scholarly journals Increased Circulating Chemerin in Relation to Chronic Microvascular Complications in Patients with Type 2 Diabetes

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Ping Gu ◽  
Wei Wang ◽  
Yue Yao ◽  
Yixin Xu ◽  
Liping Wang ◽  
...  

Objective. Type 2 diabetes (T2DM) is a global epidemic and increases mortality due to its vascular complications. Chemerin has been found to exert a major role in glucose and lipid metabolism. The aim of this study was to explore the correlation between plasma chemerin levels and microangiopathy in patients with T2DM. Methods. A total of 598 T2DM patients were classified into two groups: with and without microvascular complications. Anthropometric parameters and blood pressure were taken. The amounts of glycosylated hemoglobin, glucose, lipid profiles, creatinine, and chemerin concentrations in the blood were determined. The presence and severity of nephropathy, retinopathy, and neuropathy were also evaluated by specific tests. Results. Plasma levels of chemerin in diabetic subjects with microvascular complications were markedly elevated compared to those without. The number of microvascular complications increased with high plasma chemerin levels. Patients with high chemerin levels had an increased incidence of nephropathy and retinopathy. Furthermore, the chemerin plasma concentrations increased with the progression of diabetic nephropathy with highest values in macroalbuminuria groups. In contrast, no significant difference was observed in plasma chemerin levels between subjects with and without peripheral neuropathy. Pearson correlation analysis showed that plasma chemerin levels were positively related to duration of diabetes, serum creatinine, and 24-hour urine albumin excretion, even after multiple adjustments. Using logistic regression analysis, plasma chemerin concentrations were independently associated with the presence of nephropathy and retinopathy, not neuropathy. Conclusion. This study elucidated a positive correlation between increased chemerin levels and the development of some subtypes of diabetic microangiopathy.

2019 ◽  
Vol 6 (10) ◽  
pp. 4636-4646
Author(s):  
Prinka Perswani ◽  
Rajesh Kumar ◽  
Ram Sandesh ◽  
Syeda Mehak Fatima ◽  
Syeda Moazzama Zaidi

Type 2 diabetes (T2DM) is a global epidemic and increases mortality due to its vascular complications. Chemerin has been found to exert a major role in glucose and lipid metabolism. The aim of this study was to explore the correlation between plasma Chemerin levels and microangiopathy in patients with T2DM. Methods. A total of 598 T2DM patients were classified into two groups: with and without micro vascular complications. Anthropometric parameters and blood pressure were taken. The amounts of glycosylated hemoglobin, glucose, lipid profiles, creatinine, and Chemerin concentrations in the blood were determined. The presence and severity of nephropathy, retinopathy, and neuropathy were also evaluated by specific tests. Results. Plasma levels of Chemerin in diabetic subjects with micro vascular complications were markedly elevated compared to those without. The number of micro vascular complications increased with high plasma Chemerin levels. Patients with high Chemerin levels had an increased incidence of nephropathy and retinopathy. Furthermore, the Chemerin plasma concentrations increased with the progression of diabetic nephropathy with highest values in macro albuminuria groups. In contrast, no significant difference was observed in plasma Chemerin levels between subjects with and without peripheral neuropathy. Pearson correlation analysis showed that plasma Chemerin levels were positively related to duration of diabetes, serum creatinine, and 24-hour urine albumin excretion, even after multiple adjustments. Using logistic regression analysis, plasma Chemerin concentrations were independently associated with the presence of nephropathy and retinopathy, not neuropathy. Conclusion. This study elucidated a positive correlation between increased Chemerin levels and the development of some subtypes of diabetic microangiopathy.


2021 ◽  
Vol 17 ◽  
Author(s):  
Mohammed I. Abd El-Ghany ◽  
Nahed Abdallah ◽  
Waleed Eldars

Background: Type 2 diabetes is a part of metabolic syndrome associated with a higher risk of vascular complications. Diabetes is characterized by changes in platelet morphology, function, and platelet hyperactivity so, it's considered a prothrombotic condition. Morbidity and mortality in people with type 2 diabetes-related to micro and macrovascular complications. Novel biomarkers are needed to identify and treat people at higher risk. Objective: The main objective of this controlled cross-sectional study was to evaluate Platelet volume indices (PVI) in subjects with type 2 diabetes with and without complications in comparison to subjects without diabetes. Methods: Hundred and thirty-five subjects aged from 35 to 60 years were subdivided into 3 groups. Group A includes 55 subjects with type 2 diabetes with complications. Group B includes 45 subjects with type 2 diabetes without complications. Group C includes 35 normal healthy subjects. Detailed clinical history was taken. Also, PVI, fasting blood glucose (FBG), hemoglobin A1c, and creatinine were obtained. Results: Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Plateletcrit (PCT), and Platelet large cell ratio (P-LCR) were significantly higher among subjects with retinopathy, nephropathy, and neuropathy than other subjects with diabetes who didn't develop complications (P<0.001). At cutoff value > 11.9 fL, MPV have diagnostic sensitivity 80% and specificity 97.8%. Whereas PDW >16.9fL has a sensitivity of 74.5% and specificity of 100% for diabetic microvascular complications (retinopathy, nephropathy, and neuropathy). Conclusion: MPV and PDW may be considered as possible biomarkers for the early detection of diabetic microvascular complications.


2020 ◽  
Vol 72 (2) ◽  
pp. 51-58
Author(s):  
О. Korzh ◽  
A. Titkova ◽  
M. Kochuieva ◽  
Yu. Vinnyk ◽  
L. A. Ruban ◽  
...  

The aim of the study was to identify the proportion of patients with type 2 diabetes who were unable toachieve the triple treatment goal for concomitant control of blood glucose level, blood pressure, LDL and modifying factors associated with achieving triple therapy goals. The study included 675 patients with type 2 diabetes,dyslipidemia and hypertension. The analysis was performed using concurrent triple treatment goals with specific levels of HbA1c, LDL and blood pressure as the main result. The questionnaire for patients with dyslipidemiaincluded self-assessment of compliance with prescribed drugs and perceptions related to their understandingand attitude towards lifestyle changes and pharmacological treatment. The results of the analysis of the logistic regression of factors associated with the achievement of triple treatment goals showed that patients whoreceived moderate doses of statins with high intensity were less likely to achieve concurrent treatment of thegoal compared to low intensity. Younger patients were less likely to achieve the triple treatment goal than thoseover 60 years of age. Based on life expectancy, they will be more susceptible to vascular complications due to anearlier onset of the disease and a longer period of time during which these adverse events can develop. Fewerdrugs and a shorter duration of type 2 diabetes were significant factors in the triple control. It was proved thatsimultaneous control of glycemia, hypertension and lipids was achieved in 22.4% of patients, who were affectedby the intensity of statin treatment, the number of diabetic drugs and the presence of concomitant pathology.Thus, the simultaneous achievement of the triple goal is a more comprehensive mitigation measure to reduce therisk of both macro- and microvascular complications


2020 ◽  
Vol 73 (3) ◽  
pp. 457-461
Author(s):  
Taras I. Griadil ◽  
Ivan V. Chopey ◽  
Kristian O. Debreceni ◽  
Mykhaylo M. Hechko ◽  
Yaroslav O. Mykhalko ◽  
...  

The aim: Evaluate clinical and laboratory parameters of the patients with type 2 diabetes mellitus and concomitant obesity after a course of dapagliflozin treatment and compare with a standard treatment regimen. Materials and methods: Conducted a comprehensive clinical laboratory examination and measurement of the anthropometric parameters of the patients with type 2 diabetes mellitus and concomitant obesity, with subsequent statistical calculations. Results: The data obtained at different stages of the study revealed a statistically significant effect of glucose treatment and glycosylated hemoglobin (HbA1c). Since the 6th month of dapagliflozin treatment, we have shown a tendency to lose weight compared to baseline in this group of patients and controls. Conclusions: Type 2 diabetes mellitus and obesity significantly increase the risk of developing a number of complications. Complex control and effects on clinical laboratory and anthropometric parameters can statistically significantly influence the development of the complications, and in this context, dapaglifloflozin showed statistically better results than standard metformin monotherapy.


2020 ◽  
Vol 11 ◽  
pp. 204062232092415
Author(s):  
Alexandra E. Butler ◽  
Soha R. Dargham ◽  
Aishah Latif ◽  
Haira R. Mokhtar ◽  
Amal Robay ◽  
...  

Background: Epidemiological studies have suggested that vitamin D deficiency is associated with the development of type 2 diabetes (T2DM) and is related to diabetes complications. This study was undertaken to determine the relationship between diabetes complications and cardiovascular risk factors with vitamin D3 and its metabolites: 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), 25-hydroxyvitamin D3 (25(OH)D3), 24,25-dihydroxyvitamin D3 (24,25(OH)2D3); and 25-hydroxy-3epi-vitamin D3 (3epi25(OH)D3). Methods: 750 Qatari subjects, 460 (61.3%) with and 290 (38.7%) without T2DM, who were not taking vitamin D3 supplements, participated in this cross-sectional, observational study. Plasma concentrations of vitamin D3 and its metabolites were measured by liquid chromatography tandem mass spectrometry analysis. Results: T2DM subjects had lower concentrations of all vitamin D3 metabolites ( p < 0.001) except 3epi25(OH)D3 ( p < 0.071). Males had higher concentrations of all vitamin D3 metabolites ( p < 0.001). In the T2DM subjects, lower 25(OH)D3 was associated with retinopathy ( p < 0.03) and dyslipidemia ( p < 0.04), but not neuropathy or vascular complications; lower 1,25(OH)2D3 was associated with hypertension ( p < 0.009), dyslipidemia ( p < 0.003) and retinopathy ( p < 0.006), and coronary artery disease ( p < 0.012), but not neuropathy; lower 24,25(OH)2D3 concentrations were associated with dyslipidemia alone ( p < 0.019); 3epi25(OH)D3 associated with diabetic neuropathy alone ( p < 0.029). In nondiabetics, 25(OH)D3, 1,25(OH)2D3 and 24,25(OH)2D3 were associated with dyslipidemia ( p < 0.001, p < 0.001, p < 0.015, respectively) and lower 1,25(OH)2D3 was associated with hypertension ( p < 0.001). Spearman’s correlation showed 1,25(OH)2D3 to be negatively correlated to age and diabetes duration. Conclusions: Different diabetes complications were associated with differing vitamin D parameters, with diabetic retinopathy related to lower 25(OH)D3 and 1,25(OH)2D3 levels, hypertension significantly associated with lower 1,25(OH)2D3, while dyslipidemia was associated with lower 25(OH)D3, 1,25(OH)2D3 and 24,25(OH)2D3. While 25(OH)D metabolites were lower in females, there was not an exaggeration in complications.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Huiqin Li ◽  
Xiaohua Xu ◽  
Jie Wang ◽  
Xiaocen Kong ◽  
Maoyuan Chen ◽  
...  

Objective. To evaluate the effects of once-weekly dulaglutide injection and once-daily glimepiride on glucose fluctuation in patients with type 2 diabetes mellitus (T2DM) using the Continuous Glucose Monitoring System (CGMS). Methods. A total of 23 patients with T2DM were randomly assigned into two groups for 26 weeks: the dulaglutide group (n=13) and the glimepiride group (n=10). 72-hour CGMS was applied to all patients: before and after the treatment. General clinical data were collected and measured, such as fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), tumor necrosis factor-α (TNF-α), 8-iso-prostaglandin F2α (8-iso-PGF2α), and interleukin-6 (IL-6). Results. HbA1c of the dulaglutide group was reduced from 8.38±0.93% to 6.68±0.73% after the treatment (P<0.05); similarly, it was reduced from 7.91±0.98% to 6.67±0.74% (P<0.05) in the glimepiride group. The levels of serum 8-iso-PGF2α, TNF-α, and IL-6 all decreased significantly in both groups after treatment, and there was no significant difference found between the two groups (P>0.05). The Mean Blood Glucose (MBG) of the two groups declined significantly after therapy (P<0.05). However, the Standard Deviation of Blood Glucose (SDBG) decreased significantly only in the dulaglutide group (from 2.57±0.74 mmol/L to 1.98±0.74 mmol/L, P<0.05). There were no significant changes of Mean Amplitude of Glycemic Excursion (MAGE) and Absolute Means of Daily Difference (MODD) after treatment in both groups. Furthermore, no statistically significant difference was found between the two groups in MBG, SDBG, MAGE, and MODD (P>0.05). The percentage time (PT) (>10 mmol/L and 3.9-10 mmol/L) of the two groups was significantly changed after the treatment (P<0.05). However, this was not seen in the PT<3.9 mmol/L after the treatment (P>0.05). Conclusion. Once-weekly dulaglutide injection has the same effectiveness as daily glimepiride on lowering blood glucose and decreasing oxidation stress and inflammation and is more effective in controlling glucose fluctuation as compared with glimepiride. This trial is registered with ClinicalTrials.gov NCT01644500.


2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Lin Xu ◽  
Bo Zhou ◽  
Huixia Li ◽  
Jiali Liu ◽  
Junhui Du ◽  
...  

Objective. Progranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the correlation between PGRN and type 2 diabetics with microvascular complications.Methods. PGRN serum levels and glucose metabolism related substance were measured in 84 type 2 diabetic patients with or without microangiopathies and 12 health persons. Further analyses of serum PGRN in different stages of diabetic microangiopathies were conducted.Results. Serum levels of PGRN were markedly higher in type 2 diabetic patients with microangiopathies. PGRN serum levels increased with the progress of diabetic microangiopathies with significantly highest values detectable in clinical diabetic nephropathy (CDN) and proliferative diabetic retinopathy (PDR) groups. Serum PGRN concentrations in all individuals positively and markedly correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), triglyceride (TG), urinary albumin excretion rate (UAER), blood urea nitrogen (BUN), creatinine (CRE), white blood cell (WBC), disease duration, IL-6, and TNF-α, while correlating negatively and significantly with eGFR. Multiple linear regression analysis showed that only UAER and CRE were independently associated with serum PGRN.Conclusion. PGRN might be considered as a marker for diabetic microangiopathy and its severity.


2009 ◽  
Vol 2009 ◽  
pp. 1-7 ◽  
Author(s):  
Valerio Costa ◽  
Amelia Casamassimi ◽  
Katherine Esposito ◽  
Angela Villani ◽  
Mariaelena Capone ◽  
...  

Peroxisome proliferator-activated receptor gamma polymorphisms have been widely associated with type 2 diabetes, although their role in the pathogenesis of vascular complications is not yet demonstrated. In this study, a cohort of 211 type 2 diabetes, 205 obese, and 254 control individuals was genotyped for Pro12Ala, C1431T, C-2821T polymorphisms, and for a newly identified polymorphism (A-2819G). The above-mentioned polymorphisms were analyzed by gene-specific PCR and direct sequencing of all samples. A significant difference was found for -2819G frequency when patients with type 2 diabetes—particularly diabetic women with the proliferative retinopathy—were compared with healthy control individuals. In conclusion, we identified a novel polymorphism, A-2819G, inPPARGgene, and we found it to be associated with type 2 diabetes and proliferative retinopathy in diabetic females. In the analyzed population, this variant represents a genetic risk factor for developing the diabetic retinopathy, whereas Pro12Ala and C1431T do not.


2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Nina S Widiarto ◽  
Jimmy Posangi ◽  
Arthur Mongan ◽  
Maya Memah

Abstract: Diabetes mellitus (DM) is a degenerative disease which has increased from year to year. Type 2 diabetes has the highest number of cases. There is a change in platelet count in type 2 diabetes. The change in platelet count can lead to vascular complications in DM. This was a descriptive analytic study with a cross sectional design by using the medical record data of type 2 diabetic patients in the outpatient department of Prof. DR. R. D. Kandou Hospital, Manado. Subjects who met the inclusion criteria were 72 patients; 36 patients with vascular complications and 36 patients without vascular complications. Data were analyzed by using the Mann-Whitney test to determine the ratio of the platelet count in patient with type 2 diabetes patient with and without vascular complication, with α = 0.05. The Mann-Whitney test showed that there was no significant difference in platelet count among patients with type 2 diabetes, with and without vascular complication (P = 0.051). Conclusion: There was no significant difference in the platelet count of type 2 diabetes patients with and without vascular complication.Keywords: type 2 diabetes mellitus, vascular complication, platelet countAbstrak: Diabetes Melitus (DM) merupakan salah satu penyakit degeneratif yang semakin meningkat jumlahnya dari tahun ke tahun. Jenis DM yang paling banyak kasusnya ialah DM tipe 2. Pada DM tipe 2 terjadi perubahan jumlah trombosit, yang dapat menyebabkan terjadinya komplikasi vaskular pada DM. Penelitian ini bersifat deskriptif analitik dengan rancang penelitian cross sectional dengan menggunakan data rekam medik pasien DM tipe 2 yang rawat jalan di RSUP Prof. DR. R. D. Kandou Manado. Subjek penelitian yang memenuhi kriteria inklusi berjumlah 72 pasien; 36 pasien dengan komplikasi vaskular dan 36 pasien tanpa komplikasi vaskular. Hasil penelitian diuji menggunakan uji Mann-Whitney untuk mengetahui perbandingan jumlah trombosit pada pasien DM tipe 2 dengan komplikasi vaskular dan tanpa komplikasi vascular, α = 0,05. Uji Mann-Whitney menunjukkan bahwa perbedaan jumlah trombosit tidak bermakna antara pasien DM tipe 2 dengan komplikasi vaskular dan tanpa komplikasi vaskular (p=0,051). Simpulan: Tidak terdapat perbedaan bermakna antara jumlah trombosit pada pada DM tipe 2 dengan komplikasi vaskular dan tanpa komplikasi vaskular.Kata kunci: DM tipe 2, komplikasi vaskular, jumlah trombosit


Author(s):  
Krishan Kumar Meena ◽  
Praveen Sharma ◽  
Swati Srivastava ◽  
Uma Kumari Meena

Introduction: Diabetes mellitus (DM) is common metabolic disorder leading to various complications including micro-vascular complication. Diabetes and thyroid dysfunction can result in abnormalities of one another, as both are strongly implicated in cellular metabolism.  Aim of study was to establish any association between hypothyroidism and micro-vascular complications in patients of type 2 DM. Material and Methods: This Hospital based Cross sectional analytical Study was included 80 Euthyroid and 80 hypothyroid patients of type 2 DM. These patients were subjected to fundus examination (for retinopathy), urine for spot albumin and creatinine ratio and routine microscopy (for nephropathy), clinical examination and NCV (for neuropathy). Results: Age of patients ranged from 30 – 80 years. Most patients had duration of Diabetes > 5 years. Diabetic retinopathy was found in 15% Euthyroid and 37.5% Hypothyroid diabetics (p=0.002). Neuropathy was more in Hypothyroid (35%) as compared to Euthyroid (12.5%) patients (p=0.003). Prevalence of Nephropathy was also significantly more (p=0.011) in Hypothyroids (60%) as compared to Euthyroid (38.75%). Conclusion: Significant association was found between hypothyroidism and micro vascular complications in type 2 Diabetes mellitus. Screening of diabetics for thyroid functions is essential to reduce morbidity. Keywords: Diabetes, thyroid, retinopathy, neuropathy, nephropathy


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