scholarly journals Endocrine Regulator rFGF21 (Recombinant Human Fibroblast Growth Factor 21) Improves Neurological Outcomes Following Focal Ischemic Stroke of Type 2 Diabetes Mellitus Male Mice

Stroke ◽  
2018 ◽  
Vol 49 (12) ◽  
pp. 3039-3049 ◽  
Author(s):  
Yinghua Jiang ◽  
Ning Liu ◽  
Qingzhi Wang ◽  
Zhanyang Yu ◽  
Li Lin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ischemic Stroke ◽  
White Matter ◽  
Brain Infarction ◽  
White Matter Integrity ◽  
Fibroblast Growth Factor 21 ◽  
Neurological Outcomes

Background and Purpose— The complexity and heterogeneity of stroke, as well as the associated comorbidities, may render neuroprotective drugs less efficacious in clinical practice. Therefore, the development of targeted therapies to specific patient subsets has become a high priority in translational stroke research. Ischemic stroke with type 2 diabetes mellitus has a nearly double mortality rate and worse neurological outcomes. In the present study, we tested our hypothesis that rFGF21 (recombinant human fibroblast growth factor 21) administration is beneficial for improving neurological outcomes of ischemic stroke with type 2 diabetes mellitus. Methods— Type 2 diabetes mellitus db/db and nondiabetic genetic control db/+ mice were subjected into permanent focal ischemia of distal middle cerebral artery occlusion, we examined the effects of poststroke administration with rFGF21 in systemic metabolic disorders, inflammatory gatekeeper PPARγ (peroxisome proliferator-activated receptor γ) activity at 3 days, mRNA expression of inflammatory cytokines and microglia/macrophage activation at 7 days in the perilesion cortex, and last neurological function deficits, ischemic brain infarction, and white matter integrity up to 14 days after stroke of db/db mice. Results— After permanent focal ischemia, diabetic db/db mice presented confounding pathological features, including metabolic dysregulation, more severe brain damage, and neurological impairment, especially aggravated proinflammatory response and white matter integrity loss. However, daily rFGF21 treatment initiated at 6 hours after stroke for 14 days significantly normalized systemic metabolic disorders, rescued PPARγ activity decline, inhibited proinflammatory cytokine mRNA expression, and M1-like microglia/macrophage activation in the brain. Importantly, rFGF21 also significantly reduced white matter integrity loss, ischemic brain infarction, and neurological function deficits up to 14 days after stroke. The potential mechanisms of rFGF21 may in part consist of potent systematic metabolic regulation and PPARγ-activation promotion-associated antiproinflammatory roles in the brain. Conclusions— Taken together, these results suggest rFGF21 might be a novel and potent candidate of the disease-modifying strategy for treating ischemic stroke with type 2 diabetes mellitus.

scholarly journals Pengaruh Simvastatin Terhadap Ketebalan Intima-Media Karotis Pada Pasien Stroke Iskemik Dengan Diabetes Mellitus Tipe 2

2019 ◽  
Vol 6 (1) ◽  
pp. 20-23
Author(s):  
Aditya Kurnianto ◽  
Dodik Tugaswowo Pramukarso
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
T Test ◽  
Stroke Patients ◽  
Media Thickness

BACKGROUND :Ischemic stroke is the most common stroke comprising 70-80% of all cases. Carotid intima-media thickness (CIMT) is associated with the occurrence of stroke in older age and adults. Patients with type 2 diabetes mellitus tend to develop a thickening of intima-media carotid artery. Simvastatins inhibit further atherothrombotic process. OBJECTIVE : To analyze the effect of simvastatin for CIMT in ischemic stroke patient with type 2 diabetes mellitus. METHOD : This study was a Randomized Pretest-Posttest Design and conducted at the Hospital Inpatient Ward Dr. Kariadi and Ketileng Semarang from January to December 2014 for all first ischemic stroke patients with Type 2 Diabetes Mellitus. Subjects were divided into groups of 26 controls and 28 patients treated groups. Treatment group were given simvastatin 20 mg each daily for 24 weeks in 28 subjects with a history of acute ischemic stroke and type 2 Diabetes mellitus. Examine the CIMT at the 1st week and 24th week. The normality of the data were tested using Shapiro Wilk and the differences analyzed by using Paired t-test and independent t test. RESULT : There was a significant differences between delta carotid intima-media thickness on administration of simvastatin for ischemic stroke patients with type 2 diabetes mellitus (p=0,008). CONCLUSION : Simvastatin significantly decreases CIMT on ischemic stroke patients with type 2 diabetes mellitus. Keyword : simvastatin, ischemic stroke, carotid intima-media thickness, type 2 diabetes mellitus   LATAR BELAKANG :Stroke iskemik memiliki angka insidensi terbanyak yaitu 70-80% kasus stroke. Ketebalan Intima-media karotis berhubungan dengan terjadinyastroke pada usia tua.Pasien dengan Diabetes mellitus tipe 2 memiliki kemungkinan yang lebih besar mengalami penebalan intima-media carotis. Simvatatin menghambat proses aterotrombosis. TUJUAN :Untuk menganalisis pengaruh simvastatin terhadap ketebalan intima-media karotis pada pasien stroke iskemik dengan diabetes mellitus tipe 2. METODE :Penelitian ini adalah dengan Randomized Pretest-Posttest Design dan telah dilakukan di Rawat Jalan RSUP dr. Kariadi dan poli saraf rawat jalan RSUD Kota Semarang mulai Januari sampai dengan Desember 2014 untuk semua pasien stroke iskemik pertama kali dengan diabetes mellitus tipe 2. Subjek dibagi menjadi kelompok kontrol 26 pasien dan kelompok perlakuan 28 pasien. Kelompok perlakuan diberi simvastatin 20 mg sehari selama 24 minggu pada 28 subjek stroke iskemik dengan  diabetes mellitus tipe 2. Pemeriksaan ketebalan intima-media karotis dilakukan pada minggu ke-1 dan minggu ke-24. Data kemudian di uji normalitasnya menggunakan Saphiro wilk, lalu di analisis menggunakan uji beda paired t testdan independent t test. HASIL :  Kelompok perlakuan didapatkan penurunan ketebalan tunika intima arteri karotis (0,395 + 0,46; p=0,514), KESIMPULAN : Pemberian simvastatin menurunkan ketebalan intima-media karotis secara bermakna pada pasien stroke iskemik dengan diabetes mellitus tipe 2. Kata Kunci     :simvastatin,stroke iskemik, ketebalan intima-media karotis, diabetes mellitus tipe 2      

Predictors of Recurrent Ischemic Stroke in Obese Patients With Type 2 Diabetes Mellitus: A Population-based Study

2020 ◽  
Vol 29 (10) ◽  
pp. 105173
Author(s):  
Orwa Albitar ◽  
Sabariah Noor Harun ◽  
Nur Ezzati Abidin ◽  
Balamurugan Tangiisuran ◽  
Hadzliana Zainal ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Population Based ◽  
Obese Patients ◽  
Population Based Study

scholarly journals Altered Hippocampal White Matter Connectivity in Type 2 Diabetes Mellitus and Memory Decrements

2016 ◽  
Vol 28 (3) ◽  
Author(s):  
F. C. G. van Bussel ◽  
W. H. Backes ◽  
P. A. M. Hofman ◽  
M. P. J. van Boxtel ◽  
M. T. Schram ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
White Matter ◽  
White Matter Connectivity

scholarly journals Association of Fibroblast Growth Factor 21 with Lipid Profile, MDA and AOPP in Patients with Type 2 Diabetes Mellitus

2021 ◽  
pp. 179-186
Author(s):  
P. Divya ◽  
R. Inmozhi Sivakamasundari ◽  
T. K. Jithesh ◽  
K. Santha ◽  
K. Shifa ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Growth Factor ◽  
Lipid Profile ◽  
Fibroblast Growth Factor 21 ◽  
Diabetic Patients ◽  
Fibroblast Growth

Background: Diabetes mellitus is rising all over the world due to population growth, aging, urbanisation, and the increase of obesity due to physical inactivity, characterized by persistent high blood glucose levels associated with aberrations in lipid, carbohydrate, and protein metabolisms leading to water and electrolyte imbalance. Cardiovascular diseases are the leading causes of mortality in diabetic patients. Mechanisms such as oxidative stress, lipid metabolism imbalance, as well as myocardial cell apoptosis are key factors to facilitate the progression of Diabetic cardiomyopathy. Aim: The aim of this study was to assess FGF-21 levels and their association with lipid profile parameters and oxidative stress in patients with type 2 diabetes mellitus. Methods: A patient based cross-sectional study was conducted among the subjects with history of type 2 DM for the past 10 years. Results: Variations in FBS, T.C, TG, LDL, HDL, VLDL, FGF-21, MDA and AOPP levels among cases and controls were depicted in Table 2. There was an increase in all these parameters in cases compared to controls whereas HDL showed a decrease among cases. Conclusion: Our study concluded that there is a significant correlation between fibroblast growth factor 21 (FGF-21), oxidative stress, and abnormal lipid profile in type 2 diabetic patients. We would recommend further studies to explore the role of FGF21 as an important marker in predicting cardiovascular risk in diabetic patients.

scholarly journals Assessment of Brain Lesions in Type 2 Diabetes Mellitus and Hypertension using Magnetic Resonance imaging

2020 ◽  
Vol 10 (4) ◽  
pp. 382-386
Author(s):  
Qurain Alshammari ◽  
Mohammed Salih ◽  
Moawia Gameraddin ◽  
Bushra Abdelmalik ◽  
Sultan Alshoabi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Brain Infarction ◽  
Brain Lesions ◽  
Resonance Imaging ◽  
Ischemic Brain ◽  
Ischemic Brain Infarction

Background: Type 2 diabetes mellitus (T2DM) and hypertension (HTN) are risk factors for the spectrum of brain lesions. In this paper, we studied the impact of T2DM and HTN on the incidence of several brain lesions diagnosed with magnetic resonance imaging (MRI). Methods and Results: This retrospective, single-center study was conducted at Royal Care International Hospital (Khartoum, Sudan) from January 2016 to December 2016 and included 80 patients (40 male and 40 female, aged between 20 years and 90 years) with suspected brain disorders. MRI brain examinations were conducted on a 1.5 Tesla MRI system (Toshiba Medical Systems, Tokyo, Japan). The following sequences were analyzed: T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid-attenuated inversion recovery (FLAIR), and diffusion-weighted imaging (DWI). Brain lesions were characterized by magnetic imaging spectroscopy and histopathological analysis. Binary logistic regression analysis was used to establish a mathematical model of the relationship between T2DM/HTN and the prevalence of brain lesions. Among 80 patients, HTN, T2D, and the combination of T2D and HTN were identified in 18(22.5%), 9(11.2%), and 11(13.8%) patients, respectively. Brain lesions were found in 48(60%) patients and were most prevalent in the age group of 66-80 years. The brain lesions included ischemic brain infarction (IBI) (22.5%), brain tumors (11.2%), cerebral hemorrhages (6.2%), brain atrophy (BA) (1.2 %), IBI with BA (16.2%), and brain metastases (2.5%). Regression analysis showed that HTN and T2DM were associated with significantly higher ORs for brain lesions ([OR=2.459, 95% CI: 1.673–3.614, P<0.001] and [OR=1.507, 95% CI: 1.067–2.128, P= 0.042], and [OR=1.078, 95% CI:1.033–1.124, P=0.001], respectively). HTN was associated with significantly higher OR for ischemic brain infarction (OR=7.404, 95% CI: 2.600–21.081, P<0.001). Conclusion: The study showed a significant interaction between HTN and T2DM on the prevalence of brain lesions, especially ischemic brain infarction and brain atrophy.

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