Diabetes is the seventh leading cause of death in the United States, and nearly 34% of U.S. adults are prediabetic. CTRP3 is an adipose secreted protein that has shown to play a key role in glucose metabolism and insulin sensitivity, however, the research on CTRP3 total levels and its relationship to type 2 diabetes is controversial. The oligomeric state (protein structure) of CTRP3 in relation to metabolic dysfunction has not been studied. This study will be the first analysis of the circulating forms of CTRP3 in human blood. Hypothesis: The relative circulating amounts of the three oligomeric states of CTRP3 will differ in patients with type 2 diabetes. Methods: Human serum samples are analyzed using western blotting under native, reduced non-denaturing, and denaturing conditions. Results: In reducing non-denaturing conditions, three oligomeric states of CTRP3 were visualized in human serum: the high molecular weight (HMW) oligomer, the low molecular weight (LMW) oligomer, and the trimer. Conclusion: Reduced, non-denaturing conditions appear to yield the most effective separation of the three oligomeric states of CTRP3, and further studies aim to observe a difference in oligomeric state with a diabetic phenotype. Investigating the relationship of CTRP3’s oligomeric state with diabetic phenotype could present novel understanding of this protein’s possible protective effects against certain metabolic disorders.

<p>Current evidence suggests that both prediabetes and diabetes can reverse to normoglycemia; however, predictors of remission of these conditions are poorly understood. We performed analyses on 1,209 people with impaired fasting glucose and/or impaired glucose tolerance treated with placebo rosiglitazone and placebo ramipril in the DREAM trial. Normoglycemia was defined as a fasting plasma glucose <5.6 mmol/L and 2-hour plasma glucose <7.8 mmol/L on a 75 g oral glucose tolerance test (OGTT).</p> <p>The effects of baseline ALT and waist to hip ratio (WHR) on regression of prediabetes to normoglycemia 2 years later were found to be interdependent (p-value for interaction 0.01). Adjusted odds ratios ORs (95% CI) of regression to normoglycemia per 10 U/L increase in ALT were 0.79 (0.66-0.94) when WHR was at the mean minus 1 standard deviation (SD), 0.90 (0.80-1.02) when WHR was at the mean of 0.91, and 1.03 (0.90-1.18) when WHR was at the mean plus 1 SD. Adjusted ORs of regression to normoglycemia per 0.1 unit increase in WHR were 0.75 (0.60-0.95) when ALT was at the mean minus 1 SD, 0.91 (0.76-1.08) when ALT was at the mean of 25 U/L, and 1.09 (0.89-1.35) when ALT was at the mean plus 1 SD.</p> <p>Similarly, the effects of baseline ALT and WHR on AUC_{glucose0-120 min} obtained from the OGTT were found to be interdependent (p-value for interaction 0.056). A 10 U/L increase in ALT was associated with an adjusted AUC_{glucose0-120 min} increase of 19.5 (95% CI 5.3 to 33.7) min*mmol/L when WHR was at the mean minus 1 SD, 11.0 (1.4 to 20.6) min*mmol/L when WHR was at the mean of 0.91, and 2.5 (-9.2 to 14.1) min*mmol/L when WHR was at the mean plus 1 SD. A 0.1 unit increase in WHR was associated with an adjusted AUC_{glucose0-120 min} increase of 30.3 (10.2 to 50.3) min*mmol/L when ALT was at the mean minus 1 SD, 18.3 (3.8-32.9) min*mmol/L when ALT was at the mean of 25 U/L, and 6.4 (-11.5 to 24.3) min*mmol/L when ALT was at the mean plus 1 SD.</p> <p>In conclusion, high baseline ALT and WHR predict a lower likelihood of regression of prediabetes to normoglycemia and an increase in AUC_{glucose0-120 min} 2 years later; however, the effects of ALT and WHR on these outcomes are interdependent.</p> / Master of Science (MSc)

A dissertation submitted to the Faculty of medicine of the university of Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Masters of science Johannesburg 1991 / Carnitine plays a role in the transport of activated long chain fatty acyl groups from the site of activation to the site of beta-oxidation in the mitochondria. Endogenous synthesis of carnitine from the amino acids methionine and lysine, takes place mainly in the liver. From there free and acyl carnitine are released into the blood and transported to other tissues.A few studies have indicated that poor nutritional status may lead to carnitine deficiency.[Abbreviated Abstract. Open document to view full version] / GR2017

MPH, Faculty of Health Sciences, University of the Witwatersrand / Background: The increase use of highly active antiretroviral therapy (HAART) among patients with HIV infection and AIDS has led to increasing reports of metabolic abnormalities such as diabetes mellitus, hypertension, dyslipidaemia and obesity. Therefore, it is important to explore the burden of these diseases among HIV infected patients. Objectives: To determine the burden of metabolic diseases (hypertension, diabetes, obesity and dyslipidaemia) in patients attending HIV clinic at the Charlotte Maxeke Johannesburg Academic Hospital (JHBH). Methodology: It was a cross-sectional study. The study population included patients attending JHBH HIV clinic and on HAART for more than one year. A sample size of 304 patients, including 237 females and 67 males partook in this study. Anthropometric measurements were taken from patients and blood samples of these patients were sent to laboratory for lipograms, HbA1c, random glucose, CD4 lymphocytes counts as well as HIV viral load testing. The data was analysed with standard statistical software Epi-info version 6.0. Both descriptive and analytical statistics was used. Results: The prevalence of metabolic syndrome according to the IDF was 20.4 %; obesity (BMI 30 kg/m2) was 16.8% and patients that were overweight (BMI > 25 kg/m2 and BMI < 29.9 kg/m2) was 28.6%; hypercholesterolemia (TC 5.0 mmol/l) = 35.5%; HDL< 1.29 mmol\L in females was 58% and HDL <1.04 mmol/l in males was 36%; elevated triglycerides 1.7 mmol/l was 30% and only 16% was classified as being hypertensive (BP 140/90 mmHg and / or on Hypertensive medication). The majority of the patients (86.2%) had a CD4 lymphocyte count 200 X 106 cells/l and 84% of patients had less than detectable limits for viral loads (VL< 40 copies / μl), which has been reported as optimum levels for metabolic diseases in HAART recipients. Conclusion: These results clearly indicate that there is a growing burden of metabolic diseases among HIV patients on HAART attending the Johannesburg hospital HIV clinic. The current study also indicates that the metabolic disturbances are more frequent in women than in men, except for hypertension.

Background: Diabetes is the sixth leading cause of death in the United States (U.S), and a major risk factor for cardiovascular disease (CVD). The prevalence of diabetes in central Appalachian region is higher than the rest of the nation (14.4% versus 9.0%, respectively). Objectives: Examine the association between multiple risk factors for CVD and diabetes in asymptomatic adults in central Appalachia. Methods: Between January 2012 and July 2016, 3,000 community-dwelling asymptomatic individuals from central Appalachia participated in screening for sub-clinical atherosclerosis. Participants were asked to report their diabetes status (yes/no). In addition, data on coronary artery calcium (CAC), a marker for sub-clinical coronary atherosclerosis, in quartiles (0, 1-99, 100-399, ≥400), obesity (body mass index ≥30 kg/m2), hypercholesterolemia (yes/no), hypertension (yes/no), current smoking (yes/no), sedentary lifestyle (yes/no), and family history of coronary artery disease (CAD) (yes/no), were collected. Multivariable logistic regression analyses were conducted to assess association between CVD risk factors and diabetes. Results: Of the 3,000 participants, 2,509 subjects (mean age: 58.3 years; SD = 9.8 years) had complete data on variables of interest. Approximately, 14% of the study population reported having type 2 diabetes. Among subjects with diabetes, 58% had a CAC score ≥1, 22% were obese, 17% had hypercholesterolemia, 20% had hypertension, 16% were current smokers, 17% had a sedentary lifestyle, and 15% had a family history of CAD. After adjusting for sex and age, having a CAC score of 1-99, 100-399, and ≥400 increased the odds of having diabetes (Odds ratio (OR): 1.4, 95% Confidence interval (CI) = 1.02-1.9; OR: 2.0, 95% CI = 1.4-2.8; OR: 3.1, 95% CI = 2.1-4.7, respectively) in a linear fashion. Being obese (OR: 3.2; 95% CI = 2.5-4.0), having hypercholesterolemia (OR: 1.8; 95% CI=1.4-2.4), being hypertensive (OR: 3.0; 95% CI= 2.3-3.8), being a smoker (OR: 1.5; 95% CI = 1.1-2.1), and being sedentary (OR: 1.6; 95% CI = 1.3-2.0) were significantly associated with diabetes. Having three (OR: 3.0; 95% CI=1.3-6.6), four (OR: 4.4; 95% CI=2.0-9.7), five (OR: 7.0; 95% CI=3.1-16.1) or six (OR: 9.9; 95% CI= 3.5-27.7) CVD risk factors significantly increased the odds of diabetes. Subjects with any of the seven risk factors under study were 1.7 times (95% CI= 1.5-1.9) more likely to have diabetes. Conclusion. Odds of type 2 diabetes increase with higher number of risk factors for CVD. Results support the use of multifaceted CVD and diabetes prevention programs to lower the incidence of type 2 diabetes.

Abstract available through Circulation.

Geography disparities exist in obesity and obesity related conditions. This study aimed to examine the geographic differences in obesity prevalence and its risk factors among Asian Americans in California. Data (n = 4,000) from the 2013–2014 California Health Interview Survey were used. Obesity (≥27.5 kg/m2) was defined according to the World Health Organization Asian body mass index cut points in Asian groups. Results suggest that 66.5% of Asians lived in urban areas. Among Asian adults, obesity prevalence was highest in Filipinos (33.8%) and lowest in Koreans (12.8%). Compared to rural Vietnamese, obesity prevalence was higher for urban Vietnamese (8.3% vs. 20.2%, p = 0.0318). Weighted multiple logistic regression analyses showed that being 45–64 years (vs. 65 years or above), being Japanese, Filipino, or other Asians (vs. Chinese) were associated with a higher odds of obesity among urban residents; whereas being 18–44 years and being 45–64 years (vs. 65 years or older), being male, having high school education (vs. having graduate education) were associated with a higher odds of obesity among rural residents. Being Vietnamese (vs. Chinese) was associated with 64% decreased odds of obesity only among rural residents (95% confidence interval = 0.14–0.94). The findings show geography disparities in obesity among Asians in California.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2010. / Härtill 4 uppsatser.

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Made available in DSpace on 2014-10-09T12:33:21Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:06:31Z (GMT). No. of bitstreams: 0 / Diabetes Mellitus (DM) é uma síndrome metabólica complexa, causada pela secreção diminuída ou ausente de insulina pelas células beta pancreáticas, levando a hiperglicemia. A hiperglicemia promove a glicação de proteínas e, conseqüentemente, o aparecimento de produtos finais da glicação avançada (AGEs). Atualmente, os pacientes diabéticos são monitorados pela determinação dos níveis de glicemia e hemoglobina glicada (HbA1c). As complicações geradas pela hiperglicemia podem ser divididas em micro e macrovasculares, representadas por retinopatias, nefropatias, neuropatias e doenças cardiovasculares. A albumina (HSA) é a proteína sérica mais abundante no organismo humano e está sujeita à glicação. A protoporfirina XI (PpIX) é a molécula precursora da síntese do heme, componente estrutural da hemoglobina. Ensaios in vitro e em animais indicaram que a hiperglicemia promove uma diminuição de sua concentração em eritrócitos. A espectroscopia de fluorescência é uma técnica bastante utilizada na área biomédica. A autofluorescência corresponde à fluorescência intrínseca presente em algumas moléculas, estando esta associada à estrutura das mesmas. O objetivo deste trabalho foi utilizar a técnica de espectroscopia de fluorescência para mensurar os níveis de autofluorescência da PpIX eritrocitária e AGE-HSA em pacientes diabéticos e indivíduos saudáveis e compará-los com os níveis de glicemia e HbA1c. Este estudo foi realizado com 151 indivíduos (58 controles e 93 diabéticos). Os dados epidemiológicos de pacientes e controles foram obtidos nos prontuários médicos. Para os indivíduos controle, os valores de glicemia foram adquiridos dos prontuários médicos e os níveis de Hb1Ac obtidos pela utilização de kits comerciais. A determinação da autofluorescência da PpIX foi realizada com excitação de 405 nm e emissão de 632 nm. Para a determinação do AGE-HSA foi realizada excitação de 370 nm e emissão de 455 nm. Aproximadamente 50% dos diabéticos apresentaram lesões micro ou macrovasculares decorrentes da hiperglicemia. Não foram observadas diferenças significativas nos valores de intensidade de emissão de PpIX entre os grupos estudados (P=0,89). Na análise do AGE-HSA observou-se diferenças significativas dos valores de intensidade de emissão entre os dois grupos, sendo este valor 1,45 vezes maior para o grupo de indivíduos diabéticos (P<0,0001). Os pacientes com complicações diabéticas apresentavam intensidade de emissão de fluorescência 1,19 vezes maior que os indivíduos sem complicações decorrentes da doença (P= 0,01), mesmo não havendo diferenças significativas nos valores de HbA1c entre os dois grupos. Concluímos que a espectroscopia de fluorescência foi uma técnica eficaz na identificação da autofluorescência da PpIX e do AGE-HSA. A PpIX não foi um biomarcador eficiente para o acompanhamento do DM. A determinação dos níveis de autofluorescência do AGE-HSA foi eficiente para a discriminação entre os grupos e para o monitoramento da progressão da doença, podendo ser mais eficiente que a dosagem de HbA1c. A espectroscopia de fluorescência é uma técnica simples, rápida e de baixo custo para o acompanhamento de indivíduos diabéticos. / Dissertacao (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP