Diabetes Mellitus Wetenschap

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Increased serum miR-7 is a promising biomarker for type 2 diabetes mellitus and its microvascular complications.

Diabetes Res Clin Pract. 2017 Jun 11;130:171-179

Authors: Wan S, Wang J, Wang J, Wu J, Song J, Zhang CY, Zhang C, Wang C, Wang JJ

Abstract
AIMS: To investigate the alteration pattern and physiologic state of islet-specific miR-7 in the serum of patients with type 2 diabetes mellitus (T2DM) and T2DM-associated microvascular complications (T2DMC) and to evaluate its clinical significance.
METHODS: The levels of serum miR-7 were firstly examined and compared in 76 T2DM patients, 76 T2DMC patients and 74 age-gender matched controls using RT-qPCR. Subsequently, the physiologic state of serum miR-7 was characterized by determining its concentrations in isolated exosomes and corresponding exosome-free samples from the same three cohorts' samples. Moreover, statistical analyzes were performed to evaluate the associations of serum miR-7 with T2DM and T2DMC.
RESULTS: Serum miR-7 was significantly elevated in the T2DM patients [(401.0±34.37) fmol/L, P<0.001] and in the T2DMC patients [(501.4±81.69) fmol/L, P<0.001] when compared with the controls [(175.7±16.59) fmol/L]. Circulating miR-7 was mainly existed as exosome-free form rather than in membrane-bound exosomes. The concentrations of exosome-free miR-7 were markedly higher in the T2DM group [(107.2±9.63) fmol/L, P<0.001] and in the T2DMC group [(122.1±10.80) fmol/L, P<0.001] compared to the control group [(54.18±2.37) fmol/L]. Logistic regression and ROC curve analyses revealed the serum miR-7 was significantly associated with T2DM and microvascular complications (P<0.05).
CONCLUSION: Increased serum miR-7 might have the potential as a promising marker for T2DM and its microvascular complications.

PMID: 28646700 [PubMed - as supplied by publisher]

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Efficacy of an education course delivered to community health workers in diabetes control: A randomized clinical trial.

Endocrine. 2017 Jun 23;:

Authors: de Souza CF, Dalzochio MB, Zucatti ATN, De Nale R, de Almeida MT, Gross JL, Leitão CB

Abstract
BACKGROUND: Community health workers are community members who provide education and care for patients for a broad range of health issues, including diabetes mellitus. However, few community health workers are trained for diabetes education and little is known about the effectiveness of their interventions. The aim of this study is to evaluate the effect of a diabetes education program delivered to community health workers in improving the metabolic control of patients with type 2 diabetes mellitus.
METHODS: Eight community health workers, providing care for 118 patients, were randomized in two groups to receive a 1-month diabetes education program (intervention, patients n = 62) or an education course in other health issues (control, patients n = 56). Each community health worker was responsible for transmitting the acquired knowledge to patients. Primary outcome was changed in HbA1C 3 months after the intervention.
RESULTS: PARTICIPANTS: Mean age was 61 ± 11 years, 35% were men and 62% were whites. HbA1c levels reduced in both groups (intervention: 9.1 ± 2.2 vs. 7.9 ± 1.9%; control: 9.1 ± 2.1 vs. 8.4 ± 2.5%, p < 0.001), but no statistically significant differences were observed between groups (p between groups = 0.13). Total cholesterol (intervention: 192 ± 43 vs. 182 ± 39 mg/dl; control: 197 ± 44 vs. 191 ± 45 mg/dl, p between groups = 0.035) and triglycerides (intervention: 158 [106-218] vs. 135 [106-215]; control: 128 [100-215] mg/dl vs. 146 [102-203] mg/dl, p between groups = 0.03) reduced overtime only in intervention group.
CONCLUSIONS: In this study, a significant decrease in HbA1c was observed during patients' follow-up, but it was similar in intervention and control groups. The diabetes mellitus education course delivered to community health workers was able to improve patients' lipid profile.

PMID: 28646377 [PubMed - as supplied by publisher]

Angiopoietin-Like Protein 4 Is a High-Density Lipoprotein (HDL) Component for HDL Metabolism and Function in Nondiabetic Participants and Type-2 Diabetic Patients.

J Am Heart Assoc. 2017 Jun 23;6(6):

Authors: Yang LY, Yu CG, Wang XH, Yuan SS, Zhang LJ, Lang JN, Zhao D, Feng YM

Abstract
BACKGROUND: ANGPTL4 (angiopoietin-like protein 4) is a LPL (lipoprotein lipase) inhibitor and is present in high-density lipoprotein (HDL). However, it is not defined whether ANGPTL4 in HDLs could affect HDL metabolism and function in type 2 diabetes mellitus (T2DM).
METHODS AND RESULTS: ANGPTL4 levels in the circulation and HDLs were quantified in nondiabetic participants (n=201, 68.7% females) and T2DM patients (n=185, 66.5% females). HDLs were isolated from nondiabetic controls and T2DM patients to assess cholesterol efflux or subjected to endothelial lipase (EL)-overexpressed HEK293 cells for EL hydrolysis in vitro. The association between ANGPTL4 in HDLs and HDL components and function was analyzed in nondiabetic participants or diabetic patients, respectively. Plasma or HDLs of ANGPTL4+/+ and ANGPTL4-/- mice was subjected for cholesterol efflux or EL hydrolysis, respectively. ANGPTL4 levels in the plasma and HDLs were 1.7- and 2.0-fold higher in T2DM patients than nondiabetic controls, respectively (P<0.0001). Multivariable analysis demonstrated that per 1 doubling increase of ANGPTL4 levels in HDLs, the changes amounted to +0.27% cholesterol efflux (P=0.03), +0.06 μg/mL apolipoprotein A-I (P=0.09) and -9.41 μg/L serum amyloid A (P=0.02) in nondiabetic controls. In T2DM patients, the corresponding estimates were -0.06% cholesterol efflux (P=0.10), -0.06 μg/mL apolipoprotein A-I (P=0.38), and +3.64 μg/L serum amyloid A (P=0.72). HDLs isolated from ANGPTL4-/- mice showed accelerated hydrolysis by EL and reduced cholesterol efflux compared with ANGPTL4+/+ littermates.
CONCLUSIONS: Physically, ANGPTL4 in HDLs protected HDLs from hydrolysis. Resulting from increased circulating ANGPTL4 levels in T2DM, ANGPTL4 levels in HDLs were elevated but with compromised inhibitory effect on EL, leading to increased HDL hydrolysis and dysfunction.

PMID: 28645936 [PubMed - in process]

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Regulation of testicular steroidogenesis by Foxa3 via transcriptional modulation of ERα signaling in type 2 diabetes mellitus (T2DM).

Biochem Biophys Res Commun. 2017 Jun 20;:

Authors: Zhao Y, Li HX, Wang K, Yan BY, Li W

Abstract
Although both insulin and estrogen receptor α (ERα) are known to exert inhibitory effects on testicular steroidogenesis, it remains unknown whether these pathways regulate testosterone (T) production under certain pathological conditions [e.g., type 2 diabetes mellitus (T2DM)] in a coordinated manner. Here, we found that the expression of forkhead box protein A3 (Foxa3), an essential transcriptional regulator engaged in adipogenesis and energy metabolism, was significantly down-regulated in the Leydig cells (LCs) from T-deficient T2DM mice. Functionally, upon hCG stimulation, Foxa3 recruits to the Esr1 promoter and suppresses the transactivation of Esr1 gene. Disruption of this recruitment by T2DM-elicited hyperinsulinemia led to abnormal activation of ERα pathway, inhibited steroidogenic enzyme genes expression, and thus caused inadequate T production. Therapeutically, insulin-impaired and Foxa3 ablation-compromised steroidogenesis were effectively rescued by a pharmacological inhibitor of the ERα pathway. These findings reveal an obligatory coregulatory role of Foxa3 in the regulation of ERα expression and of the Foxa3/ERα cascade, at least in part, in the pathogenesis of androgen deficiency caused by T2DM.

PMID: 28645613 [PubMed - as supplied by publisher]

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Acute effects of ambient temperature and particulate air pollution on fractional exhaled nitric oxide: A panel study among diabetic patients in Shanghai, China.

J Epidemiol. 2017 Jun 20;:

Authors: Li H, Bai H, Yang C, Chen R, Wang C, Zhao Z, Kan H

Abstract
BACKGROUND: Epidemiological studies have shown the associations of ambient temperature and particulate matter (PM) air pollution with respiratory morbidity and mortality. However, the underlying mechanisms have not been well characterized. The aim of this study is to investigate the associations of temperature and fine and coarse PM with fractional exhaled nitric oxide (FeNO), a well-established biomarker of respiratory inflammation.
METHODS: We conducted a longitudinal panel study involving six repeated FeNO tests among 33 type 2 diabetes mellitus patients from April to June 2013 in Shanghai, China. Hourly temperature and PM concentrations were obtained from a nearby fixed-site monitoring station. We then explored the associations between temperature, PM, and FeNO using linear mixed-effect models incorporated with distributed lag nonlinear models for the lagged and nonlinear associations. The interactions between temperature and PM were evaluated using stratification analyses.
RESULTS: We found that both low and high temperature, as well as increased fine and coarse PM, were significantly associated with FeNO. The cumulative relative risk of FeNO was 1.75% (95% confidence interval [CI], 1.04-2.94) comparing 15 °C to the referent temperature (24 °C) over lags 0-9 days. A 10 μg/m(3) increase in fine and coarse PM concentrations were associated with 1.18% (95% CI, 0.18-2.20) and 1.85% (95% CI, 0.62-3.09) FeNO in lag 0-1 days, respectively. PM had stronger effects on cool days than on warm days.
CONCLUSIONS: This study suggested low ambient temperature, fine PM, and coarse PM might elevate the levels of respiratory inflammation. Our findings may help understand the epidemiological evidence linking temperature, particulate air pollution, and respiratory health.

PMID: 28645522 [PubMed - as supplied by publisher]