Original Data

Adiponectin and Adiponectin Receptor Gene Variants in Relation to Type 2 Diabetes and Insulin Resistance-Related Phenotypes

Viktor A. Potapov¹, Dimitry A. Chistiakov¹, Anna Dubinina², Minara S. Shamkhalova², Marina V. Shestakova², Valery V. Nosikov¹

Abstract

BACKGROUND: Alterations in adiponectin-mediated pathways are known to be associated with glucose intolerance, insulin resistance (IR), obesity, and type 2 diabetes (T2D) mellitus. Genetic variations in adiponectin (ADIPOQ) and adiponectin 1 and 2 receptor (ADIPOR1 and ADIPOR2) could have effects on IR-related phenotypes and T2D. Here we examine whether the polymorphic markers rs2241766 (ADIPOQ), rs22753738 (ADIPOR1), rs11061971 and rs16928751 (both in ADIPOR2) are implicated in susceptibility to T2D in a Russian population. METHODS: The polymorphic markers were genotyped in 129 T2D patients, and 117 non-diabetic controls, by polymerase chain reaction (PCR) restriction fragment length polymorphism approach. In the subjects, biochemical characteristics including serum insulin, plasma glucose and serum lipids/lipoproteins were measured and compared for correlation with the genetic variations studied. RESULTS: Allele T of rs11061971 and allele A of rs16928751 showed association with higher risk of diabetes providing odds ratios (OR) of 2.05 (p = 0.0025) and 1.88 (p = 0.018), respectively. Haplotype A-G consisting of allele A of rs11061971 and allele G of rs16928751 was associated with reduced risk of T2D (OR = 0.59, p_c = 0.0224). Compared to other variants, diabetic patients double homozygous for A/A of rs16928751 and G/G of rs16928751 had decreased homeostasis model assessment-insulin resistance (p_c = 0.0375) and serum triglycerides (p_c = 0.0285). CONCLUSIONS: The variants of ADIPOR2 confer susceptibility to T2D and are associated with some IR-related phenotypes in the Russian study population.

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How to Use Image Analysis for Islet Counting

Peter Girman, Zuzana Berkova, Eva Dobolilova, Frantisek Saudek

Abstract

AIM: Assessment of islet mass before islet transplantation requires a reliable technique to enable exact analysis of islet volume. This study aimed to test the applicability of digital image analysis (DIA) for evaluation of samples of purified and non-purified islets. METHODS: Pancreatic islets were isolated from 10 Lewis rats. Samples of purified (n = 10) and non-purified islets (n = 30) were counted conventionally and by using a computerized method. The equipment for the computerized counting consisted of a digital camera installed on a stereomicroscope and connected to a personal computer. Images of 2272x1704 pixels were processed using a previously described non-commercial program originally developed for this purpose. Islets were converted to equivalents using globe and ellipsoid models. The insulin content of purified islets was assessed using radioimmunoassay and was correlated to the absolute and standardized islet number. RESULTS: Mean absolute numbers of purified islets ± SD were 908 ± 130 and 1049 ± 230 (manually and DIA respectively). Mean insulin content ± SD obtained from purified islets was 161 ± 45 mU. The mean equivalents of purified islets (1589 ± 555 for globe and 1219 ± 452 for ellipsoid) significantly correlated with insulin content. However, this correlation was not significant when absolute islet numbers were used, counted using either method. There was no significant difference in absolute non-purified islet numbers assessed by manual and computerized methods (average ± SD in 50 µl samples; 12.6 ± 4.1 and 13.3 ± 5.3 respectively; p = 0.22). The manual method showed a significantly higher yield of islet equivalents (IE; p < 0.001 for both globe and ellipsoid). CONCLUSION: The computer-based system for islet counting correlated better to insulin content than conventional islet estimation and prevented overestimation. Reproducibility and ease of assessment make it potentially applicable to clinical islet transplantation.

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The Prognostic Significance of Serum Glucose Levels After the Onset of Ventricular Arrhythmia on In-Hospital Mortality of Patients with Acute Coronary Syndrome

Vassilios N. Nicolaou¹, John E. Papadakis¹, Christina Chrysohoou², Demosthenes B. Panagiotakos², Xenofon Krinos¹, Panagiotis D. Skoufas¹, Christodoulos Stefanadis²

Abstract

BACKGROUND: Several studies have illustrated the role played by serum glucose levels in cardiovascular morbidity and mortality in general and, more particularly, after an acute coronary event. AIM: The aim of this study was to evaluate the impact of serum potassium and glucose levels on in-hospital mortality in patients with ischemic heart disease, who exhibited severe ventricular arrhythmia. METHODS: We enrolled 162 consecutive patients who were referred to our institution for an acute coronary event and presented with sustained ventricular tachycardia or ventricular fibrillation during the first 24 hours of hospitalization. Serum potassium and glucose levels were measured in all patients at the onset of tachycardia and after 2, 4, 6, 12, 36, 48 hours. RESULTS: During hospitalization, 23 out of 162 patients died (61% males). Serum glucose levels at the onset of the arrhythmia, as well as after 2, 12, 36 and 48 hours, were higher in the deceased (onset: 228.8 ± 108 vs. 158 ± 68 mg/dl, p = 0.0001, 2 h: 182 ± 109 vs. 149 ± 59 mg/dl, p = 0.03, 12 h: 155.5 ± 72 vs. 128 ± 48 mg/dl, p = 0.025, 36 h: 163.8 ± 63 vs.116 ± 42 mg/dl, p = 0.002, and 48 h: 138 ± 64 vs. 122 ± 42 mg/dl, p = 0.05, respectively), even after adjustment for age, sex, diabetes, left ventricular ejection fraction, type of acute coronary syndrome and site of infarction and medication intake. There was no difference in serum potassium levels between the deceased and survivors. CONCLUSION: Serum glucose levels at the onset of arrhythmia and 2, 36 and 48 hours later seem to have prognostic significance for in-hospital mortality in patients hospitalized for an acute coronary event, who exhibit severe ventricular arrhythmia.

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Quality of Care for First-Degree Relatives of Type 2 Diabetes Patients Diagnosed with Diabetes at a Screening Program One Year After Diagnosis

Massoud Amini, Azam Timori, Ashraf Aminorroaya

Abstract

AIMS: Diabetes screening is an effective tool for diagnosing patients who are unaware of their diabetes and for providing them with optimal treatment. The quality of care and treatment of diabetic patients diagnosed at a screening program during one year in Isfahan, a centrally located Iranian city, was assessed. METHODS: In a prospective study, 1640 first-degree relatives of diabetic patients (aged 35-55) were screened for diabetes mellitus at Isfahan Endocrine and Metabolism Research Center during 2003-2004. All patients diagnosed with diabetes during screening were selected and their height, weight, blood pressure, fasting plasma glucose, lipids and HbA1c were recorded at the time of diagnosis and one year later. The values at the time of screening were subsequently compared with those collected one year later. RESULTS: Eighty-three subjects (5.06%) were diagnosed with diabetes during screening. Of these patients, 78.3% were dyslipidemic and 45% were hypertensive. One year after diagnosis, 77.1% of patients were receiving treatment for hyperglycemia. However, only 49.2% of dyslipidemic and 45% of hypertensive patients were being treated for these conditions. Body mass index, fasting plasma glucose, lipids and HbA1c had improved one year after diagnosis, but no significant improvement was observed in blood pressure. CONCLUSIONS: The evaluation of the quality of care for newly diagnosed diabetic patients revealed that more attention should be paid to glycemic control and reducing cardiovascular risk factors, in particular hypertension.

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