NDM Group Research Articles

Changes of serum FGF19 and PEDF levels in patients with type 2 diabetic retinopathy

Objective To observe the expression of FGF19 ( fibroblast growth factor 19) and PEDF (pigment epithelium-derived factor) in the serum of type 2 diabetic retinopathy (DR) patients and discuss their significance. Methods Total 89 patients with type 2 diabetes were selected and divided into two groups according to whether they were combined with diabetic retinopathy: 45 patients with type 2 diabetes alone (DM group) and 44 patients with type 2 diabetes mellitus combined with retinopathy (DR group). At the same time, 40 healthy people were selected as the control group (NDM group). The serum levels of FGF19 and PEDF and their biochemical indexes were detected and compared in each group. The correlation between the indexes and the relationship between FGF19, PEDF and DR were analyzed. Results Compared with NDM group, serum FGF19 level in DM group and DR group decreased, while C-reactive protein (CRP) and PEDF level in DM group and DR group increased (P 0.05); the levels of Hcy, triacylglycerol (TG) and CRP in DR group were higher than those in DM and NDM group (P 12.76 mg/L, the sensitivity and specificity of PEDF dignosing DR were 80.9% and 56.7% respectively. Conclusions In patients with DR, serum FGF19 level decreased and serum PEDF levels increased. The level of both changes is closely related to DR and may be involved in the development of DR. Key words: Diabetic retinopathy; Diabetes mellitus, type 2; Fibroblast growth factor 19; Pigment epithelium derived factor

Abstract P3-02-10: The possible association among breast cancer, diabetes mellitus and GLP-1 receptor

Abstract Introduction: Diabetes mellitus (DM) has been generally considered one of the risk factors of breast cancer (BC) development. Glucagon-like-peptide-1 (GLP-1) has been reported to be associated with increased risks of cancer development in some human malignancies. Koehler et.al.,reported that GLP-1 analogues could be associated with intestinal tumor growth through increased Fibroblast Growth Factor 7 (FGF7). However, the involvement of GLP-1 has not been studied in BC. Therefore, in this study, we explored the possible association of GLP-1 with BC risk in DM patients, by comparing GLP-1 receptor (GLP-1R), FGF7 and Fibroblast Growth Factor Receptor2 (FGFR2) status of BC between DM and non-DM BC patients. Method: We immunolocalized GLP-1R, FGFR2 and FGF7, the ligand of FGFR2 in 125 BC cases with DM and 57 without DM (NDM), operated from 2005 to 2013 and 2017 at Nahanishi Clinic and Tohoku University Hospital, Japan, excluding those who received neoadjuvant chemotherapy. Result: The status of GLP-1R was significantly more frequent in BC tissue (Ca) than in normal mammary gland tissue (NCa) regardless of DM (DM Ca 67.2% vs NCa 19.5% P<0.001, NDM Ca 51.7% vs NCa 16.4% P<0.001). That of GLP-1R in Ca of the DM group was significantly more frequent than in the NDM group (DM 67.2% vs NDM 51.7% P=0.044). That of FGFR2 was significantly more frequent in Ca than NCa of DM group (Ca 92% vs NCa 59.3% P<0.01), although no significant difference detected in NDM group (Ca 82.8% vs NCa 74.5% P=0.29). There were no significant differences of FGFR2 status in BC between the DM and NDM groups (DM 92% vs NDM 82.8% P=0.062). H score of FGF7 tended to be higher in Ca than NCa in the DM group (Ca 176.5 vs NCa 158.5 P=0.058) but this was not detected in the NDM group (Ca 166.3 vs NCa 161.1 P=0.7). The status of FGF7 in Ca was not different between the DM and NDM groups (DM 176.5 vs NDM 166.3 P=0.37). That of FGF7 in Ca harboring GLP-1R was significantly higher than Ca without GLP-1R regardless of DM (DM GLP-1R+ 189.4 vs GLP-1R- 150 P<0.01, NDM GLP-1R+ 185.5 vs GLP-1R- 146.4 P<0.01) with the same findings obtained in NCa tissue (DM GLP-1R+ 237.8 vs GLP-1R- 137.8 P<0.001, NDM GLP-1R+ 228.8 vs GLP-1R- 149.3 P=0.032). Conclusion: Results of our present study did demonstrate that GLP-1R was more frequently detected in BC tissue than in normal mammary gland tissue with more pronounced in DM patients. These results also indicated an association between GLP1 and FGF7 in the development of BC in DM patients. Citation Format: Naoko Takigami, Shimpei Kuniyoshi, Yasuhiko Miki, Kentaro Tamaki, Yoshihiko Kamada, Kano Uehara, Seiko Tsuchiya, Shigeharu Terukina, Takanori Ishida, Minoru Miyashita, Ayako Kanai, Keely May McNamara, Nobumitsu Tamaki, Hironobu Sasano. The possible association among breast cancer, diabetes mellitus and GLP-1 receptor [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-02-10.

The changes of dynorphin in the peripheral white blood cells and plasma of diabetic patients during the perioperative period

Objective To investigate the changes of dynorphin A (DYN-A) in plasma and derived from peripheral white blood cells (WBCs) of diabetic patients during the perioperative period. Methods Patients scheduled for posterior lumbar interbody fusion (PLIF) under general anesthesia were selected and divided into two groups: a non-diabetes group (an NDM group, n=49) and a diabetes group (a DM group, n=23). The total number of peripheral WBCs and their classification such as lymphocytes, monocytes, and granulocytes were counted before and after operation. Before anesthesia (T1), and after awakening from anesthesia (T2), blood samples from the non-infusion sided elbow vein were collected. The plasma levels of DYN-A were measured by enzyme-linked immunosorbent assay(ELISA). Flow cytometry (FCM) was used to determine the percentage of DYN-A fluorescence positive cells and mean fluorescence intensity (MFI) of WBCs. Results In the NDM group, the total number of peripheral WBCs at T2 [(12.9±4.1)×109/L] was remarkably higher than the count at T1 [(6.3±1.6)×109/L](P 0.05). Conclusions The total number of peripheral WBCs significantly increases in the diabetic patients during the perioperative period, with the most obvious increase in granulocyte count. The percentage of DYN-A positive cells in leukocyte classification significantly decreases, while the level of DYN-A in plasma and derived from granulocytes also decreases. These changes are related to the perioperative stress and immune status of the diabetic patients. Key words: Diabetes; Perioperative period; White blood cell; Dynorphin

Patient and tumor factors contributing to distant metastasis in well-differentiated thyroid cancer: a retrospective cohort study

BackgroundDistant metastasis in thyroid cancer significantly reduces survival in patients with well-differentiated thyroid carcinoma (WDTC). There is limited information available to clinicians regarding pathological features that confer a higher risk of distant metastasis (DM). This study aimed to identify patient and tumor factors that were associated with the development of DM over time in patients with WDTC.MethodsA retrospective cohort analysis of patients with WDTC (n = 584) at our institution was performed between 2007 and 2017. A total of 39 patients with DM and 529 patients with no DM (NDM) were included. Patient demographics, tumor characteristics and patient survival were compared between the DM and NDM groups using a univariate analysis. Multivariate Cox-proportional hazards model was used to evaluate the risk of developing distant metastasis over time. Kaplan-Meier analysis was used to compare survival between the DM and NDM groups.ResultsDistant metastasis had a substantial impact on disease-specific survival (DSS) at 5 and 10-years in the DM group; 71.0% (SE 8.4%) and 46.9% (SE 11.6%) respectively, compared to 100% survival in the NDM group (p < 0.001). The DM group had significantly higher proportions of males, lymphovascular invasion (LVI), nodal metastasis (NM), large tumor size (TS), extrathyroidal extension (ETE), positive resection margins, multifocality, follicular thyroid cancer (FTC), tall cell variant of papillary thyroid cancer (PTC), and Hurthle cell carcinoma (HCC), when compared to the NDM group (p < 0.05). A TS ≥ 2 cm (Hazard Ratio (HR) 1.370), NM (HR 3.806) and FTC (HR 7.068) were associated with a significantly increased hazard of developing distant metastasis in patients with WDTC.ConclusionsTS ≥ 2 cm, NM and FTC are associated with a significantly increased propensity for developing DM in our cohort of WDTC patients.Graphical abstract

The Initial Oral Microbiota of Neonates Among Subjects With Gestational Diabetes Mellitus.

Objective: The objective was to investigate the potential effect of gestational diabetes mellitus on the initial neonatal oral microbiome community structure.Methods: Oral samples were collected from 20 full-term, vaginally delivered newborns with sterile swabs. Nine of them had mothers diagnosed with gestational diabetes mellitus (GDM group), while 11 had non-diabetic mothers (NDM group). The oral microbiota was analyzed using multi-barcode 16S rRNA sequencing on Illumina MiSeq system.Results: The results showed that the birth weight, gestational age and gestational weight gain were significantly higher in NDM group. There was a significant correlation between gestational age and birth weight. Neonatal oral microbiome was composed of five dominant phyla from Actinobacteria, Bacteroidetes, Firmicutes, Proteobacteria, and Tenericutes. Compared to NDM group, a higher alpha diversity and reduction of phylum Firmicutes were observed in GDM group. Genus Lactobacillus dominated in NDM group, while Alistipes, Streptococcus, and Faecalibacterium were overabundant in GDM group. Additionally, carbohydrate metabolism increased in NDM group, whereas amino acid metabolism, vitamin metabolism and lipopolysaccharide biosynthesis were more abundant in GDM group.Conclusions: This study showed a distinct oral microbiota profile in neonates born to mothers with GDM, which indicated that maternal diabetes status played an important role in neonatal initial oral microbiota.

The clinical significance of long non-coding RNA ANRIL level in diabetic retinopathy

AimTo analyse the expression of lncRNA-ANRIL and other related factors in different human body fluids, explore the clinical significance of ANRIL and validate whether ANRIL is interrelated with the renin–angiotensin system and NF-κB signalling pathway.MethodsNinety-one patients were included in this cross-sectional study and were divided into the NDM group (20 patients), DM group (25 patients), NPDR group (21 patients) and PDR group (25 patients). Basic information and samples of serum, aqueous fluid and vitreous fluid were collected before vitrectomy or intravitreal injection. The transcription and levels of ANRIL and other related factors were detected by RT-PCR and ELISA. Statistical Package for Social Sciences software was used for statistical analysis.ResultsANRIL expression varied among different groups and body fluids. There was no difference in ANRIL expression between the NDM and DM groups, but the level of ANRIL was significantly lower in the DM group than in the NPDR and PDR group. In vitreous fluid, ANRIL expression was positively correlated with Ang II, p65 and VEGF expression in the PDR group. The expression of ANRIL in serum was not significantly correlated with age or the random blood sugar but was positively correlated with diabetic duration and HbAc1 level.ConclusionsLevels of lncRNA-ANRIL are higher in DR patient and correlated with the progression of DR that may be used as an indicator to predict the development of DR. The activation of the RAS and the NF-κB pathway may be closely related to the upregulation of ANRIL.Clinical trial number ChiCTR1800017500. Registry Chinese Clinical Trial Registry.

Search for clinical predictors of good glycemic control in patients starting or intensifying oral hypoglycemic pharmacological therapy: A multicenter prospective cohort study

AimsOur aim was to search for clinical predictors of good glycemic control in patients starting or intensifying oral hypoglycemic pharmacological therapy. MethodsA multicenter, prospective cohort of 499 diabetic subjects was enrolled in this study: patients with newly diagnosed diabetes (NDM group) or poor glycemic control with oral antidiabetic drugs (OADs) (PDM group). All subjects then started or intensified OADs therapy and followed up for 91 days. Glycemic control was determined according to HbA1c at day 91 with HbA1c <7% considered good. ResultsThe proportions of patients with good glycemic control after follow up for 91 days were 66.9% and 34.8% in NDM group and PDM group respectively. Logistic regression analysis showed that the change in GA at 28 days was the only predictor of good glycemic control in NDM patients (OR = 1.630, 95% CI 1.300–2.044, P < 0.001). In PDM patients, changes in GA at 28 days, CPI, baseline HbA1c, diabetic duration, and BMI were all independent predictors of good glycemic control (All P < 0.05). ConclusionsGA decline is a good predictor of future success in newly diagnosed patients. In patients intensifying therapy, beside GA decline, other individualized clinical characteristics should also be considered.

Morphological and cytological changes of meibomian glands in patients with type 2 diabetes mellitus.

To observe the changes of microcellular structure of meibomian glands (MGs) in type 2 diabetes mellitus (DM), and to explore its correlation with the duration of diabetes. The study assessed 132 eyes of 132 patients with type 2 diabetes mellitus (DM group) and 100 eyes of 100 non-diabetic participants (NDM group). All patients underwent the examination of the Keratograph 5M system to obtain the meibography which were used to evaluate the structure dropout of the MGs. And then laser scanning confocal microscopy (LSCM) was performed for observing the acinar cells and ducts of the MGs to obtain the following parameters: the MG acinar unit density (MGAUD), MG acinar longest diameter (MGALD) and MG acinar shortest diameter (MGASD). The examination results of the right eye were selected for analysis. Compared with that in NDM group, the meiboscore was significantly higher (Z=-4.057, P<0.001), and there were more MGs dropout in DM group. With the prolongation of the course of diabetes, the absence of MGs aggravated and the MGs dropout score increased (r=0.596; P<0.001). LSCM showed that there were various cytological alterations in acinar cells of MGs with the progress of diabetes duration, such as expansion, atrophy or fibrosis of MG acinar units, decreased density of MG acinar units, deposition of lipid substances, infiltration of inflammatory cells, proliferation of fibrous tissues, etc. And the opening of the glandular duct changed from smooth at the beginning to narrow, blocked, fibrotic and so on. Compared with that in NDM group, the MGAUD in DM group was significantly lower (Z=-9.713; P<0.001), the MGALD and MGASD were significantly larger (Z=-9.751, -6.416; P<0.001). With the duration of diabetes, the MGAUD reduced, the MGASD increased (r=0.860, 0.364, P<0.001); but the MGALD had no correlation with diabetic duration (r=0.133, P=0.151). With the progress of diabetes, the meibomian glandular acinar cells of diabetic patients show various manifestations. Those changes may result in the dysfuction of the MGs, tear film instability and dry eye symptoms in patients with type 2 DM.

Natural polyphenols improve erectile function and lipid profile in patients suffering from erectile dysfunction.

Erectile dysfunction (ED) is characterised as the inability to achieve or maintain an erection to complete sexual intercourse. ED may be considered as an early complication of diabetes mellitus (DM). The aim of this study was to assess the effect of registered food supplement, natural polyphenolic extract from the French maritime pine bark, Pycnogenol (PYC) on erectile function and lipid profile in ED patients. 53 patients with ED were divided into two groups (32 with DM, 21 non-DM) in randomised, blinded and placebo-controlled study. During 3-month intervention with PYC or placebo and one month after the end of the intervention patients were investigated for ED with validated questionnaire International Index of Erectile Function-5 (IIEF-5); lipid profile, glycaemia was analysed in each group. In a randomised, blinded and placebo-controlled study, we found that natural polyphenolic extract, Pycnogenol improved erectile function in DM group by 45 % compared to the NDM group, where the improvement was also significant, but only by 22 %. Total cholesterol, LDL-cholesterol and glucose level was lowered by PYC in patients with DM. Glucose level was not affected by PYC in non-DM. Placebo showed no effect on monitored parameters in both groups. Administration of Pycnogenol leads in improvement of erectile function in patients with ED and diabetes (DM group) by 45 %, in NDM group by 22 %, in lowering of total-, LDL-cholesterol by 20 % and 21 % and glycaemia by 22 % in DM (Tab. 2, Fig. 2, Ref. 19).

Use of commercially available sodium hyaluronate 0.18% eye drops for corneal epithelial healing in diabetic patients.

To evaluate the effect of topical sodium hyaluronate (SH) 0.18% treatment on corneal epithelial healing after epithelial debridement in pars plana vitrectomy in diabetic patients. This is prospective and randomized clinical trial. Our study population included 30 eyes undergoing pars plana vitrectomy that required near total corneal debridement intra-operatively for surgical view. We compared the residual wound and wound healing rate in between 3 groups: 10 diabetic eyes (DMV) on topical SH 0.18%; 10 diabetic eyes (DMC) and 10 non-diabetic eyes (NDM) not treated with topical SH 0.18%. The corneal epithelial wound was measured at 12, 24, 36, 48, 60, 72 and 120h after the vitrectomy surgery. DMC group had corneal wounds that reepithelialization significantly more slowly than in NDM and DMV groups at 12, 24, 36 and 48h (Mann-Whitney test p < 0.05). The epithelial healing rate was significantly faster at 12h in NDM and DMV group (Mann-Whitney test p < 0.05). No differences in the residual epithelial wound and wound healing were detected in between NDM and DMV groups. The mean for epithelial closure in DMC group was delayed 87.6 ± 28.31h, compared with DMV group (64.8 ± 21.31) and NDM group (56.4 ± 9.88). All groups were followed up 1month beyond completed wound closure. No recurrent corneal epithelial wound, corneal melting or corneal neovascularization was noted. Diabetic patients on SH 0.18% four times daily for epithelial defect had similar corneal wounds healing rate as non-diabetics. This treatment significantly improved corneal wound healing and accelerated complete corneal wound resurfacing in diabetic patients.

Hibiscus sabdariffa (ROSELLE) POLYPHENOL-RICH EXTRACT PREVENTS THE AORTIC OXIDATIVE DAMAGE IN TYPE 1 DIABETIC RATS

Diabetes mellitus complications mainly occur due to the oxidative stress-related condition. Thus, this study aimed to investigate the protective effect of the polyphenol-rich extract of Hibiscus sabdariffa (roselle) (HPE) on the aorta of streptozotocin-induced diabetic rats. Twenty-four male Sprague-Dawley rats were divided into four groups (n=6/group); non-diabetes control (NDM), diabetes (DM), diabetes treated with HPE (DM+HPE) and metformin (DM+MET). HPE and metformin were given orally at the dose of 100mg/kg and 150mg/kg respectively for eight weeks duration. At the end of the experiment period, blood pressure was measured before the rats were sacrificed. Blood was taken for measurement of plasma glucose and lipid levels whilst aorta was excised for oxidative stress and histological evaluation. Results showed that HPE treatment reduced plasma glucose level, blood pressure and improved dyslipidemia significantly (p&lt;0.05) in DM+HPE group compared to DM group. Malondialdehyde (MDA) and advanced oxidation protein product (AOPP) levels were significantly decreased (p&lt;0.05) while GSH level was significantly increased (p&lt;0.05) in DM+HPE group compared to DM group. No histological changes observed in the aorta of all diabetic groups compared to NDM group. In conclusion, HPE might have a potential in minimizing the risk of vascular damage in diabetic conditions.

Association of plasma irisin level with prevalence of type 2 diabetes mellitus and physical activity

A total of 186 type 2 diabetic patients ( DM group) and 72 healthy subjects (NDM group) were enrolled. Metabolic parameters and serum irisin levels were measured. The effects of intensity and time of the physical activity were evaluated. According to quartiles of plasma irisin levels, all subjects were divided into four groups and the prevalence of type 2 diabetes mellitus (T2DM) among four groups was compared. The relationship between plasma irisin level and physical activity in DM group was investigated. The results showed that plasma irisin levels were correlated negatively with the prevalence of T2DM (OR=0.984, 95%CI 0.973~0.996); also negatively correlated with age (r=-0.227, P=0.029) and blood uric acid (r=-0.225, P=0.032) in the DM group. When corresponding exercise time was up to grade 4, the intensity of exercise would influence the irisin levels (χ2=7.319, P=0.025). After controlling for potential confounders such as age, metabolic parameters, intensity of work, timing of work, plasma irisin levels in DM group were correlated positively with the intensity of exercise (β=0.326, P=0.014) and negatively with corresponding exercise time (β=-0.454, P=0.001). These results suggest that the prevalence of T2DM decreases with the increase of plasma irisin level. Plasma irisin levels are increased after moderate intensity exercise (5~7 times weekly and 1h each time) or by short-term high-intensity exercise. (Chin J Endocrinol Metab, 2017, 33: 838-841) Key words: Irisin; Diabetes mellitus, type 2; Physical activity

Assessment of Atorvastatin Effect on Body Weight and Blood Glucose Levels Among Diabetic and Non-Diabetic Patients

Abstract Background and aims: Atorvastatin is a member of the drug class known as statins, which used as a lipid-lowering agent. The study aim was to assess the effect of atorvastatin on body weight and blood glucose levels among diabetic and non-diabetic patients. Material and Methods: A 359 hyperlipidemic Jordanian patients using atorvastatin at least for 1 year were divided into two groups: diabetic (DM) and non-diabetic (NDM). The changes in lipid profile, thyroid function test, blood glucose indices as well as body weight were assessed and compared between both groups. Results: There was no statistical significant (p &gt; 0.05) difference between means of body weight after treatment among DM (85.74 ± 3.56) and NDM (81.75 ± 1.25) groups. Descriptive statistics and mean comparisons before and after atorvastatin treatment, showed statistical significant (p ≤ 0.05) differences in body weight and total cholesterol among NDM group and in total cholesterol and LDL-Ch among DM group. There was an increase in fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) and a decrease in triglycerides among both groups but the difference was not statistically (p &gt; 0.05) significant. Conclusions: Atorvastatin may increase body weight, fasting blood glucose and HbA1c for diabetic and non-diabetic patients.

Effects of Percutaneous Coronary Intervention on Viable Myocardium and Heart Function of Diabetic Patients With Chronic Total Occlusion.

The aim of this study was to compare the effects of percutaneous coronary intervention (PCI) on coronary chronic total occlusion patients with (DM) or without (NDM) diabetes mellitus. A total of 78 patients were divided into DM group and NDM group according to whether the patient has DM. The results of PCI were analyzed using quantitative coronary analysis. In addition, all the patients underwent Tc-MIBI (methoxyisobutylisonitrile) single-photon emission computed tomography (SPECT) and ultrasonic cardiogram in the first week and the sixth month after PCI to evaluate PCI results. During the 6-month follow-up, major adverse cardiac event (MACE) was recorded and analyzed as well. The first and second classes of collateral circulation between the 2 groups have significant differences (P < 0.05). Left ventricular end-diastolic volume index and left ventricular end-systolic volume index were decreased at the sixth month compared with those at the first week. Left ventricular ejection fraction was significantly increased. In both groups, the defect size significantly reduced, and percentage of radionuclide scintigraphic count significantly increased between rest and nitroglycerin interventional SPECT. After 6 months, both groups repeated nitroglycerin interventional SPECT, which showed that defect size was significantly reduced, and the percentage of radionuclide scintigraphic count was significantly increased compared with those of the first week. During the 6-month follow-up, the incidence of MACE between the 2 groups had no significant difference. Percutaneous coronary intervention has beneficial effects on heart functions and MACE when performed on chronic total occlusion patients with and without DM.

Gender Differences in Inflammatory Markers among Type 2 Diabetic Subjects

In India currently around 40.9 million people are diabetic and is expected to rise to 69.9 million by 2025unless preventive steps are taken. The so called “Asian Indian Phenotype” refers to certain unique clinicaland biochemical abnormalities. Diabetes mellitus and cardiovascular diseases act as two sides of the samecoin. According to Framingham study, diabetic women have an increased cardiovascular risk about 3.5 foldhigher than non diabetic women. In view of the impact of sexual hormones on glucose homeostasis, themolecular pathways involved in insulin resistance suggest a gender specificity mechanism in the developmentof diabetic complications and also seems to progress at a faster rate in females compared to males andwomen benefit less from treatment than do men. Hence a case controlled study was done to mark the genderdifferences in inflammatory markers among newly detected and known type 2 diabetic subjects. The studyincluded 33 women and 17 men in the NDM group and 30 women and 20 men in the DM5 group. Thebiomarkers namely homocysteine (µmol/l), C-reactive protein (mg/l), lipoprotein (a) (mg / dl) and vitaminB12 (pg/ml) were analyzed. It was observed that the Hcy and Lp(a) values were higher in males than thefemales but CRP and Vitamin B12 values were higher in women when compared to males. (24.54±12.59,3.81±1.14, 15.67±14.22 and 280.69±77.03 and among the women it was 17.06 ±5.54, 5.84 ±3.47, 10.55±12.89 and 352.35± 238.02 respectively). Among the DM5 all the values of the inflammatory markers werehigher in males than in females. (It was 24.59 ±5.13, 4.25 ±0.79, 32.70 ±14.54 and 343.43 ±178.39 and inwomen, 17.64 ±5.07, 3.68 ±0.51, 24.25 ± 9.40 and 338.40 ± 158.15 respectively) From these observations itcan be suggested that there are marked differences among the gender in the values of the inflammatorymarkers. It can also be suggested that the process of inflammation begins on the onset of diabetes which canprogress as the disease progresses. Thus periodic analysis is required to efficiently treat the inflammationprocess to avoid complications related to cardio vascular risk

Associations of Salivary BPIFA1 Protein in Chronic Periodontitis Patients with Type 2 Diabetes Mellitus.

Aims To explore the differences in salivary BPI fold containing family A, member 1 (BPIFA1) concentration among type 2 diabetes mellitus (T2DM) subjects with various severities of chronic periodontitis and to determine whether BPIFA1 in saliva can be used as a potential biomarker of T2DM. Methods Unstimulated saliva samples were collected from 44 subjects with T2DM and 44 without T2DM (NDM). Additionally, demographic data and general health parameters, including fasting blood glucose (FBG) and body mass index (BMI), were collected. We also detected full-mouth clinical periodontal parameters including probing pocket depth (PPD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI). Salivary BPIFA1, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) concentrations were also detected. Results BPIFA1 in saliva was detected at relatively high levels. T2DM subjects had decreased salivary BPIFA1 concentrations (P = 0.031). In T2DM subjects with nonperiodontitis or severe periodontitis, the level of BPIFA1 was significantly lower compared with that of NDM. Salivary TNF-α concentration displayed a similar trend to BPIFA1 in the NDM group. Conclusions BPIFA1 protein is rich in saliva and might be used as a potential predictive biomarker of T2DM, especially in patients with severe periodontitis and nonperiodontitis. This trial is registered with ChiCTR-ROC-17010310.

Type 2 Diabetic Mellitus Is a Risk Factor for Nasopharyngeal Carcinoma: A 1:2 Matched Case-Control Study.

BackgroundDiabetes has been identified as an adverse prognostic variable which associated with an increased mortality in various cancers, including colorectal, lung, and breast cancers. However, previous studies provided inconsistent results on the association between diabetes and nasopharyngeal carcinoma (NPC). The main aim of this study was to investigate the associations between diabetes mellitus and the survival of NPC patients.MethodsThis study was designed as a 1:2 matched case–control study. Cases were patients who met the criteria for the diagnosis of type 2 diabetic mellitus (DM) below. Controls, matched 1:2, were patients who were normoglycemic (NDM). The survival rates were assessed by Kaplan–Meier analysis, and the survival curves were compared using a log-rank test. Multivariate analysis was conducted using the Cox proportional hazard regression model.ResultsBoth locoregional relapse-free survival (LRRFS) and disease-free survival (DFS) in the NDM group were higher than that in the DM group (p = 0.001 and p = 0.033). Additionally, subset analyses revealed that the differences in OS, LRRFS, and DFS were all significant between the two groups in the N0-N1 subset (p = 0.007, p =.000 and p = 0.002). The LRRFS was higher in the NDM group in the III-IV, T3-T4 and N0-N1 subsets (p = 0.004, p = 0.002 and p =.000). In T3-T4 subset, the NDM group experienced higher DFS than the DM group (p = 0.039). In multivariate analysis, T stage and N stage were found to be independent predictors for OS, DMFS and DFS; chemotherapy was a significant prognostic factor for DMFS and DFS, age for OS, and diabetes for LRRFS and DFS.ConclusionsType 2 diabetic mellitus is associated with poorer prognosis among patients with NPC.

Association of macular pigment optical density with early stage of non-proliferative diabetic retinopathy in Chinese patients with type 2 diabetes mellitus.

To detect the association between macular pigment optical density (MPOD), which reflects the antioxidant ability of retina, and diabetic retinopathy (DR) and to investigate the correlated factors of MPOD. Totally 435 subjects of urban Chinese were recruited to the study and divided into 3 groups: non-diabetes mellitus controls (NDM), diabetic patients without retinopathy (DWR), and patients with early stage of non-proliferative diabetic retinopathy (DR). Demographic and lifestyle characteristics were ascertained by questionnaire. A food-frequency questionnaire, general physical and ophthalmic examinations were completed for all participants. MPOD was measured by heterochromatic flicker photometry. Foveal thickness was measured by optical coherence tomography. The difference of MPOD among 3 groups was analyzed by analysis of covariance. The correlation analyses of MPOD with the candidate influence factors were assessed using the generalized estimating equations (GEE) model. Of the 435 participants, 34 could not perform the MPOD measurements. Final analysis included 401 subjects, including 48 were in DR group, 134 in DWR group, and 219 in NDM group. MPOD was not significantly different among DR (0.49±0.21), DWR (0.45±0.21), and NDM (0.49±0.17) groups (P=0.24) after adjustment for fasting plasma glycemia, central foveal thickness, green vegetables, Chinese wolfberry, carotene and vitamin E. For all the 401 participants included, MPOD was positively associated with central foveal thickness (E=0.0007, P=0.001), Chinese wolfberry (E=0.0345, P=0.01), and green vegetables (E=0.0596, P<0.001) intake. The data suggest that MPOD level is not statistically significantly influenced by the onset of diabetes or early stage of DR in the studied population. MPOD level is positively associated with thicker central foveal thickness and higher intake of foods containing carotenoids.

Seventy two-hour glucose monitoring profiles in mild gestational diabetes mellitus: differences from healthy pregnancies and influence of diet counseling.

To study glucose profiles of gestational diabetes (GDM) patients with 72 h of continuous glucose monitoring (CGM) either before (GDM1) or after (GDM2) dietary counseling, comparing them with nondiabetic (NDM) controls. We performed CGM on 22 GDM patients; 11 before and 11 after dietary counseling and compared them to 11 healthy controls. Several physiological and clinical characteristics of the glucose profiles were compared across the groups, including comparisons for pooled 24-h measures and hourly median values, summary measures representing glucose exposure (area under the median curves) and variability (amplitude, standard deviation, interquartile range), and time points related to meals. Most women (81.8%) in the GDM groups had fasting glucose <95mg/dL, suggesting mild GDM. Variability, glucose levels 1 and 2h after breakfast and dinner, peak values after dinner and glucose levels between breakfast and lunch, were all significantly higher in GDM1 than NDM (P<0.05 for all comparisons). The GDM2 results were similar to NDM in all aforementioned comparisons (P>0.05). Both GDM groups spent more time with glucose levels above 140mg/dL when compared with the NDM group. No differences among the groups were found for: pooled measurements and hourly comparisons, exposure, nocturnal, fasting, between lunch and dinner and before meals, as well as after lunch (P>0.05 for all). The main differences between the mild GDM1 group and healthy controls were related to glucose variability and excursions above 140mg/dL, while glucose exposure was similar. Glucose levels after breakfast and dinner also discerned the GDM1 group. Dietary counseling was able to keep glucose levels to those of healthy patients.

Choroidal Thickness Evaluation Before and After Hemodialysis in Patients With and Without Diabetes.

We evaluated the effect of hemodialysis on the choroidal thickness in patients with and without diabetes who have end-stage kidney disease (ESKD). Forty-one patients with ESKD were recruited and divided into two groups: those with ESKD due to diabetic nephropathy (DM group, 37 eyes of 20 patients) and those with nondiabetic ESKD (NDM group, 40 eyes of 21 patients). Using spectral-domain optical coherence tomography (SD-OCT), the subfoveal choroidal thickness (SCT) was measured before and after hemodialysis, and the change ratio (ΔSCT [%]) was calculated. The SCT decreased in all eyes after hemodialysis. The ΔSCT value in the DM group (-12.6 ± 2.7%) was significantly (P = 0.00027) larger than that in the NDM group (-6.9 ± 2.3%). Moreover, the ΔSCT per body fluid removal (BFR [L]) in the DM group was significantly (P = 0.013) greater than in the NDM group. In the DM group, the mean ΔSCT in the eyes treated with panretinal photocoagulation (PRP; n = 19) was significantly (P = 0.035) larger than that in eyes not treated with PRP (n = 18). The relationship between the ΔSCT and BFR was not significant (R² = 0.0038, P = 0.80) in the DM group but was significant (R² = 0.54, P = 0.00013) in the NDM group. The current results may reflect that systemic fluid accumulation has a greater effect on the diabetic choroid, probably due to damage to the choroidal vasculature, in patients with ESKD.