Diabetes mellitus tipo 2 (DM2) está associado a um estado de inflamação crônica e ativação do estresse do retículo endoplasmático (ERE). Nesse contexto, são necessários estudos para encontrar alternativas que melhorem o quadro inflamatório, como os ácidos graxos poli-insaturados ômega 3 (n-3 PUFA), um conhecido agente anti-inflamatório. Esse estudo teve por objetivo avaliar o efeito da suplementação do ácido alfa-linolênico (ALA, um n-3 PUFA) no estresse do retículo endoplasmático e no estado inflamatório no tecido adiposo subcutâneo abdominal (TASC) em pacientes com DM2. Foi conduzido um estudo duplo-cego, prospectivo, placebo-controlado. Vinte pacientes com DM2 foram randomizados para suplementação com 3g/dia de ALA ou placebo durante 60 dias. O tecido adiposo foi coletado através de punção aspirativa por agulha fina do abdome antes e após a suplementação e os genes e proteínas foram avaliados através de PCR em tempo real e western blot. Foi encontrada, após suplementação, uma redução da expressão gênica do XBP1 (20%), sXBP1 (70%) e aumento da expressão gênica do GRP78 (150%), confirmado na expressão proteica. Além disso, foi encontrado aumento da expressão gênica da adiponectina (90%) e redução da expressão gênica do IL-6 (80%) e IRS-1 (60%), sem correlação com a expressão proteica, no tempo pós-suplementação com ALA. Portanto, foi demonstrado que o ALA pode modular o ERE através da via da IRE1/XBP, levando ao aumento das chaperonas (BIP/GRP78), além de um efeito adicional na expressão gênica da adiponectina, IL-6 e IRS-1, o que pode demonstrar um potencial terapêutico do ALA em pacientes com DM2. / Type 2 diabetes mellitus (T2DM) is a state of chronic inflammation and activation of endoplasmic reticulum stress (ERS). In this context, studies are necessaries to find new possibilities to improve this inflammation such as the n-3 polyunsaturated fatty acid (n-3 PUFA) acting as an anti-inflammatory agent. In this study, we aimed to evaluate the effect of n-3 PUFA alpha-linolenic acid (ALA, a n-3 PUFA) supplementation in T2DM patients on the molecular expression of ERS genes in abdominal subcutaneous adipose tissue (SAT). We performed a placebo-controlled study, in a double-blind design with 20 T2DM patients, receiving, randomly, 3g/day of ALA or placebo for 60 days. The adipose tissue was collected by fine-needle aspiration in abdomen before and after the supplementation and the genes and proteins were evaluated by real-time PCR and western blot. It was seen, after the supplementation, a reduction in XBP1 (20%), sXBP1 (70%) and an increase in Grp78 (150%) gene expression, likewise same results in protein concentration. Furthermore, it was observed an increase in adiponectina (90%) gene expression and reduction in IL-6 (80%) and IRS-1 (60%) gene expression, with no correlation to protein expression after supplementation of ALA. Therefore, we have provided evidence that ALA may modulate ERS by the IRE1/XBP pathway leading to an increase in chaperones (BIP/GRP78), additionally its effect on adiponectina, IL-6 and IRS-1 gene expression can demonstrate a therapeutic potential in T2DM.

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-12-07T13:23:28Z No. of bitstreams: 1 Laura da Silva Coimbra de Carvalho.pdf: 3060322 bytes, checksum: e4abf6b3a10853319b1c00ae23b91ca5 (MD5) / Made available in DSpace on 2015-12-07T13:23:28Z (GMT). No. of bitstreams: 1 Laura da Silva Coimbra de Carvalho.pdf: 3060322 bytes, checksum: e4abf6b3a10853319b1c00ae23b91ca5 (MD5) Previous issue date: 2011 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / Estudo sobre a saúde do homem, que vive com Diabetes Mellitus tipo 2 (DM2), dos 25 aos 59 anos. Os objetivos foram descrever a qualidade de vida de homens com DM2 através dos questionários SF-36 e B-PAID; identificar as principais dimensões que interferem na qualidade de vida de homens com DM2, discutir a relação dos domínios de qualidade de vida com os problemas referentes ao diabetes e saúde do homem. A fundamentação teórica utilizou conceitos referentes à qualidade de vida; questões de gênero e qualidade de vida relacionada ao diabetes. A influência da doença na Qualidade de Vida Relacionada à Saúde (QVRS) em termos metodológicos foi avaliada pelos instrumentos de avaliação SF-36 (genérico) e B-PAID, (específico) e aspectos sócio-clínico-demográficos. A qualidade de vida dos pacientes masculinos DM2 pôde ser descrita a partir do SF-36 e B-PAID. A média do B-PAID apresentou o escore de variação alto, indicando prejuízo na QVRS nos sujeitos do estudo. Dentre as dimensões do SF-36, seis domínios encontraram-se acima da média de variação (0-100) considerada pela literatura de qualidade de vida. As duas dimensões do SF-36 que apresentaram escores baixos foram relacionadas aos domínios Vitalidade e Saúde Mental. Os domínios do SF-36 com maiores associações com o B-PAID foram os Aspectos Emocionais (AE) e Aspectos Sociais (AS). Os resultados do B-PAID e do SF-36, principalmente nas questões referentes às dimensões Vitalidade/SF-36 e Saúde Mental/SF-36, baseiam-se no estado atual do paciente nas últimas quatro semanas e foram os mais baixos. Suas questões referem-se a cansaço, esgotamento, vitalidade, estresse, desânimo, infelicidade e depressão. Apesar de os resultados dos domínios do SF-36 demonstrarem uma QV satisfatória (excetuando-se Vitalidade e Saúde Mental), o grupo de idade de até 44 anos teve uma representatividade baixa na pesquisa. A pesquisa encontrou na maioria das entrevistas a ausência de consultas com profissionais de saúde e exames laboratoriais recentes para indicar um tratamento adequado para uma doença crônica com alto impacto social. / The purpose of this study was to evaluate the men’s health with type 2 diabetes mellitus (T2DM) aged 25 to 59 years. The objectives were to describe the quality of life of male patients with T2DM of the SF-36 and PAID-B; identify the dimensions that affect the quality of life of male patients with T2DM; discuss the relationship of domains of quality of life with problems related to diabetes and men’s health. The theoretical concepts sought on quality of life, gender issues and quality of life related to diabetes. The influence of disease on quality of life related to health (HRQoL) was assessed in terms of methodology for assessment instruments SF-36 (generic) and PAID-B (specific) and social, demographic and clinical issues. The quality of life of male patients T2DM might be described from the SF-36 and PAID-B. The average PAID-B score showed high variation, indicating impairment in HRQoL in the study subjects. Among the dimensions of the SF-36, six domains were found above the average range (0-100) considered the literature of quality of life. The two dimensions of the SF-36 showed that low scores were related to areas were Vitality and Mental Health. The domains of the SF-36 with larger associations with PAID-B were the Role-emotional and Social Functioning. The results of the PAID-B and the SF-36, especially on issues relating to Vitality and Mental Health, based on the current state of the patient in the past four weeks and were the lowest. Your questions relate to fatigue, exhaustion, vitality, stress, depression, unhappiness and depression. Although the results of the SF-36 demonstrate a satisfactory QoL (except for Vitality and Mental Health), the age group up to 44 years had a low representation in research. The survey found the majority of cases the lack of consultation with health professionals and recent laboratory tests to indicate an appropriate treatment for a chronic disease with high social impact.

Background: Modern health systems are increasingly faced with the challenge to provide effective, affordable and accessible health care for people with chronic conditions. As evidence on the specific unmet needs and their impact on health outcomes is limited, practical research is needed to tailor chronic care to individual needs of patients with diabetes. Qualitative approaches to describe professional and informal caregiving will support understanding the complexity of chronic care. Results are intended to provide practical recommendations to be used for systematic implementation of sustainable chronic care models. Method: A mixed method study was conducted. A standardised survey (n = 92) of experts in chronic care using mail responses to open-ended questions was conducted to analyse existing chronic care programs focusing on effective, problematic and missing components. An expert workshop (n = 22) of professionals and scientists of a European funded research project MANAGE CARE was used to define a limited number of unmet needs and priorities of elderly patients with type 2 diabetes mellitus and comorbidities. This list was validated and ranked using a multilingual online survey (n = 650). Participants of the online survey included patients, health care professionals and other stakeholders from 56 countries. Results: The survey indicated that current care models need to be improved in terms of financial support, case management and the consideration of social care. The expert workshop identified 150 patient needs which were summarised in 13 needs dimensions. The online survey of these pre-defined dimensions revealed that financial issues, education of both patients and professionals, availability of services as well as health promotion are the most important unmet needs for both patients and professionals. Conclusion: The study uncovered competing demands which are not limited to medical conditions. The findings emphasise that future care models need to focus stronger on individual patient needs and promote their active involvement in co-design and implementation. Future research is needed to develop new chronic care models providing evidence-based and practical implications for the regional care setting.

Orientador: Carla Beatriz Collares Buzato / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-18T15:01:37Z (GMT). No. of bitstreams: 1 Oliveira_RicardoBeltramede_M.pdf: 4343326 bytes, checksum: c45de34d36b3510fa7bea078864506dc (MD5) Previous issue date: 2011 / Resumo: Tem havido um grande interesse na determinação das vias envolvidas na proliferação e função/disfunção da célula beta e a aplicação deste conhecimento em terapias moleculares e celulares da diabetes. A patogênese da diabetes melito tipo 2 (T2DM) é complexa, mas frequentemente está associada com obesidade e distúrbios do metabolismo de lipídios (hipercolesterolemia e hipertrigliceridemia). A T2DM envolve o desenvolvimento de um quadro de resistência periférica à insulina parcialmente compensada por hiperinsulinemia e hiperplasia da célula beta pancreática, resultando em intolerância à glicose e hiperglicemia. Os mecanismos interligando os estados de obesidade/hipercolesterolemia e resistência à insulina ao fenômeno da hiperplasia da célula beta não são completamente conhecidos. A presente dissertação teve como objetivos: 1) caracterizar um modelo animal adequado para se estudar a proliferação e disfunção da célula beta pancreática, e 2) avaliar, no pâncreas endócrino desses animais, a possível ativação da via de sinalização Wnt/beta-catenina, conhecida por estar envolvida no processo de proliferação celular em outros tecidos/órgãos. Para tal, foram empregados camundongos C57BL/6, wild-type (WT) e knockout para receptor de lipoproteína LDL (LDLr-/-), os quais foram submetidos à dieta hiperlipídica (HF) por 60 dias. Após a dieta HF, os animais WT tornaram-se obesos e hipercolesterolêmicos, bem como moderadamente hiperglicêmicos, hiperinsulinêmicos, intolerantes à glicose e resistentes à insulina, caracterizando-os como pré-diabéticos. Além disso, os animais alimentados com dieta HF apresentaram uma diminuição significativa na resposta secretora das células beta à glicose. De modo geral, os animais LDLr-/- apresentaram uma susceptibilidade relativamente mais alta à dieta HF, sugerida pela acentuada hipercolesterolemia, intolerância à glicose, e reduzida secreção de insulina estimulada por glicose observadas nestes animais. No entanto, a dieta HF induziu, de forma semelhante em animais WT e LDLr-/-, uma diminuição significativa no conteúdo celular de Cx36, uma proteína associada à junção comunicante e um marcador de diferenciação terminal da célula beta. Ambos os grupos WT e LDLr-/- alimentados com dieta HF mostraram aumento na proliferação de células beta, como avaliada pela imunomarcação das ilhotas para a proteína Ki67, mas apenas os animais WT exibiram alterações morfométricas indicativas de hiperplasia do pâncreas endócrino, tais como aumento na massa total de ilhotas e de células beta. Uma vez estabelecido que camundongos WT alimentados com dieta HF por 60 dias consistiam em um modelo adequado para a segunda etapa deste estudo, fomos investigar a possível ativação da via Wnt/beta-catenina nas ilhotas pancreáticas desses animais, avaliando-se a distribuição e expressão celular das proteínas beta-catenina total, beta-catenina ativada, c-Myc e ciclina D. A análise por imunofluorescência para beta-catenina não mostrou acúmulo citoplasmático ou translocação para o núcleo desta proteína em ilhotas pancreáticas, que poderia indicar ativação da via Wnt/beta-catenina no nosso modelo de hiperplasia do pâncreas endócrino. No entanto, a análise por Western Blot revelou um aumento significativo na expressão de beta-catenina ativada e ciclina D em ilhotas de animais alimentados com dieta HF em relação ao grupo controle. Concluindo, a dieta HF por 60 dias induz alterações metabólicas típicas da pré-diabetes em animais WT e LDLr-/-. O estado de pré-diabetes está associado a uma diminuição da expressão de Cx36 nas células beta pancreáticas, sugerindo um possível papel da comunicação intercelular mediada pelas junções comunicantes na patogênese da T2DM. A maior susceptibilidade metabólica à dieta HF apresentada por camundongos LDLr-/-, em relação aos WT, pode ser explicada pela maior deficiência na secreção de insulina em resposta à glicose e ausência de hiperplasia compensatória do pâncreas endócrino. Ainda, a análise preliminar de expressão protéica de algumas proteínas da via Wnt/beta-catenina sugere que esta via parece estar ativada durante o processo de hiperplasia do pâncreas endócrino observada no nosso modelo animal / Abstract: The pathogenesis of type 2 diabetes mellitus (T2DM) is often associated with obesity and dyslipidemia (hypercholesterolemia and hypertriglyceridemia). T2DM involves intolerance to glucose and insulin resistance partially compensated by hyperinsulinemia and pancreatic beta cell hyperplasia. The mechanisms linking obesity/hypercholesterolemia and insulin resistance to beta cell hyperplasia are not fully known. The Wnt/beta-catenin signaling pathway has been reported to be involved in cell growth and differentiation in several tissues/organs but its role in endocrine pancreas development and function is still unclear. This work aimed at: 1) establishing an appropriate animal model of T2DM to study pancreatic beta cell proliferation and dysfunction and, 2) investigating a putative involvement of the Wnt/beta-catenin signaling pathway in the beta cell hyperplasia in this model. To this end, we employed C57BL/6 wild-type (WT) and LDL lipoprotein receptor knockout (LDLr-/-) mice, fed a high fat (HF) diet for 60 days. After feeding a HF diet, WT mice became obese, hypercholesterolemic and moderately hyperglycemic, hyperinsulinemic, glucose intolerant and insulin resistant, characterizing them as pre-diabetics. Moreover, animals fed a HF diet showed a significant decrease in beta-cell secretory response to glucose. In general, LDLr-/- animals showed a relatively higher susceptibility to HF diet, as suggested by a marked hypercholesterolemia, glucose intolerance and reduced insulin secretion stimulated by glucose observed in these animals as compared to the control ones. However, HF diet induced similarly in both WT and LDLr-/- mice a significant decrease in cellular content of Cx36, a gap junctional protein and marker of terminally differentiated beta cell. Both WT and LDLr-/- fed a HF diet showed increased proliferation of beta cells, as assessed by Ki67 immunostaining, but only WT mice exhibited morphometric changes indicative of endocrine pancreas hyperplasia, such as increased total islet and beta cell masses. After we investigated a possible activation of Wnt/beta-catenin signaling pathway in these hyperplasic pancreatic islets of WT animals fed a HF diet. This was done by assessing the distribution and cellular protein expression of some proteins associated to this pathway (i.e., total and activated beta-catenin, c-Myc and cyclin D) in islets of our animal model. Beta-catenin immunofluorescence showed no cytoplasmic accumulation or translocation into the nucleus of beta cells in HF-fed mice. However, immunoblotting revealed a significant increase of unphosphorylated beta-catenin (activated) and cyclin D expression in islets of HF diet-fed animals when compared to its control group. In conclusion, a HF diet for 60d induced pre-diabetes state in both WT and LDLr-/- mice. The pre-diabetes state is associated with a decreased expression of Cx36 in pancreatic beta cells, suggesting a possible role of intercellular communication mediated by gap junctions in the pathogenesis of T2DM. The relatively high metabolic susceptibility to the HF diet showed by LDLr-/- mice, as compared to WT, may be explained by a marked impairment of glucosestimulated insulin secretion and a lack of compensatory hyperplasia of the endocrine pancreas. In addition, the protein expression analysis suggests that the Wnt/beta-catenin pathway may be activated during the islet hyperplasia process in our animal model / Mestrado / Histologia / Mestre em Biologia Celular e Estrutural

INTRODUÇÃO: Diabetes mellitus tipo 2 (DM2) é um fator de risco isolado para coronariopatia, principalmente quando associado à microalbuminúria (MA). Alterações estruturais e funcionais das lipoproteínas não são totalmente esclarecidas nesse contexto. OBJETIVO: Avaliar, em pacientes DM2, a influência da presença da MA e do tratamento com estatina ou insulina nas transferências para HDL (T) de lípides e no tamanho desta lipoproteína. MÉTODOS: Estudamos 33 pacientes DM2 e 34 controles pareados para idade. Uma nanoemulsão lipídica artificial radiomarcada com 3H-Triglicéride (TG) e 14C-Colesterol Livre (CL) ou 3H-Colesterol Éster (CE) e 14C-Fosfolípide (FL) foi incubada com plasma. A nanoemulsão e as lipoproteínas foram precipitadas, exceto a HDL, que teve sua radioatividade contada. O diâmetro da HDL foi mensurado por método de dispersão da luz. RESULTADOS: A TFL (%) foi maior no grupo com DM2 que no grupo controle (25,2±3,2 e 19,7±3,2 respectivamente; p<0,001), assim como a TCL (%): 9,1±2,7 e 6,3±1,5 respectivamente; p<0,001. O diagnóstico de MA não se associou às mudanças da propriedade de transferência. O uso da insulina associou-se à menor TFL(%): 23,5±2,1 contra 26,1±3,3; p=0,018. Já o uso da estatina associou-se à queda de todas: TCE(%): 3,5±0,9; TFL(%):23,8±2,0; TTG(%): 3,9±0,8; TCL(%):7,4±1,3 quando comparado ao grupo que não usava estatina (TCE(%):5,9±2,4; TFL(%):26,9±3,6; TTG(%):6,4±2,2; TCL(%):11,1±2,6). O tamanho de HDL foi semelhante em qualquer condição analisada. CONCLUSÕES: DM2 aumenta a transferência de lípides de superfície para HDL, enquanto o uso de estatina diminuiu todas as transferências. A presença de MA não se associou às alterações das transferências de lípides / INTRODUCTION: Type 2 diabetes mellitus (DM2) is an isolated risk factor for coronary artery disease, especially when associated to microalbuminuria (MA). Structural and functional alterations of lipoproteins are not well known in this context. OBJECTIVE: To evaluate, in DM2 patients, the influence both of MA and the treatment with statins or insulin on the lipids transfer to HDL (T) and on the size of this lipoprotein. METHODS: We studied 33 DM2 patients and 34 controls paired for age. An artificial lipidic nanoemulsion radio labeled with 3H-Triglyceride (TG) and 14C-Free Cholesterol (FC) or 3H-Cholesterol Ester (CE) and 14C-Phospholipid (PL) was incubated with plasma. The nanoemulsion and the lipoproteins were precipitated, except for HDL, that had its radioactivity measured. The HDL diameter was measured by laser light scattering method. RESULTS: The TPL (%) was greater in the DM2 group then in the control group (25,2±3,2 and 19,7±3,2 respectively; p<0,001), as well as TFC (%): 9,1±2,7 and 6,3±1,5 respectively; p<0,001. The MA did not affect the transfer. Insulinotherapy was associated with less TPL(%): 23,5±2,1 against 26,1±3,3; p=0,018, and the statin therapy with less transfer of all lipids: TCE(%): 3,5±0,9; TPL(%):23,8±2,0; TTG(%): 3,9±0,8; TFC(%):7,4±1,3 when compared to the group that did not use statin: TCE(%):5,9±2,4; TPL(%):26,9±3,6; TTG(%):6,4±2,2; TFC(%):11,1±2,6. The HDL size was about the same under all the circumstances analyzed. CONCLUSIONS: DM2 is associated with greater transfer of superficial lipids to HDL, while the statin usage was associated with a smaller transfer of all lipids. The MA diagnosis was not associated with any change in lipids transfer

Adipose tissue as an active endocrine organ is explored in a number of processes associated with metabolic disorders. This work is aimed on studying the effect of endoscopically implantable weight-reducing device - duodeno-jejunal bypass liner - on subclinical inflammation of adipose tissue in obese patients, which contributes to the development of type 2 diabetes mellitus. Specifically, for patients implanted with duodeno- jejunal bypass liner we determined anthropometric, biochemical and hormonal characteristics, and mRNA expression of subcutaneous adipose tissue proinflammatory (TNF-α, leptin, CCL- 2, CX3CL1, CD40, CD80, CD86, CD206, CD163 and IL-6) and anti-inflammatory genes (Adiponektin, IL-10) before, one month and ten months after the intervention. The implantation of duodeno-jejunal bypass liner significantly decreased body weight, waist circumference, and improved metabolic and glycemic control. In addition, C-reactive protein a highly sensitive indicator of inflammatory processes in the body was reduced ten months after implantation. In the case of mRNA expression of CD86 (a marker of activated B lymphocytes and macrophages) there was temporarily increase in adipose tissue one month after the surgery and the subsequent significant decrease after ten months. mRNA expression of other...

El presente proyecto nace de la búsqueda de una solución que brinde atención médica remota a los adultos mayores diagnosticados con Diabetes tipo 2, con el fin de mantener un control periódico de su enfermedad y poder reducir las complicaciones presentadas por el incumplimiento del tratamiento médico y control glucémico. La solución consiste en una plataforma tecnológica que soporta una aplicación móvil para el paciente que controla de forma autónoma su enfermedad a través de información sobre la Diabetes, medicamentos, detalle del tratamiento recomendado por el médico y el control periódico del nivel de glucosa. Y una página web permite al endocrinólogo realizar el seguimiento del paciente y videollamadas periódicas. El proyecto se validó en una casa de reposo para adultos mayores y con un médico endocrinólogo en Lima, Perú. Para medir la efectividad del proyecto se evaluó lo siguiente: Constancia del registro del nivel de glucosa Tiempo promedio de respuesta ante emergencias e indicadores fuera de rango, por parte del médico Porcentaje de reducción de las complicaciones de la enfermedad Nivel de satisfacción, de los adultos mayores, sobre la solución de Telehomecare Los resultados demuestran que la frecuencia del uso de la aplicación se incrementó conforme adoptaron la solución como parte de su rutina. El tiempo de respuesta promedio del endocrinólogo fue 4,13 minutos aproximadamente desde su registro, el porcentaje de complicaciones se redujo en un 14% y el nivel de satisfacción de la solución se concentró en las dimensiones de tiempo de respuesta y comprensión de la necesidad del usuario / This project begins to seek a solution that provides remote medical care to older adults diagnosed with Type 2 Diabetes Mellitus, in order to maintain periodic control of their disease and to reduce the complications presented by non-compliance medical treatment and glycemic control. The solution consists in a mobile application for the patient that controls his disease through information related to diabetes, medications, details of the treatment recommended by the doctor and the periodic monitoring of glucose level. Another application allows the endocrinologist to monitor the patient and make periodic video calls. The project was validated in a nursing home for the elderly and with an endocrinologist in Lima, Peru. To measure the effectiveness of the project, the following was evaluated: Record of glucose level record Average response time to emergencies and indicators out of range, by the doctor Percentage reduction in complications of the disease Level of satisfaction, of the elderly, about the Telehomecare solution The results show that the frequency of use of the application increased as they adopted the solution as part of their routine. The average response time of the endocrinologist was approximately 4.13 minutes from its registration, the percentage of complications was reduced by 14% and the level of satisfaction with the solution was concentrated in the dimensions of response time and understanding of patient need. / Tesis

(AJ) Adipose tissue produces numerous adipokines, pro- and antiinflammatory cytokines and hormones which may influence the development of insulin resistance, type 2 diabetes mellitus and other comorbidities of the metabolic syndrome. The ability of adipose tissue to store lipids and thus protect other organs and tissues from ectopic lipid accumulation and development of insulin resistance (IR) is largely dependent on the adipogenic potential of preadipocytes. The amount and function of these cells may be the key factor in creating "healthy" adipose tissue or on the contrary "unhealthy" adipose tissue eventually leading to metabolic derangements. The regulation of the amount of body fat by converting preadipocytes into mature adipocytes may be crucial in the prevention and treatment of obesity and its comorbidities. One of the reasons for development of insulin resistance can be the inhibition of the differentiation process of preadipocytes into mature adipocytes with consequent ectopic lipid accumulation caused by the secretion of preadipocyte factor - 1 (Pref - 1). Pref - 1 has been discovered recently as a protein produced by preadipocytes but not by mature adipocytes. Pref - 1 is a member of the protein family sharing similarity with epidermal growth factors which regulate the differentiation of...

(EN) GH/IGF-1 axis components (GH, growth hormone receptor (GH-R), IGF-1, IGF-1 receptor (IGF-1R), IGF-binding proteins (IGFBPs)) participate in the control of glucose metabolism, inflammatory processes as well as cell proliferation and differentiation, including adipocytes and monocytes. The aim of the present study was to evaluate the role of local mRNA expression of GH/IGF-1 axis components in subcutaneous adipose tissue (SCAT) and peripheral monocytes (PM) in the development of insulin resistance and differences of adipose tissue mass in following groups of patients: obese females with and without type 2 diabetes mellitus and subjects with active untreated acromegaly. A total number of 66 subjects were included in the study: obese females without type 2 diabetes mellitus (OB), obese females with type 2 diabetes mellitus (T2DM), acromegalic patients (AC) and healthy lean control subjects (C). T2DM underwent 2 weeks of very-low- calorie diet (VLCD - energy content 2500 kJ/day). According to our results we suggest that decreased mRNA expression of IGF-1, IGF-1R, IGFBP-2 and IGFBP-3 in adipose tissue of T2DM subjects may contribute to changes of fat differentiation capacity and the increased IGF-1R mRNA expression in peripheral monocytes in these patients may play a role in the regulation of...

Background: The prevalence of diabetes and obesity has been on the rise for many years and the search for new and effective dietetic solutions aiming at reducing calories, reducing body mass and improving diabetes has been ongoing. Currently, the intermittent fasting diet - the practice of alternating periods of eating and fasting - is gaining popularity. One of them is Time-restricted feeding (TRF), which time-limits energy intake within a defined window of time up to 10 hours per day without necessarily altering diet quality or quantity. A reduction in calorie intake, bodyweight, blood pressure, oxidative stress, inflammation biomarkers and triglycerides are evident with TRF studies conducted so far. Aim: The aim of the thesis is to investigate the effects of time-restricted feeding on glycemic biomarkers in human studies. Methods: A literature study is conducted with six chosen experimental studies which are primarily randomized controlled trials or randomized crossover trials with a TRF window of maximum 10 hours per day and predominantly with participants with overweight/obesity, prediabetes, type 2 diabetes and metabolic syndrome. Results: Compared to either baseline and/or control group, fasting glucose was reduced in 3 out of 6 TRF studies, while fasting insulin was reduced in 3 out of 5 TRF studies and HbA1C was decreased in 1 out of 2 TRF studies. For postprandial response, 1 out of 2 TRF studies found a reduction in glucose and likewise for insulin. Mean glucose levels were reduced in 1 out of 3 TRF studies. Insulin resistance was reduced in 3 out of 4 TRF studies while insulin sensitivity was reduced in the one study measuring this. Beta cell function improved in 2 out of 2 TRF studies compared to the control group or baseline. Conclusion: There are indications that TRF has an effect on glycemic biomarkers and thus potentially being able to reduce the risk and/or improve the treatment of type 2 diabetes. But in order to give a more definite answer more studies need to be conducted. In general, these studies should preferably have more participants and be methodologically stronger when it e.g. comes to the control of the dietary regimen.