Involvement of beta-3-Adrenergic Gene Polymorphism in Insulin Resistance in Iraqi Type 2 Diabetic Patients

A tryptophan to arginine substitution (TGG?CGG) in codon 64 (Trp 64 Arg) of ?3-adrenergic receptor is thought to be important for binding of noradrenaline and G proteins with ?3-adrenergic receptor in adipose cells. ?3-adrenergic receptor polymorphism may lead to a decrease in thermogenesis and lipolysis in adipose tissue. Therefore, an impairment of ?3-adrenergic receptor function may lead to obesity and insulin resistance. The present study was designed to estimate prevalence and association of ?3-adrenergic receptor gene T?C (Trp 64 Arg) SNP in insulin resistance type 2 diabetic patients in Iraq. To achieve this aim, 103 of type 2 diabetic patients and 57 apparently healthy control group were subjected to the study. The results of present study show that the heterozygous genotype (TC) of  ?3-adrenergic receptor gene T?C (Trp 64 Arg) SNP was significantly increased (OR=4.12, CI 95% 1.14-15.86, P < 0.05) the risk of type 2 diabetes mellitus four folds with respect to those of the wild genotype (TT). Also, the results revealed that significant increase (P < 0.05) in fasting insulin, HOMA, BMI and significant decrease (P < 0.05) in HDL-cholesterol of heterozygous genotype (TC) when compared with wild genotype (TT). Also, there are no significant differences in other clinical characteristics between wild genotype (TT) and heterozygous genotype (TC). The study concluded that ?3-adrenergic receptor gene T?C (Trp 64 Arg) SNP are associated and involved in the pathogenesis of insulin resistant type 2 diabetes mellitus. Keyword: Diabetes Mellitus, Insulin resistance, Obesity, ?3-adrenergic receptor,  Trp 64 Ar

Association of Insulin Receptor Substrate-1 Gene Polymorphism with Insulin Resistance in Type 2 Diabetes Mellitus in Iraqi Population

A glycine to arginine substitution (GGG?AGG substitutions) in codon 972   (Gly 972 Arg) is the common polymorphism of the IRS-1 gene. This polymorphism interfere with the interaction between IRS-1 and PI3-kinase. It participate in the development of insulin resistance and diabetes by impairing the ability of insulin to activate the  IRS-1/PI3-kinase/Akt signaling pathway. The present study was designed to evaluate the association of insulin receptor substrate-1 gene G?A (Gly 972 Arg) polymorphism with insulin resistance in type 2 diabetes mellitus in Iraqi population. To achieve this aim, 103 of type 2 diabetic patients and 57 apparently healthy control group were subjected to the study. The results of present study show that the heterozygous genotype (GA) of insulin receptor substrate-1 gene G?A (Gly 972 Arg) SNP was significantly increased (OR=9.14, CI 95% 1.13-75.53, P < 0.05) the risk of type 2 DM by nine folds with respect to those of wild genotype (GG). The allele frequencies of G and A were 92.93% and 7.07% for the insulin resistant type 2 diabetic patients group and 99.04% and 0.96% for the control group respectively. Also, the results revealed that no significant differences in clinical characteristics between wild genotype (GG) and heterozygous genotype (GA). The study concluded that insulin receptor substrate-1 gene G?A (Gly 972 Arg) SNP are associated and involved in the pathogenesis of  insulin resistant type 2 diabetes mellitus. Keywords: Diabetes Mellitus, Insulin resistance, IRS-1, Gly 972 Ar

Shape Preserving GOl Rational Interpolation.

A GCl rational quartic function has been constructed with three parameters to preserve the shape of positive and monotone curve data. Simple data dependent constraints are derived on one of the parameters to preserve the shape of data while other two are free to refine the shape of curve at user choice

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings In 2021, there were 529 million (95% uncertainty interval [UI] 500–564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8–6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7–9·9]) and, at the regional level, in Oceania (12·3% [11·5–13·0]). Nationally, Qatar had the world’s highest age-specific prevalence of diabetes, at 76·1% (73·1–79·5) in individuals aged 75–79 years. Total diabetes prevalence—especially among older adults—primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1–96·8) of diabetes cases and 95·4% (94·9–95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5–71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5–30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22–1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1–17·6) in north Africa and the Middle East and 11·3% (10·8–11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%.Peer ReviewedPostprint (published version

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially