• Title/Summary/Keyword: DM

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Vascular dysfunction in patients with type 2 diabetes mellitus

  • Ekta, Khandelwal;Mahaveer Jain;Sumeet Tripathi
    • Annals of Clinical Neurophysiology
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    • v.25 no.1
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    • pp.32-37
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    • 2023
  • Background: Type 2 diabetic mellitus (T2DM) is an emerging global pandemic which is associated with lots of co-morbidities and reported vascular dysfunctions. T2DM associated vascular dysfunctions leads to vasculopathy in the form of altered peripheral vascular dynamics. Cold stress test (CST) is a reliable sympathetic reactivity test used for assessing vascular dysfunctions. In this study we are trying to quantify vascular dysfunctions in T2DM patients non invasively by various parameters of photoplethysmography (PPG) of cold stress test. Methods: Case control study had done in referral health center AIIMS, Raipur. Parameters are recorded by finger-PPG before, during and after CST (1 min) in 2 groups, control (n = 20 healthy volunteers) and case (n = 20 diagnosed T2DM patients). Results: Due to cold stress, PPG parameter peak amplitude was significantly decreased in both healthy and T2DM groups (p <0.001 and p <0.001, respectively). However, recovery trend of amplitude was significantly slow in T2DM compared to healthy subjects. Another PPG parameter peak to peak interval was significantly higher in healthy group compared to T2DM patients. Conclusions: This study showed that T2DM patients has significant deranged pulse volume parameters like amplitude and peak to peak interval can be used to objectively quantify the vasculopathy in T2DM patients by using sympathetic reactivity to cold stress.

Association of ABO genetic Polymorphisms and Type 2 Diabetes Mellitus Susceptibility in the Korean Population

  • Yu-Na Kim;Sung Won Lee;Sangwook Park
    • Biomedical Science Letters
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    • v.30 no.2
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    • pp.65-72
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    • 2024
  • The national diabetes and prediabetes prevalence rate has risen among Korean adolescents and adults. Type 2 diabetes mellitus (T2DM) is commonly interrelated with genetic, metabolic, and environmental risk factors in clinical practice. In this study, we analyzed the association between genetic polymorphisms of the ABO gene with T2DM in the Korean population, we conducted an analysis of gene-phenotype correlation, based on an additive genetic model. A total of 8,840 subjects from the Korea Association REsource (KARE) were selected for this study. Using the genetic and epidemiologic data of 754 T2DM cases and 5721 normal controls from the KARE, single nucleotide polymorphisms (SNPs) in the ABO gene were analyzed for their genetic correlation. As a result, 8 SNPs out of the ABO gene demonstrated statistically significant association with T2DM. Among them, rs657152 in the ABO gene statistically showed the most significant correlation with T2DM (P-value=0.0084, OR=1.15, CI=1.04~1.28). The minor allele of A polymorphism within the intron genetic region of ABO directed increased risk of T2DM. This work reveals a significant association between genetic polymorphism in the ABO gene and T2DM. This finding suggested that ABO SNPs markers might be a genetic correlation to the etiology of T2DM.

Analysis of Quantitative Indices in Tl-201 Myocardial Perfusion SPECT: Comparison of 4DM, QPS, and ECT Program (Tl-201 심근 관류 SPECT에서 4DM, QPS, ECT 프로그램의 정량적 지표 비교 분석)

  • Lee, Dong-Hun;Shim, Dong-Oh;Yoo, Hee-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.67-75
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    • 2009
  • Purpose: As to the analytical method of data, the various programs in which it is used for the quantitative rating of the Tl-201 myocardial perfusion SPECT are reported that there is a difference. Therefore, the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made against data of the same patient. Using quantitative index that able to represent myocardial perfusion defect level, we aimed to determine correlation among three myocardial perfusion analysis programs 4DM (4DMSPECT), QPS (Quantitative Perfusion SPECT), ECT (Emory Cardiac Toolbox) that be used generally in most departments of Nuclear Medicine. Materials and Methods: We analyzed the 145 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Mediacal Center from December 1th 2008 to February 14th 2008. We sorted as normal group and abnormal group. Normal group consist of 80 patients (Male/Female=38/42, age:$65.1{\pm}9.9$) who have low possibility of cardiovascular disease. And abnormal group consist of 65 patients (Male/Female=45/20, age:$63.0{\pm}8.7$) who were diagnosed cardiovascular disease with reversible perfusion defect or fixed perfusion defect through myocardial perfusion SPECT results. Using the 4DM, QPS, and ECT programs, the total defect extent (TDE) such as LAD, LCX, RCA and the summed stress score (SSS) have been analysed for their correlations and statistical comparison with the paried t-test for the quantitative indices analysed from each group. Results: The correlation of 4DM:QPS, QPS:ECT, ECT:4DM each group result from 145 patients is 0.84, 0.86, 0.82 at SSS, 0.87, 0.84, 0.87 at TDE, and both index showed good correlation. In paired t-test and Bland-Altman analysis results showed no statistically significant difference in the comparison of QPS:ECT at the mean SSS and TDE, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index. The correlation of 4DM:QPS, QPS:ECT, ECT:4DM program results from abnormal group (65 patients) is 0.72, 0.72, 0.70 at SSS and 0.77, 0.70, 0.77 at TDE and TDE and SSS has a good correlation. In abnormal group, paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.89) and TDE (p=0.23) comparison, 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). In normal group (80 patients), paired t-test and Bland-Altman analysis results showed no statistically significant difference at QPS:ECT SSS (p=0.95) and TDE (p=0.73) comparison. And 4DM:QPS, ECT:4DM comparative analysis results showed statistically significant difference at SSS and TDE index (p<0.01). Conclusions: The perfusion defect of the Tl-201 myocardial perfusion SPECT was analyzed in not only the patient in whom it has the cardiovascular disease but also the patient in whom the possibility of the cardiovascular disease is few. In the comparison of the all group research, the mean of the TDE and SSS, 4DM was lower than QPS and ECT progrms. Each program showed good correlation and the results showed statistically significant difference. However, in this way, it is determined to be compatible about the analysis value in which the large-scale side between the programs uses each program a difference in a clinical in the Bland-Altman analyzed result in spite of the good correlation and cannot use. but, this analyzed result will be able to be usefully used as the reference material for the clinical read and is expected.

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Effects of Aralia elata, Acanthopanacis cortex and Ulmus davidiana Water Extracts on Plasma Biomarkers in Streptozotocin - Induced Diabetic Rats (두릅, 오가피 및 느릅 열수추출물이 Streptozotocin 투여 흰쥐의 혈장바이오마커에 미치는 영향)

  • Shin, Kyong-Hee;Cho, Soo-Yeul;Lee, Mi-Kyung;Lee, Jeong-Sook;Kim, Myung-Joo
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.9
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    • pp.1457-1462
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    • 2004
  • This study was conducted to investigate the effects of Aralia elata, Acanthopanacis cortex and Ulmus davidiana water extracts on plasma glucose and biomarkers in the streptozotocin (STZ)-induced diabetic rats. Male Wistar rats were divided into normal and diabetic groups. The diabetic groups subdivided into the control group (DM), Aralia elata (DM-AE), Acanthopanacis cortex (DM-AC) and Ulmus davidiana (DM-UD). The extracts were supplemented in diet base on 11.42 g of raw materials/㎏ diet for 7 weeks. The diabetes was induced by injecting STZ (55 ㎎/㎏ B.W., i.p.) once 2 weeks before sacrifying. Plasma glucose level was significantly higher in the DM group than in the normal group, whereas insulin and C-peptide concentrations were significantly lowered in the DM groups compared to the normal group. These parameters were normalized in the DM-AE, DM-AC and DM-UD supplemented groups. Plasma albumin content was significantly lowered in the DM group compared to the normal group, yet it was significantly higher in the DM-AE group than in the DM group. Bilirubin and creatinine contents were elevated in the DM group, while the supplementation of Aralia elata, Acanthopanacis cortex and Ulmus davidiana water extracts ameliorate the change of these contents in STZ-induced diabetic rats. Plasma AST, ALT, ALP and LDH activities were significantly higher in the DM group than in the normal groups. The supplementation of Araliaceae family water extracts significantly lowered these parameters compared to the DM group. Accordingly, these results indicate that Aralia elata, Acanthopanacis cortex and Ulmus davidiana water extracts would seem to improve the glucose and biomarker in STZ-induced diabetic rats.

Changes in the Endothelin-1-induced Contraction of Aorta in Streptozotocin-induced Diabetic Rats

  • Cheong, Hyun-Joo;Kim, Eun-Jin;Kim, Su-Jin;Lee, Sun-Hee;Rhim, Byung-Yong
    • The Korean Journal of Physiology and Pharmacology
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    • v.4 no.3
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    • pp.185-195
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    • 2000
  • Vascular diseases are significant complications of diabetes mellitus (DM), and the endothelial cells may play a pivotal role in the development of vascular disease in DM. Endothelin-1 (ET-1) released from endothelium is a potent vasoconstrictor peptide and circulating level of ET-1 is increased in a variety of disease states. The purpose of this study was to determine the changes of responsiveness to ET-1 in DM, and we experimented on the changes in the ET-1-induced contraction, levels of nitrite and lipid peroxidation, and ET-1 immunoreactivity in aorta from streptozotocin-induced DM rats. DM was induced by single injection of streptozotocin (55 mg/kg, i.p.). The immunoreactive ET-1 levels in endothelial layer of thoracic aorta were much higher in DM rats than control rats. Nitrite in tissue homogenate was decreased and plasma nitrite was increased in DM rats. Malondialdehyde (MDA) was significantly increased in DM rats and cGMP was not significantly different between control and DM rats. ET-1 produced concentration- dependent contractile responses that are significantly attenuated in DM rats compared to controls. In the presence of selective $ET_A$ receptor antagonist BQ610, the maximum contraction was decreased and the concentration ratios for BQ610 yielded $pA_2$ values of 7.3 (slope, 0.65) in control rats, whereas BQ610 had no antagonistic effect on ET-1-induced contraction in DM rats. However, pretreatment with BQ788, an $ET_B$ receptor antagonist, maximum response was decreased and the dose-response curves for ET-1 were shifted to the right in both groups and $pA_2$ values were 7.9 and 7.7 (slope, 1.05 in control and DM rats), respectively. IRL 1620 and sarafotoxin S6c, $ET_B$ agonists, induced relaxation in control rats but not in DM rats. These results indicate that endothelial cell dysfunction and enhanced immunoreactivity of ET-1 have been found in DM rat and ET-1-induced contraction was attenuated in DM rat. These attenuated responses might be at least in part caused by the alteration of $ET_A$ receptor properties (e.g. desensitization), and partly related with an alteration in intracellular mechanism for contraction to ET-1.

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effects of Vitamin E on the Antioxidative Defense System of Kidney in Streptozotocin-Induced Diabetic Rats (Streptozotocin 유발 당뇨쥐 신장조직의 항산화계에 미치는 Vitamin E의 영향)

  • 이순재;곽오계;양정아
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.28 no.3
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    • pp.654-662
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    • 1999
  • The purpose of this study was to investigate the effects of vitamin E on the antioxidative defense system of kidney in streptozotocin induced diabetic rats. Sprague Dawley male rats weighing 100$\pm$10g were randomly assigned to one normal and three STZ induced diabetic groups, which were subdivided into vitamin E free diet(DM 0E group), 40mg vitamin E per kg diet(DM 40E group) and 400mg vitamin E per kg diet(DM 400E group). Vitamin E level of normal group was 40 mg per kg diet. Diabetes was experimentally induced by intravenous injection of 55mg/kg of body weight of streptozotocin(STZ) in citrate buffer(pH 4.3) after 4 weeks feeding of experimental diets. Animals were sacrificed at the 6th day of diabetic states. There were no significant on body weights, food intakes, and food efficiency ratio before the diabetic occurrence. But after the injection of STZ, body weights and food efficiency ratios were significantly decreased and the food intakes was increased. Kidney weights were significantly increased in diabetic groups compared to normal group. However, there were no significant differences among the diabetic groups. Plasma insulin levels of diabetic groups were significantly decreased, whereas, blood sugar levels were increased compared to that of normal group. There were no significant differences among diabetic groups in plasma insulin and glucose levels. Activities of superoxide dismutase(SOD) in DM 0E and DM 40E groups were signi ficantly decreased by 33% and 27%, respectively, compared to normal group. But that of DM 400E group was increased by 35% compared to DM 0E group. Activity of glutathione peroxidase(GSHpx) in DM 0E group was decreased by 20% compared with normal group. GSHpx activity in DM 400E group was increased by 29% compared to normal group. The contents of vitamin E in kidney were 58% and 49% lower in DM 0E and DM 40E group, respectively, than normal group. There was no significant difference in renal vitamin E contents between DM-400E group and normal group. The contents of superoxide radical(O2 ) in kidney were 150% and 98%, respectively, higher in DM 0E and DM 40E groups than normalgroup. DM 400E and normal groups were similar levels in their superoxide radical contents of kidneys. These results indicate that vitamin E functioned as chain breaking antioxidant in kidney such as in other tissues.

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Diabetes Mellitus Increases the Risk of Bladder Cancer: An Updated Meta-analysis

  • Yang, Xiao-Qing;Xu, Chen;Sun, Yan;Han, Rui-Fa
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2583-2589
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    • 2013
  • Purpose: Studies have indicated that diabetes mellitus (DM) is a risk factor for bladder cancer; however, not all evidence supports this conclusion. The aim of this meta-analysis was to collate and evaluate all primary observational studies investigating the risk of bladder cancer associated with DM. Methods: The PubMed and Google Scholar databases were searched to identify studies that estimated the association of DM and bladder cancer. Summary effect estimates were derived using a random-effects meta-analysis model. Results: A total of 23 studies (8 case-control studies, 15 cohort studies) including 643,683 DM and 4,819,656 non-DM cases were identified. Analysis of all studies showed that DM was associated with an increased risk of bladder cancer compared with non-DM overall (OR=1.68, 95% CI 1.32-2.13). Analysis of subgroups demonstrated this to be the case in both case-control studies (OR=1.59, 95% CI 1.28-1.97, $I^2$=58%) and cohort studies (RR=1.70, 95% CI 1.23-2.33, $I^2$=96%). There was no gender difference in DM-associated bladder cancer risk. Bladder cancer risk was increased in Asia and the North America region, but not in Europe. Furthermore, DM-associated bladder cancer risk was obviously higher in Asia than North America and Europe or in those with Caucasian ethnicity. With extension of follow-up time, the bladder cancer risk was not increased for the patients with DM. Conclusions: This meta-analysis provided further evidence supporting theDM association with a significantly higher risk of bladder cancer obtained from observational studies.

Clinicopathologic Predictors and Impact of Distant Metastasis from Adenoid Cystic Carcinoma of the Head and Neck (두경부 전양낭성암종에서 원격전이와 관련된 임상적, 병리학적 예측 인자)

  • Kim Jeong-Whun;Kim Kwang-Hyun;Kwon Taek-Kyun;Lee Sang-Joon;Sung Myung-Whun
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.157-162
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    • 2002
  • Background and Objectives: Adenoid cystic carcinoma (ACC) is a unique tumor characterized by frequent and delayed distant metastasis (DM) with uncommon regional lymph node metastasis. We evaluated the factors affecting DM of ACC and survival after appearance of DM. Materials and Methods: Medical records, radiographs and pathologic slides were reviewed for 94 patients from 1979 through 2001. Results: DM of ACC occurred in 46 patients, and developed more frequently in patients with tumors of the solid histologic subtype than in patients with tubular or cribriform subtypes. DM occurred less frequently in the sinonasal tract, and development of DM was not affected by tumor stage. Disease-specific 5- and 10-year survival rates were 88% and 72% for patients without DM, respectively and 76% and 48% for those with DM(p=0.02). Regarding the site of DM and its impact on outcomes, 30 patients had lung metastasis alone, 5 patients bone metastasis alone and 6 patients developed both lung and bone metastasis. Median survivals after appearance of DM among patients with isolated lung metastases and those with bone metastases with or without lung involvement were 54 and 21 months, respectively (p=0.04). Conclusions: Development of DM in ACC is predicted by solid histologic subtype, and major salivary gland or oral/pharyngeal rather than sinonasal primary site. Those patients with bone involvement with our without lung metastases had worse outcomes than those with pulmonary metastasis only.

Comparison of Renal Function and Clinical Outcomes between Diabetic and Non-diabetic Patients Underwent Off-Pump Coronary Artery Bypass Grafting Surgery

  • Moon, Seong-Min
    • Biomedical Science Letters
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    • v.17 no.4
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    • pp.337-345
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    • 2011
  • It is well recognized that conventional coronary artery bypass grafting (ONCAB) often leads to major organ dysfunction including renal injury. Diabetes mellitus is a major cause of nephropathy and poor clinical outcomes. The aim of this retrospective study was to evaluate the occurrence of adverse outcomes including renal impairment between diabetic (n=75, DM group) and non-diabetic patients (n=72, Non-DM group) underwent off-pump coronary artery bypass grafting surgery (OPCAB). Fasting glucose, hemoglobin A1c, fructosamine, fibrinogen and serum osmolality levels in the DM group were higher than those of the Non-DM group at pre-operative (Pre-OP) period ($P$ <0.05). History of hypertension and renal impairment in the DM group was higher than that of the Non-DM group ($P$ <0.05). Potassium ($K^+$), blood urea nitrogen and creatinine levels were higher, whereas sodium ($Na^+$) and glomerular filtration rate (GFR) levels were lower in the DM group than the Non-DM group at peri-operative period ($P$ <0.05). Fasting glucose levels at Pre-OP period had positive correlations with blood urea nitrogen and creatinine levels at peri-operative period, but negative correlations with GFR levels at peri-operative period in the DM group ($P$ <0.05). Incidences of renal impairment, diuretic therapy or continuous renal replacement therapy and fever in the DM group were higher than those of the Non-DM group at post-operative period ($P$ <0.05). These results suggest that blood glucose level should be tightly controlled at peri-operative period to avoid renal dysfunction in diabetic patients.

Association between Diabetes Mellitus and Fatty Liver Based on Ultrasonography Screening in the World's Highest Cholangiocarcinoma Incidence Region, Northeast Thailand

  • Thinkhamrop, Kavin;Khuntikeo, Narong;Phonjitt, Pichai;Chamadol, Nittaya;Thinkhamrop, Bandit;Moore, Malcolm Anthony;Promthet, Supannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3931-3936
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    • 2015
  • Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.