The use of fish oil has no adverse affects on HbA1c in diabetic subjects and lowers triglyceride levels effectively by almost 30%. However, this may be accompanied by a slight increase in LDL cholesterol concentration. Fish oil may be useful in treating dyslipidemia in diabetes.

At presentation with a fracture, 26.5% of patients have previously unknown contributors to SECOB, which are treatable or need follow-up, and more than 90% of patients have an inadequate vitamin D status and/or calcium intake. Systematic screening of patients with a recent fracture identifies those in whom potentially reversible contributors to SECOB and calcium and vitamin D deficiency are present.

In rat mesangial cells, exogenously added secreted phospholipases A 2 (sPLA 2 s) potentiate the expression of pro-inflammatory sPLA 2 -IIA first induced by cytokines like tumor necrosis factor-␣ (TNF␣) and interleukin-1␤. The transcriptional pathway mediating this effect is, however, unknown. Because products of PLA 2 activity are endogenous activators of peroxisome proliferatoractivated receptor ␣ (PPAR␣), we postulated that sPLA 2 s mediate their effects on sPLA 2 -IIA expression via sPLA 2 activity and subsequent PPAR␣ activation. This study shows that various sPLA 2 s, including venom enzymes, human sPLA 2 -IIA, and wild-type and catalytically inactive H48Q mutant of porcine pancreatic sPLA 2 -IB, enhance the TNF␣-induced sPLA 2 -IIA expression at the mRNA and protein levels. In cells transfected with luciferase sPLA 2 -IIA promoter constructs, sPLA 2 s are active only when the promoter contains a functional PPRE-1 site. The effect of exogenous sPLA 2 s is also blocked by the PPAR␣ inhibitor MK886. Interestingly, the expression of sPLA 2 -IIA induced by TNF␣ alone is also attenuated by MK886, by the sPLA 2 -IIA inhibitor LY311727, by heparinase, which prevents the binding of sPLA 2 -IIA to heparan sulfate proteoglycans, and by the specific cPLA 2 -␣ inhibitor pyrrolidine-1. Together, these data indicate that sPLA 2 -IIA released from mesangial cells by TNF␣ stimulates its own expression via an autocrine loop involving cPLA 2 and PPAR␣. This signaling pathway is also used by exogenously added sPLA 2 s including pancreatic sPLA 2 -IB and is distinct from that used by TNF␣ .

No abstract

No abstract