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One-year follow-up of biologic correlates for arterial blood pressure in type 2 diabetes
No full textBackground: Previous results suggested that blood pressure
(BP) response to exercise was significantly correlated with
HbA1c levels in healthy normotensive non-diabetic control
subjects. Present investigation evaluated the biologic determinants
of arterial BP during one-year follow-up in patients with
type 2 diabetes (T2D).
Materials and methods: Cardiovascular risk factors were
assessed at baseline, 1, 3, 6, 9 and 12 months in 20 T2D (age
60 ± 5 year). Were measured: body mass index (BMI), waist to
hip ratio (WHR), mean BP, fasting plasma glucose (FPG),
HbA1c, plasma LDL cholesterol, folate and total homocysteine
(tHcy), urinary albumin excretion (UAE). Dietary habits were
estimated at each visit by administering a 2-day 24-h dietary
recall (24 HDR).
Results: BMI was 31 ± 5 kg/m2, WHR 0Æ97 ± 0Æ06, mean BP
98 ± 10 mmHg, FPG 159 ± 42 mg/dL, HbA1c 7Æ4 ± 1Æ2%, LDL
118 ± 31 mg/dL, folati 8Æ9 ± 6Æ6 ng/mL, tHcy 11Æ5 ± 3Æ4 lmol/
L. UAE ranged from 0 to 2957 lg/min (median 15Æ8). Multivariate
regression analysis of longitudinal data found the following
independent variables to be associated with MBP
(|r| = 0Æ54, P < 0Æ0001): HbA1c (t-value 5Æ24), folati (-2Æ84), and
LDL (2Æ21). Estimated daily intake of folic acid was
286 ± 129 lg/day significantly lower than Recommended Dietary
Allowance.
Conclusions: This study confirms in T2D previous observations
in healthy people. There is a significant positive correlation
between protein glycosylation and arterial BP.
Additional influential factors are plasma folate and LDL cholesterol.
These findings strengthen the need for maintaining
a strict metabolic control (glycosylation of matrix proteins affect artery compliance) and promoting an adequate dietary
intake of folate
Trattamento short-term (1 mese) con Armolipid Plus nel dislipidemico soprappeso
No full textIntroduzione: Le dislipidemie sono un importante fattore di rischio cardiovascolare. Le raccomandazioni dell’ATP III suggeriscono valori <100 mg/dl di Colesterolemia LDL (LDL- Ch) nei soggetti ad elevato rischio cardiovascolare, inferiori a 130 nei soggetti a rischio moderato ed a 160 nelle persone a basso rischio. Urgono strategie valide di prevenzione primaria e secondaria.
Armolipid Plus è un nutraceutico contenente Policosanolo, Lievito rosso e Berberina con Acido folico, Coenzima Q10 e Astaxantina, che agisce riducendo il LDL-Ch ed incrementando possibilmente la Colesterolemia HDL (HDL-Ch).
Scopo: L’obiettivo dello studio è stato di valutare l’effetto di Armolipid Plus sui classici parametri lipidici (Colesterolo Totale (T-Ch), LDL-Ch, HDL-Ch, Trigliceridi (TG)), glicemia a digiuno, Pressione Arteriosa Sistolica (PAS), Pressione Arteriosa Diastolica (PAD), peso corporeo in soggetti dislipidemici in sovrappeso, senza modificare le loro abitudini alimentari ed il loro stile di vita.
Metodi: In 22 soggetti consecutivi (1 maschio e 21 femmine, età media 59.7±11.4, BMI 28.9±5.6) che avevano rifiutato la terapia con statine, abbiamo deciso di iniziare un trattamento alternativo con Armolipid Plus. Il protocollo osservazionale prevedeva un follow-up di due mesi.
Risultati: Abbiamo osservato una riduzione altamente significativa del livello medio di T-colesterolemia, LDL-colesterolemia e trigliceridemia, senza variazioni significative seppur decrementali di glicemia e BMI. La HDL-colesterolemia è aumentata, seppur in modo non significativo, inalterate PAS e PAD.
Conclusioni: L’Armolipid Plus si rivela un affidabile risorsa terapeutica prontamente efficace nella dislipidemia non trattata con statine di sintesi. Valuteremo nel follow-up gli effetti e la sostenibilità terapeutici
Leukocyte mitochondrial membrane potential in type 1 diabetes families
No full textBackground: Proper cellular function requires the maintenance of mitochondrial membrane potential (MMP) sustained by the electron transport chain. Mitochondrial dysfunction is believed to play a role in the development of diabetes and diabetic complications possibly because of the active generation of free radicals. Since MMP can be investigated in clinical settings using fluorescent probes and living whole blood cells, mitochondrial membrane alterations have been observed in some chronic disorders.
Materials and Methods: We have used the mitochondrial indicator 5,5’,6,6’-tetra chloro-1,1’,3,3’-tetraethylbenzimidazolyl-carbocyanine iodide (JC-1) in conjunction with flow cytometry to measure the MMP in peripheral blood granulocytes from type 1 diabetes (T1D) families (diabetic probands and non-diabetic siblings). The intracellular ROS levels and the respiratory burst activity were also measured.
Results: Leukocyte MMP was elevated in 20 T1D patients and their 20 non-diabetic siblings compared with 25 healthy subjects without family history of T1D. Fasting plasma glucose was the only correlate of MMP.
Conclusions: The flow cytometric finding of mitochondrial hyperpolarisation in circulating leukocytes suggests a functional synchronization across the mitochondrial network in T1D family members, even without frank diabetes. The functional implications of mitochondrial hyperpolarisation (probably different among different cells) will require extensive investigation
Circadian blood pressure variability and ambulatory arterial stiffness in type 1 diabetes families
No full textBackground: Normotensive non-diabetic relatives of type 1
diabetics (T1D) have an abnormal blood pressure response to
exercise testing that is associated with indices of metabolic
syndrome and oxidative damage. We compared the pattern of
24-h ambulatory blood pressure monitoring (ABPM), ambulatory
arterial stiffness index (AASI), indices of cardiovascular
autonomic function, clinical and biochemical parameters, and
oxidative biomarker between T1D patients, their siblings and
control individuals without a family history for T1D.
Materials and methods: ABPM was undertaken in 25 controls,
20 T1D and 20 siblings. In addition to laboratory examination
(including homeostasis model assessment of insulin sensitivity)
and clinical testing of autonomic function, we measured the
rate of oxidant-induced erythrocyte electron transfer to extracellular
ferricyanide (RBC vfcy).
Results: Systolic blood pressure (SBP) midline-estimating statistic
of rhythm and pulse pressure were higher in T1D and
correlated positively with diabetes duration and RBC vfcy;
autonomic dysfunction was associated with diastolic BP ecphasia
and increased AASI. Siblings had higher BMI, lower insulin
sensitivity, larger SBP amplitude, and higher AASI than
controls. Daytime SBP was positively independently associated
with BMI and RBC vfcy. Among non-diabetic people, there
was a significant correlation between AASI and fasting plasma
glucose.
Conclusions: Siblings of T1D exhibited a cluster of metabolic
abnormalities associated with consensual perturbations in vascular
variability (abnormal diurnal profiles of SBP and abnormal
dynamic relationship between SBP and DBP over 24 h as
described by AASI). Moreover, our findings support, in a clinical
setting, the proposed role of transplasma membrane electron
transport systems in vascular pathobiolog
Liver disease in diabetes mellitus: potential therapeutic value of vitamin E-silibyn complex
No full textThe liver has a central role in glucose homeostasis. In turn, glucose-induced signals modulate the transcrip- tional regulation of genes involved in the glycolysis and lipogenesis pathways and could favour fatty acid storage in the liver. The prevalence of hepatobiliary diseases is increased in patients with diabetes mellitus. Type 1 diabetes is associated with a hepatic form of microvascular disease (diabetic hepatosclerosis), hemochromatosis and autoimmune hepatitis. Type 2 diabetes is associated with nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) whose prevalence increases with multiple components of metabolic syndrome. Hepatitis C virus infection has been reported to be associated with and predispose to diabetes mellitus. Silibinin or silybin is a flavonoid derived from Silybum marianum and known to have hepatoprotective, anti-carcinogenic and anti-inflammatory effects. Silymarin is a standardised extract of four polyphenolic flavanolignans (silybin, isosilybin, silydianin and silychristin) from the seeds of Silybum marianum; it possesses a potent scavenging capacity of oxidizing free radicals whose mechanistic aspects have been extensively evaluated. This single herbal drug formulation is used for hepatoprotection although recent evidence in carbon tetrachlo- ride-induced cirrhotic rats suggests that chronic silymarin treatment might compromise the hemodynamic endothelial nitric oxide synthase activity. In order to enhance silymarin bioavailability flavonoid molecules have been converted into lipid-compatible molecular complexes, phytosomes. A new silybin-phosphatidylcholine-Vitamin E complex, character- ised by elevated oral bioavailability and lipophilicity, was effective on rat hepatic fibrosis induced by dimethylnitrosamine administration and by bile duct ligation. The complex has been suggested as a complementary approach to the treatment of patients with chronic liver damage. The manuscript provides a review of literature on this topic and discusses the potential usefulness of the complex to prevent/treats liver disease in diabetes as well as contraindications
Exploring Leukocyte Mitochondrial Membrane Potential in Type 1 Diabetes Families.
No full textProper cellular function requires the maintenance of mitochondrial membrane potential (MMP) sustained by the electron transport chain. Mitochondrial dysfunction is believed to play a role in the development of diabetes and diabetic complications possibly because of the active generation of free radicals. Since MMP can be investigated in clinical settings using fluorescent probes and living whole blood cells, mitochondrial membrane alterations have been observed in some chronic disorders. We have used the mitochondrial indicator 5,5',6,6'-tetra chloro-1,1',3,3'-tetraethylbenzimidazolyl-carbocyanine iodide (JC-1) in conjunction with flow cytometry to measure the MMP in peripheral blood granulocytes from type 1 diabetes (T1D) families. The intracellular ROS levels and the respiratory burst activity were also measured. Leukocyte MMP was elevated in 20 T1D patients and their 20 non-diabetic siblings compared with 25 healthy subjects without family history of T1D. Fasting plasma glucose was the only correlate of MMP. If confirmed by further observations, the functional implications of mitochondrial hyperpolarisation (probably different among different cells) will require extensive investigation
Nutritional status and Adiponectine plasma levels in patients affected by Anorexia Nervosa
No full textNutritional status and Adiponectine plasma
levels in patients affected by Anorexia Nervosa
C. Masoni, L. Ghiadoni, C. Scarpellini, C. Consani,
E. Matteucci & O. Giampietro
Department of Internal Medicine, University of Pisa, Italy
Background: Anorexia Nervosa (AN) is prevalent in modern
societies but is not well understood yet.
Aim: The aim of this study is to evaluate circulating levels of
Adiponectine (Apn) and the relationship between these levels
and anthropometric and metabolic parameters.
Materials and methods: The study included 40 women, 20
with AN (BMI 15Æ7 ± 2Æ1 kg m)2, age 30Æ2 ± 10Æ5 years), 12
restricter (BMI 14Æ9 ± 1Æ6 kgm)2) and 8 binge-purge subtype (BMI
18Æ3 ± 0Æ8 kg m)2), and 20 healthy controls (BMI 22Æ06 ± 0Æ93 kg
m)2, age 32Æ4 ± 4Æ4 years). Food intake was evaluated by a 5-day
24 hour dietary recall.
Results: Apn was higher (P < 0Æ001) in AN (36Æ84 ± 13Æ12 ng
mL)1) than controls (15Æ1 ± 3Æ0 ng mL)1) and (P = 0Æ004) in restricter
(41Æ8 ± 11Æ0 ng mL)1) than in binge-purge AN subtype
(22Æ1 ± 4Æ5 ng mL)1). Apn levels were negatively related with
BMI in total population (AN + C), without significance.
Total and LDL (Low Density Lipoprotein) Cholesterol levels
were higher (P < 0Æ05; P = 0Æ001) in AN (193Æ09 ± 39Æ86 mg
dL)1; 107Æ95 ± 27Æ75 mg dL)1) than C (166Æ09 ± 13Æ70 mg dL)1;
83Æ6 ± 15 mg dL)1), while Albumin was lower (P < 0Æ05) in
AN than C (4Æ40 ± 0Æ41 vs. 4Æ65 ± 0Æ57 g dL)1); no difference
between restricter and binge-purge subtype. Prealbumin and C
Somatomedine were similar in AN and C because of these
parameters rapidly change with changing of nutritional habits,
and the study’s patients were already included into nutritional
educational program: although their daily caloric intake was
lower than the recommended assumption levels of nutrients
(LARN, National Institute of Nutrition), the caloric division
between macronutrients was correct.
Conclusions: Increase of Apn in AN might be related to fat
mass reduction, in fact Apn progressively increase in losing
weight obese, or fat mass might exert negative feedback on Apn production, the severe emaciation in AN could inhibit
this feedback
Type 2 diabetes: blood pressure control and endothelial function are influenced by nutritional educational program
No full textBackground: Achievement of blood pressure (BP) control is
an important target in type 2 diabetic patients (T2DM) to prevent
microvascular and macrovascular complication. T2DM
patients are characterized by endothelial dysfunction, which
represents a key mechanism for the development of atherosclerotic
disease.
Aim: The aim of this study is to evaluate the effect of a nutritional
and dietary counseling on BP control and endothelial
dysfunction in T2DM.
Materials and methods: Nineteen T2DM patients (age
61 ± 5 years, 4 females) were provided of a by a 2-day 24 hour
dietary recall at 1, 3, 6, 9 and 12 months. BP, endotheliumdependent
(flow-mediated dilation, FMD, after 5-minute of
forearm ischemia) and independent (sublingual glycerol trinitrate,
GTN, 25 lg) vasodilation by high resolution ultrasounds
and computerized analysis of brachial artery diameter (maximal
% increase) were assessed at baseline and after 12 months.
Twenty age and gender matched healthy subjects were
recruited as controls.
Results: At baseline T2DM had significantly (P < 0Æ01) lower
FMD (4Æ3 ± 1Æ9%) and FMD/GTN ratio (0Æ61 ± 0Æ15) as compared
to controls (6Æ9 ± 2Æ1% and 0Æ91 ± 0Æ22, respectively).
Response to GTN was similar in T2DM (7Æ8 ± 2Æ4%) and controls
(7Æ6 ± 3Æ0%). After 12 months, there was a significant
(P < 0Æ01) reduction in systolic BP (from 145 ± 17 to
133 ± 8 mmHg) and a not significant reduction in diastolic BP
(from 85 ± 12 to 78 ± 9 mmHg, P = 0Æ06), HbA1c (from
7Æ7 ± 17 to 7Æ1 ± 0Æ8%, P = 0Æ18) and plasma folate (from
6Æ1 ± 8Æ4 to 11Æ4 ± 8Æ5 mg mL)1, P < 0Æ001). Number or dosage
of antihypertensive drugs was increase in 25% of the patients.
FMD (5Æ9 ± 2Æ9%) and FMD/GTN ratio (0Æ84 ± 0Æ61), but not
response to GTN (7Æ4 ± 1Æ7%) were also significantly (P < 0Æ05)
improved. However, the improvement in FMD and FMD/
GTN ratio was not related to changes in BP, metabolic control,
plasma folate concentration or pharmacological treatment, but
to sodium excretion reduction exclusively (r = 0Æ51, P < 0Æ005).
Conclusions: A long term nutritional and dietary counseling
have positive effect on dietary behavior of T2DM patients
resulting in a significant better BP control and an improvement
of endothelial dysfunction
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