Perceived need to increase physical activity levels among adults at high risk of type 2 diabetes. A cross-sectional analysis within a community-based diabetes prevention project FIN-D2D

Background. Increased physical activity is a cornerstone of type 2 diabetes prevention. The perception of a need to change is considered essential in behaviour change processes. However, the existing literature on individuals' perceived need to change health behaviour is limited. In order to improve understanding of diabetes prevention through increased physical activity levels (PAL), we assessed factors associated with perceiving a need to increase PAL among adults at high risk of diabetes. Methods. Opportunistic screening was used within a primary-care based lifestyle intervention covering 10 149 men and women at high risk of type 2 diabetes. Data were obtained at baseline visits. The explored determinants were demographic, anthropometric/clinical, behavioural and psychosocial characteristics, along with four categories of PAL awareness. Logistic regression was used in the analysis. Results. 74% of men (n=2 577) and 76% of women (n=4 551) perceived a need to increase their PAL. The participants most likely to perceive this need were inactive, had a larger waist circumference, rated their PAL as insufficient, and were at the contemplation stage of change. Smoking, elevated blood pressure, dyslipidaemia, and a family history of diabetes were not associated with this perception. The likelihood was also greater among women with less perceived fitness and less education. Demographic factors other than education did not determine participants' perceived need to increase PAL. PAL overestimators were less likely to perceive the need to increase their PAL than realistic inactive participants. Conclusions. Subjective rather than objective health factors appear to determine the perception of a need to increase PAL among adults at high risk of diabetes. Client perceptions need to be evaluated in health counselling in order to facilitate a change in PAL. Practical descriptions of the associations between metabolic risk factors, PAL, and diabetes are needed in order to make the risk factors concrete for at-risk individuals.peerReviewe

HIV-1 infection is associated with changes in nuclear receptor transcriptome, pro-inflammatory and lipid profile of monocytes

<p>Abstract</p> <p>Background</p> <p>Persistent residual immune activation and lipid dysmetabolism are characteristics of HIV positive patients receiving an highly active antiretroviral therapy (HAART). Nuclear Receptors are transcription factors involved in the regulation of immune and metabolic functions through the modulation of gene transcription. The objective of the present study was to investigate for the relative abundance of members of the nuclear receptor family in monocytic cells isolated from HIV positive patients treated or not treated with HAART.</p> <p>Methods</p> <p>Monocytes isolated from peripheral blood mononuclear cells (PBMC) were used for analysis of the relative mRNA expressions of FXR, PXR, LXR, VDR, RARα, RXR, PPARα, PPARβ, PPARγ and GR by Real-Time polymerase chain reaction (PCR). The expression of a selected subset of inflammatory and metabolic genes MCP-1, ICAM-1, CD36 and ABCA1 was also measured.</p> <p>Results</p> <p>Monocytes isolated from HIV infected patients expressed an altered pattern of nuclear receptors characterized by a profound reduction in the expressions of FXR, PXR, PPARα, GR, RARα and RXR. Of interest, the deregulated expression of nuclear receptors was not restored under HAART and was linked to an altered expression of genes which supports both an immune activation and altered lipid metabolism in monocytes.</p> <p>Conclusions</p> <p>Altered expression of genes mediating reciprocal regulation of lipid metabolism and immune function in monocytes occurs in HIV. The present findings provide a mechanistic explanation for immune activation and lipid dysmetabolism occurring in HIV infected patients and could lead to the identification of novel potential therapeutic targets.</p

Personalized diagnosis and therapy.

Personalized medicine, i.e., the use of information about a person&rsquo;s genes, proteins, metabolites, and environment to prevent, diagnose, and treat disease, has been much talked about in recent years. So some observers are wondering what the excitement is all about cumulating in the following statement: &ldquo;Personalized health care is nothing new. Doctors have always tried to fit the therapy to the patient&rsquo;s need if possible.&rdquo; But what has happened more recently is that one has now begun to go a level deeper, i.e., to explore the biology of the disease and its treatment at the molecular level. However, molecular medicine does not per se define personalized medicine, but the molecular tools are important as they should enable greater relevance in the information provided by corresponding diagnostic tests (see below) (Edwards et al. 2008; Weedon et al. 2006; Romeo et al. 2007; Hegel et al. 1999; Wildin et al. 2001; Grant et al. 2006; Rothman and Greenland 2005; Raeder et al. 2006; Hegele et al. 2000; Capell and Collins 2006; Delepine et al. 2000; Janssens et al. 2006; Xiayan and Legido-Quigley 2008; Figeys and Pinto 2001; M&uuml;ller 2002, 2010; Pearson et al. 2007; Janssens et al. 2008; Risch and Merikangas 1996; Janssens and van Duijn 2008; McCarthy 2003; McCarthy et al. 2003; Stumvoll et al. 2005; Lyssenko et al. 2005; Florez et al. 2003)