The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)aft...The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)after cardiovascular disease,eye disease,neuropathy,nephropathy,and peripheral vascular disease.DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease.On the other hand,the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM.Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss.A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM.The prevalence of periodontitis was found to be 75.7%in this study.Based on logistic regression analysis,the predictive factors for higher risk were low tooth brushing frequency[odds ratio(OR)=4.3],high triglycerides(TG;OR=3.31),high total cholesterol(TC;OR=2.87),higher glycated hemoglobin(HbA1c;OR=2.55),and higher age(OR=1.05)while higher education level was protective(OR=0.53).However,the most influential variables were HbA1c followed by age,TC,TG,low education level,brushing frequency,and sex on the random forest model(this model showed higher sensitivity for predicting the risk).A good understanding of the predictors for periodontitis in T2DM patients is important in prevention,early detection of susceptible patients,and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.展开更多
Throughout the globe,diabetes mellitus（DM） is increasing in incidence with limited therapies presently available to prevent or resolve the significant complications of this disorder.DM impacts multiple organs and af...Throughout the globe,diabetes mellitus（DM） is increasing in incidence with limited therapies presently available to prevent or resolve the significant complications of this disorder.DM impacts multiple organs and affects all components of the central and peripheral nervous systems that can range from dementia to diabetic neuropathy.The mechanistic target of rapamycin（m TOR） is a promising agent for the development of novel regenerative strategies for the treatment of DM.m TOR and its related signaling pathways impact multiple metabolic parameters that include cellular metabolic homeostasis,insulin resistance,insulin secretion,stem cell proliferation and differentiation,pancreatic β-cell function,and programmed cell death with apoptosis and autophagy.m TOR is central element for the protein complexes m TOR Complex 1（m TORC1） and m TOR Complex 2（m TORC2） and is a critical component for a number of signaling pathways that involve phosphoinositide 3-kinase（PI 3-K）,protein kinase B（Akt）,AMP activated protein kinase（AMPK）,silent mating type information regulation 2 homolog 1（Saccharomyces cerevisiae）（SIRT1）,Wnt1 inducible signaling pathway protein 1（WISP1）,and growth factors.As a result,m TOR represents an exciting target to offer new clinical avenues for the treatment of DM and the complications of this disease.Future studies directed to elucidate the delicate balance m TOR holds over cellular metabolism and the impact of its broad signaling pathways should foster the translation of these targets into effective clinical regimens for DM.展开更多
AIM:To determine the frequency of atherosclerotic cardiovascular disease and its risk factors among patients with type 2 diabetes in Basrah,Iraq.METHODS:Participants in this cross-sectional study were patients who had...AIM:To determine the frequency of atherosclerotic cardiovascular disease and its risk factors among patients with type 2 diabetes in Basrah,Iraq.METHODS:Participants in this cross-sectional study were patients who had type 2 diabetes for at least 1 year,presenting at the Al-Faiha Diabetes Endocrine and Metabolism Center in Basrah(Southern Iraq) over the period from January to December 2008.RESULTS:The series included 1079 patients(58.8% men),of whom 25.0% were smokers.The prevalence of symptomatic cardiovascular disease and hypertension was 16.0%,and 44.3% respectively.Those who were overweight or obese constituted 70.5%.Insulin was used in only 26.9% despite 56.1% having had diabetes for 6 years and more.The mean glycated hemoglobin(HbA1c) was 9.46% ± 2.0% and only 5.5% achieved the target of HbA1c of < 7%.We had 68.7% of patients with total cholesterol of ≥ 200 mg/dL,21.5% with high density lipoprotein cholesterol of < 40 mg/dL,84.1% with low density lipoprotein cholesterol of ≥ 100 mg/dL and 71.6% with triglyceride of ≥ 150 mg/dL.CONCLUSION:Among adults with type 2 diabetes mellitus,there was increased frequency of cardiovascular disease and its modifiable risk factors.This finding necessitated urgent work to modify these risk factors in a population based setting.展开更多
BACKGROUND There are no consistent results between previous studies for an independent association between non-alcoholic fatty liver disease(NAFLD)and cardiovascular disease(CVD)events.AIM To determine if there is an ...BACKGROUND There are no consistent results between previous studies for an independent association between non-alcoholic fatty liver disease(NAFLD)and cardiovascular disease(CVD)events.AIM To determine if there is an independent association between NAFLD and CVD events.METHODS In the present study,valid outcome data of 4808 subjects were available for phase 2 of our cohort study.These subjects had been followed up for seven years from phase 1,beginning in 2009-2010 to phase 2 during 2016-2017.Simple and multiple Cox proportional models were used to determine the association between NAFLD in the primary phase of the cohort and subsequent fatal and non-fatal CVD events during follow-up.RESULTS The incidence of non-fatal CVD events in males with NAFLD was significantly higher(P=0.004)than in males without NAFLD.A positive association was demonstrated between NAFLD and non-fatal CVD events in males(Hazard ratio=1.606;95%CI:1.166-2.212;P=0.004)by the simple Cox proportional hazard model,but no independent association was detected between these in the multiple Cox models.CONCLUSION No independent association was detected between NAFLD and CVD.It is likely that diabetes mellitus and age may be the principle mediators in this regard.展开更多
文摘The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)after cardiovascular disease,eye disease,neuropathy,nephropathy,and peripheral vascular disease.DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease.On the other hand,the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM.Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss.A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM.The prevalence of periodontitis was found to be 75.7%in this study.Based on logistic regression analysis,the predictive factors for higher risk were low tooth brushing frequency[odds ratio(OR)=4.3],high triglycerides(TG;OR=3.31),high total cholesterol(TC;OR=2.87),higher glycated hemoglobin(HbA1c;OR=2.55),and higher age(OR=1.05)while higher education level was protective(OR=0.53).However,the most influential variables were HbA1c followed by age,TC,TG,low education level,brushing frequency,and sex on the random forest model(this model showed higher sensitivity for predicting the risk).A good understanding of the predictors for periodontitis in T2DM patients is important in prevention,early detection of susceptible patients,and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.
基金supported by American Diabetes Association,American Heart Association,NIH NIEHS,NIH NIA,NIH NINDS,and NIH ARRA
文摘Throughout the globe,diabetes mellitus（DM） is increasing in incidence with limited therapies presently available to prevent or resolve the significant complications of this disorder.DM impacts multiple organs and affects all components of the central and peripheral nervous systems that can range from dementia to diabetic neuropathy.The mechanistic target of rapamycin（m TOR） is a promising agent for the development of novel regenerative strategies for the treatment of DM.m TOR and its related signaling pathways impact multiple metabolic parameters that include cellular metabolic homeostasis,insulin resistance,insulin secretion,stem cell proliferation and differentiation,pancreatic β-cell function,and programmed cell death with apoptosis and autophagy.m TOR is central element for the protein complexes m TOR Complex 1（m TORC1） and m TOR Complex 2（m TORC2） and is a critical component for a number of signaling pathways that involve phosphoinositide 3-kinase（PI 3-K）,protein kinase B（Akt）,AMP activated protein kinase（AMPK）,silent mating type information regulation 2 homolog 1（Saccharomyces cerevisiae）（SIRT1）,Wnt1 inducible signaling pathway protein 1（WISP1）,and growth factors.As a result,m TOR represents an exciting target to offer new clinical avenues for the treatment of DM and the complications of this disease.Future studies directed to elucidate the delicate balance m TOR holds over cellular metabolism and the impact of its broad signaling pathways should foster the translation of these targets into effective clinical regimens for DM.
文摘AIM:To determine the frequency of atherosclerotic cardiovascular disease and its risk factors among patients with type 2 diabetes in Basrah,Iraq.METHODS:Participants in this cross-sectional study were patients who had type 2 diabetes for at least 1 year,presenting at the Al-Faiha Diabetes Endocrine and Metabolism Center in Basrah(Southern Iraq) over the period from January to December 2008.RESULTS:The series included 1079 patients(58.8% men),of whom 25.0% were smokers.The prevalence of symptomatic cardiovascular disease and hypertension was 16.0%,and 44.3% respectively.Those who were overweight or obese constituted 70.5%.Insulin was used in only 26.9% despite 56.1% having had diabetes for 6 years and more.The mean glycated hemoglobin(HbA1c) was 9.46% ± 2.0% and only 5.5% achieved the target of HbA1c of < 7%.We had 68.7% of patients with total cholesterol of ≥ 200 mg/dL,21.5% with high density lipoprotein cholesterol of < 40 mg/dL,84.1% with low density lipoprotein cholesterol of ≥ 100 mg/dL and 71.6% with triglyceride of ≥ 150 mg/dL.CONCLUSION:Among adults with type 2 diabetes mellitus,there was increased frequency of cardiovascular disease and its modifiable risk factors.This finding necessitated urgent work to modify these risk factors in a population based setting.
文摘BACKGROUND There are no consistent results between previous studies for an independent association between non-alcoholic fatty liver disease(NAFLD)and cardiovascular disease(CVD)events.AIM To determine if there is an independent association between NAFLD and CVD events.METHODS In the present study,valid outcome data of 4808 subjects were available for phase 2 of our cohort study.These subjects had been followed up for seven years from phase 1,beginning in 2009-2010 to phase 2 during 2016-2017.Simple and multiple Cox proportional models were used to determine the association between NAFLD in the primary phase of the cohort and subsequent fatal and non-fatal CVD events during follow-up.RESULTS The incidence of non-fatal CVD events in males with NAFLD was significantly higher(P=0.004)than in males without NAFLD.A positive association was demonstrated between NAFLD and non-fatal CVD events in males(Hazard ratio=1.606;95%CI:1.166-2.212;P=0.004)by the simple Cox proportional hazard model,but no independent association was detected between these in the multiple Cox models.CONCLUSION No independent association was detected between NAFLD and CVD.It is likely that diabetes mellitus and age may be the principle mediators in this regard.
