DM in men, while eTGWC was the best marker for both HT and T2DM in women. In conclusion, it is suggested AO may serve as the early phenotype-associated sequel to eTG reach to eTGWC. Waist circumference measurements and fasting triglycerides can serve as inexpensive screening tools for HT and T2DM to identify those at high risk of HT and T2DM.

Platelet hemostasis in patients with metabolic syndrome and type 2 diabetes mellitus: cGMP- and NO-dependent mechanisms in the insulin-mediated platelet aggregation.

Patients with metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) have high risk of microcirculation complications and microangiopathies. An increase in thrombogenic risk is associated with platelet hyperaggregation, hypercoagulation, and hyperfibrinolysis. Factors leading to platelet activation in MetS and T2DM comprise insulin resistance, hyperglycemia, non-enzymatic glycosylation, oxidative stress, and inflammation. This review discusses the role of nitric oxide (NO) in the regulation of platelet adhesion and aggregation processes. NO is synthesized both in endotheliocytes, smooth muscle cells, macrophages, and platelets. Modification of platelet NO-synthase (NOS) activity in MetS patients can play a central role in the manifestation of platelet hyperactivation. Metabolic changes, accompanying T2DM, can lead to an abnormal NOS expression and activity in platelets. Hyperhomocysteinemia, often accompanying T2DM, is a risk factor for cardiovascular accidents. Homocysteine can reduce NO production by platelets. This review provides data on the insulin effects in platelets. Decrease in a number and sensitivity of the insulin receptors on platelets in T2DM can cause platelet hyperactivation. Various intracellular mechanisms of anti-aggregating insulin effects are discussed. Anti-aggregating effects of insulin are mediated by a NO-induced elevation of cGMP and upregulation of cAMP- and cGMP-dependent pathways. The review presents data suggesting an ability of platelets to synthesize humoral factors stimulating thrombogenesis and inflammation. Proinflammatory cytokines are considered as markers of T2DM and cardiovascular complications and are involved in the development of dyslipidemia and insulin resistance. The article provides an evaluation of NO-mediated signaling pathway in the effects of cytokines on platelet aggregation. The effects of the proinflammatory cytokines on functional activity of platelets are demonstrated.

Type 2 Diabetes, Genomics, and Nursing

Type 2 diabetes mellitus (T2DM) is an inherited, chronic disorder with long-term complications; including cardiovascular disease the leading cause of mortality in the United States. The prevalence of T2DM and its complications are on the rise in the United States, highlighting the need for improved individualized prevention and treatment strategies. Exciting advancements in the field of genomics has led to the recent discovery of numerous genetic markers for T2DM; completing a promising first step toward improved, individualized prevention and treatment strategies for T2DM. These genomic markers, identified using genome-wide association studies (GWAS), candidate gene, and rare variant methodology, identify new physiologic pathways underlying the development of T2DM. Much more work is needed to successfully translate the identification of genetic markers for T2DM into improved, individualized prevention and treatment strategies. As front line providers and leaders of prevention and treatment strategies for chronic disease, nurses, nurse practitioners, and nurse scientists must contribute to this translational effort. Thus, it is important for nurses at all levels to (a) be aware of the current science of genetics and T2DM and (b) participate in the translation of this genetic information into improved, personalized patient care. The aim of this review is to (a) provide an overview of the current state of the science of genetic markers and T2DM and (b) highlight essential next steps to successfully translate the identification of genetic markers for T2DM into improved prevention and treatment strategies; focusing particularly on the role of nursing in this process.