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Editor’s Choice : Clinical Characteristics of Diabetic Patients with Diabetic Retinopathy
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Abstract: Background: Proliferative diabetic retinopathy is a consequence of retinal ischemia due to capillary occlusion resulting from damage to the retinal endothelium, and is associated with increased risk of cardiovascular morbidity and mortality. Methods:We randomly assigned seventy three patients with DM type II and grouped them according to their retinal proliferative disease (Group A - 25 patients [12 males], mean age 62.8±10.8 years, no diabetic retinopathy; Group B - 25 patients [19 males], mean age 61.9±9.4 years, non-proliferative retinopathy; and Group C - 23 patients [13 males], mean age 59.2±10.3 years, proliferative retinopathy). Twenty three healthy subjects (14 males; mean age 44.3±11.6 years) served as the control group. We studied their retinal vasculopathy status, height, weight, body mass index (BMI), waist circumference, age, endothelial function (flow mediated diameter [FMD%] percent change) and their peripheral artery disease (ankle brachial index [ABI]).
Results:A significant difference was found between the duration of length of DM type II between patients without retinopathy [group A] (9±6 years) and patients with non-proliferative retinopathy [group B] (17±9 years) (p=0.001). No difference in length of diabetes was observed between patients with non-proliferative retinopathy [group B] and patients with proliferative retinopathy [group C] (19±6 years) (p=0.30). A significant difference was observed in HgA1C% between group A (7.1±2.7%) and group B (8.5±1.5%) (p=0.02). No such difference was noted between group B and group C (8.5±1.6%) (p=0.98). Only 6 patients (out of 23) used insulin treatment in group A compared with 16 group B (out of 25) and 17 in group C (out of 25) (p=0.004). All three groups of diabetic patients were older (62.8±10.8, 61.9±9.4, 59.2±10.3 years, respectively) than volunteers (44.3±11.6 years) (p≤0.001), had a lower stature (1.65±0.09, 1.68±0.07, 1.65±0.09 meters, respectively) compared with controls (1.73±0.08 meters) (p≤0.05), had a larger waist circumference (110.04±14.17, 108.88±13.00, 109.30±13.49 cm, respectively) than controls (93.43±11.66 cm) (p≤0.001), and larger BMIs (30±6, 29±4, 30±5) compared with controls (25±4) (p≤0.001). All diabetic patients had severe endothelial dysfunction measured by FMD% (-1.9±7.4, -3.3±9.2, -3.1±6.6 %, respectively) compared with the control group (16.5±7.5%) (p≤0.001). ABI was within normal range in all patient (0.97±0.18, 1.14±0.24, 1.03±0.28, respectively), and in volunteers (1.06±0.18) (p≥0.05). There was no significant change within the 3 subgroups of diabetic retinopathy patients in age, height, weight, BMI, or FMD%.
Conclusions:All patients with DM type II had severe endothelial dysfunction, higher BMIs, lower statures, larger waist circumferences; however they all had normal ABIs. Keywords: Endothelial function, diabetic retinopathy, ABI. Download Full Article |
Editor’s Choice : Caloric Restriction Diet Induces Specific Epigenotypes Associated with Life Span Extension
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Abstract: The lifespan of Wistar rats on caloric restriction diet (CRD) is correlated with the changes in prooxidant-antioxidant balance, in the contents of triiodothyronine, and thyroxin (epigenotype characteristics). It has been shown that in a month after the moment of one-month-old rats began to receive CRD the part (up to 15 %) of experimental animals died without any apparent cause, irrespective of the degree of calorie restriction (40 %, 57 % and 60 % weight-loss). The rest of animals with 40 %, 57 % and 60 % weight-loss had longer life span in comparison with control group. The CRD-induced life-span prolongation in animals was accompanied by the induction of specific epigenotypes featured by acceleration of the electron transfer rate in electron transport chain and subsequent reduced production of reactive oxygen species and increased antioxidant activity. The activity of glutathione reductase, glutathione transferase, NADH-cytochrome C reductase, isocitrate dehydrogenase was elevated. The activity of Se-dependent glutathione peroxidase was higher more than 30 times as compared with control. Likewise, the epigenotypes of animals with 40 %, 57 % and 60 % weight-loss CR, were characterized by 37, 43 and 56 % decrease in triiodothyronine and 50, 25, 39 % decrease in tyrosine, respectively. The observed induction of specific epigenotypes is associated with higher life-span and is related to the multivariant metabolic strategies of adaptation to CRD. Keywords: Caloric restriction diet, aging, prooxidant-antioxidant system, epigenotype.Download Full Article |
Editor’s Choice : Malnutrition and Left Ventricular Systolic Function in Hospitalized Elderly Patients with and without Heart Failure
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Abstract: Heart failure (HF) is highly prevalent among older subjects and it is associated with poor prognosis. HF frequently coexists with malnutrition. Objectives of our work were to assess nutritional status of old inpatients with and without HF and to study the association of malnutrition markers with echocardiographic parameters of left ventricular function and geometry.We enrolled 165 patients (72 men, 93 women; mean age: 80±7 years) consecutively admitted to Cardiology ward of our geriatric research hospital. For all subjects we performed clinical examination, echocardiogram and laboratory tests. Nutritional status was assessed evaluating anthropometric and laboratory markers of malnutrition (BMI ≤ 24 kg/m2 and/or serum albumin ≤ 3.2 g/dL). We found high prevalence of HF (67.3%) and malnutrition (28.5%). Mean serum albumin and mean BMI were 3.6±0.5 g/dL and 25.8±5.2 kg/m2 respectively. T-Student tests showed lower values of serum albumin in patients with HF compared with patients without HF (3.5±0.6 g/dL vs 3.7±0.4 g/dL; p:0.043). Conversely BMI values were not significantly different. We found significant association between serum albumin and ejection fraction (EF) of left ventriculum (r:0.311; p:0.001). An independent correlation between EF and serum albumin was confirmed by multivariate analysis (β:0.301; p:0.027). Our study highlights that malnutrition is common among elderly inpatients with HF. Lower albumin was associated with worse systolic left ventricular function. Efforts should be made in the research setting to better understand the pathophysiology of malnutrition in HF and to identify useful management strategies for nutritional assessment and supplementation. Keywords: Heart failure, Malnutrition, Elderly, Albumin, Systolic function.Download Full Article |
Editor’s Choice : Agreement Between a Food Frequency Questionnaire and the Willett Questionnaire in Overweight or Obese Pregnant Women
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Abstract: Background & Aims: Overweight and obesity during pregnancy is associated with an increased risk of many adverse health outcomes for both women and their infants. There is a need for simple food frequency questionnaires to assess nutritional intake and aid implementation and evaluation of nutritional interventions in these women. The aim of this study was to compare a newly developed food frequency questionnaire with the Willett food frequency questionnaire in Australian pregnant women who were overweight or obese. Methods: 170 overweight or obese pregnant women (12-20 weeks’ gestation) completed both the Willett and the devised (LIMIT) food frequency questionnaire with n=41 excluded due to unrealistic energy intake or incomplete questionnaires. The mean nutrient intake for each questionnaire and the mean difference in nutrient intake between the questionnaires was assessed. The correlation and agreement between the two questionnaires were assessed by Spearmans correlation coefficients and Bland-Altman method. Results: There were high correlations for total energy intake, protein, carbohydrates, cholesterol, iron, folate, and caffeine (r>0.50, P<0.01), and moderate correlations for fat, fibre, and calcium (r=0.4-0.5, P<0.01). Correlations were low (r0.05). The limit of agreement (LOA) was wide (LOA 200%) for macronutrients, calcium, and folate, but within the acceptable range for iron, vitamins, and caffeine (LOA 133%). Conclusions: There is good agreement between the Willett and the LIMIT food frequency questionnaires in estimating macronutrient and some key pregnancy-related micronutrients for group-level comparisons. Keywords: Food frequency questionnaire, Obesity, Overweight, Diet, Pregnancy.Download Full Article |
