B Wierusz-Wysocka

Poznan University of Medical Sciences, Posen, Greater Poland Voivodeship, Poland

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Publications (96)154.08 Total impact

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    ABSTRACT: Our aim was to assess the association between skin autofluorescence (AF) related to advanced glycation end products (AGEs) accumulation and long-term metabolic control, microvascular complications and carotid intima-media thickness (IMT) in an observational cohort of type 1 diabetes (DM1). The analysis included 77 patients with DM1 (28 women and 49 men) aged 38 (IQR: 34-41), diabetes duration 15 (14-17), participating in Poznan Prospective Study (PoProStu). Skin AF was measured with AGE Reader (DiagnOptics). We found 50% of any microvascular complication; 37% of retinopathy, 37% of diabetic kidney disease and 22% of distal symmetrical neuropathy. Median carotid IMT was 0.57 (0.52-0.67)mm and skin AF 2.2 (IQR: 1.9-2.6). We found positive correlation between skin AF and patients' age (r=0.31, p=0.006), mean HbA1c from the observation time (r=0.35, p=0.001) and IMT (r=0.39, p<0.001). In multivariate logistic regression presence of microvascular complications was independently associated with skin AF: for retinopathy (OR 3.49; 95%CI:1.08-11.28, p=0.03), for diabetic kidney disease (OR 3.62; 95%CI:1.16-11.28, p=0.02), for neuropathy (OR 5.01; 95%CI:1.21-20.77, p=0.02) and for any microangiopathy (OR 3.13; 95%CI: 1.06-9.18, p=0.03). Skin AF is a reliable marker of past glycaemic control of diabetes. Increased accumulation of AGEs is related to the presence of diabetic microangiopathy as well as subclinical macroangiopathy in patients with type 1. Copyright © 2015. Published by Elsevier Inc.
    Microvascular Research 01/2015; · 2.43 Impact Factor
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    ABSTRACT: Purpose The cardiovascular diseases (CVD) are the leading cause of mortality in type 1 diabetes (DM1). Carotid intima-media thickness (IMT) has been approved as a marker of subclinical atherosclerosis. The aim of this prospective study was to evaluate the relationship between baseline diabetic knowledge after five-day teaching program and IMT in patients with (DM1) treated with intensive functional insulin therapy (IFIT) from the onset of the disease. Material/methods The analysis included 79 subjects aged 23.4 ± 5.1 years with newly diagnosed DM1, participating in Poznan Prospective Study (PoProStu). The patients attended a five-day structured training program in IFIT at diagnosis, followed by a test consisting of 20 questions. After follow-up period of 11 years we evaluated the presence of microangiopathy and subclinical macroangiopathy. IMT of the right common carotid artery was determined using high resolution ultrasonography and calculated automatically with the Carotid Analyzer for Research program. Results After 11-year follow-up median intima-media thickness was 560 (IQR: 520–630) μm. We found a negative correlation between diabetes knowledge at baseline and IMT at the end of follow-up (r = −0.27, p = 0.017). In multivariate linear regression model baseline diabetic knowledge test result was associated with IMT at follow-up, independently from sex, age, smoking status, presence of hypertension and diabetic kidney disease (all at follow-up) and from mean follow-up LDL-cholesterol concentrations and HbA1c results (β = −8, 95% CI −16, −1, p = 0.037). Conclusions Baseline diabetic knowledge after 5-day teaching program is an independent predictor of subclinical macroangiopathy in patients with DM1.
    Advances in Medical Sciences 09/2014; · 0.80 Impact Factor
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    ABSTRACT: The aim of study was to evaluate the relationship between serum cystatin C and insulin resistance (IR) in type 1 diabetic patients being the participants of Poznan Prospective Study.
    Clinical Biochemistry 06/2014; · 2.23 Impact Factor
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    ABSTRACT: INTRODUCTION One of the reasons of impaired antioxidant response in patients with type 1 diabetes (DM1) could be decreased expression of mitochondrial superoxide dismutase (MnSOD). OBJECTIVES The purpose of this study was to evaluate expression of MnSOD at both transcript and protein level in polymorphonuclear leukocytes (PMNLs) from DM1 patients and analyzed their relation with presence of microvascular complications. PATIENTS AND METHODS MnSOD expression was assessed in PMNLs from 46 DM1 patients and age and gender matched 12 healthy subjects. The study group was divided into two subgroups according to the absence (DM) or presence (DMC) of microvascular complications. MnSOD expression on transcript level was evaluated by quantitative PCR (RQ-PCR), whereas MnSOD expression on protein level was measured by western blot technique. RESULTS A significant increase in MnSOD transcript level was found in all DM1 patients regardless to the presence of microvascular complications (p=0.013, p=0.024, respectively). Interestingly, MnSOD protein level was higher in DM group compared with DMC group and the control group (p=0.049, p=0.029, respectively). MnSOD expression at both transcript and protein level positively correlated with fasting plasma glucose (FPG) level and total cholesterol (TCH) concentrations (r=0.400, r=0.389, r=0.310, r=0.391, n=46, p<0.05, respectively) in all DM1 patients. CONCLUSIONS Even though increased MnSOD transcript level in DM1 patients suggests enhanced antioxidant mobilization in all diabetic patients, decreased level of MnSOD protein in PMNLs from DMC patients in comparison with DM patients could indicate that DM1 patients with microvascular complications display impaired antioxidant response.
    Polskie archiwum medycyny wewnȩtrznej 04/2014; · 2.05 Impact Factor
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    ABSTRACT: The diagnosis of autoimmune diabetes in non-obese adults is based on detection of autoantibodies to glutamic acid decarboxylase autoantibodies (GADA), islet cells antibodies (ICA), antibodies to tyrosine phosphatase (IA-2A). Zinc transporter 8 (ZnT8) was identified as a new auto-antigen in diabetes type 1. The coincidence of autoimmune thyroiditis with diabetes is common, therefore screening of thyroid stimulating hormone (TSH) and thyroid peroxidase antibodies (ATPO) is recommended at diagnosis of diabetes. We address the question whether occurrence of islet autoantibodies is associated with positive titre of ATPO in newly diagnosed adult onset autoimmune diabetes. DESIGN AND METHODS STUDY INVOLVED 80 NON-OBESE ADULTS AGED 44 [INTERQUARTILE RANGE (IQR): 37-51] years, body mass index (BMI) 24.0 (IQR: 22.2- 26.0) kg/m2, with new onset diabetes. Markers of autoimmune diabetes [GADA, ICA, IA-2A and ZnT8A], TSH and thyroid peroxidase antibodies (ATPO) were evaluated. 70% (n=56) subjects had positive at least 1 of 4 assessed markers of autoimmune diabetes (83.9% GADA, 62.5% ICA, 42.8% anty-IA2 and 33% ZnT8A), 37,5% patients were ATPO positive. ZnT8A positive patients had higher ATPO titre in comparison to ZnT8A negatives [(172.7 (IQR: 0.36-410.4) vs 92.4 (IQR: 0-23.7) IU/ml p=0,001)]. From the marked islet autoantibodies, occurrence of positive ZnT8A and GADA was related to positive titre of ATPO using logistic regression: OR=5.48 95%CI: 1.65-18.14 p=0.006 and OR=3.42 95%CI: 1.09-10.71 p=0.03 respectively.Conclusions In non-obese adults with new onset diabetes presence of glutamic acid decarboxylase autoantibodies and especially zinc transporter 8 autoantibodies increases the risk of autoimmune thyroiditis.
    European Journal of Endocrinology 01/2014; · 3.69 Impact Factor
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    ABSTRACT: The association of inflammation with cardiovascular (CV) complication in diabetes is still a matter of considerable debate. Arterial stiffness and enhanced wave reflection play an important role in CV complication. Therefore we address the question whether markers of inflammation are correlated with parameters of wave reflection in type 1 diabetes. We included 145 type 1 diabetic patients, median age 32 years, disease duration 10 years, HbA1c 8.2%. Serum high sensitive C-reactive protein (hsCRP), matrix metalloproteinase-9 (MMP-9), soluble intracellular adhesion molecule-1 (sICAM-1) and myeloperoxidase (MPO) concentrations were estimated as markers of inflammation. Parameters of pulse wave reflection (central- CAIx and peripheral augmentation index- PAIx ) were assessed with the use of Pulse Wave Analysis. In the study group CAIx and PAIx were associated with serum concentration of hsCRP [1.838 (95% CI: 0.336 - 3.339), p=0.017; 2.041 (95% CI: 0.683 - 3.400), p=0.004)] and sICAM-1 [0.073 (95% CI: 0.015 - 0.131) p=0.014; 0.066 (95 % CI: 0.013 - 0.119), p=0.016] in multivariate linear regression analysis after adjustment for age, BPmean,, HbA1c, LDL cholesterol and presence of at least one microangiopathic complication of diabetes. In type 1 diabetes parameters of wave reflection are related to markers of inflammation.
    Journal of Diabetes 01/2014; · 2.94 Impact Factor
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    ABSTRACT: INTRODUCTION Little is known about the effects of metformin on lipid profile in patients with type 1 DM. OBJECTIVES The study is the first prospective clinical trial evaluating the effect of combined therapy of metformin and insulin on the pool of atherogenic, oxidized low density lipoproteins (LDL) and glycated-LDL in young patients with type 1 diabetes and concomitant obesity. PATIENTS AND METHODS 33 obese, young, type 1 diabetic subjects treated with intensive insulin therapy were randomized into a group where metformin was added (insulin/metformin group). The remaining 19 patients were treated with insulin alone (control group, insulin group). All patients had lipid profile as well as glycemia assessed by means of routine laboratory tests. The oxLDL and glycated-LDL were measured using a commercially available kits. All laboratory tests were performed at the beginning of the study and at control visit after 6 months of treatment. RESULTS A decrease in the levels of glycated hemoglobin, fasting plasma glucose, postprandial glycemia, average glycemia, triglycerides, glycated-LDL and body mass index were observed in the metformin/insulin group during follow-up. A similar decrease was not found in the insulin group.CONCLUSIONS Addition of metformin to intensive insulin therapy in obese young patients with type 1 diabetes results in reduction of glycated-LDL.
    Polskie archiwum medycyny wewnȩtrznej 08/2013; · 2.05 Impact Factor
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    ABSTRACT: Interleukin 6 (IL-6) plays an important role in the initiation and acceleration of chronic inflammation and could contribute to development of microvascular complications in patients with type 1 diabetes (DM1). Therefore, this study was aimed to investigate the association between concentration of IL-6 in relation to glucose control, lipid profile, and body mass index (BMI) in 69 DM1 patients subdivided according to the absence or presence of microvascular complications. BMI, level of fasting plasma glucose (FPG), and concentrations of total cholesterol (TCH), LDL cholesterol (LDL-C), and IL-6 were higher in DM1 patients compared to the control group. In DM1 patients, IL-6 concentration was positively correlated with level of FPG, LDL-C, TCH concentrations, and BMI. These correlations were stronger in the subgroup of patients with microvascular complications. In addition, BMI independently influences IL-6 concentration in DM1 patients. In conclusion, elevated IL-6 concentration is associated with diabetes-related variables which could accelerate progression of microvascular complications in DM1 patients.
    Inflammation 02/2013; · 1.92 Impact Factor
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    ABSTRACT: OBJECTIVE: The aim of the study was to investigate whether changes in the level of oxidized LDL (oxLDL) over 2-years contribute to the development of subclinical macroangiopathy and/or microvascular complications in patients with DM1. DESIGN AND METHODS: Basic clinical and biochemical parameters and oxLDL level were measured in 70 patients at baseline and after 2years of the study. In addition, an ultrasonographic study was performed to assess the carotid intima media thickness (IMT). RESULTS: Patients did not differ according to basic clinical and biochemical parameters at the beginning and after 2years of the study. IMT increased (p=0.000001) whereas oxLDL level decreased (p=0.00001) in DM1 patients during 2years. Multivariate regression analysis showed that oxLDL independently influences IMT in DM1 patients (β=0.454, R2=0.35). Further, positive correlations between oxLDL value and LDL-C concentration (r=0.585, p<0.05, n=70) and between oxLDL level and apo-B concentration have been established (r=0.610, p<0.05, n=70). Moreover, patients with chronic microvascular complications showed a higher value of IMT in comparison with patients without them (p=0.003). CONCLUSION: Our results provide the evidence that oxLDL accelerates atherosclerotic plaque formation and may contribute to the development of microvascular complications in DM1.
    Clinical biochemistry 08/2012; · 2.02 Impact Factor
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    ABSTRACT: INTRODUCTION: The degeneration of retinal neurons and glial cells has been postulated recently in the pathogenesis of diabetic retinopathy. Optical coherence tomography (OCT) allowed quantitive measurements of retinal thickness with identification of individual retinal layers. OBJECTIVES: We compared retinal thickness (RT), retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thickness obtained in OCT in type 1 diabetic patients with and without clinically diagnosed retinopathy. PATIENTS AND METHODS: We included 77 consecutive patients with DM1 (39 men), median age 35 years [interquartile range (IQR): 29-42], median disease duration 10 years (IQR: 9-14) and 31 age-matched controls to measure RT fovea, parafovea and perifovea, RNFL and GCL thickness. We divided the diabetic patients into two subgroups with diabetic retinopathy and without retinopathy. RESULTS: We found thicker retina perifovea (p=0.05), mean RNFL (p=0.002), inferior RNFL (p<0.0001) and GCL superior and inferior (p=0.05, p=0.04) in diabetic subjects compared to healthy people. We detected retinopathy in 23 diabetic patients (29%). Compared to patients without retinopathy, subjects with retinopathy had thinner retina parafovea (p=0.05), mean RNFL (p=0.002), inferior and nasal RNFL (p=0.002, p=0.03), GCL superior (p=0.05) and inferior (p=0.006). A significant correlations were found between duration of diabetes and nasal RNFL thickness (r=-0.32, p=0.004) and RT parafovea (r=-0.47, p<0.001). CONCLUSIONS: The results might suggest the loss of intraretinal neural tissue in type 1 diabetic patients with retinopathy. The neurodegeneration in diabetic retinopathy is strongly associated with disease duration.
    Polskie archiwum medycyny wewnȩtrznej 08/2012; · 2.05 Impact Factor
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    ABSTRACT: The aim of the study was to assess carotid intima-media thickness (CIMT) as a subclinical marker of atherosclerosis and arterial stiffness in type 1 diabetic patients in relation to microangiopathy. We included 87 type 1 diabetic patients (44 women, 43 men), median age 34 years (interquartile range [IQR] 29-43), median disease duration 10 years (IQR: 9-14), mean ± standard deviation (SD) glycated haemoglobin (HbA(1c)) 8.4 ±1.4%. Fifty patients had at least one microangiopathic complication. Intima-media thickness (IMT) of the common carotid artery was measured using high resolution ultrasonography. Arterial stiffness was assessed using digital volume pulse analysis and tonometric measurement of wave reflection and central haemodynamics. SUBJECTS WITH MICROANGIOPATHY COMPARED WITH THOSE WITHOUT HAD HIGHER VALUES OF CIMT (MEDIAN [IQR]: 0.53 mm [0.45-0.60 mm] vs 0.47 mm [0.34-0.52 mm], p = 0.002), higher central augmentation index (CAI(x)) (mean ± SD: 120.2 ±19.4% vs. 110.5 ±17.1%, p = 0.016) and higher peripheral augmentation index (PAI(x)) (65.7 ±18.1% vs. 57.2 ±14.9%, p = 0.023). In the logistic regression analysis, the duration of diabetes, systolic and diastolic blood pressure, postprandial glycaemia, HbA(1c) and triglycerides predicted the presence of diabetic microangiopathy independently of age and sex. The CIMT, CAI(x) and PAI(x) were associated with the presence of diabetic microangiopathy only in the univariate model. In type 1 diabetic patients with microangiopathic complications, increased carotid IMT and arterial stiffness were observed. The study confirms the role of traditional risk factors for late diabetic complications, such as the duration of the disease and metabolic control in the development of microangiopathy.
    Archives of medical science : AMS. 07/2012; 8(3):484-90.
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    ABSTRACT: Classification of diabetes type in adults patients remains difficult. This study was undertaken to determine the relationship between presence of autoantibodies in the serum and the result of glucagon stimulation test in non obese patients at aged above 35 years with newly diagnosed diabetes.Study involved 52 non obese adults aged 42 years [interquartile range (IQR): 37-46], with body mass index (BMI) 23.7 kg/m2 (IQR: 21.4-26.2). Presence of autoantibodies to islet cells (ICA), antibodies to tyrosine phosphatase (IA-2), glutamic acid decarboxylase autoantibodies (anti-GAD) and plasma fasting and stimulating (6 min after intravenous injection of 1 mg glucagon) C-peptide level was assessed.73.1% subjects had at least 1 of 3 assessed autoantibodies, 26.9% patients were autoantibodies negative. According to serum C-peptide concentration after stimulation test with glucagon patients were divided into 2 groups. Receiver Operating Characteristic (ROC) Curve for determination of an optimal cut-point (C-peptide stimulation above and below 1.6) was used. In patients with negative stimulation test higher prevalence of 2 (33.3% vs. 66.7%; p=0.04) or 3 (12.5% vs. 87.5%, p=0.01) positive autoantibodies was noticed in comparison to patients with positive stimulation test. Multivariate logistic regression showed that presence of autoantibodies was independently associated with stimulated C-peptide level (OR 2.3; 95%CI: 1.07-5.28, p=0.03).Autoimmune diabetes should be suspected in subjects with lower response of β- cell in glucagon stimulation test. If the C-peptide do not increase more than 1.6 after glucagon presence of autoanibodies is more probable.
    Experimental and Clinical Endocrinology & Diabetes 04/2012; 120(7):428-34. · 1.76 Impact Factor
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    ABSTRACT: Poor metabolic control of type 1 diabetes is one of the most important factors accelerating the development of late diabetic complications. Several other factors that might contribute to this process are currently being investigated. Low paraoxonase 1 (PON1) activity and high lipid peroxide (LPO) levels contribute to endothelial damage, but it remains unclear whether they are critical for the development of late diabetic complications. The aim of the study was to evaluate PON1 arylesterase activity and LPO levels in patients with type 1 diabetes and to investigate whether these parameters are associated with metabolic control and late complications. Moreover, we aimed to establish whether PON1 activity and LPO levels differ between women and men with type 1 diabetes. The study involved 80 patients with type 1 diabetes and 24 healthy subjects. PON1 activity was measured by a spectrophotometric method. LPO levels were measured by a commercial assay kit. Diabetic patients had lower PON1 activity and higher LPO levels than healthy people. We observed a negative correlation between PON1 activity and LPO levels in diabetic patients. There was no association between PON1 activity or LPO levels and metabolic parameters or late diabetic complications. There was a positive correlation between LPO levels and the body mass index (BMI) in women with type 1 diabetes. Our study showed that low PON1 activity and high LPO levels are not the most critical factors involved in late diabetic complications in type 1 diabetes. Increased LPO levels in women with type 1 diabetes may result from enhanced lipogenesis in this subgroup compared with diabetic men.
    Polskie archiwum medycyny wewnȩtrznej 12/2011; 121(12):448-54. · 2.05 Impact Factor
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    ABSTRACT: The duration of partial remission of Type 1 diabetes is associated with the degree of initial metabolic disturbance and features of insulin resistance. Cigarette smoking decreases insulin sensitivity, but its influence on the length of remission is unknown. Therefore, this study assessed the relationship between cigarette smoking and duration of partial remission in adults with newly diagnosed Type 1 diabetes. We recruited 149 patients (48 women and 101 men, aged 16-35 years, median age 25 years), admitted to a teaching hospital with newly diagnosed Type 1 diabetes and followed them for a median period of 1 year and 9 months. We introduced intensive insulin therapy in multiple injections (basal-bolus) in all patients. We defined partial remission as an insulin dose of ≤ 0.3 U/kg body weight/24 h, an HbA(1c) value < 53 mmol/mol (7.0%) and a random serum C-peptide concentration over 0.5 ng/ml. Cigarette smoking was determined by self-report. Of 149 patients, 68 (46%) fulfilled the criteria for partial remission at 1 year after diagnosis of diabetes. Fewer patients who were in partial remission at 1 year smoked (19/68, 28%) than did patients that were not in partial remission (41/81, 51%). In logistic regression analyses, non-smoking was associated with remission at 1 year independent of age, sex, HbA(1c) and presence of diabetic ketoacidosis, all measured at onset of diabetes (OR 3.32, 95% CI 1.42-7.75, P = 0.005). Relative to individuals in this study who smoked, those who did not smoke at diagnosis of Type 1 diabetes experienced a longer duration of partial remission.
    Diabetic Medicine 10/2011; 29(4):464-9. · 3.24 Impact Factor
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    ABSTRACT: The aim of the study was to assess the relationships between diabetic retinopathy, subclinical atherosclerosis and wave reflection in type 1 diabetic patients. The investigation involved 87 type 1 diabetic patients aged 34 years (interquartile range [IQR]: 29-43), with a disease duration of 10 years (IQR: 9-14). Of these 39 (45%) had diabetic retinopathy. Carotid intima-media thickness (CIMT) was measured using high resolution ultrasonography. Wave reflection and central hemodynamics [central (CAI(x)) and peripheral augmentation index (PAI(x))] were determined with the use of tonometry. Patients with retinopathy compared to those without had increased CIMT (530 vs 480 μm, p = 0.017) and wave reflection (CAI(x) [118.90 vs 110.96 %, p = 0.03] and PAI(x) [64.95 vs 57.44 %, p = 0.029]). In logistic regression analysis, patient's age, duration of diabetes, systolic and diastolic blood pressure, postprandial glycemia, HbA1c value, CIMT (p = 0.017), CAI(x) (p = 0.03) and PAI(x) (p = 0.016) were associated with the presence of diabetic retinopathy. However, in the multivariate model, CIMT and CAI(x) did not remain predictors of retinopathy. We have shown that the presence of retinopathy in type 1 diabetic patients is associated with subclinical atherosclerosis and wave reflection.
    Scandinavian journal of clinical and laboratory investigation 07/2011; 71(7):563-8. · 1.38 Impact Factor
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    ABSTRACT: Skin autofluorescence (AF) measured with an AF reader device is a noninvasive tool to measure the tissue accumulation of advanced glycation end products (AGEs). The aim of the study was to assess the association between AF and microvascular complications in type 1 diabetes mellitus (DM1). The study population consisted of 140 DM1 patients, 28 years old (interquartile range [IQR], 23-35), 76 of whom were women, with disease duration of 13 years (IQR, 8-19). We used the AGE Reader (DiagnOptics, Groningen, The Netherlands) to measure the AF phenomenon, which occurs because of fluorescent properties of AGEs. The patients were divided according to the presence or absence of diabetes-associated microvascular complications: retinopathy, nephropathy, and neuropathy and any microangiopathy. The median AF was 2.0 (IQR, 1.7-2.4). In the univariate logistic regression AF was significantly associated with retinopathy (odds ratio [OR] 2.47, 95% confidence interval [CI] 1.26-4.84, P = 0.008), nephropathy (OR 3.15, 95% CI 1.34-7.39, P = 0.008), neuropathy (OR 3.17, 95% CI 1.46-6.90, P = 0.003), and any microvascular complication (OR 2.94, 95% CI 1.46-5.92, P = 0.002). Multivariate logistic regression showed that skin AF was independently associated only with diabetic neuropathy (OR 2.98, 95% CI 0.99-8.90, P = 0.05). The tissue accumulation of AGE is significantly associated with microvascular complications in DM1.
    Diabetes Technology &amp Therapeutics 05/2011; 13(8):837-42. · 2.29 Impact Factor
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    ABSTRACT: Objectives: Candida-associated denture stomatitis (CaDS), is a common disease in complete denture wearers with type 2 diabetes mellitus (T2DM). C-reactive protein (CRP), an acute phase reactant is a sensitive marker of inflammation associated with diabetes. The aim of this study was to determine the concentrations of CRP in patients with T2DM and CaDS, and investigate the relationship between CRP concentrations and glycated hemoglobin A1c (HbA1c) levels, which was used as an indicator of glycemic control. Materials and Methods: The study involved 110 T2DM patients (63 women and 47 men, mean age 63.210.5 years) with CaDS, and 20 patients (12 women and 8 men, mean age 65.812.9 years), with T2DM and healthy oral mucosa. A group of 20 non-diabetics (11 women and 9 men, mean age 59.29.9 years) with healthy oral mucosa served as a control. The yeasts were isolated by the culture method, and identified by microscopic examination and with the test kit, ID 32 C (bioMerieux SA, Marcy-l'Etoile, France). Serum concentrations of CRP were determined by rocket immunoelectrophoresis according to Laurell. Glycemic control was evaluated by measuring HbA1c levels using HPLC together with the Variant Hemoglobin A1c Program (Bio-Rad Laboratories, Hercules CA, USA). Results: The mean duration of diabetes was 10.65.1 years, and the mean HbA1c levels in T2DM subjects were 8.6 1.9%. Patients with T2DM had significantly elevated mean levels of CRP in comparison to patients with normal glucose metabolism (6.122.86 vs 2.570.96 mg/l, p<0.05). The highest CRP levels were observed in diabetics with type II (Newton classification) CaDS (8.392.70 mg/l). A positive correlation was found between the concentrations of CRP and fasting plasma glucose levels (rS=0.517, p<0.001) and HbA1c levels (rS=0.572, p<0.001). Conclusions: The findings suggest that CRP concentrations can be used as a non-specific indicator of ongoing inflammation in patients with T2DM.
    IADR General Session 2011; 03/2011
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    ABSTRACT: Advanced glycation end products (AGEs) are important in the pathogenesis of atherosclerosis and reflect the risk of cardiovascular mortality. AGE levels are significantly higher in patients with diabetes. The aim of the study was to compare AGE accumulation in the skin of patients with type 1 diabetes and nondiabetic population as well as to assess its association with disease duration and metabolic control. We also aimed to assess the potential usefulness of this method in the monitoring of diabetes control, especially in a long-term follow-up. The study included 140 type 1 diabetes patients (mean age 30.4 ± 9.7 years; mean disease duration 13.6 ± 8.5 years) and 57 nondiabetic subjects. AGE accumulation in the skin was assessed noninvasively with the AGE Reader device, which measures autofluorescence (AF) that occurs because some AGEs have fluorescent properties. Mean AF in the diabetes group was 2.13 ± 0.55 and it was significantly higher than in controls (AF 1.70 ± 0.27, P <0.05). A significant positive correlation between AF and the age of patients was found for the whole study population (P <0.05). In diabetic subjects, we observed a significant positive correlation between AF and diabetes duration (P <0.05), and between AF and glycated hemoglobin (HbA1c) (P <0.05). AF measurement is a simple and noninvasive method of assessing AGE accumulation in the skin. It may be useful as a secondary method of assessing metabolic control, as it reflects glycemic control over a longer period of time than that reflected by HbA1c levels.
    Polskie archiwum medycyny wewnȩtrznej 03/2011; 121(3):67-72. · 2.05 Impact Factor
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    ABSTRACT: C-reactive protein (CRP) is one of the most widely used risk markers of cardiovascular disease in clinical practice. The contribution of hepatitis C virus (HCV) infection to low-grade inflammation in diabetic patients and its significance for cardiovascular risk scoring remain unclear. The aim of the study was to investigate the relationship between HCV infection and CRP levels as one of the markers of cardiovascular risk in diabetic patients. we compared patients with HCV infection and diabetes (n = 46) with HCV-negative type 1 (n = 56) or type 2 diabetic patients (n = 54), as well as HCV patients without diabetes (n = 54). CRP levels in diabetic HCV patients were lower than in type 2 diabetic patients (P <0.001), similar to those in the type 1 diabetic group (P = 0.747), and higher than in nondiabetic HCV subjects (P = 0.002). The median values were 1.07, 2.58, 0.91, and 0.45 mg/l, respectively. White blood cell count in diabetic HCV subjects was lower than in those with type 2 diabetes (P = 0.029) and similar to that found in type 1 diabetic (P = 0.064) and nondiabetic HCV patients (P = 0.279). There was difference in erythrocyte sedimentation rate between diabetic and nondiabetic HCV groups (P = 0.025); the respective medians were 10 and 5 mm/h. these findings indicate that HCV hepatitis may modulate chronic inflammatory state in diabetic patients. Moreover, these results suggest that screening for HCV should be considered prior to assessment of cardiovascular risk in diabetic patients, because the results may affect the cardiovascular risk scoring.
    Polskie archiwum medycyny wewnȩtrznej 12/2010; 120(12):491-6. · 2.05 Impact Factor
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    ABSTRACT: The aim of the study was to assess myocardial perfusion by means of non-invasive diagnostic methods and measurement of the plasma concentration of vascular endothelial growth factor (VEGF) in patients with long-lasting type 1 diabetes. The study was performed on 41 Type 1 diabetic patients (23 females, 18 males), aged 30±7.6 with a duration of disease 15.2±5.5years. 17 patients exhibited microalbuminuria (10 females, 7 males) and 24 subjects were without microalbuminuria (13 females, 11 males). The methods used included a 24-h ECG tape, an exercise treadmill test, echocardiological evaluation with dobutamine and atropine challenge and single photon emission computer tomography (SPECT) at rest, and after dipyridamol induction of ischemia. All the exercise and stress echocardiography tests were negative. There were significant differences between microalbuminuric and normoalbuminuric subjects in the duration of their exercise tests (586.9±110.5 vs. 664.9±133.2s, p=0.027), performed work (11.4±1.6.vs. 12.6±1.8 METs, p=0.045), achieved pulse limit (89.1±3.6 vs. 92.6±5.2%, p=0.037), rest ejection fraction (55.8±8.7 vs. 62.0±4.4%, p=0.040), abnormal changes in SPECT (53 vs. 21%, p=0.047) and VEGF concentration (101.5±7.8 vs. 75.15±16.5pg/ml, p<0.05). The presence of retinopathy increased 12-fold the probability of significant changes in the SPECT (OR 12.1, 95% CI 1.38-105.64, p=0.02) and nephropathy (OR 4.27; 95%CI 1.09-16.83, p=0.03). Asymptomatic patients with long lasting type 1 diabetes may have disturbances in myocardial perfusion, especially these with microalbuminuria.
    Microvascular Research 12/2010; 80(3):440-4. · 2.43 Impact Factor