46 research outputs found
Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes.
No full textNutritional habits of subjects with Type 2 diabetes mellitus in the Mediterranean basin: comparison with the non-diabetic population and the dietary recommendations. Multi-centre study of the Mediterranean group for the study of Diabetes (MGSD)
No full textAims/hypothesis. The aim of this study was to compare
the nutritional habits of Type 2 diabetic patients
among Mediterranean countries and also with those of
their background population and with the nutritional
recommendations of the Diabetes and Nutrition Study
Group.
Methods. We did a cross-sectional study of 1833 nondiabetic
subjects and 1895 patients with Type 2 diabetes, in nine centres in six Mediterranean countries. A dietary questionnaire validated against the 3-Day Diet Diary was used.
Results. In diabetic patients the contribution of proteins,
carbohydrates and fat to the energy intake varied
greatly among centres, ranging from 17.6% to 21.0%
for protein, from 37.7% to 53.0% for carbohydrates
and from 27.2% to 40.8% for fat, following in every
centre the trends of the non-diabetic population. Furthermore, diabetic patients compared to the corresponding
background population had: (i) lower energy intake, (ii) lower carbohydrate and higher protein contribution to the energy intake, (iii) higher prevalence of obesity, ranging from 9 to 50%. The adherence to the nutritional recommendations for proteins, carbohydrate and fat was very low ranging from 1.4 to 23.6%, and still decreased when fibre was also considered.
Conclusion/interpretation. In diabetic patients of the
Mediterranean area: (i) dietary habits vary greatly
among countries, according to the same trends of the
background population; (ii) the prevalence of obesity
is much lower than the 80% reported for patients with
diabetes in Western countries; (iii) Carbohydrate intake
is decreased with a complementary increase of protein and fat consumption, resulting to a poor compliance with the nutritional recommendations
DIETARY FAT INTAKE AS RISK FACTOR FOR THE DEVELOPMENT OF DIABETES: MULTINATIONAL MULTICENTER STUDY OF THE MEDITERRANEAN GROUP FOR THE STUDY OF DIABETES IF:7.912
No full textNonalcoholic Fatty liver disease, diabetes mellitus and cardiovascular disease: newer data
No full textNutritional habits in the Mediterranean Basin. The macronutrient composition of diet and its relation with the traditional Mediterranean diet. Multi-centre study of the Mediterranean Group for the Study of Diabetes(MGSD)
No full textNutritional habits in the Mediterranean Basin. The macronutrient composition of the diet and its relation with the traditional Mediterranean diet. Multi-centre study of the Mediterranean Group for the Study of Diabetes (MGDS)
No full textNonalcoholic Fatty Liver Disease, Diabetes Mellitus and Cardiovascular Disease: Newer Data
No full textNonalcoholic fatty liver disease (NAFLD) is the most common, chronic liver disease worldwide. Within this spectrum, steatosis alone is apparently benign, while nonalcoholic steatohepatitis may progress to cirrhosis and hepatocellular carcinoma. NAFLD is strongly associated with obesity, dyslipidemia, type 2 diabetes mellitus, and cardiovascular disease. The pathogenesis of hepatic steatosis is not clearly known, but its main characteristics are considered insulin resistance, mitochondrial dysfunction, increased free fatty acids reflux from adipose tissue to the liver, hepatocyte lipotoxicity, stimulation of chronic necroinflammation, and fibrogenic response. With recent advances in technology, advanced imaging techniques provide important information for diagnosis. There is a significant research effort in developing noninvasive monitoring of disease progression to fibrosis and response to therapy with potential novel biomarkers, in order to facilitate diagnosis for the detection of advanced cirrhosis and to minimize the need of liver biopsy. The identification of NAFLD should be sought as part of the routine assessment of type 2 diabetics, as sought the microvascular complications and cardiovascular disease, because it is essential for the early diagnosis and proper intervention. Diet, exercise training, and weight loss provide significant clinical benefits and must be considered of first line for treating NAFLD
Dietary fat intake as a risk factor for the development of diabetes. Multinational, multicenter study of the Mediterranean Group for the Study of Diabetes (MGDS)
No full textIn the context of the Multinational MGSD Nutrition Study, three groups of subjects were studied: 204 subjects with recently diagnosed diabetes(RDM),42subjectswithundiagnoseddiabetes(UDM)(AmericanDiabetesAssociation criteria—fasting plasma glucose [FPG] 126 mg/dl), and 55 subjects with impaired fasting glucose(IFG)(FPG 110and126mg/dl).Eachgroupwascomparedwithacontrolgroupof nondiabetic subjects, matched one by one for center, sex, age, and BMI. Nutritional habits were evaluated by a dietary history method, validated against the 3-day diet diary. In RDM, the questionnaire referred to the nutritional habits before the diagnosis of diabetes. Demographic data were collected, and anthropometrical and biochemical measurements were taken. RESULTS— Compared with control subjects, RDM more frequently had a family history of diabetes(49.0vs.14.2%;P0.001),exercisedless(exerciseindex53.5vs.64.4;P0.01),and more frequently had sedentary professions (47.5 vs. 27.4%; P 0.001). Carbohydrates contributed less to their energy intake (53.5 vs. 55.1%; P 0.05), whereas total fat (30.2 0.5 vs. 27.8 0.5%; P 0.001) and animal fat (12.2 0.3 vs. 10.8 0.3%; P 0.01) contributed moreandtheplant-to-animalfatratiowaslower(1.50.1vs.1.80.1;P0.01).UDMmore frequentlyhadafamilyhistoryofdiabetes(38.1vs.19.0%;P0.05)andsedentaryprofessions (58.5vs.34.1%;P0.05),carbohydratescontributedlesstotheirenergyintake(47.61.7vs. 52.81.4%;P0.05),totalfat(34.71.5vs.30.41.2%;P0.05)andanimalfat(14.2 0.9 vs. 10.6 0.7%; P 0.05) contributed more, and the plant-to-animal fat ratio was lower (1.6 0.2 vs. 2.3 0.4; P 0.05). IFG differed only in the prevalence of family history of diabetes (32.7 vs. 16.4%; P 0.05). CONCLUSIONS— Our data support the view that increased animal fat intake is associated with the presence of diabetes
Increased endothelin-1 levels in women with polycystic ovary syndrome and the beneficial effect of metformin therapy
No full textWomen with polycystic ovary syndrome who present with hyperandrogenemia, hyperinsulinemia, and insulin resistance appear to be at high risk of cardiovascular disease. Elevated levels of endothelin-1, a marker of vasculopathy, have been reported in insulin-resistant subjects with endothelial dysfunction. Male gender also seems to be an aggravating factor for cardiovascular disease. In this study we investigated endothelin-1 levels in women with polycystic ovary syndrome, and we evaluated the effect of an insulin sensitizer, metformin, on endothelin-1 levels. Plasma endothelin-1 levels were measured in 23 obese (mean age, 24.3 ± 4.6 yr; body mass index, 35 ± 5.6 kg/m2) and 20 nonobese women with polycystic ovary syndrome (24.1 ± 3.6 yr; body mass index, 21.8 ± 2.5 kg/m2) as well as in 7 obese and 10 nonobese healthy, normal cycling, age-matched women. Additionally, endothelin-1 levels were evaluated in a sub-group of women with polycystic ovary syndrome (10 obese and 10 nonobese) 6 months postmetformin administration (1700 mg daily). Our results showed that obese and nonobese women with polycystic ovary syndrome had higher levels of endothelin-1 compared with the controls [obese, 2.52 ± 1.87 vs. 0.44 ± 0.23 pmol/liter (by analysis of covariance, P < 0.02); nonobese, 1.95 ± 1.6 vs. 0.43 ± 0,65 pmol/liter (P < 0.009)]. All of the participating women with polycystic ovary syndrome (n = 43) when compared with the total group of controls (n = 17) demonstrated hyperinsulinemia (polycystic ovary syndrome, 24.5 ± 19.6; controls, 11.2 ± 3.4 U/liter; P < 0.03), lower glucose utilization (M40) during the hyperinsulinemic euglycemic clamps (3.4 ± 2.4 vs. 5.6 ± 1.75 mg/kg·min; P < 0.045, by one-tailed test), and higher levels of endothelin-1 (polycystic ovary syndrome, 2.52 ± 1.87; controls, 0.44 ± 0.23 pmol/liter; P < 0.02, analysis of covariance covariate for body mass index). A positive correlation of endothelin-1 with free T levels was also shown (r = 0.4, P = 0.002) as well as a negative correlation of endothelin-1 with glucose utilization (r = -0.3; P = 0.033) in the total studied population. Finally, after metformin therapy, endothelin-1 levels were significantly reduced in obese (endothelin-1 before, 3.25 ± 2.2; endothelin-1 after, 1.1 ± 0.9 pmol/liter; P < 0.003) and nonobese (endothelin-1 before, 2.7 ± 2; endothelin-1 after, 0.7 ± 0.4 pmol/liter; P < 0.01) women with polycystic ovary syndrome, with no change in body mass index. Moreover, after metformin therapy, hyperandrogenemia and hyperinsulinemia were normalized, and glucose utilization improved [obese before: total T, 0.9 ± 0.15 ng/ml; fasting insulin, 22.2 ± 12.1 U/liter; glucose utilization, 2.15 ± 0.5 mg/kg·min; obese after: total T, 0.5 ± 0.2 ng/ml; fasting insulin, 11.6 ± 6 U/liter; glucose utilization, 4.7 ± 1.4 mg/kg·min 9P < 0.003, P < 0.006, and P < 0.002, respectively); nonobese before: total T, 1 ± 0.5 ng/ml; fasting insulin, 15.5 ± 7.6 U/liter; glucose utilization, 3.4 ± 0.7 mg/kg·min; nonobese after: total T, 0.8 ± 0.5 ng/ml; fasting insulin, 9 ± 3.8 U/liter; glucose utilization, 6 ± 1.7 mg/kg·min (P < 0.04, P < 0.02, and P < 0.0008, respectively)]. In conclusion, our data clearly demonstrate that women with polycystic ovary syndrome, obese and nonobese, have elevated endothelin-1 levels compared with the age-matched control group. In addition, 6 months of metformin therapy reduces endothelin-1 levels and improves their hormonal and metabolic profile
Cutaneous manifestations in relation to immunologic parameters in a cohort of primary myelodysplastic syndrome patients
No full textBackground: Cutaneous lesions in myelodysplastic syndrome (MDS) may be specific or not and may reveal bone marrow transformation. Our purpose was to investigate in a cohort of 84 MDS patients the correlation of cutaneous findings with immunologic parameters and prognostic features of MDS in order to clarify their potential clinical significance. Materials and methods: We studied a cohort of 84 newly diagnosed MDS patients in order to assess the cutaneous findings present at the time of diagnosis and during 1 to 3.years of follow-up. We described the clinical variety of cutaneous findings ascertained by histology. We also looked for any association between the group of MDS patients with skin manifestations and MDS subtype, immunologic and prognostic features highlighting transformation to acute leukaemia. Results: Twenty-one patients presented cutaneous manifestations: 1 patient developed leukaemia cutis, 6 patients photosensitivity not associated with autoimmune disease, 3 prurigo nodularis, 2 Sweet's syndrome, 6 leucocytoclastic vasculitis, 2 ecchymoses and purpura associated with preexisting relapsing polychondritis, 1 patient subcutaneous nodules associated with Wegener's granulomatosis and 1 patient with malar rash and oral ulcers associated with preexisting systemic lupus erythematosus. Adjusted for age and gender, the presence of skin findings constitutes a significant predictor of the high-risk MDS subgroup (odds ratio, 3.59; 95% confidence interval, 1.18-10.92). Hypergammaglobulinemia was significantly higher in the MDS subgroup with skin manifestations (P = 0.03). Conclusion: Most MDS patients with cutaneous manifestations belong to the high-risk MDS subgroup and present hypergammaglobulinemia. Early biopsy of skin lesions in myelodysplasia is indicated. © 2007 The Authors Journal compilation © 2007 European Academy of Dermatology and Venereology
