Anca Elena Craciun’s research while affiliated with Iuliu Hațieganu University of Medicine and Pharmacy and other places

Introduction and objective: This literature review aims to provide an overview of the progress in metabolomic assessment in animal and cell models and in humans with diabetic neuropathy (DN). Methods: Metabolomics has emerged as an important approach for investigating, identifying, and describing biomarkers related to DN. None has yet been validated for use in clinical practice. Results: DN induced significant alterations in energy metabolism and carbohydrates, lipids, amino acids, peptides, and proteins. Several treatments for DN, evaluated using metabolomics, were proved to have promising results. Conclusions: The ideal metabolite or set of metabolites that could be used as biomarkers should identify patients with diabetes prone to develop DN or those prone to progress to severe forms of sensory loss, associated with risk of ulcerations and amputation. Another potential use of a metabolite might be as an indicator of treatment response in clinical trials using agents with potential disease-modifying properties.

In this analysis, we aimed to investigate the effect of COVID-19 disease on eating behavior. A total of 55 right-handed adults, <50 years of age, without overweight or obesity, from two cross-sectional studies were included. The first one enrolled subjects between September 2018 and December 2019 (non-COVID-19 group). The second one included subjects enrolled between March 2022 and May 2023; for this analysis, 28 with a history of COVID-19 (COVID-19 group) were retained. Hunger, TFEQ-18, plasma ghrelin, neuropeptide Y (NPY) and resting-state fMRI were assessed during fasting. Intraregional neuronal synchronicity and connectivity were assessed by voxel-based regional homogeneity (ReHo) and degree of centrality (DC). Significantly higher ghrelin and NPY levels were observed in the COVID-19 group than in the non-COVID-19 group (ghrelin 197.5 pg/mL vs. 67.1 pg/mL, p < 0.001; NPY 128.0 pg/mL vs. 84.5 pg/mL, p = 0.005). The NPY levels positively correlated with the DC and ReHo in the left lingual (r = 0.67785 and r = 0.73604, respectively). Similar scores were noted for cognitive restraint, uncontrolled eating and emotional eating in both groups according to the TFEQ-18 questionnaire results (p > 0.05 for all). Our data showed increased levels of appetite-related hormones, correlated with activity in brain regions involved in appetite regulation, persisting long after COVID-19 infection.

Purpose The objective of this study was to examine the association between insulin dose and high-sensitivity C-reactive protein (hsCRP), nitrotyrosine, and pentraxin 3 in patients with insulin-treated type 2 diabetes. Patients and methods Eighty patients with type 2 diabetes treated with insulin for >6 months and with stable insulin doses (±10%) within 3 months before inclusion were enrolled in this study. Medical history, including use of insulin and insulin doses, concomitant diseases and medication, and anthropometric and routine biochemical parameters were collected for each patient. hsCRP, nitrotyrosine, and pentraxin 3 were measured in fasting conditions. Comparison analysis was performed according to the distribution in tertiles of insulin dose/kg of body weight, and linear regression adjusted for confounding factors was used to examine the associations between markers of inflammation, oxidative stress, and insulin dose. Results In the comparison analysis, no statistically significant difference was found between hsCRP, nitrotyrosine, and pentraxin 3 levels across tertiles of insulin dose expressed as IU/kg of body weight (p for trend >0.05 for all comparisons) except a significantly higher hsCRP level in tertile 3 compared to tertile 1 (3.9±3.6 vs 6.1±3.8 mg/dL, p=0.035). In regression analysis, after adjustment for age, gender, smoking, body mass index, glycated hemoglobin, C-peptide, metformin, antiplatelet, and statin use, only hsCRP levels were statistically significant associated with insulin dose/kg of body weight (β=0.237, p=0.043). Conclusion In this sample of patients with type 2 diabetes treated with insulin for >6 months, hsCRP was positively associated with insulin doses. No such association was found for pentraxin 3, a more specific marker of vascular inflammation, and for nitrotyrosine as a marker of oxidative stress.

Background: Type 2 diabetes has been associated elevated high-sensitivity C-reactive protein (hsCRP) and increased expression of cellular adhesion molecules, VCAM-1 and ICAM-1, but the possible implication of heart rate (HR) variability in enhancing chronic inflammation biomarkers are incompletely understood. We aimed to evaluate the correlations between HR variability assessed during 24-hours ambulatory blood pressure monitoring and hsCRP, VCAM-1 and ICAM-1 in type 2 diabetes and control subjects. Materials and methods: The case-control study included type 2 diabetes (n=75) and control (n=11) subjects. HsCRP, VCAM-1 and ICAM-1 were determined using ELISA technique. HR was automatically assessed every 30 min/60 min for 24 hours using HolCARD CR-07, Aspel. HR variability was calculated as standard deviation of mean HR during daytime, nighttime and 24-hours periods. Results: Higher hsCRP (0.48±0.15 vs. 0.71±0.35; p=0.025), ICAM-1 (447±160 vs. 560±160; p=0.032) and VCAM-1 (818±131 vs. 908±253; p=0.17) were observed in type 2 diabetes compared to controls. In type 2 diabetes subjects, we found that daytime HR variability correlated with hsCRP (r= -0.23; p=0.045) and VCAM-1 (r= 0.27; p=0.019), nighttime HR variability correlated with ICAM-1 (r= 0.25; p=0.028), and 24-hours HR variability correlated with VCAM-1 (r= 0.26; p=0.027). Nighttime HR variability correlated with ICAM-1 (r= 0.42; p=0.009) in subjects with diabetic neuropathy (n=38), whereas daytime HR variability correlated with VCAM-1 (r= 0.42; p=0.034) in subjects with diabetic nephropathy (n=25). Conclusions: Our findings suggest that evaluation of both ambulatory HR variability and chronic inflammation biomarkers might contribute to chronic complications risk stratification in type 2 diabetes subjects.

Objectives. This study aims to evaluate the relationship between 24-hour ambulatory pulse pressure, inflammatory markers and clinical parameters in type 2 diabetes (n=50) and control subjects (n=10). Implications. Pulse pressure, the difference between systolic blood pressure and diastolic blood pressure, is an independent risk factor for the cardiovascular disease. Also, elevated pulse pressure has been associated with the development of chronic diabetes complications. The role of pulse pressure in enhancing chronic inflammation markers will be described in this study. Originality. Daytime and 24-hour ambulatory pulse pressures were significantly associated with hsCRP. Nighttime ambulatory blood pressure was associated with VCAM-1. None of the ambulatory blood pressures associated with ICAM-1. In linear regression, nighttime ambulatory pulse pressure was predicted by VCAM-1 and hypertension duration, but not hsCRP, type 2 diabetes duration or body mass index.