Association of serum adipocytokine levels with cardiac autonomic neuropathy in type 2 diabetic patients

<p>Abstract</p> <p>Background</p> <p>Cardiac autonomic neuropathy (CAN) is a common complication of diabetes associated with poor prognosis. In addition, the autonomic imbalance is associated with cardiovascular disease (CVD) in diabetes. It is thought that adipocytokines contribute to the increased risk of vascular complications in patients with type 2 diabetes mellitus (T2DM). However, literature data on the association between CAN with adipocytokines such as leptin, tumor necrosis factor-alpha (TNF-alpha), adiponectin in subjects with T2DM is limited.</p> <p>Therefore, in the present study, we examined the relationship between fasting serum leptin, TNF- alpha and adiponectin and CAN in Korean T2DM patients.</p> <p>Methods</p> <p>A total of 142 T2DM patients (94 males, 48 females) were recruited. CAN was assessed by the five tests according to the Ewing's protocol and the time and frequency domain of the heart rate variability (HRV) was evaluated. Serum TNF-alpha and adiponectin levels were measured using enzyme-linked immunosorbent assay and serum leptin levels were measured using radioimmunoassay.</p> <p>Results</p> <p>Although, the mean levels of leptin, TNF-alpha and adiponectin were not significantly different between the groups with and without CAN, the levels of leptin and adiponectin had a tendency to increase as the score of CAN increased (p = 0.05, p = 0.036). Serum leptin levels demonstrated a negative correlation with low frequency (LF) in the upright position (p = 0.037). Regarding TNF-alpha, a significant negative correlation was observed with SDNN and RMSSD in the upright position (p = 0.023, p = 0.019). Adiponectin levels were not related to any HRV parameters. Multivariate logistic regression analysis demonstrated that the odds of CAN increased with a longer duration of diabetes (1.25, [1.07-1.47]) and higher homeostatic model of assessment-insulin resistance (HOMA-IR) (5.47, [1.8-16.5]). The relative risks for the presence of CAN were 14.1 and 51.6 for the adiponectin 2^nd, 3^rdtertiles when compared with first tertile (p-value for trend = 0.022).</p> <p>Conclusions</p> <p>In the present study, the higher serum adiponectin levels and HOMA-IR were associated with an increased risk for the presence of CAN. Also, the CAN score correlated with the serum adiponectin. Serum adipocytokines such as leptin and TNF-alpha were significantly correlated with parameters of HRV, representative markers of CAN. Future prospective studies with larger number of patients are required to establish a direct relationship between plasma adipocytokine concentrations and the development or severity of CAN.</p

Investigation of Enhanced Polygon Wall Boundary Model in PNU-MPS Method

With regard to demonstration of fluid flow, there are two descriptions which are Eulerian description and Lagrangian description. In the field of CFD (Computational Fluid Dynamics), a number of studies relevant to grid method based on Eulerian description have been conducted generally. However, when the grid method is employed to simulate flow field, it is inevitable to give consideration to convection term which generates severe numerical diffusion and fluctuation. To obtain the accuracy of solution, a different type of method based on Lagrangian description is come to the fore. Numerical approaches following Lagrangian description have been called meshfree or particle method. Even though particle method does not accompany convection term and fully satisfies conservation of mass, its studies have not been carried out extensively because it is difficult to implement the boundary conditions correctly due to insufficient number of particles in the vicinity of boundary. It affects directly the stability of flow field and accuracy in computation. In MPS (Moving Particle Semi-implicit) method [1], fixed-type of dummy particles are placed inside wall boundary. By placing extra particles as the wall, it seems to be not easy to satisfy the boundary condition for sharp-edged or extremely thin body configuration. In this study, the enhanced polygon wall boundary model, which was suggested originally by Mitsume et al. [2], is employed to the PNU-MPS (Pusan-National-University-modified MPS) method [3] to improve and stabilize the analysis of fluid flow with arbitrary-shaped body including sharp-edged body configuration without any additional particles. The developed simulation method, called as PNU-MPS-POLY, is adopted to the Couette flow and the lid-driven cavity flow with various corner angles. The present simulation results are validated through comparison with the analytic solutions, the experiments [4], and other simulation results [5,6]

Differential associations of central and brachial blood pressure with carotid atherosclerosis and microvascular complications in patients with type 2 diabetes

BACKGROUND: We examined the relationship between central blood pressure (BP), brachial BP with carotid atherosclerosis and microvascular complications in type 2 diabetes mellitus (T2DM). METHODS: We recruited 201 patients who were evaluated for central BP, brachial BP, carotid ultrasonography, brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and microvascular complications. Central BP were calculated using a radial automated tonometric system. RESULTS: Agreement between central BP and brachial BP was very strong (concordance correlation coefficient between central and brachial SBP = 0.889, between central and brachial PP = 0.816). Central pulse pressure (PP) was correlated with mean carotid intima-media thickness (CIMT), baPWV and ABI, whereas brachial PP was borderline significantly correlated with CIMT. The prevalence of nephropathy(DN) and retinopathy(DR) according to the brachial PP tertiles increased, the prevalences of microvascular complications were not different across central PP tertiles. In multivariate analysis, the relative risks (RRs) for the presence of DR were 1.2 and 4.6 for the brachial PP tertiles 2 and 3 when compared with the first tertile. Also, the RRs for the presence of DN were 1.02 and 3 for the brachial PP tertiles 2 and 3 when compared with the first tertile. CONCLUSIONS: Agreement of central BP and brachial BP was very strong. Nonetheless, this study showed that higher brachial PP levels are associated with increased probability for the presence of microvascular complications such as DR/DN. However, there are no associations with central SBP and central PP with microvascular complications. Central BP levels than brachial BP are correlated with surrogate marker of macrovascular complications

THE EFFECT OF SHOULDER MOBILITY ON AGONIST AND SYNERGIST DURING SHOULDER PRESS

The purpose of this study was to investigate the effect of shoulder mobility score on agonist and synergist muscle activation during shoulder press and to provide an underpinning fundamental to optimize the training effect while reducing the risk of injuries when instructing training in the field. The participants were divided to two different groups according to individual shoulder mobility score which is part of the Functional Movement Screen (FMS). There were five participants in the score of 3 group (upper group) and six included in the group with the score of less than 3 (lower group). The results of this study revealed that the shoulder mobility score showed a negative correlation with the ratio of the left and right latissimus dorsi/anterior deltoid muscle activation in the concentric contraction phase (