Association of Angiotensin Converting Enzyme Gene I/D Polymorphism With Type 2 Diabetes Mellitus

Objective To investigate the association of angiotensin converting enzyme （ACE） gene insertion/deletion （I/D） polymorphism with type 2 diabetes mellitus （T2DM）. Methods Two hundred and nine patients with T2DM diagnosed based on the criteria for diabetes mellitus in 1999 by WHO and 221 controls were recruited from general population of Dongcheng District in Beijing. All subjects were genotyped for the I/D polymorphism of ACE gene by PCR-fragment length polymorphism （FLP） assay. Blood pressure, levels of plasma glucose, lipids and serum insulin were determined. Body mass index （BMI）, waist-trip ratio （WHR） and homeostasis model assessment-insulin resistance index （HOMA-IR） were calculated. Results The genotype frequencies for ACE genes DD, ID, and II were 19.1%, 42.1%, and 38.8% in patients, respectively, and 9.6%, 49.4%, and 41.0% in controls, respectively. The ACE DD genotype frequency was significantly higher in patients than in controls （χ^2=7.61, P=0.022）. Multivariate logistic regression analysis showed that the ACE DD genotype was a risk factor for T2DM, with the OR of 2.35 （95% CI 1.17-4.71） adjusted for age, sex, BMI, WHR, blood pressure, and serum cholesterol levels. Conclusion The ACE DD genotype is associated with the increased susceptibility to type 2 diabetes mellitus.

The impact of obesity in managing diabetes

The epidemic of diabetes has been fueled by a parallel increase in the prevalence of overweight and obesity. Both diabetes and overweight/obesity have become major public health problems causing increased morbidity and mortality and are important risk factors for cardiovascular disease. Cardiovascular disease is the leading cause of death in China. Excess weight has been shown to be associated with increased prevalence of type 2 diabetes, hypertension, dyslipidemia, metabolic syndrome and certain cancers; while weight loss dramatically reduces these obesity-related diseases. Overweight and obesity are important modifiable risk factors for diabetes and cardiovascular disease. There has also been encouraging progress in treatments for obesity. In 2013, the American Medical Association declared obesity a ＂disease state＂ requiring a range of medical interventions to advance obesity treatment and prevention. Since 2012, four new drugs have been approved by the U.S. FDA for the treatment of obesity.

Elevation of tumor necrosis factor-α,interleukin-1β and interleukin-6 levels in aortic intima of Chinese Guizhou minipigs with streptozotocin-induced diabetes

Background Large animal models with toxin-mediated pancreatic damage have been used extensively in researches with respect to diabetes mellitus and cardiovascular diabetic complications. The present study aimed to establish Chinese Guizhou minipig models with streptozotocin （STZ）-induced diabetes and characterize the animal models by analyzing inflammatory cytokine levels in aortic wall, such as tumor necrosis factor （TNF）-α, interleukin-1β （IL-1β） and interleukin-6 （IL-6）. Methods Twenty-two male Chinese Guizhou minipigs （age, 4 to 6 months; weight, 20 kg to 30 kg） were divided into STZ-induced diabetic group （n=-12） and control group （n=-10）. STZ （125 mg/kg） was administrated to induce hyperglycemia and afterwards insulin was used to control fasting blood glucose levels below 10 mmol/L. Oral glucose tolerance test （OGTT） was performed before and one month after STZ administration and serum concentrations of alanine transaminase, asparegine transaminase, albumin, blood urea nitrogen, creatinine, lipids and white blood cell count were measured before and six months later. Animals in both groups were euthanized after six months and pancreas was examined immunohistochemically for islet 13 cells. Aortic intima of diabetic minipigs and controls was analyzed for TNF-α level in tissue conditioned medium by Western blot. TNF-α, IL-β and IL-6 mFINA levels in aortic intima were assayed by reverse transcription and polymerase chain reaction （FIT-PCR）. Results Significant elevation in serum glucose levels was observed one month and six months after STZ induction （P〈0.001） and markedly increased OGTT values were noted, compared with baseline data. The normal pancreas had many irregular sized islets and small clusters of islet β cells, while in pancreas of diabetic minipigs islet β ceils almost disappeared. No statistical difference was notified in serum concentrations of biochemical examinations before and six months after STZ induction. Westem blot demonstrated dramatically increased TNF-α level in aotic intima conditioned medium, and significant elevation of TNF-α, IL-1β and IL-6 mRNA levels was revealed by RT-PCR. Conclusions The present study has established Chinese Guizhou minipig models with STZ-induced diabetes. Inflammatory cytokines （TNF-α, IL-β and IL-6） significantly elevated in aortic intima of diabetic minipigs.

Anti-diabetic effects of cinnamaldehyde and berberine and their impacts on retinol-binding protein 4 expression in rats with type 2 diabetes mellitus

Background Retinol binding protein 4 （RBP4）, as an adipocyte secreted cytokine, was recently found to be inversely correlated with expression of glucose transporter 4 （GLUT4） in insulin resistance （IR） state and to have an intimate relationship with IR and type 2 diabetes mellitus （T2DM）. The present study aimed to evaluate the anti-diabetic efficacy of cinnamaldehyde （Cin）, berberine （Ber）, and metformin （Met） as well as their impacts on the RBP4-GLUT4 system. Methods Rat models of T2DM were established by combination of intraperitoneal injection of low-dose streptozotocin and high fat diet induction. Rats were divided into five groups： the control group, the diabetes group, the diabetes＋Ber group, the diabetes＋Cin group, and the diabetes＋Met group. Western blotting was used to detect the serum or tissue RBP4 and GLUT4 protein levels. Results After treatment for four weeks, both Cin and Ber displayed significant hypolipidemic, hypoglycemic, and insulin sensitizing functions （P 〈0.01） compared with the control group. Their effects on lowering fasting plasma glucose （FPG）, low density lipoprotein-cholesterol （LDL-C） and homeostasis model assessment of insulin resistance （HOMA-IR） seem even better than that of Met. Cin and Ber markedly lowered serum RBP4 levels and up-regulated the expression of tissue GLUT4 protein, and Cin seemed more notable in affecting these two proteins. Conclusions Both Cin and Ber display an exciting anti-diabetic efficacy in this study and may be of great value for the treatment of type 2 diabetes. Their mechanisms involve the RBP4-GLUT4 system, during which the serum RBP4 levels are lowered and the expression of tissue GLUT4 protein is up-regulated.

Effects of multiple nursing cares on quality of life in individuals with coronary artery disease complicated with diabetes mellitus

Patients with coronary artery disease （CAD） complicated with diabetes mellitus （DM） have a reduced quality of life （QOL） partly due to their limited range of physical activity and independence. The primary objective of this study was to examine the effect of the application of the multiple nursing cares on QOL and de- pressive symptoms in individuals with CAD complicated with DM. Methods A total of 82 CAD complicated with DM patients in Guangdong General Hospital from January 2014 to January 2015 were selected, and random- ly divided into control group （n = 41） and experimental group （n = 41） according to World Health Organization DM diagnosis criteria. The subjects in control group received routine nursing care, and the subjects in experimen- tal group were treated with the multiple nursing cares additionally for a 10-week period. The outcome measures include the Short Form-36 Health Survey （SF-36）, and Self-Rating Anxiety Scale （SAS）. Results Following 10-week intervention, the QOL scores and SAS anxiety scores in all groups were improved （P 〈 0.05）. In addi- tion, QOL and SAS anxiety scores in the experimental group were significantly improved （P 〈 0.05）, when com- pare with the control group. Conclusions Based on the results of this study, the application of the multiple nurs- ing cares to individuals with CAD complicated with DM is effective in increasing selected aspects of a general QOL and improving the anxiety situation in individuals with CAD complicated with DM. It is worthwhile to be widely used in clinical practice.

Jiaotai Pill(交泰丸) Enhances Insulin Signaling through Phosphatidylinositol 3-Kinase Pathway in Skeletal Muscle of Diabetic Rats

objective： To investigate the effect of Jiaotai Pill （交泰丸, JTP） at different constitutional proportions on insulin signaling through phosphatidylinositol 3-kinase （PI3K） pathway in the skeletal muscle of diabetic rats. Methods： The rat model of type 2 diabetes mellitus （T2DM） was established by intravenous injection of a small dose of streptozotoein plus high fat diet feeding. JTP at the same dosage of cinnamon and the increasing dosage of Coptis chinensis was administered to diabetic rats for nine weeks respectively. Plasma glucose and insulin levels were assayed. The expressions of proteins were determined by Western blot method. Results： All the three formulations of JTP decreased plasma glucose and fasting insulin levels as well as increased the protein expressions of insulin receptor β （InsR β） subunit, insulin receptor substrate-1 （IRS-1）, PI3K p85 subunit and glucose transporter 4 （GLUT4） in skeletal muscle. Meanwhile, JTP increased the tyrosine phosphorylation of InsRβ subunit and IRS-1, and reduced the serine phosphorylation of IRS-1 in skeletal muscle. Interestingly, the effect of JTP on improving insulin sensitivity was not dose-dependent. In contrast, JTP containing the least amount of Coptis chinensis exhibited the best effect. Conclusion： JTP at different constitutional proportions attenuates the development of diabetes in a rat model of T2DM. The mechanism might be associated with enhancing insulin signaling through PI3K pathway in the skeletal muscle.