Lipid profile indices in young people with different types of diabetes mellitus

Of all types of diabetes mellitus (DM), type 1 diabetes mellitus (DM1) and type 2 diabetes (DM2) are most often diagnosed in young people. However, up to 10 % of all cases of DM diagnosed at a young age are monogenic forms of DM – MODY (Maturity-Onset Diabetes of the Young), the most common forms of which are MODY2 (GCK-MODY) and MODY3 (HNF1AMODY). These genetic forms of DM are poorly understood, so the investigation of their clinical and biochemical parameters, including lipid profile, and comparison with more studied forms of DM is of high importance. The aim of this study was to analyze the characteristics of the lipid profile in patients aged 18–45 years with DM1, DM2, GCK-MODY and HNF1A-MODY. Material and methods. In 56 patients diagnosed by the molecular genetic method MODY, as well as in 82 patients with DM2 and 14 patients with DM1, matched by sex, age, a lipid profile was studied. Results. There were no statistically significant differences in total cholesterol and low-density lipoprotein cholesterol between young patients with different types of DM. In HNF1a-MODY, the highest level of triglycerides was revealed; in DM1, the level of high-density lipoprotein cholesterol was significantly higher than in other types of DM. Among the changes in the lipid profile among all types of DM, hypercholesterolemia was more often determined

Тhe prevalence of metabolically healthy obesity: data from the epidemiological survey in of Novosibirsk

Background: Obesity is associated with numerous metabolic complications, such as type 2 diabetes mellitus (DM2), dyslipidemia, arterial hypertension (AH), cardiovascular diseases and some forms of cancer. Nevertheless, the literature describes a group of obese individuals who are more resistant to the development of metabolic disorders. At present, this phenomenon is known as "Metabolically healthy obesity", "metabolically healthy obesity" (MZO). Despite the presence of excess weight or obesity, a favorable metabolic profile can be observed in this cohort of patients, characterized by preserved insulin sensitivity, absence of arterial hypertension, normal lipid, hormonal profile, absence of inflammation and unchanged hepatic transaminases. Aims: To study the prevalence of metabolically healthy obesity (MHO) and its characteristics in men and women at the age of 45–69 years in Novosibirsk. Materials and methods: To study covered 3197 persons from the base of the international project HAPPIE. They had a body mass index (BMI ≥ 30 kg/m²). «Metabolically healthy obesity» was determined as obesity (BMI ≥ 30 kg/m², with 2 and fewer components of metabolic syndrome (MS) by criteria NCEP ATP III, 2001. Statistical analisys SPSS-13. Results: The prevalence of metabolic healthy obesity (MHO) was 42% (38% for men and 43% for women). The examined people with MHO have reliably more favorable average level of TG, HDL-cholesterol, indicators of blood glucose, systolic arterial pressure and diastolic arterial pressure and less waist circumference. In the groups withMHO and MS abdominal obesity is common in men at 95 and 71%, in women at 99 and 90%; hyperTG – in men at 74 and 9%, in women at 72 and 5,5%; lower level HDL-cholesterol in 16 and 1% for men, and in 44,5% and 3% for women; AP in 96 and 77% and 94 and 71% in men and women respectively, the frequency fasting of hyperglycaemia 77 and 21% in men and 60 and 5% in women was markedly different. According to the data obtained by us, the frequency in the sample is high and amounted to 42%. In the subgroup the most commonly found is the MHO phenotype – 53%, than in the men -38%, р <0,001 Conclusions: According to our data, the frequency of metabolic healthy obesity in the sample is high and amounted to 42%. In the female subgroup, a metabolically healthy phenotype is more common 43% than in the male 38%, p <0.001. Metabolically healthy obese individuals are characterized by a significantly lower incidence of fasting hyperglycaemia and dyslipidemia

Diabetes mellitus associated with the mutation of the ABCC8 gene (MODY 12): features of clinical course and therapy

Maturity-Onset Diabetes of the Young (MODY) is a heterogeneous group of diseases associated with genes mutations leading to dysfunction of pancreatic β-cells. Among the 14 identified MODY variants, MODY 1–5 are the most studied. The article reports a MODY 12 clinical case, with mutation in ABCC8, encoding the sulphonylurea receptor. Diabetes mellitus manifested in a 27-year-old man with hyperglycaemia up to 24 mmol/L, without ketosis. Non-proliferative diabetic retinopathy, microalbuminuria, dyslipidaemia and carotid atherosclerosis were revealed upon initial examination. The levels of pancreatic islet cell antibodies and glutamate decarboxylase antibodies were negative, while the level of C-peptide was within the normal range. Insulin therapy in the basal-bolus regimen was provided with a gradual dose reduction due to frequent hypoglycaemia. The preproliferative retinopathy with macular oedema was revealed after 4 months of therapy, and panretinal photocoagulation of both eyes was performed. A molecular genetics study revealed a mutation in the gene ABCC8, the same mutation was found in patient’s mother and uncle. Insulin therapy was cancelled, and the treatment of gliclazide MR 60 mg/day was initiated, which resulted in extreme glycaemic excursions. Thereby, sodium–glucose cotranporter-2 (SGLT2) inhibitor dapagliflozin 10 mg/day was added. A reduction in glucose variability parameters were observed on combination therapy. After 6 months till 1.5 years of treatment, glycaemic control was optimal, no hypoglycaemic episodes were observed. This case study demonstrates clinical features of MODY 12, and the potential of combination of sulfonylurea and SGLT2 inhibitor in the treatment of this disease

eDNA inactivation and biofilm inhibition by the polymeric biocide polyhexamethylene guanidine hydrochloride (PHMG-Cl)

The choice of effective biocides used for routine hospital practice should consider the role of disinfectants in the maintenance and development of local resistome and how they might affect antibiotic resistance gene transfer within the hospital microbial population. Currently, there is little understanding of how different biocides contribute to eDNA release that may contribute to gene transfer and subsequent environmental retention. Here, we investigated how different biocides affect the release of eDNA from mature biofilms of two opportunistic model strains Pseudomonas aeruginosa ATCC 27853 (PA) and Staphylococcus aureus ATCC 25923 (SA) and contribute to the hospital resistome in the form of surface and water contaminants and dust particles. The effect of four groups of biocides, alcohols, hydrogen peroxide, quaternary ammonium compounds, and the polymeric biocide polyhexamethylene guanidine hydrochloride (PHMG-Cl), was evaluated using PA and SA biofilms. Most biocides, except for PHMG-Cl and 70% ethanol, caused substantial eDNA release, and PHMG-Cl was found to block biofilm development when used at concentrations of 0.5% and 0.1%. This might be associated with the formation of DNA–PHMG-Cl complexes as PHMG-Cl is predicted to bind to AT base pairs by molecular docking assays. PHMG-Cl was found to bind high-molecular DNA and plasmid DNA and continued to inactivate DNA on surfaces even after 4 weeks. PHMG-Cl also effectively inactivated biofilm-associated antibiotic resistance gene eDNA released by a pan-drug-resistant Klebsiella strain, which demonstrates the potential of a polymeric biocide as a new surface-active agent to combat the spread of antibiotic resistance in hospital settings

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Risk Factors for Chronic Non-Communicable Diseases and Osteoporotic Fractures in a Middle and Elderly-Aged Population

Aim. To study the associations of risk factors for chronic non-communicable diseases (CNCDs) and osteoporotic fractures (OFs) in a population sampling over 50 years. Materials and Methods. The data of a cross-sectional population-based study obtained in the Russian part of the international project HAPIEE (Novosibirsk) are analyzed. The present analysis comprised 7363 men and women aged 50&ndash;69 years old. We have assessed the frequency of OFs for the last 12 months and risk factors of CNCDs. Cross-sectional associations between OF history and potential determinants were analyzed using multivariable-adjusted logistic regression. Results. The frequency of OFs in the last 12 months was 3.6% (3.2% in men and 4.0% in women, p = 0.074). In men, the probability of OFs increased with an elevation of blood pressure (BP), high-density lipoprotein cholesterol (HDL-C), ethanol consumption, and reduced with increased body mass index (BMI). In women, the probability of a fracture increased with current smoking and an increased duration of post-menopause and reduced with an increase in triglycerides (TG) levels, independently of other factors. Conclusions. A syndemia of risk factors, both generally recognized for OFs (BMI, tobacco smoking, alcohol consumption, postmenopausal duration) and new factors associated with CNCDs (BP, HDL, TG), have been defined

Validation of the Finnish diabetes risk score (FINDRISC) for the Caucasian population of Siberia

Aim. A validation of the Finnish diabetes risk score (FINDRISC) was conducted among the Siberian population. FINDRISC was used to study the prevalence of risk factors for type 2 diabetes mellitus (T2DM) and to estimate the incidence of T2DM in high-risk groups during a 10-year observation period.  Materials and methods. A total of 9,360 subjects aged between 45 and 69 years were enrolled in this cross-sectional, population-based study. FINDRISC was used to group 8,050 people without diabetes according to their risk for T2DM. Statistical analysis was performed using SPSS.  Results. When a cutoff point of 11 was used to identify those with diabetes, sensitivity was 76. 0% and specificity was 60. 2%. The area under the receiver operating curve for diabetes was 0. 73 (0. 73 for men and 0. 70 for women). More than one-third (31. 7%) of the adult population of Novosibirsk was estimated to have medium, high or very high risk of developing T2DM in the next 10 years. Cases of T2DM estimated to occur during the 10 years of follow-up had significantly higher incidence of risk factors such as BMI ≥30 kg/m2, waist circumference 102 cm in men and 88 cm in women and a family history of T2DM and were more likely to take drugs to lower blood pressure.  Conclusion. FINDRISC provided good results in our sample, and we recommend its use in the Siberian population