Background Previous genome-wide association studies (GWAS) identified IGF1, IRS1, GCKR, PPARG, GCK1 and KCTD1 as candidate genes for insulin resistance and type 2 diabetes (T2D). We investigated the associations of these previously reported common variants in these genes with insulin resistance in overweight children from Romania and Moldova. Methods Six single nucleotide polymorphisms (SNPs), IGF1 (rs35767), IRS1 (rs2943634), GCKR (rs780094), PPARG (rs1801282), GCK1 (rs1799884) and KCTD15 (rs29941), were genotyped in 100 overweight children along with clinical and metabolic parameters. Homeostatic model assessment of insulin resistance (HOMA-IR) above 3.4 (defining insulin resistance) was used as the outcome. Results Children differed in insulin resistance status despite having similar body mass index (BMI) standard deviation scores (SDS) (World Health Organization, [WHO] reference). The identified predictors for altered insulin metabolism were higher cholesterol levels, higher diastolic blood pressure and higher waist-to-hip-ratio (as a marker for increased abdominal fat). None of the SNPs showed significant association with increase in the risk for insulin resistance in children (p range=0.478–0.724; odds ratio [OR] range=1.924–4.842); however, the risk allele in GCKR (rs780094, p=0.06, OR=6.871) demonstrated near statistical significance. Conclusions The interrogated risk alleles did not show any significant association with insulin resistance in children in our cohort; however, the GCKR (rs780094) might be a viable candidate in larger cohorts. The lack of replication of the proposed association may point to differences in linkage disequilibrium or effect modifiers across studies.
Background: In the current proposal, we used the intralipid in standard therapy against COVID / 19 as an energy carrier for parenteral nutrition in critically ill patients. In patients receiving intralipid, there was an accelerated recovery of the lungs, a decrease in markers of endogenous intoxication (EI), tissue hypoxia and an improvement in general condition. In the absence of Intralipid in the intensive care unit, there was a slow recovery of the lungs and a more prolonged improvement in the general condition with the preservation of EI markers (cytolytic enzymes, C-reactive protein, platelets) and tissue hypoxia (pCO2 AV> 6 mm Hg). Collectively, Intralipid has been seen in the targeted LPO treatment plan for oxidative and nitro-galogenic stress in SARS-Cov2 / COVID / 19 patients.
IntroductionReducing exposure to cigarette smoke is an imperative for public health and for patients with diabetes. Increasingly, combustion-free nicotine delivery systems (C-F NDS) such as e-cigarettes and heated tobacco products are substituting conventional cigarettes and accelerating the downward trends in smoking prevalence. However, there is limited information about the long-term health impact in patients with diabetes who use C-F NDS. This randomised trial of type 2 diabetic cigarette smokers will test the hypothesis that following a switch from conventional cigarettes to C-F NDS a measurable improvement in metabolic syndrome (MetS) factors will be shown over the course of 2 years.Methods and analysisThe study is multicentre and thus will take place in five locations in four countries in an ambulatory setting. A total of 576 patients with diabetes will be randomised (1:2 ratio) to either a control arm (Study Arm A), in which they will be offered referral to smoking cessation programmes or to an intervention arm (Study Arm B) assigned to C-F NDS use. Participants will be at least 23 years old and of any gender. Patient recruitment will start in February 2021 and is expected to be completed by December 2021. Primary outcome measures include fasting plasma glucose, blood pressure, triglycerides, high-density lipoprotein and waist circumference, while secondary feature absolute change in the sum of the individual factors of MetS and change in each individual factor of MetS measured at each study time point.Ethics and disseminationThe approval of research ethics committee (REC) regarding the trial protocol, informed consent forms and other relevant documents is required to commence the study. Substantial amendments to the study protocol cannot be implemented until the REC grants a favourable opinion. The results of the study are intended to be published as articles in high quality peer-reviewed journals and disseminated through conference papers.Trial registration numberNCT04231838. Pre-results stage.
Introduction. Pathological left ventricular (LV) remodeling in children with metabolic syndrome (MS) is associated with a significant increase in cardiometabolic risk. However, data regarding the prevalence of LV remodeling patterns in children with MS are limited. Material and methods. An observational analytical cohort study was conducted on 145 children. The diagnosis of MS was established according to the International Diabetes Federation (IDF) criteria. We analyzed the echocardiography, as well as clinical and paraclinical data. Participants were distributed, depending on LV mass index and relative wall thickness into four LV geometric patterns as recommended by American and European Society of Echocardiography: normal geometry, concentric left ventricular remodeling (cLVR), concentric left ventricular hypertrophy (cLVH), and eccentric left ventricular hypertrophy (eLVH). Results. The pathological remodeling patterns were distributed as follows: 62.1% (n=90) participants showed a normal LV geometry pattern, 27.6% (n=40)-cLVH, 5.5% (n=8)-cLVR and 4.8% (n=7)-eLVH. In terms of presence/absence of MS, 54.7% (n=29) participants from the research group showed a normal LV geometry pattern, 32.1% (n=17)-cLVH, 5.7% (n=3)-cLVR and 7.5% (n=4)-eLVH, whereas 66.3% (n=61) participants from the control group presented normal LV geometric appearance, 25% (n=23)-cLVH, 5.4% (n=5)-cLVR and 3.3% (n=3)-eLVR (χ2=0.52; p>0.05). Conclusions. Concentric left ventricular hypertrophy was the commonest LV geometric pattern among the subjects with metabolic syndrome. Concentric left ventricular remodeling and eccentric left ventricular hypertrophy were rare among the study population. Cuvinte cheie: sindrom metabolic, copii, modele de remodelare a ventriculului stâng. MODELE DE REMODELARE VENTRICULARĂ STÂNGĂ LA COPIII CU SINDROM METABOLIC Introducere. Remodelarea patologică a ventriculului stâng (VS) la copiii cu sindrom metabolic (SM) este asociată cu o creștere semnificativă a riscului cardiometabolic. Cu toate acestea, date privind prevalența paternelor de remodelare ale VS la copiii cu SM sunt limitate. Material și metode. Studiu analitic, observațional, de cohortă. Au fost incluși 145 de copii. Diagnosticul de SM a fost stabilit conform criteriilor Federației Internaționale de Diabet (FID). Am analizat datele clinice, paraclinice și ecocardiografice. Participanții au fost stratificați în patru tipare geometrice, folosind indicele de masă a VS și grosimea relativă a PPVS, așa cum recomandă Societatea Americană și Europeană de Ecocardiografie: geometrie normală VS, remodelare concentrică VS (RC VS), hipertrofie concentrică VS (HC VS) și hipertrofie excentrică VS (HE VS). Rezultate. Tipurile de remodelare patologică s-au repartizat în felul următor: 62.1% (n=90) participanți au prezentat aspect geometric normal al VS, la 27,6% (n=40) dintre ei s-a înregistrat HC VS, la 5,5% (n=8) participanți s-a atestat RC VS, iar 4,8% (n=7) din acest lot au prezentat HE VS. În funcție de prezența/absența SM, în lotul de bază, 54,7% (n=29) participan...
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