scholarly journals Quantitative Color Fundus Autofluorescence in Patients with Diabetes Mellitus

2020 ◽  
Vol 10 (1) ◽  
pp. 48
Author(s):  
Stela Vujosevic ◽  
Caterina Toma ◽  
Paolo Nucci ◽  
Marco Brambilla ◽  
Stefano De Cillà
Keyword(s):  
Diabetes Mellitus ◽  
Retinal Thickness ◽  
Fundus Autofluorescence ◽  
Retinal Disease ◽  
Metabolic Evaluation ◽  
Glycation End Products ◽  
Custom Software ◽  
Patients With Diabetes ◽  
Immunohistochemical Studies ◽  
Present Pilot Study

A new short wavelength confocal blue-light 450 nm-fundus autofluorescence (color-FAF) allows for visualization of minor fluorophores (e.g., advanced glycation end products, AGEs), besides lipofuscin. The aim of the present pilot study was to quantitatively evaluate color-FAF in patients with diabetes mellitus (DM) and to correlate these data with different stages of retinal disease severity. Optical coherence tomography and color-FAF images of 193 patients/eyes and 18 controls were analyzed using a custom software for quantification of the long (red) and short (green) wavelength components of the emission spectrum (REFC/GEFC). Measurements were performed in nine quadrants of the 6-mm ETDRS macular grid. Foveal GEFC and REFC intensities were higher in patients with DM compared to controls (p = 0.015 and p = 0.006 respectively) and in eyes with center involving diabetic macular edema (DME) compared to eyes without DME (p < 0.001). A positive correlation was found between GEFC and REFC intensities and central retinal thickness, r = 0.37 (p < 0.001) and r = 0.42 (p < 0.001), respectively. No differences were found in color-FAF among different DR severity groups. Quantitative color-FAF could become helpful for the metabolic evaluation of retina in patients with DM and in DME; however, further histologic and immunohistochemical studies on distribution of different retinal fluorophores in DM are needed to better understand its role.

scholarly journals Early Detection of Microvascular Changes in Patients with Diabetes Mellitus without and with Diabetic Retinopathy: Comparison between Different Swept-Source OCT-A Instruments

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Stela Vujosevic ◽  
Caterina Toma ◽  
Edoardo Villani ◽  
Valentina Gatti ◽  
Marco Brambilla ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Group Versus ◽  
Retinal Disease ◽  
Control Group ◽  
Microvascular Damage ◽  
Swept Source ◽  
Microvascular Changes ◽  
Circularity Index ◽  
Patients With Diabetes ◽  
Perfusion Density

Optical coherence tomography angiography (OCT-A) has recently improved the ability to detect subclinical and early clinically visible microvascular changes occurring in patients with diabetes mellitus (DM). The aim of the present study is to evaluate and compare early quantitative changes of macular perfusion parameters in patients with DM without DR and with mild nonproliferative DR (NPDR) evaluated by two different swept-source (SS) OCT-A instruments using two scan protocols (3×3 mm and 6×6 mm). One hundred eleven subjects/eyes were prospectively evaluated: 18 healthy controls (control group), 73 eyes with DM but no DR (no-DR group), and 20 eyes with mild NPDR (DR group). All quantitative analyses were performed using ImageJ and included vessel and perfusion density, area and circularity index of the FAZ, and vascular complexity parameters. The agreement between methods was assessed according to the method of Bland-Altman. A significant decrease in the majority of the considered parameters was found in the DR group versus the controls with both instruments. The results of Bland-Altman analysis showed the presence of a systemic bias between the two instruments with PLEX Elite providing higher values for the majority of the tested parameters when considering 6×6 mm angiocubes and a less definite difference in 3×3 mm angiocubes. In conclusion, this study documents early microvascular changes occurring in the macular region of patients at initial stages of DR, confirmed with both SS OCT-A instruments. The fact that early microvascular alterations could not be detected with one instrument does not necessarily mean that these alterations are not actually present, but this could be an intrinsic limitation of the device itself. Further, larger longitudinal studies are needed to better understand microvascular damage at very early stages of diabetic retinal disease and to define the strengths and weaknesses of different OCT-A devices.

scholarly journals Leptin and leptin receptor evaluation in atherosclerotic plaques in patients with type 2 diabetes mellitus

2021 ◽  
Vol 93 (10) ◽  
pp. 1186-1192
Author(s):  
Diana A. Dimitrova ◽  
Ilya A. Mikhailov ◽  
Konstantin Yu. Tokarev ◽  
Marina S. Michurova ◽  
Anna M. Gorbacheva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Atherosclerotic Plaque ◽  
Leptin Receptor ◽  
Atherosclerotic Plaques ◽  
Aortofemoral Bypass ◽  
Leptin Receptors ◽  
Number Of Patients ◽  
Patients With Diabetes ◽  
Local Inflammatory Reaction ◽  
Immunohistochemical Studies

Background. Diabetes mellitus (DM) is a significant predictor of atherosclerosis, cardiovascular disease, and cardiovascular mortality. It is known that atherosclerosis occurs earlier in patients with diabetes, reducing the duration of their life. Leptin as well as other inflammatory markers can contribute to the progression of atherosclerosis in patients with DM, participate in the development of a local inflammatory reaction. Aim. Determine the cells immunophenotype of atherosclerotic plaques in patients with diabetes. Materials and methods. We analyzed 24 patients (20 men and 4 women), who underwent aortofemoral bypass, femoral-tibial bypass or carotid endarterectomy. During the operation, a fragment of the arterial wall with an atherosclerotic plaque was obtained for further immunohistochemical studies. Five histologic plaque characteristics (CD68+, -SMA, CD34, leptin and leptin receptor) were compared. Results. No difference in the expression of CD68 (p=0.922), -SMA (p=0.192), CD34 (p=0.858), leptin receptor (p=0.741) and leptin (p=0.610) in atherosclerotic plaques were observed between patients with and without DM. The lack of significant differences between the two groups was possibly due to the small number of observations with DM. In particular, when assessing the expression of selected markers in atherosclerotic plaques, patients with DM showed significantly more leptin receptors than patients without DM (2160.716 and 1205.88 respectively); and also significantly less CD68+ (0.39 and 0.98 respectively) and -SMA+ (6.5 and 13.5 respectively). Conclusion. Based on the expression of CD68, -SMA, CD34, leptin receptor and leptin, no significant differences were observed in atherosclerotic plaque between patients with and without DM. At the same time, despite the limitations of the study (a small number of patients, moderate severity of DM, elderly patients in the DM group), we found a tendency in the increased number of leptin receptors and a decreased number of -SMA+, CD68+ in DM atherosclerotic plaques. Further study needed, taking into account the limitations of this work.

Autophagy: a two-edged sword in diabetes mellitus

2013 ◽  
Vol 456 (3) ◽  
pp. e1-e3 ◽  
Author(s):  
Suguru Yamamoto ◽  
Junichiro J. Kazama ◽  
Masafumi Fukagawa
Keyword(s):  
Diabetes Mellitus ◽  
Disease Stage ◽  
Osteoblastic Cell ◽  
Cellular Functions ◽  
Systemic Complications ◽  
Beneficial Effects ◽  
Biochemical Journal ◽  
Glycation End Products ◽  
Patients With Diabetes ◽  
Prevention Of Diabetes

A fragility fracture is a serious complication in patients with diabetes mellitus as a result of hyperglycaemia, insulin resistance and the production of AGEs (advanced glycation end-products). In their paper published in the Biochemical Journal, Bartolomé et al. identified a role for autophagy in the differentiation, function and survival of osteoblastic cells in a high-glucose environment, and they also demonstrated that osteoblastic cell survival was limited by chemical and genetic inhibition of autophagy. These novel findings show the possibility of investigating a therapeutic strategy of maintaining autophagy in osteoblasts to lead to the prevention of diabetes-related osteopaenia. Autophagy is one of the common functions for maintaining cellular health, and the regulation of autophagy that is perturbed by diabetes mellitus may induce improvement of cellular functions not only for diabetes-related osteopaenia, but also for other systemic complications. However, systemic activation of autophagy may not always induce beneficial effects for non-targeted healthy cells, and autophagy should be controlled at a proper level at each disease stage in each target organ.

scholarly journals The role of glycation end products in the development and progression of diabetic neuroarthropathy

2021 ◽  
Vol 67 (3) ◽  
pp. 4-9
Author(s):  
M. M. Kalandiya ◽  
A. Yu. Tokmakova ◽  
G. R. Galstyan
Keyword(s):  
Diabetes Mellitus ◽  
Enzymatic Reaction ◽  
Oxidation Products ◽  
Glycation End Products ◽  
End Products ◽  
Patients With Diabetes ◽  
Exogenous Factors ◽  
Prolonged Heat ◽  
Prolonged Heat Treatment

Diabetic neuroarthropathy (DNOAP, Charcot’s foot) is a serious complication of diabetes mellitus, the genesis of which is not fully understood. In most cases, this pathology is diagnosed late, which leads to the development of severe deformities of the foot, up to the loss of support ability of the limb. There is no single hypothesis for the formation of Charcot’s foot, but there are factors predisposing to its development, as well as a few likely provoking events. Excessive formation and accumulation of end products of glycation may play an important role in the pathogenesis of this complication of diabetes. End products of glycation (AGE) are a variety of compounds formed as a result of a non-enzymatic reaction between carbohydrates and free amino groups of proteins, lipids and nucleic acids. There are various factors that lead to the accumulation of AGE in the human body. Allocate endogenous and exogenous factors. The former include certain diseases, such as diabetes mellitus, renal failure, which accelerate glycation processes. Exogenous factors leading to the formation of lipo-oxidation and glyco-oxidation products include tobacco smoke and prolonged heat treatment of food.This review provides information on the role of glycation end products in the development and progression of complications in patients with diabetes mellitus.

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