scholarly journals Metabolic Consequences of Gestational Cannabinoid Exposure

2021 ◽  
Vol 22 (17) ◽  
pp. 9528
Author(s):  
Kendrick Lee ◽  
Daniel B. Hardy
Keyword(s):  
Indirect Effects ◽  
Fetal Development ◽  
Type Ii Diabetes ◽  
Metabolic Diseases ◽  
Clinical Findings ◽  
Placental Insufficiency ◽  
Type Ii ◽  
Direct Effects ◽  
Increased Risk ◽  
Cannabis Consumption

Up to 20% of pregnant women ages 18–24 consume cannabis during pregnancy. Moreover, clinical studies indicate that cannabis consumption during pregnancy leads to fetal growth restriction (FGR), which is associated with an increased risk of obesity, type II diabetes (T2D), and cardiovascular disease in the offspring. This is of great concern considering that the concentration of Δ9- tetrahydrocannabinol (Δ9-THC), a major psychoactive component of cannabis, has doubled over the last decade and can readily cross the placenta and enter fetal circulation, with the potential to negatively impact fetal development via the endocannabinoid (eCB) system. Cannabis exposure in utero could also lead to FGR via placental insufficiency. In this review, we aim to examine current pre-clinical and clinical findings on the direct effects of exposure to cannabis and its constituents on fetal development as well as indirect effects, namely placental insufficiency, on postnatal metabolic diseases.

scholarly journals Cardiac adipose tissue volume and IL-6 level at admission are complementary predictors of severity and short-term mortality in COVID-19 diabetic patients

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Franck Phan ◽  
Samia Boussouar ◽  
Olivier Lucidarme ◽  
Mohamed Zarai ◽  
Joe-Elie Salem ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Intensive Care ◽  
Interleukin 6 ◽  
Type Ii Diabetes ◽  
Troponin T ◽  
Early Mortality ◽  
Diabetic Patients ◽  
Type Ii ◽  
Short Term ◽  
Increased Risk

Abstract Background COVID-19 diabetic adults are at increased risk of severe forms irrespective of obesity. In patients with type-II diabetes, fat distribution is characterized by visceral and ectopic adipose tissues expansion, resulting in systemic inflammation, which may play a role in driving the COVID-19 cytokine storm. Our aim was to determine if cardiac adipose tissue, combined to interleukin-6 levels, could predict adverse short-term outcomes, death and ICU requirement, in COVID-19 diabetic patients during the 21 days after admission. Methods Eighty one consecutive patients with type-II diabetes admitted for COVID-19 were included. Interleukin-6 measurement and chest computed tomography with total cardiac adipose tissue index (CATi) measurement were performed at admission. The primary outcome was death during the 21 days following admission while intensive care requirement with or without early death (ICU-R) defined the secondary endpoint. Associations of CATi and IL-6 and threshold values to predict the primary and secondary endpoints were determined. Results Of the enrolled patients (median age 66 years [IQR: 59–74]), 73% male, median body mass index (BMI) 27 kg/m2 [IQR: 24–31]) 20 patients had died from COVID-19, 20 required intensive care and 41 were in conventional care at day 21 after admission. Increased CATi and IL-6 levels were both significantly related to increased early mortality (respectively OR = 6.15, p = 0.002; OR = 18.2, p < 0.0001) and ICU-R (respectively OR = 3.27, p = 0.01; OR = 4.86, p = 0.002). These associations remained significant independently of age, sex, BMI as well as troponin-T level and pulmonary lesion extension in CT. We combined CATi and IL-6 levels as a multiplicative interaction score (CATi*IL-6). The cut-point for this score was ≥ 6386 with a sensitivity of 0.90 and a specificity of 0.87 (AUC = 0.88) and an OR of 59.6 for early mortality (p < 0.0001). Conclusions Cardiac adipose tissue index and IL-6 determination at admission could help physicians to better identify diabetic patients with a potentially severe and lethal short term course irrespective of obesity. Diabetic patients with high CATi at admission, a fortiori associated with high IL-6 levels could be a relevant target population to promptly initiate anti-inflammatory therapies.

scholarly journals Longitudinal Associations Between Gait, Falls, and Disability in Community-Dwelling Older Adults With Type II Diabetes Mellitus: Findings From The Irish Longitudinal Study on Ageing (TILDA)

2020 ◽  
Author(s):  
Orna A Donoghue ◽  
Siobhan Leahy ◽  
Rose Anne Kenny
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Type Ii Diabetes ◽  
Step Length ◽  
Community Dwelling ◽  
Type Ii ◽  
Diabetes Status ◽  
Increased Risk ◽  
Community Dwelling Older Adults ◽  
Task Step

Abstract Background Diabetes is associated with gait deficits, future falls, and disability; however, it is unclear if associations remain after controlling for relevant confounders. This study investigated (i) the effects of type II diabetes on spatiotemporal gait parameters in community-dwelling older adults and (ii) if diabetes status was independently associated with future falls and disability, after controlling for gait and other confounders. Method Baseline data were obtained from 2608 community-dwelling adults (≥60 years) participating in The Irish Longitudinal Study on Ageing (TILDA). Diabetes was identified from self-reported doctors’ diagnosis, medications, and glycated hemoglobin levels. Gait characteristics were obtained during single- and dual-task walking using a GAITRite mat (n = 2560). Incident falls and disability were collected over 4 years follow-up (n = 2473). Associations between diabetes status and gait (cross-sectional) and falls and disability (longitudinal) were investigated using regression analysis, adjusting for medications, cardiovascular health, neuropsychological function, and fall-related factors. Results Diabetes (prevalence = 9.1%) was cross-sectionally associated with shorter dual-task step length after adjusting for covariates (β = −1.59, 95% CI: −3.10, −0.08, p &lt; .05). Diabetes was independently associated with increased risk of future instrumental activity of daily living (IADL) difficulty in those with no prior difficulty (incidence rate ratio [IRR] = 1.51, 95% CI: 1.08, 2.11, p &lt; .05) although dual-task step length was an important confounder in all disability models. No independent associations between diabetes and falls were observed. Conclusions Diabetes was independently associated with shorter dual-task step length and increased risk of future IADL difficulty. Multidimensional interventions addressing poor health and function in those with diabetes may help reduce the risk of gait deficits and future disability.

Study of Association between Microalbuminuria and Microvascular Complications in Type II Diabetes Mellitus Patients in RajaRajeswari Medical College and Hospital, Karnataka

2017 ◽  
Vol 3 (1) ◽  
pp. 6-10
Author(s):  
N Bhavya ◽  
V Ajith Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Observational Study ◽  
Type Ii Diabetes ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Duration Of Diabetes ◽  
Medical College ◽  
Increased Risk

ABSTRACT Introduction India is claimed to be the diabetes capital of the world. Many studies had proven that persistent hyperglycemia and associated metabolic syndrome features like hypertension, dyslipidemia, and obesity contribute to the development of vascular complications. The risk of chronic complications increases as a function of the duration of hyperglycemia; they usually become apparent in the second decade of hyperglycemia. Since type II diabetes mellitus (DM) often has a long asymptomatic period of hyperglycemia, many individuals with type II DM have complications at the time of diagnosis. The vascular complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular (coronary artery disease, peripheral arterial disease, cerebro-vascular disease) complications. The present study aims to study the occurrence of microalbuminuria in patients with type II DM and note its association with the duration of diabetes since diagnosis and microvascular complications of DM. Study design Prospective observational study. Materials and methods The study is a clinical, prospective, and observational study of 100 type II diabetics attending the medicine department outpatient/inpatient of RajaRajeswari Medical College & Hospital, Bengaluru, Karnataka, India, who form the subjects for the study conducted from August 2015 to July 2016 (12 months) and who matched the inclusion criteria. Data were collected after obtaining informed/written consent from patient. After detailed history, detailed clinical examination, and general physical and systemic examinations, fundoscopy was carried out and relevant laboratory investigations were done. Results and conclusion The overall occurrence of microalbuminuria was 38%. The occurrence of microalbuminuria showed a direct relationship with increasing age (p = 0.053) and increasing duration of diabetes since diagnosis. A hemoglobin (Hb)A1c value above 7% is associated with 50% or higher incidence of microalbuminuria (p = 0.018). Patients with a body mass index of more than 25kg/m2 have increased risk of developing type II DM and significant increase in microalbuminuria. The incidence of microalbuminuria is significantly associated with How to cite this article Bhavya N, Kumar VA. A Study of Association between Microalbuminuria and Microvascular Complications in Type II Diabetes Mellitus Patients in RajaRajeswari Medical College and Hospital, Karnataka. J Med Sci 2017;3(1):6-10.

Is Type II Diabetes Associated With an Increased Risk of Cognitive Dysfunction?: A critical review of published studies

Diabetes Care ◽  
1997 ◽  
Vol 20 (3) ◽  
pp. 438-445 ◽  
Author(s):  
M. W. J. Strachan ◽  
I. J. Deary ◽  
F. M. E. Ewing ◽  
B. M. Frier
Keyword(s):  
Cognitive Dysfunction ◽  
Critical Review ◽  
Type Ii Diabetes ◽  
Type Ii ◽  
Increased Risk

Indirect Effects of Cytomegalovirus Infection

2009 ◽  
Vol 03 (01) ◽  
pp. 41 ◽  
Author(s):  
Götz Ulrich Grigoleit ◽  
Markus Kapp ◽  
Hermann Einsele ◽  
◽  
◽  
...  
Keyword(s):  
Indirect Effects ◽  
Opportunistic Infections ◽  
Organ Transplant ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Haematopoietic Stem Cell ◽  
Solid Organ ◽  
Direct Effects ◽  
Cmv Infection ◽  
Increased Risk

Primary cytomegalovirus (CMV) infection often presents as an asymptomatic self-limiting disease in immunocompetent individuals and is followed by latent persistence in different host tissues. However, solid organ transplant (SOT) recipients and patients undergoing allogeneic haematopoietic stem cell transplantation (alloHSCT) are at risk of life-threatening complications caused by CMV infection. Direct effects (or CMV disease) are marked by viral proliferation in a variety of tissues and organs. Clinical manifestations that are observed after SOT and alloHSCT are gastroenteritis, pneumonitis, hepatitis, uveitis, retinitis, encephalitis and graft rejection. In contrast to the direct effects, indirect effects are a consequence of the maintenance of persistent low-level viral replication and have been associated with an increased risk of rejection and graft dysfunction, graft-versus-host disease, accelerated atherosclerosis, opportunistic infections, malignancies, posttransplant diabetes and Guillain-Barré syndrome. This article aims to summarise these indirect effects of CMV, their possible causes and possible treatment strategies.

scholarly journals Gestational Diabetes Mellitus and Macrosomia: A Literature Review

2015 ◽  
Vol 66 (Suppl. 2) ◽  
pp. 14-20 ◽  
Author(s):  
Kamana KC ◽  
Sumisti Shakya ◽  
Hua Zhang
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Neonatal Intensive Care ◽  
Fetal Macrosomia ◽  
Large For Gestational Age ◽  
Type Ii ◽  
Increased Risk ◽  
The Impact

Background: Fetal macrosomia, defined as a birth weight ≥4,000 g, may affect 12% of newborns of normal women and 15-45% of newborns of women with gestational diabetes mellitus (GDM). The increased risk of macrosomia in GDM is mainly due to the increased insulin resistance of the mother. In GDM, a higher amount of blood glucose passes through the placenta into the fetal circulation. As a result, extra glucose in the fetus is stored as body fat causing macrosomia, which is also called ‘large for gestational age'. This paper reviews studies that explored the impact of GDM and fetal macrosomia as well as macrosomia-related complications on birth outcomes and offers an evaluation of maternal and fetal health. Summary: Fetal macrosomia is a common adverse infant outcome of GDM if unrecognized and untreated in time. For the infant, macrosomia increases the risk of shoulder dystocia, clavicle fractures and brachial plexus injury and increases the rate of admissions to the neonatal intensive care unit. For the mother, the risks associated with macrosomia are cesarean delivery, postpartum hemorrhage and vaginal lacerations. Infants of women with GDM are at an increased risk of becoming overweight or obese at a young age (during adolescence) and are more likely to develop type II diabetes later in life. Besides, the findings of several studies that epigenetic alterations of different genes of the fetus of a GDM mother in utero could result in the transgenerational transmission of GDM and type II diabetes are of concern.

Triacylglycerol-rich lipoproteins alter the secretion, and the cholesterol-effluxing function, of apolipoprotein E-containing lipoprotein particles from human (THP-1) macrophages

2001 ◽  
Vol 356 (2) ◽  
pp. 515-523 ◽  
Author(s):  
E. Marie LINDHOLM ◽  
Anna M. PALMER ◽  
Annette GRAHAM
Keyword(s):  
Apolipoprotein E ◽  
Type Ii Diabetes ◽  
Cholesterol Efflux ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cholesterol Content ◽  
Type Ii ◽  
Increased Risk ◽  
Triacylglycerol Accumulation ◽  
Dose Dependent

Elevated plasma levels of triacylglycerol-rich lipoproteins (TGRLP) are associated with increased risk of atherogenesis and abnormal reverse cholesterol transport, as illustrated in Type II diabetes. Here we examine the effect of plasma triacylglycerol-rich or cholesteryl ester-rich lipoproteins on the secretion of nascent apolipoprotein E (apoE)-containing lipoprotein E (LpE) particles by human (THP-1) macrophages. As expected, preincubation with low-density lipoprotein (LDL) yielded small but significant increases in total cellular cholesterol content and also the secretion of apoE by macrophages. By contrast, preincubation with TGRLP resulted in higher, dose-dependent, increases in apoE secretion that reflected, but were not dependent on, cellular triacylglycerol accumulation. Secreted apoE was incorporated into a pre-β migrating LpE fraction that differed in lipid composition and flotation density depending on preincubation conditions. Specifically, the LpE-containing lipoprotein fraction produced by macrophages preincubated with TGRLP was cholesterol-poor, markedly heterogeneous and of higher peak flotation density (d 1.14–1.18) when compared with particles produced after preincubation with LDL. Both the conditioned medium and the isolated (d < 1.21) LpE-containing fraction, yielded by macrophages preincubated with TGRLP, seemed poorer at inducing cholesterol efflux than the equivalent fractions from cells preincubated with LDL, as judged by [3H]cholesterol efflux from untreated ‘naïve’ macrophages. Thus, although the interaction of TGRLP with macrophages can enhance apoE output from these cells, the LpE particles produced seem to be relatively inefficient mediators of cholesterol efflux. These factors might contribute to the increased risk of atherosclerosis in individuals with Type II diabetes.

Diastolic dysfunction is associated with anaemia in patients with Type II diabetes

2005 ◽  
Vol 110 (1) ◽  
pp. 109-116 ◽  
Author(s):  
Piyush M. Srivastava ◽  
Merlin C. Thomas ◽  
Paul Calafiore ◽  
Richard J. MacIsaac ◽  
George Jerums ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Cardiac Dysfunction ◽  
Type Ii Diabetes ◽  
Systolic Dysfunction ◽  
Cardiac Risk ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Type Ii ◽  
Increased Risk ◽  
Patients With Diabetes

Anaemia is common in patients with diabetes and associated with an increased risk of diabetic complications. Although the role of anaemia in heart failure is established, we hypothesize that anaemia also contributes to an increased risk of cardiac dysfunction in patients with Type II diabetes. In the present study, 228 consecutive adults with diabetes were investigated using transthoracic echocardiography. Echocardiographic parameters were correlated with the Hb (haemoglobin) level and adjusted for other risk factors for cardiac dysfunction using multivariate analysis. More than one in five patients (23%) had anaemia, which was an independent risk factor for cardiac dysfunction on echocardiography. Over one-third of all patients with evidence of abnormal cardiac function (diastolic and/or systolic dysfunction) on echocardiography had anaemia compared with <5% of patients with normal echocardiographic findings. Most patients with anaemia had cardiac dysfunction (94%), with the major abnormality being diastolic dysfunction associated with an increased left ventricular mass and impaired relaxation indices. A continuous association between diastolic function and Hb was also observed in patients without anaemia. In patients with a history of cardiovascular disease, systolic dysfunction was twice as common in patients with anaemia. Anaemia was also correlated with plasma markers of cardiac risk, including BNP (brain natriuretic peptide), CRP (C-reactive protein) and AVP (arginine vasopressin). Notably, the predictive utility of these markers was eliminated after adjusting for Hb. Consequently, the inexpensive measurement of Hb may be a useful tool to identify diabetic patients at increased risk of cardiac dysfunction.

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