Blood pressure and hypertension in type 1 diabetes mellitus patients with long duration

Type 1 diabetes mellitus (T1DM) has significantly better prognosis which has led to increased cardio-vascular diseases (CVD) prevalence. The detection of CVD risk factors and their treatment become tasks of paramount importance. Among them, high blood pressure (BP) is a target of primary purpose. Aim: to explore the blood pressure values, the prevalence of hypertension (HTN) and its management in patients with T1DM with long duration and without overt CVD, in comparison to matched controls. Participants and methods: totally, 124 patients with T1DM were matched to 59 controls by sex, age and approximate body mass index (BMI). All participants filled in questionnaires with information on demographics, physical activity, life style, concomitant diseases, treatments, presence of complications, etc. Blood samples were taken for laboratory and biomarkers investigation. Blood pressure was measured by investigators twice and the mean of the two measurements was used. HTN was accepted using standard definitions. BP values were compared using t-test. Multiple linear regression models with dependent variable BP measures and age, sex, BMI, presence of T1DM, glycated hemoglobin levels, creatinine levels as independent variables were created. ANOVA method was used to test the interaction of sex and presence of T1DM. Results: The mean age of the participants was 43.47 ± 10.1 years, 54% were males. The mean duration of T1DM was 25.31 ± 8.2 years and the mean HbA1c was 8.42 ± 1.8% for diabetic patients. The mean blood pressure measures in T1DM groups were higher than in controls, both in males and females. The difference reached significance for SBP and pulse pressure (PP). The presence of T1DM independently affected the BP values, after adjusting for major confounders. The mean adjusted differences between T1DM and controls were 8.37 mm Hg for SBP, 4.92 mm Hg for DBP, and 5.19 mm Hg for PP (p < 0.001). HTN was significantly more frequent in T1DM patients than in controls – 54% vs. 27%, p = 0.0001, mainly due to already known hypertension. BP control was insufficient – in only 36% and 13% of the treated hypertensive participants, respectively, for BP < 140/90 and < 130/80 mm Hg. The majority of the patients with HTN were treated with combination therapy, mostly single-pill fixed dosage but 30% of the hypertensive patients with diabetes did not take antihypertensive medications. Inhibitors of the renin-angiotensin system were the preferred class of medications. Conclusions: SBP and PP were significantly higher in middle-aged patients with T1DM with long duration than their control counterparts. The presence of HTN was significantly more common in T1DM. Although treated according to the current recommendations, the control of BP was far from effective. These results show the need for constant screening of patients with T1DM for HTN and other risk factors and for more aggressive antihypertensive treatment to prevent future CVD events

Age-related changes in global motion coherence: conflicting haemodynamic and perceptual responses

Our aim was to use both behavioural and neuroimaging data to identify indicators of perceptual decline in motion processing. We employed a global motion coherence task and functional Near Infrared Spectroscopy (fNIRS). Healthy adults (n = 72, 18-85) were recruited into the following groups: young (n = 28, mean age = 28), middle-aged (n = 22, mean age = 50), and older adults (n = 23, mean age = 70). Participants were assessed on their motion coherence thresholds at 3 different speeds using a psychophysical design. As expected, we report age group differences in motion processing as demonstrated by higher motion coherence thresholds in older adults. Crucially, we add correlational data showing that global motion perception declines linearly as a function of age. The associated fNIRS recordings provide a clear physiological correlate of global motion perception. The crux of this study lies in the robust linear correlation between age and haemodynamic response for both measures of oxygenation. We hypothesise that there is an increase in neural recruitment, necessitating an increase in metabolic need and blood flow, which presents as a higher oxygenated haemoglobin response. We report age-related changes in motion perception with poorer behavioural performance (high motion coherence thresholds) associated with an increased haemodynamic response

Epigenetic regulation of fetal bone development and placental transfer of nutrients: progress for osteoporosis

Osteoporosis is a common age-related disorder and causes acute and long-term disability and economic cost. Many factors influence the accumulation of bone minerals, including heredity, diet, physical activity, gender, endocrine functions, and risk factors such as alcohol, drug abuse, some pharmacological drugs or cigarette smoking. The pathology of bone development during intrauterine life is a factor for osteoporosis. Moreover, the placental transfer of nutrients plays an important role in the building of bones of fetuses. The importance of maternal calcium intake and vitamin D status are highlighted in this review. Various environmental factors including nutrition state or maternal stress may affect the epigenetic state of a number of genes during fetal development of bones. Histone modifications as histone hypomethylation, histone hypermethylation, hypoacetylation, etc. are involved in chromatin remodeling, known to contribute to the epigenetic landscape of chromosomes, and play roles in both fetal bone development and osteoporosis. This review will give an overview of epigenetic modulation of bone development and placental transfer of nutrients. In addition, the data from animal and human studies support the role of epigenetic modulation of calcium and vitamin D in the pathogenesis of osteoporosis. We review the evidence suggesting that various genes are involved in regulation of osteoclast formation and differentiation by osteoblasts and stem cells. Epigenetic changes in growth factors as well as cytokines play a rol in fetal bone development. On balance, the data suggest that there is a link between epigenetic changes in placental transfer of nutrients, including calcium and vitamin D, abnormal intrauterine bone development and pathogenesis of osteoporosis

Feel4Diabetes healthy diet score: Development and evaluation of clinical validity

Background: The aim of this paper is to present the development of the Feel4Diabetes Healthy Diet Score and to evaluate its clinical validity. Methods: Study population consisted of 3268 adults (63% women) from high diabetes risk families living in 6 European countries. Participants filled in questionnaires at baseline and after 1 year, reflecting the dietary goals of the Feel4Diabetes intervention. Based on these questions the Healthy Diet Score was constructed, consisting of the following components: breakfast, vegetables, fruit and berries, sugary drinks, whole-grain cereals, nuts and seeds, low-fat dairy products, oils and fats, red meat, sweet snacks, salty snacks, and family meals. Maximum score for each component was set based on its estimated relative importance regarding T2DM risk, higher score indicating better quality of diet. Clinical measurements included height, weight, waist circumference, heart rate, blood pressure, and fasting blood sampling, with analyses of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Analysis of (co) variance was used to compare the Healthy Diet Score and its components between countries and sexes using baseline data, and to test differences in clinical characteristics between score categories, adjusted for age, sex and country. Pearson''s correlations were used to study the association between changes from baseline to year 1 in the Healthy Diet Score and clinical markers. To estimate reproducibility, Pearson''s correlations were studied between baseline and 1 year score, within the control group only. Results: The mean total score was 52.8 ± 12.8 among women and 46.6 ± 12.8 among men (p < 0.001). The total score and its components differed between countries. The change in the Healthy Diet Score was significantly correlated with changes in BMI, waist circumference, and total and LDL cholesterol. The Healthy Diet Score as well as its components at baseline were significantly correlated with the values at year 1, in the control group participants. Conclusion: The Feel4Diabetes Healthy Diet Score is a reproducible method to capture the dietary information collected with the Feel4Diabetes questionnaire and measure the level of and changes in the adherence to the dietary goals of the intervention. It gives a simple parameter that associates with clinical risk factors in a meaningful manner

Interactions between the endogenous cannabinoid system and the peptides of the Tyr-MIF-1 family modulate heat stress-induced analgesia

The present study aimed at evaluating whether an interaction between the endocannabinoid system (ECS) and peptides from the Tyr-MIF-1 family modulates heat stress-induced analgesia. For this purpose, adult male rats were subjected to 1 hour of heat stress. Pain perception was estimated in vivo by Paw pressure test. Immunohistochemical evaluation of CB1 receptors was also performed in the periaqueductal grey (PAG). Our results showed that the application of CB1-receptor agonist anandamide at the end of the stress led to a tendency of decrease in heat-SIA. We also found that each of the four Tyr-MIF-1 peptides interacted with the ECS after acute heat stress, resulting in changes in the PP-thresholds with different direction, degree, and duration. In particular, the administration of MIF-1 and Tyr-K-MIF-1 after CB1-receptor agonist anandamide increased heat stress-induced analgesia (heat-SIA) after the 10th min, while Tyr-MIF-1 and Tyr-W-MIF-1 produced only short-lasting analgesia. CB1-expression in the PAG was also estimated, showing an increase after Tyr-MIF-1 and Tyr-W-MIF-1 administration with anandamide pretreatment, and a decrease after Tyr-W-MIF-1 administration with the CB1-receptor antagonist AM251- or the opioid receptor antagonist naloxone pretreatment. In summary, it can be inferred that under heat stress conditions the peptides from the Tyr-MIF-1 family, interacting with opioid and non-opioid receptors, differently relate with the cannabinoid system and such an interaction modulates heat stress-induced analgesia. It also seems that Tyr-MIF-1 and Tyr-W-MIF-1 have a direct impact on CB1-expression in the PAG, while MIF-1 and Tyr-K-MIF-1 probably act via second messengers or the activation of additional neurotransmitter system(s)

Serum Copper and Zinc in a Representative Sample of Bulgarian Population

Copper (Cu) and zinc (Zn) are essential for life. Body Cu and Zn content depends on variety of factors - age, gender, and diet, type of drinking water, geographical location and genetic predisposition. Copper status becomes even more relevant not only in rare genetic disorders such as Wilson disease but in diseases such as cardiovascular ones, impaired glucose tolerance and neuro-degenerative and tumor diseases. The study aimed to examine the distribution of serum Cu and Zn in a representative group of the Bulgarian population and to describe factors which influence metal content. It also aimed to describe the link between serum Cu levels and the frequency of Alzheimer’s disease (AD) in Bulgarians. Cu and Zn in serum were measured in 379 individuals (172 males and 207 females) from 5 different regions in Bulgaria by flame atomic absorption using AAnalyst 400, Perkin Elmer. Statistical analyses were performed by SPSS, 19. Median and inert-quartile range (IQR) for blood Cu were 15.89 (13.87-7.89) μmol/L and for Zn - 13.00 (11.7-14.68) μmol/L in the examined group. Higher Cu levels in females than in males were found (p 0.05). Significant difference (p < 0.05) was found in serum Cu between young people (< 30 year old) and adults over 61 year old. Statistically significant difference in Cu and Zn was observed (p < 0.05) in respect of residences. Difference without significance was measured between serum lipids and serum Cu (p = 0.541) and Zn (p = 0.741)