Red Blood Cells Aggregation in the Patients with Type 2 Diabetes and T2D Associated Anemia, a Case Control Study in Bangladesh

Background and Aims: Type 2 Diabetes (T2D) is a chronic metabolic disorder. Nowadays the number of people with diabetes mellitus is quadrupling in the world as well as in Bangladesh. It is related to different types of disease morbidity and sociodemographic parameters. The present study aimed to investigate the association of RBC aggregation (measured by ESR level) with T2D and T2D associated anemia. Material and method: A total of 234 subjects were included in the study. Sociodemographic and anthropometric information about study subjects were collected using a standard questionnaire. Blood samples were tested for random blood glucose levels, Hb percentage, and ESR. Association of these data with metabolic disorders was analyzed by statistical analysis software, SPSS. Results: This study provides a piece of evidence that anemia is highly prevalent in T2D patients than the healthy control subjects in Bangladesh (59.1% vs 22.5%; P value <0.001). The ESR values were significantly elevated in T2D patients as well as anemic and aged subjects (P value <0.001). Conclusion: The study thus suggests that anemia was prevalent in T2D patients in Bangladesh. The RBC aggregation was significantly elevated in patients with T2D as well as anemia, indicating increased inflammatory response in these diseases.

The Usage of Lasso, Ridge, and Linear Regression to Explore the Most Influential Metabolic Variables that Affect Fasting Blood Sugar in Type 2 Diabetes Patients

Background and aims: To explore the most influential variables of fasting blood sugar (FBS) with three regression methods, to identify the existence chance of type 2 diabetes based on influential variables with logistic regression (LR), and to compare the three regression methods according to Mean Squared Error (MSE) value. Material and Methods: In this cross-sectional study, 270 patients suffering from type 2 diabetes for at least 6 months and 380 healthy people were participated. The Linear regression, Ridge regression, and Least Absolute Shrinkage and Selection Operator (Lasso) regression were used to find influential variables for FBS. Results: Among 15 variables (8 metabolic, 7 characteristic), Lasso regression selected HbA1c, Urea, age, BMI, heredity, and gender, Ridge regression selected HbA1c, heredity, gender, smoking status, and drug use, and Linear regression selected HbA1c as the most effective predictors for FBS. Conclusion: HbA1c is the most influential predictor of FBS among 15 variables according to the result of three regression methods. Controlling the variation of HbA1c leads to a more stable FBS. Beside FBS that should be checked before breakfast, maybe HbA1c could be helpful in diagnosis of Type 2 diabetes.

Beneficial Effect of Pachyrhizus erosus Fiber as a Supplemental Diet to Counteract High Sugar-Induced Fatty Liver Disease in Mice

Background and aims: Edible fiber isolated from the tuber of yam bean (Pachyrhizus erosus, Leguminosae) has been suggested to prevent the development of metabolic diseases caused by excessively consuming sugary foods. However, it is unclarified whether P. erosus fiber (PEF) is also capable of preventing liver diseases. This study aimed to determine the effectivity of PEF in counteracting the development of non-alcoholic fatty liver disease (NAFLD) caused by excessive intake of high-sugar diet (HSD). Material and method: 25% of PEF in HSD (w/w) was fed in BALB/c mice for eight weeks followed by subsequent morphological and histological examinations of the liver at the end of treatment in comparing with HSD alone. Results: We found that supplementation of 25% PEF sustained the normal morphological feature of the liver in HSD-fed mice. Moreover, PEF also prevented the development of microvesicles in the liver tissue, nuclear shrinkage, and hepatolysis as indicators of liver disease. Macrophages infiltration as a marker of liver inflammation was also less observed in PEF-treated mice. Conclusions: PEF could effectively elicit a beneficial effect against NAFLD caused by HSD. Hence, PEF is suggested to be used as a potent supplemental diet to preclude the metabolic diseases caused by HSD.

Assessment of Common Risk Factors and Lifestyle Habits Associated with Atherogenic Risk and Lipid-Lowering Therapy in Men with Type 2 Diabetes

Background and aims: Our objective was to determine common risk factors and lifestyle habits associated with atherogenic risk and with the use of lipid-lowering therapy in men with type 2 diabetes. Material and Methods: A comparative cross-sectional study was performed in the northwestern Algeria during eleven months on adult men patients with type 2 diabetes. Anthropometric parameters, blood pressures and lipid profile were evaluated. Data of common risk factors and lifestyle habits associated to atherosclerosis were compared between two groups according to the lipid lowering therapy use based on statins. Results: 147 adult men patients with type 2 diabetes were involved in the study, 68 (46.26%) were under statins therapy and 79 (53.74%) were not. Significant associations with statins use were observed regarding the age group of 61-70 years (OR: 0.156 [0.043-0.570]; p=0.005), a salary of less than 30000 Algerian dinars (≈250.60$) (OR: 5.758 [1.299-25.512]; p=0.021), age of diabetes of 2-3 years (OR: 0.105 [0.013-0.867]; p=0.036) as well as with lipid ratios and body mass index (BMI). However, no significant associations were noted regarding the other studied parameters (marital status, educational level, occupation, salary, and family history, smoking status, alcohol consumption and sports practices) with lipid lowering therapy. Conclusion: Age of patients, diabetes duration, lipid ratios and the low income of patients are the strongest factors associated with the use of lipid lowering therapy (statins). However, largest longitudinal studies are needed to determine whether modifiable lifestyle habits could influence the lipid lowering therapies prescription in diabetic patients over time.

The Antiglycation Effect of Monomethyl Branched Chained Fatty Acid and Phytochemical Compounds and their Synergistic Effect on Obesity Related Colorectal Cancer Cell Panel

Background and aims: monomethyl branched chain fatty acids (mmBCFA) and phytochemicals including: Hydroxycitric Acid, Chlorogenic Acid and Piperine have been considered as an interesting agent for researches due to their role in diabetes and cancer. The present study examines the antiglycation effect of mmBCFA and phytochemicals and investigate their Synergistic effect on different colorectal cancer cell lines. Methods: This study was carried out by using murine monocyte-macrophage cell line and Methylglyoxal (MGO) to enhance the glycation process, furthermore to examine the antiproliferative effect of both the mmBCFA and phytochemicals we use Sulforhodamine B (SRB) assay against obesity related-colorectal cancer cell line panel. Results: Both phytochemicals and mmBCFA have a higher antiglycation effect than Aminoguanidine (AMG) significantly, moreover, all of the phytochemicals and mmBCFA have antiproliferative against SW620, CACO2 and SW480, nevertheless none of these agents was equipotent to Cisplatin, furthermore, the synergetic effect observed only when we co-incubate Piperine with mmBCFA. Conclusions: phytochemicals such as Hydroxycitric Acid, Chlorogenic Acid and Piperine and mmBCFA could be used as treatment to prevents the accumulation of advanced glycation end-products (AGEs) in diabetes. Furthermore, the co-incubation between these compounds can inhibit cancer growth, as alternative therapeutic strategy against obesity related-colorectal cancer.

Comparison of Efficacy of Nortriptyline Versus Transcutaneous Electrical Nerve Stimulation on Painful Peripheral Neuropathy in Patients with Diabetes

Background and aims: Diabetic peripheral neuropathic pain (DPNP) is one of the most common complications of diabetes and is difficult to treat. Existing treatments are often inadequate at controlling pain and limited by side-effects and drug tolerance. This study assessed the efficacy of nortriptyline versus Transcutaneous Electrical Nerve Stimulation (TENS) in patients with DPNP. Material and method: This is a randomized clinical trial study conducted on 39 patients with DPNP referring to Golestan Hospital in Ahvaz in 2017. Patients were randomly treated with TENS (18 sessions, each session 30 minutes; n=20) or nortriptyline (25 to 75 mg, once daily; n=19) for 6 weeks. Patients were evaluated for side effects and pain relief using visual analog scale (VAS). Results: There was a significant improvement in pain with both treatments compared with baseline (p˂0.001). The patients in nortriptyline group experienced more pain relief (7.21±1.51 to 0.84±1.34) than the TENS group (7.6±1.47 to 2.75 ±2.43) (P=0.001). The 50% pain relief was observed in 14 patients (73%) in nortriptyline group, 6 patients (30%) in TENS group. Moreover, the side effects were seen in 15% of TENS and 55% of patients in nortriptyline groups (P=0.019). Conclusion: Both TENS and nortriptyline were effective and safe in the management of DPNP. But nortriptyline showed a better performance on pain relief.

Short-Term Consumption of Probiotic Yogurt Improved HDL-C of Type 2 Diabetes Mellitus Patients: A Double-Blind Randomized Controlled Trial

Background and aims: Cardiovascular disease is the main complication and cause of morbidity and mortality in type 2 diabetes mellitus (T2DM) patients. The main cause of complication in T2DM is oxidative stress caused by insulin resistance, hence it can increase lipid profiles (cholesterol, LDL, and triglycerides) which exacerbates endothelial dysfunction. Among various functional foods with antioxidant effects, probiotic foods have been reported to suppress oxidative stress, and also improve the fasting blood glucose (FBG) and lipid profile in patients with T2DM. The aim of this clinical trial is to study the effects of probiotics and conventional yogurt on FBG and lipid profile in patients with T2DM. Material and method: Thirty-eight patients with T2DM, aged 30 to 60 years old, were assigned to two groups in this randomized, doubleblind, controlled clinical trial. The subjects in the intervention group consumed 100 ml/day probiotic yogurt containing Lactobacillus acidophilus La-5 and Bifidobacterium lactis BB-12, whereas subjects in the control group consumed 100 ml/day conventional yogurt for four weeks. Anthropometric indices, dietary intake, physical activity, serum FBG, and lipid profile were evaluated at the beginning and end of the intervention. Results: Consumption of 100 mL/day conventional yogurt could significantly reduce the fasting blood glucose (FBG) level, whereas probiotic yogurt could not reduce FBG significantly. Although the total cholesterol and triglyceride were not improved after yogurt consumption, both type of yogurt could improve HDL-C level. Conclusion: Both conventional yogurt or probiotic yogurt could be used as functional food since it improved the HDL-C in type 2 DM patients.

Relationships Between Serum Expression of IGF-1 and Metabolic Syndrome Metrics in Syrian Women with Breast Cancer

Background and aims: Insulin-like Growth Factors (IGF-1) plays as mediator between metabolic syndrome (MetS), oxidative stress and breast cancer (BrCa) progression. The objective of this study was to examine the relationships between IGF-1 serum levels and metabolic profile biomarkers in a population group of BrCa patients. Material and methods: 126 Syrian women with breast lesions were assigned in 3 study groups: I. Malignant breast tumor group, II. Benign breast tumor group and a Normal (control) group. The following biochemical parameters were measured: IGF-1, HDL-cholesterol, LDL-cholesterol, triglycerides (TG) and glucose. Results: The mean levels of serum IGF- 1 in patients with breast cancer was significantly higher than those with benign tumors but we did not find any correlation between IGF-1 serum levels and tumor stage or lymph nodes metastases. Total cholesterol and LDL-cholesterol levels, along with TG were significantly higher in patients with BrCa versus benign and normal subjects. Conclusion: Results support the link of metabolic dysregulation and oxidative stress in BrCa progression as elevation of serum IGF-1 levels in BrCa patients are associated with metabolic syndrome markers which eventually adds more risk in cancer progression.

The Relative Risk of Developing Type 2 Diabetes Mellitus in Young Adults with Schizophrenia Treated with Different Atypical Antipsychotic

Background and aim: While the link between antipsychotic treatment and metabolic adverse events, including type 2 diabetes mellitus (T2DM) are clear in adults with schizophrenia, in young this association is not so well studied although the use of secondgeneration antipsychotics (SGA) is more and more frequent. Material and methods: The local diabetes register was compared with the list of all registered young adults (18-35 years) with schizophrenia 2 years retrospective and 2 years prospective. Cumulative incidence, rate of incidence and relative risk was calculated knowing the number of persons in this age group within this region. Results: Cumulative incidence for exposed group was 0.7% with a rate of incidence of 6.27 (95%CI: 4.1-10.5) per 1,000 patientyears, when in normal population was 0.2%, respectively 2.01 (95%CI: 0.72-3.79). This means a relative risk of 3.4736 (95%CI: 1.79-6.72), p=0.0002 and NNH=202 (95%CI: 134-404). Multivariate analysis showed that gender male (OR=1.83; 95%CI: 0.9-2.7; p=0.002) and olanzapine prescription (OR=4.76; 95%CI: 1.7-7.7; p=0.0001) were independent risk factors for T2DM. Conclusions: The metabolic risk should be taken in account every time introducing or changing a SGA in young schizophrenic patient, balancing the benefits and negative metabolic effects (especially with olanzapine). Healthy nutrition and physical activities are necessary components of these patients lifestyle to avoid early onset of T2DM.