Original Data

Rev Diabet Stud, 2017, 14(4):354-363 DOI 10.1900/RDS.2017.14.354

Relationship Between Serum Uric Acid and Incident Hypertension in Patients with Type 2 Diabetes

Mohsen Janghorbani1, Heshmatollah Ghanbari2, Ashraf Aminorroaya1, Masoud Amini1

1Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
Address correspondence to: Mohsen Janghorbani, e-mail: janghorbani@hlth.mui.ac.ir


BACKGROUND: Little is known about the relationship between high baseline serum uric acid (SUA) and incident hypertension in patients with type 2 diabetes (T2D). OBJECTIVES: To evaluate the ability of baseline SUA to predict the incidence of hypertension in non-hypertensive patients with T2D. METHODS: The association between SUA and mean 20-year incidence of hypertension was examined in 1,666 non-hypertensive patients with T2D from Isfahan Endocrine and Metabolism Research Center outpatient clinics, Iran. The primary outcome was incident hypertension defined as systolic blood pressure (BP) of 140 mmHg or higher and/or diastolic BP 90 mmHg or higher and/or use of antihypertensive medications. The mean (standard error (SE)) age of participants was 49.4 years (0.25 years) with a mean (SE) duration of diabetes of 6.1 years (0.15 years) at initial registration. We used multiple logistic regression to estimate the odds ratio (OR) for the incidence of hypertension across quartiles of SUA, and plotted a receiver operating characteristic (ROC) curve to assess discrimination. RESULTS: The highest quartile of SUA was not associated with hypertension compared with the lowest quartile in multivariable adjusted models (OR: 1.22, 95% CI: 0.87, 1.73). The area under the ROC curve for SUA was 51.7% (95% CI: 48.9, 54.5). CONCLUSIONS: High initial SUA levels are not a predictor of incident hypertension in an Iranian T2D population.

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Rev Diabet Stud, 2017, 14(4):364-371 DOI 10.1900/RDS.2017.14.364

Association of Oxytocin with Glucose Intolerance and Inflammation Biomarkers in Metabolic Syndrome Patients with and without Prediabetes

Amal Akour1, Violet Kasabri1, Nailya Bulatova1, Suha Al Muhaissen1, Randa Naffa1, Hiba Fahmawi1, Munther Momani2, Ayman Zayed2, Yasser Bustanji1

1School of Pharmacy and Medicine, the University of Jordan, Amman, Jordan
2Endocrinology and Diabetes Unit, the University of Jordan Hospital, Amman, Jordan
Address correspondence to: Violet Kasabri, e-mail: hotice162@gmail.com


OBJECTIVES: The aim of this study was to explore the differences in OXT levels in metabolic syndrome (MetS) subjects, newly diagnosed type 2 diabetes mellitus (T2D), and prediabetes subjects vs. MetS subjects without glucose intolerance (non-diabetic MetS). It was also intended to determine the relationship between plasma OXT levels and inflammatory markers in those subjects. METHODS: Along with 45 lean and normoglycemic controls, a total of 190 MetS subjects (61 men, 129 women) were enrolled. Colorimetric enzymatic assays of the following components were performed: plasma OXT, high-sensitivity C-reactive protein (hs-CRP), macrophage chemoattractant protein 1 (MCP-1), plasminogen activator inhibitor 1 (PAI-1), matrix metalloproteinase 9 (MMP-9), resistin, adiponectin, leptin, macrophage migration inhibitory factor (MIF), tumor necrosis factor α (TNF-α), thrompospondin 1 (TSP-1), interleukin 10 (IL-10), interleukin 6 (IL-6), and glucagon. RESULTS: hsCRP, PAI-1, resistin, leptin-to-adiponection-ratio (LAR), TNF-α, TSP-1, and MIF were significantly higher in both MetS groups (prediabetic and T2DM) than in MetS-only subjects. Leptin and MMP-9 were significantly higher in the MetS-T2DM group (but not in MetS-prediabetics) vs. MetS-only subjects. Conversely adiponectin, OXT, MCP-1, and IL-10 were significantly lower in both MetS groups (prediabetic and T2DM) than in MetS-only subjects. There was no marked discrepancy in either glucagon or IL-6 levels among the three MetS groups. In the entire MetS study population, OXT correlated substantially and proportionally with MCP-1, IL-10, and IL-6; it correlated negatively with HbA1c, fasting plasma glucose (FPG), PAI-1, MMP-9, TNF-α, TSP-1, resistin, adiponectin, leptin, LAR, and MIF. No association could be observed between OXT and glucagon. CONCLUSIONS: OXT may be a substantial surrogate predictive/prognostic tool and putative pharmacotherapeutic target in metabolic anomalies and related disorders.

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Rev Diabet Stud, 2017, 14(4):372-380 DOI 10.1900/RDS.2017.14.372

Duration of Type 2 Diabetes is a Predictor of Elevated Plantar Foot Pressure

Brooke Falzon1, Cynthia Formosa1, Liberato Camilleri2, Alfred Gatt1

1Department of Podiatry, Faculty of Health Sciences, University of Malta, Msida, MSD 2080, Malta
2Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, MSD 2080, Malta
Address correspondence to: Alfred Gatt, e-mail: alfred.gatt@um.edu.mt


AIMS: Elevated plantar pressure is considered a significant risk factor for ulceration in diabetes mellitus. The aim of this study was to determine whether duration of diabetes could affect plantar pressure in patients with no known significant comorbidity or foot pathology. METHODS: Participants with type 2 diabetes, but without known confounding factors that could alter peak pressure, were matched for age, weight, and gender and categorized into 3 groups of diabetes duration: group 1 (1-5 yr), group 2 (6-10 yr), and group 3 (11-15 yr). Plantar pressures were recorded utilizing a two-step protocol at a self-selected speed. RESULTS: One-way analysis of variance (ANOVA) revealed significant differences in mean peak plantar pressures between the three groups under the 2nd - 4th metatarsophalangeal joint (MPJ) region of interest (ROI) (p = 0.012 and p = 0.022, respectively) and left heel (p = 0.049). Also, a significant difference in mean pressure-time integral under the left 2nd - 4th MPJ ROI (p = 0.021) and right heel (p = 0.048) was observed. Regression analysis confirmed that mean peak plantar pressures in the first group (but not in the second group) were significantly lower than in the third group (p = 0.005). CONCLUSIONS: As the duration of diabetes increased, peak plantar pressure increased significantly under the 2nd - 4th MPJ ROIs. These findings suggest that clinicians should make more use of pressure mapping technology as part of their clinical management plan in patients with diabetes >10 yr, even if they have no complications or deformities, to preserve functional limbs in this high-risk population.

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Rev Diabet Stud, 2017, 14(4):381-389 DOI 10.1900/RDS.2017.14.381

Association of Socio-Environmental Determinants with Diabetes Prevalence in the Athens Metropolitan Area, Greece: A Spatial Analysis

Antigoni Faka1, Christos Chalkias1, Diego Montano2, Ekavi N. Georgousopoulou3,4, Anestis Tripitsidis1, Efi Koloverou3, Dimitris Tousoulis5, Christos Pitsavos5, Demosthenes B. Panagiotakos3

1Department of Geography, School of Environment, Geography and Applied Economics, Harokopio University, Athens, Greece
2Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University, Ulm, Germany
3Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
4Faculty of Health, University of Canberra, Canberra, Australia
5First Cardiology Clinic, School of Medicine, University of Athens, Greece
Address correspondence to: Demosthenes B. Panagiotakos, e-mail: dbpanag@hua.gr


OBJECTIVES: The aim of this study was to investigate the spatial variation of diabetes in relation to the geographical variability of socio-environmental characteristics in the urban districts of Athens. METHODS: A sample of 2,445 individuals from the greater area of Athens was randomly enrolled in the ATTICA study between 2001 and 2002. Diabetes was defined according to American Diabetes Association criteria. Geographical and statistical analyses were applied to examine the relationship between diabetes prevalence and factors related to education, economic status, population density, immigrant status, and availability of urban green areas. Diabetes prevalence and socio-environmental factor mapping was based on the Geographic Information Systems (GIS) technology. Variograms and spatial quasi-Poisson regression analysis evaluated the associations of diabetes with the socio-environmental variables at the municipal level. RESULTS: According to the geographical analysis and mapping, the highest proportions of people with diabetes were found in the West sector and in one district of the East and South sector each. Regression analysis revealed that the proportion of inhabitants with higher education is negatively correlated with diabetes prevalence in the regional areas of Athens. CONCLUSIONS: The study revealed that socio-environmental status in residential areas, especially educational and economic levels, is correlated with diabetes prevalence at the aggregate level. These correlations may reflect socio-economic segregation patterns at the district level, and different prevalence rates of diabetes among individuals with higher income and educational levels.

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