Relationship between inflammatory markers, metabolic and anthropometric variables in the Caribbean type 2 diabetic patients with and without microvascular complications

BACKGROUND: Serum sialic acid and C reactive protein are the markers for inflammation. The main objective of this study was to determine the sialic acid level in Caribbean type 2 diabetic patients with and without microvascular complications and its relationship with metabolic and anthropometric variables. RESEARCH DESIGN AND METHODS: The Caribbean subjects aged 15–60 years with type 2 diabetes were recruited for the study. Fasting venous blood samples were collected from 162 subjects of which 44 were healthy individuals, 44 were of type 2 diabetes, 44 were of type 2 diabetes with nephropathy and 30 were of diabetes with retinopathy. Simultaneously urine samples were also collected from each of the subjects. All the blood samples were processed for lipid profile, glucose, HbA1(C, )C-reactive protein and sialic acid. The urine samples were analysed for sialic acid and microalbumin. RESULTS: Serum sialic acid concentrations were significantly higher among diabetic subjects (66.0 ± 11.7 mg %) as compared to controls (55.2 ± 8.3 mg %). There was a significantly increasing trend of serum sialic acid with severity of nephropathy (71.6 ± 23.6 mg %) and degree of urinary albumin excretion (794.3 ± 805.9). The diabetic retinopathy patients also demonstrated significantly higher values of serum sialic acid (77.9 ± 29.0) and urine microalbumin (351.1 ± 559.9). Elevated serum sialic acid microalbumin concentrations were associated with cardiovascular risk factors such as hypertension, increased waist to hip ratios. (P < 0.05). Sialic acid had no correlation with CRP or any component of the lipid profile. CONCLUSION: The increased serum sialic acid and microalbumin were strongly related to the presence of microvascular complications like diabetic nephropathy and diabetic retinopathy and cardiovascular risk factors like hypertension and waist to hip ratios in Caribbean type-2 diabetic patients. The serum sialic acid may be used as an inflammatory marker and possible indicator of microvascular complications in type-2 diabetic patients

Relationship between Sialic acid and metabolic variables in Indian type 2 diabetic patients

BACKGROUND: Plasma sialic acid is a marker of the acute phase response. Objective is to study the relationship between sialic acid relationship with metabolic variables in Indian type 2 diabetes with and without microvascular complications. RESEARCH DESIGN AND METHODS: Fasting Venous blood samples were taken from 200 subjects of which 50 were of diabetes mellitus (DM) and nephropathy patients, 50 patients with type 2 diabetes and retinopathy, 50 patients with type 2 diabetes without any complications and 50 healthy individuals without diabetes. The Indian subject's aged 15–60 years with type 2 diabetes were recruited for the study. Simultaneously urine samples were also collected from each of the subjects. All the blood samples were analyzed for total cholesterol, triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), fasting and postprandial glucose on fully automated analyzer. Serum and urine sialic acid along with microalbumin levels were also estimated. RESULTS: There was a significantly increasing trend of plasma and urine sialic acid with severity of nephropathy (P < 0.001) and with degree of urinary albumin excretion (P < 0.001). Serum sialic acid correlated with increasing serum creatinine concentration (P < 0.001). Elevated serum sialic acid concentrations were also associated with several risk factors for diabetic vascular disease: diabetes duration, HbA(1)c, serum triglyceride and cholesterol concentrations, waist-to-hip ratio and hypertension. Significant correlations were found between sialic acid concentration and cardiovascular risk factors like LDL and TG in the diabetic subjects. CONCLUSION: The main finding of this study is that elevated serum and urinary sialic acid and microalbumin concentrations were strongly related to the presence of microvascular complications like diabetic nephropathy and retinopathy and cardiovascular risk factors in Indian type 2 diabetic subjects. Further study of acute-phase response markers and mediators as indicators or predictors of diabetic microvascular complications is therefore justified

BENEFICIAL EFFECTS OF COFFEE AND MAINTENANCE OF URIC ACID LEVELS

Objective: This study aimed in finding out if drinking coffee over a long term showed a marked influence on the serum uric acid level and Fasting blood glucose level.Methods: The study population had 200 healthy subjects out of whom 143 were coffee drinkers and 90 diabetic subjects out of which 48 were coffee drinkers.Results: It was seen that the mean value of uric acid in coffee consumers was significantly lower in both normal and diabetic study population. Further, the relation of Fasting blood glucose (FBG) with uric acid in diabetic coffee consuming study population was much linear than in the normal study population.Conclusion: Since hyperglycemia and hyperuricemia are associated with the risk of cardiovascular disease and end-stage renal disorder in type 2 diabetes, coffee is considered to be useful in such subjects. The amounts of chlorogenic acid and caffeine in coffee are now considered beneficial on long term usage since it improves insulin sensitivity and lowers the uric acid and sugar level.Keywords: Coffee, Fasting Blood Glucose, Type 2 diabetes, Uric acid

Nucleic acid distribution pattern as a possible biomarker for metabolic activities of neoplastic cells: a digitally-aided fluorescence microscopy study on normal and neoplastic lymphocytes of acute and chronic canine lymphocytic leukemia

<p>Abstract</p> <p>Background</p> <p>Metabolic states of neoplastic cells are increasingly being relied upon for diagnostic and prognostic assessment of neoplastic conditions. The nucleic acid distribution pattern of cells in general, in terms of degree of condensation of the nuclear chromatin and overall spread of the nucleic acid within the nuclear and cytoplasmic compartments, can reflect the metabolic state of the cell. This simple but logical concept appears not be put into consideration to date as numerous attempts are being made towards formulating reliable biomarkers for rapid diagnosis, prognosis and subsequent therapeutic interventions for neoplastic conditions. We comparatively evaluated nucleic acid distribution patterns of normal lymphocytes and neoplastic cells of lymphocytic lineage, employing light and fluorescence microscopy procedures, as well as digital imaging analytical methods.</p> <p>Results</p> <p>The results demonstrate distinctiveness in the pattern of nucleic acid distribution for the normal lymphocytes and three lymphocytic neoplastic cell-types of canine lymphocytic leukemia that are categorized as small, intermediate and large neoplastic lymphocytes. Variably-shaped cytoplasmic processes laden with single-stranded nucleic acids (SSNA) were observed for the small and intermediate-sized neoplastic lymphocytes, compared with large neoplastic lymphocytes and the normal lymphocytes; the latter two categories of cells being virtually devoid of similar processes. Prominent cytoplasmic and nuclear clumps of SSNA, indicative of a higher rate of metabolic activity, were also observed within the neoplastic cells compared with fewer and narrower SSNA of the normal cells.</p> <p>Conclusion</p> <p>The comparative relative increases of SSNA in cytoplasmic processes and other cellular areas of small and intermediate-sized neoplastic lymphocytes is reflective of greater metabolic activity in neoplastic cells in general compared with their normal cellular counterparts.</p

Does insulin resistance co-exist with glucocorticoid resistance in the metabolic syndrome? Studies comparing skin sensitivity to glucocorticoids in individuals with and without acanthosis nigricans

<p>Abstract</p> <p>Background</p> <p>The metabolic syndrome is associated with increased risk for both diabetes and coronary artery disease, which insulin resistance alone does not satisfactorily explain. We propose an additional and complementary underlying mechanism of glucocorticoid resistance.</p> <p>Results</p> <p>Using acanthosis nigricans (AN) and skin vasoconstrictor (SVC) response to topically applied beclomethasone dipropionate as markers of insulin and glucocorticoid resistance, respectively, we compared anthropometric, biochemical, pro-inflammatory markers and the SVC response in subjects with AN in two studies: STUDY 1 was used to compare subjects with AN (Grade 4, n = 32), with those without AN (n = 68) while STUDY 2 compared these responses among a cross-section of diabetic patients (n = 109) with varying grades of AN (grade 0, n = 30; grade 1, n = 24; grade 2, n = 18; grade 3, n = 25; grade 4, n = 12).</p> <p>Findings</p> <p>In both studies there was an inverse relationship between AN Grade 4 and the SVC response, (P < 0.001). In STUDY 1, AN Grade 4 was associated with age, waist circumference, BMI, fasting blood glucose, plasma lipids and hs-CRP (P < 0.05). SVC was an independent predictor of CRP and those with combined AN and a negative SVC response, CRP levels were highest. In Study 2 when the SVC response in subjects with type 2 diabetes mellitus with varying degrees of AN was studied, it showed that for any degree of AN, the SVC response is more likely to be negative and was independent of gender and ethnicity.</p> <p>Conclusion</p> <p>An absent SVC response represents a new biomarker for the metabolic syndrome and the exaggerated inflammatory response, which characterizes the metabolic syndrome, may be an outcome of deficient glucocorticoid action in vascular tissue.</p

Evaluation of the Wound-healing Activity of Ethanolic Extract of Morinda citrifolia L. Leaf

Morinda citrifolia L. (noni) is one of the most important traditional Polynesian medicinal plants. The primary indigenous use of this plant appears to be of the leaves, as a topical treatment for wound healing. The ethanol extract of noni leaves (150 mg kg−1 day−1) was used to evaluate the wound-healing activity on rats, using excision and dead space wound models. Animals were randomly divided into two groups of six for each model. Test group animals in each model were treated with the ethanol extract of noni orally by mixing in drinking water and the control group animals were maintained with plain drinking water. Healing was assessed by the rate of wound contraction, time until complete epithelialization, granulation tissue weight and hydoxyproline content. On day 11, the extract-treated animals exhibited 71% reduction in the wound area when compared with controls which exhibited 57%. The granulation tissue weight and hydroxyproline content in the dead space wounds were also increased significantly in noni-treated animals compared with controls (P < 0.002). Enhanced wound contraction, decreased epithelialization time, increased hydroxyproline content and histological characteristics suggest that noni leaf extract may have therapeutic benefits in wound healing

Investigating risk factors for developing autism, cerebral palsy and down syndrome in a Trinidadian population

Background: Autism, Cerebral Palsy and Down Syndrome are three lifelong, non-curable common developmental disorders that affect approximately 1 in 59, 1 in 323, and 1 in 700 children respectively. This research is to study the effects of prenatal, perinatal, and postnatal factors on the development of Autism, Cerebral Palsy (CP) and Down Syndrome (DS) in a Trinidadian population.Methods: This was a descriptive case-control study comprised 75 subjects, with 25 cases from each of the three disorders investigated, i.e. autism, CP and DS.Results: The highest risk of autism was associated with mothers having high stress levels (p=0.002), high blood pressure (0.042), and low iron levels (p=0.012) during the pregnancy, as well as having a family history of autism (p=0.002) and residing in an air polluted area (p=0.034). The highest risk of cerebral palsy was associated with a child being born preterm (case 24%, control 0; p=0.009), experiencing postnatal complications (case 80%, control 4%, p=0.000), having a birth weight less than 2500 g (p=0.002), having an abnormal appearance at birth (p=0.045), specifically the prevalence of blue baby (case 20%, control 0) and abnormal appearance (case 12%, control 4%), a case father having a low educational level (p=0.002), a case of mother having gestational diabetes during the pregnancy (p=0.037) and having older mothers (p=0.033) and fathers (p=0.033) than the controls. The highest risk of down syndrome was associated with mothers having high stress (p=0.017) and blood pressure (p=0.021) during pregnancy.Conclusions: The findings of our research confirm that autism, CP and DS are multi-factorial developmental disorders. A combination of environmental conditions, genetics, prenatal and postnatal factors are associated with an increased risk of developing autism, cerebral and down syndrome

The association between indices of obesity and common clinical measures in adults with and without type 2 diabetes

Background: The aim of this study was to determine the differences amongst the anthropometric measurements, lipid profile, blood pressure and body shape in diabetics as well as non-diabetics.Methods: This was a cross-sectional study comprised of 309 subjects with 91 males and 218 females. Of this, there were 217 diabetics and 92 non-diabetics. The sample was taken from three hospitals in Trinidad. Lipid profile and blood pressure were taken from each facility’s physician’s notes while anthropometric measurements were taken from the patients themselves.Results: The diabetic group had elevated body mass index and waist to hip ratios were significant (P <0.05) when compared to non-diabetics. There was no significant association of lipid profile, blood pressure, waist circumference and waist to height ratios between diabetics and non-diabetics. As age increased, the prevalence of type 2 diabetes mellitus was more common. Out of 217 diabetics, 173 were of East Indian descent. With regards to gender, more males were found to be diabetics resulting from having an android body shape as compared to females (gynoid body shape).Conclusion: It was found that of all the anthropometric measurements used, waist to hip ratio was found to be the most effective indicator of type 2 diabetes mellitus in Trinidadians, while body mass index was found to be the least effective indicator.