The relationship of body mass index to diabetes mellitus, hypertension and dyslipidaemia: comparison of data from two national surveys

The objectives of this study were to explore the relation between body mass index (BMI) and prevalence of diabetes mellitus, hypertension and dyslipidaemia; examine BMI distributions among patients with these conditions; and compare results from two national surveys. The Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) 2004 screening questionnaire (mailed survey) and the National Health and Nutrition Examination Surveys (NHANES) 1999–2002 (interview, clinical and laboratory data) were conducted in nationally representative samples ≥ 18 years old. Responses were received from 127,420 of 200,000 households (64%, representing 211,097 adults) for SHIELD, and 4257 participants for NHANES. Prevalence of diabetes mellitus, hypertension and dyslipidaemia was estimated within BMI categories, as was distribution of BMI levels among individuals with these diseases. Mean BMI was 27.8 kg/m2 for SHIELD and 27.9 kg/m2 for NHANES. Increased BMI was associated with increased prevalence of diabetes mellitus, hypertension and dyslipidaemia in both studies (p < 0.001). For each condition, more than 75% of patients had BMI ≥ 25 kg/m2. Estimated prevalence of diabetes mellitus and hypertension was similar in both studies, while dyslipidaemia was substantially higher in NHANES than SHIELD. In both studies, prevalence of diabetes mellitus, hypertension and dyslipidaemia occurred across all ranges of BMI, but increased with higher BMI. However, not all overweight or obese patients had these metabolic diseases and not all with these conditions were overweight or obese. Except for dyslipidaemia prevalence, SHIELD was comparable with NHANES. Consumer panel surveys may be an alternative method to collect data on the relationship of BMI and metabolic diseases

Diabetes MILES – The Netherlands: rationale, design and sample characteristics of a national survey examining the psychosocial aspects of living with diabetes in Dutch adults

Background : As the number of people with diabetes is increasing rapidly worldwide, a more thorough understanding of the psychosocial aspects of living with this condition has become an important health care priority. While our knowledge has grown substantially over the past two decades with respect to the physical, emotional and social difficulties that people with diabetes may encounter, many important issues remain to be elucidated. Under the umbrella of the Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Study International Collaborative, Diabetes MILES &ndash; The Netherlands aims to examine how Dutch adults with diabetes manage their condition and how it affects their lives. Topics of special interest in Diabetes MILES - The Netherlands include subtypes of depression, Type D personality, mindfulness, sleep and sexual functioning. Methods/design : Diabetes MILES &ndash; The Netherlands was designed as a national online observational study among adults with diabetes. In addition to a main set of self-report measures, the survey consisted of five complementary modules to which participants were allocated randomly. From September to October 2011, a total of 3,960 individuals with diabetes (40% type 1, 53% type 2) completed the battery of questionnaires covering a broad range of topics, including general health, self-management, emotional well-being and contact with health care providers. People with self-reported type 1 diabetes (specifically those on insulin pump therapy) were over-represented, as were those using insulin among respondents with self-reported type 2 diabetes. People from ethnic minorities were under-represented. The sex distribution was fairly equal in the total sample, participants spanned a broad age range (19&ndash;90 years), and diabetes duration ranged from recent diagnosis to living with the condition for over fifty years. Discussion : The Diabetes MILES Study enables detailed investigation of the psychosocial aspects of living with diabetes and an opportunity to put these findings in an international context. With several papers planned resulting from a pooled Australian-Dutch dataset and data collections planned in other countries, the Diabetes MILES Study International Collaborative will contribute substantially to identifying potentially unmet needs of those living with diabetes and to inform clinical research and care across the globe. <br /

Passive immunization with phospho-tau antibodies reduces tau pathology and functional deficits in two distinct mouse tauopathy models.

In Alzheimer's disease (AD), an extensive accumulation of extracellular amyloid plaques and intraneuronal tau tangles, along with neuronal loss, is evident in distinct brain regions. Staging of tau pathology by postmortem analysis of AD subjects suggests a sequence of initiation and subsequent spread of neurofibrillary tau tangles along defined brain anatomical pathways. Further, the severity of cognitive deficits correlates with the degree and extent of tau pathology. In this study, we demonstrate that phospho-tau (p-tau) antibodies, PHF6 and PHF13, can prevent the induction of tau pathology in primary neuron cultures. The impact of passive immunotherapy on the formation and spread of tau pathology, as well as functional deficits, was subsequently evaluated with these antibodies in two distinct transgenic mouse tauopathy models. The rTg4510 transgenic mouse is characterized by inducible over-expression of P301L mutant tau, and exhibits robust age-dependent brain tau pathology. Systemic treatment with PHF6 and PHF13 from 3 to 6 months of age led to a significant decline in brain and CSF p-tau levels. In a second model, injection of preformed tau fibrils (PFFs) comprised of recombinant tau protein encompassing the microtubule-repeat domains into the cortex and hippocampus of young P301S mutant tau over-expressing mice (PS19) led to robust tau pathology on the ipsilateral side with evidence of spread to distant sites, including the contralateral hippocampus and bilateral entorhinal cortex 4 weeks post-injection. Systemic treatment with PHF13 led to a significant decline in the spread of tau pathology in this model. The reduction in tau species after p-tau antibody treatment was associated with an improvement in novel-object recognition memory test in both models. These studies provide evidence supporting the use of tau immunotherapy as a potential treatment option for AD and other tauopathies

Model of antibody engagement of tau in-vivo.

<p>A compartmental model depicting tau and antibody (IgG) levels in brain, interstitial fluid (ISF), cerebrospinal fluid (CSF) and plasma. CSF tau is truncated with levels of ~1 nM, while tau in ISF exists as a full-length molecule with levels of 3–5 nM (4-5x greater than in CSF) [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0125614#pone.0125614.ref047" target="_blank">47</a>]. Concentrations of p-tau are estimated to be about 1–10% of total tau levels. Tau antibody concentrations are 1–3 nM in CSF and ISF [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0125614#pone.0125614.ref044" target="_blank">44</a>]. Antibody engagement of p-tau in CSF and ISF would enable clearance of tau via a variety of antibody-mediated mechanisms. Full-length tau is indicated as a molecule containing N-terminal (orange line), mid-domain (blue line), microtubule-binding repeat region (black box), and C-terminal (grey line) regions, whereas truncated tau in the CSF compartment is indicated by the mid-domain and N-terminal fragments.</p

PHF13 reduces contralateral hippocampal tau pathology in PS19 mice injected with K18PL PFFs.

<p>The extent of hippocampal MC1-positive tau pathology was evaluated in PS19 mice that received K18PL PFF injections into both the hippocampus and overlying cortex and treatment with either IgG2b or PHF13 (30 mpk i.p. for 4 weeks). <b>A.</b> Contralateral hippocampal images from coronal sections stained with MC1 from mice treated with either IgG2b (top panels) or PHF13 (bottom panels). Right panels show images after non-biased thresholding to identify MC1-positive pathology for quantification. <b>B.</b> The percent of hippocampal area occupied by MC1 staining from IgG2b- and PHF13-treated mice. The left Y-axis and panels (black symbols) show ipsilateral (Ipsi) hippocampal (HP) % area, whereas the right Y-axis and panels (red symbols) show contralateral (Contra) hippocampal % area. Statistical analyses were based on t-test comparisons between IgG2b and PHF13 treatment groups (** p<0.01).</p