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ABSTRACT: INTRODUCTION. Many patients with non-alcoholic fatty liver disease (NAFLD) have impaired glucose regulation or type 2 diabetes mellitus (DM). We investigated characteristics of NAFLD patients associated with hyperglycemia. METHODS. During a 2-hour oral glucose tolerance test (OGTT), serum glucose and insulin were measured in 152 NAFLD patients. RESULTS. 48.7% of NAFLD patients had hyperglycemia. Age (odds ratio (OR) = 1.08, 95% confidence interval (CI): 1.03-1.13), body mass index (BMI) (OR = 1.12, 95% CI: 1.01-1.25), and lower high-density lipoprotein cholesterol (HDL-C) (OR = 0.95, 95% CI: 0.92-0.98) proved to be independent predictors of hyperglycemia. After OGTT, 30 min insulin was lower in hyperglycemic patients (74.2 ± 49.7 versus 94.5 ± 53.9 μIU/mL, P = 0.02), while 90 min insulin (170.1 ± 84.6 versus 122.9 ± 97.7 μU/mL, P = 0.01) and 120 min insulin (164.0 ± 101.2 versus 85.3 ± 61.9 μIU/mL, P < 0.01) were higher. CONCLUSIONS. NAFLD patients with higher BMI, lower HDL-C, or older age were more likely to have impaired glucose metabolism. An OGTT could be of value for early diagnosis of DM among this population.
Experimental Diabetes Research 01/2012; 2012:351974. · 1.20 Impact Factor
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ABSTRACT: Because many patients with diabetic macular edema (DME) do not respond to focal/grid laser photocoagulation, the only currently approved treatment, alternatives are needed. Based on encouraging preliminary findings, we aimed to assess efficacy and safety of the anti-tumor necrosis factor (TNF) monoclonal antibody infliximab in this condition.
This was a single-center, double-blind, randomized, placebo-controlled, crossover study. Eleven patients with sight-threatening DME persisting after two sessions of laser photocoagulation received infliximab (5 mg/kg) intravenously at weeks 0, 2, 6, and 14, followed by placebo at weeks 16, 18, 22, and 30, or vice versa. Blinding was maintained to week 32, when the final assessments were performed. Best corrected visual acuity evaluated by a mixed-models approach for imbalanced crossover design using the percentage difference as the outcome variable was the primary study end point. Data were analyzed on an intention-to-treat basis.
Early Treatment of Diabetic Retinopathy Study (ETDRS) scores dropped from 31.6 +/- 5.1 (mean +/- SD) letters read at baseline to 28.8 +/- 11.6 letters read at week 16 in six placebo-treated eyes and improved to 35.4 +/- 11.2 letters read after infliximab. In contrast, visual acuity improved from 23.5 +/- 10.3 at baseline to 30.4 +/- 13.4 letters read at week 16 in eight infliximab-treated eyes and was sustained at completion of placebo treatment (31.4 +/- 12.1 letters read). The excess visual acuity in infliximab-treated eyes was greater by 24.3% compared with that in placebo-treated eyes (95% CI 4.8-43.7; P = 0.017). Infliximab treatment was well tolerated.
The positive results of this small phase III study suggest that larger and longer term trials should be conducted to assess the efficacy of systemic or intravitreal anti-TNF agent administration for primary treatment of DME.
Diabetes care 04/2010; 33(7):1523-8. · 8.09 Impact Factor
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Cornelia Huth,
Iris M Heid,
Caren Vollmert,
Christian Gieger,
Harald Grallert,
Johanna K Wolford,
Birgit Langer,
Barbara Thorand,
Norman Klopp,
Yasmin H Hamid, [......],
José-Manuel Fernández-Real,
Robert L Hanson,
Luis Gallart,
Joan Vendrell,
Anastasia Tsiavou, Erifili Hatziagelaki,
Steve E Humphries,
H-Erich Wichmann,
Christian Herder,
Thomas Illig
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ABSTRACT: Several lines of evidence indicate a causal role of the cytokine interleukin (IL)-6 in the development of type 2 diabetes in humans. Two common polymorphisms in the promoter of the IL-6 encoding gene IL6, -174G>C (rs1800795) and -573G>C (rs1800796), have been investigated for association with type 2 diabetes in numerous studies but with results that have been largely equivocal. To clarify the relationship between the two IL6 variants and type 2 diabetes, we analyzed individual data on >20,000 participants from 21 published and unpublished studies. Collected data represent eight different countries, making this the largest association analysis for type 2 diabetes reported to date. The GC and CC genotypes of IL6 -174G>C were associated with a decreased risk of type 2 diabetes (odds ratio 0.91, P = 0.037), corresponding to a risk modification of nearly 9%. No evidence for association was found between IL6 -573G>C and type 2 diabetes. The observed association of the IL6 -174 C-allele with a reduced risk of type 2 diabetes provides further evidence for the hypothesis that immune mediators are causally related to type 2 diabetes; however, because the association is borderline significant, additional data are still needed to confirm this finding.
Diabetes 11/2006; 55(10):2915-21. · 8.29 Impact Factor
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ABSTRACT: This study was undertaken to assess the accuracy of GlucoDay- a portable detector of subcutaneous glucose--by comparing the results to those obtained by Biostator an established and reliable method for continuous glucose measurement in whole blood.
Subjects with type 1 diabetes (n:6), subjects with type 2 diabetes (n:6), and six healthy controls were studied for 24 hours; they consumed three main meals. The GlucoDay was connected to the subjects by inserting a microfibre probe into the periumbilical subcutaneous area, whilst the Biostator was inserted by a double-lumen catheter into an antecubital vein. A third catheter was inserted into a separate vein for blood withdrawal to measure glucose by the hexokinase method.
The three methods (GlucoDay-Biostator-hexokinase) were equally accurate in measuring glucose levels (p = 0.233, Kruskall-Wallis test). The glucose measurements performed with GlucoDay and Biostator were significantly correlated with those performed with hexokinase (p < 0.001, r2 = 66.65% and p < 0.001, r2 = 64.4%, respectively, using simple regression analysis).
Measurements of glucose fluctuations in the subcutaneous tissue with the GlucoDay were close to those in blood determined by the Biostator. GlucoDay is therefore a reliable method for continuous glucose monitoring and may prove useful for optimizating treatment in patients with type 1 or type 2 diabetes.
Hormones (Athens, Greece) 9(2):145-50. · 2.44 Impact Factor
