Diabetes & Vascular Disease Research最新文献

{"title":"Diabetes, gender and deterioration in estimated glomerular filtration rate in patients with chronic heart failure: Ten-year prospective cohort study.","authors":"Jessica Kearney, Michael Drozd, Andrew Mn Walker, Thomas A Slater, Sam Straw, John Gierula, Maria Paton, Judith Lowry, Charlotte Cole, Klaus K Witte, Richard M Cubbon, Mark T Kearney","doi":"10.1177/1479164120984433","DOIUrl":"10.1177/1479164120984433","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to evaluate the relationship between temporal changes in renal function and long-term mortality in patients with heart failure with reduced ejection fraction (HFrEF) and identify correlates of deteriorating renal function.</p><p><strong>Methods: </strong>A total of 381 patients with HFrEF enrolled in a prospective cohort study between 2006-2014 had eGFR measured at initial visit and at 1 year. Baseline characteristics were used in a multivariate analysis to establish variables that predict deterioration in eGFR. Follow-up data were used to assess whether declining eGFR was related to outcomes.</p><p><strong>Results: </strong>Patients were grouped into tertiles based on percentage change in eGFR. In a multivariate logistic regression analysis, male sex was associated with a 1.77-fold ([95% CI 1.01-2.89]; <i>p</i> = 0.045) and diabetes a 1.66-fold ([95% CI 1.02-2.70]; <i>p</i> = 0.041) greater risk of a decline in eGFR compared to those with stable/improving eGFR. Declining eGFR was associated with a 1.4-fold greater risk of death over 10 years ([95% CI 1.08-1.86]; <i>p</i> = 0.01) and a 3.12-fold ([1.44-6.75]; <i>p</i> = 0.004) greater risk of death at 1 year from second eGFR measurement.</p><p><strong>Conclusions: </strong>In patients with HFrEF diabetes and male sex are independent predictors of a decline in eGFR at 1 year. A decline eGFR over 1 year is associated with higher long-term all-cause mortality.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"18 1","pages":"1479164120984433"},"PeriodicalIF":2.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120984433","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25371048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maturity onset diabetes of the young and fibrin-related thrombosis risk.","authors":"R C Sagar,&nbsp;F Phoenix,&nbsp;G Thanabalasingham,&nbsp;K Naseem,&nbsp;R A Ajjan,&nbsp;K R Owen","doi":"10.1177/1479164120963048","DOIUrl":"https://doi.org/10.1177/1479164120963048","url":null,"abstract":"<p><strong>Background: </strong>Fibrin network characteristics determine predisposition to cardiovascular disease (CVD). Individuals with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) have higher risk of CVD and display deranged fibrin network structure. Those with maturity onset diabetes of the young (MODY) may also be at increased risk but their fibrin clot properties have not been studied.</p><p><strong>Methods: </strong>Plasma clots properties from 13 individuals with HNF1A-MODY, 12 matched-individuals with T2DM and 12 with T1DM were studied using a validated turbidimetric assay and confocal microscopy. Plasma levels of fibrinogen, plasminogen activator inhibitor-1, complement C3 and C-reactive protein were also measured.</p><p><strong>Results: </strong>MODY clot maximum absorbance was 0.37 ± 0.03 AU, similar to T1DM (0.32 ± 0.03 AU; <i>p</i> = 0.26), but lower than T2DM (0.49 ± 0.03 AU; <i>p</i> = 0.02), with confocal microscopy confirming structural differences. Clot lysis time in MODY was similar to T1DM (456 ± 50 and 402 ± 20 s, respectively; <i>p</i> = 0.09) but shorter than T2DM (588 ± 58 s; <i>p</i> = 0.006). Comparing inflammatory/thrombotic proteins in HNF1A-MODY and T2DM, C3 levels were lower in MODY than T2DM (0.58 ± 0.09 and 0.80 ± 0.1 mg/ml, respectively; <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>HNF1A-MODY fibrin network alterations are at least as pronounced as in T1DM but less thrombotic than T2DM clots. Differences in fibrin clot characteristics comparing HNF1A-MODY and T2DM may, in part, relate to lower C3 levels.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 6","pages":"1479164120963048"},"PeriodicalIF":2.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120963048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9149527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High hemoglobin glycation index is associated with increased systemic arterial stiffness independent of hyperglycemia in real-world Japanese population: A cross-sectional study.","authors":"Daiji Nagayama,&nbsp;Yasuhiro Watanabe,&nbsp;Takashi Yamaguchi,&nbsp;Atsuhito Saiki,&nbsp;Kohji Shirai,&nbsp;Ichiro Tatsuno","doi":"10.1177/1479164120958625","DOIUrl":"https://doi.org/10.1177/1479164120958625","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the association of metabolic parameters including hemoglobin glycation index (HGI, observed HbA1c - predicted HbA1c) with systemic arterial stiffness assessed by cardio-ankle vascular index (CAVI).</p><p><strong>Subjects: </strong>We analyzed the cross-sectional data from 22,696 subjects (mean age 48.0 years, mean FPG 88 mg/dL, mean HbA1c 5.5%) with or without past history of metabolic disorders including diabetes.</p><p><strong>Results: </strong>Men had higher body mass index (BMI), CAVI, blood pressure (BP), FPG, HbA1c, total cholesterol and triglyceride; and lower age, HGI and HDL-cholesterol. After stratifying subjects into HGI quartiles, the highest quartile (Q4) group showed higher age, female ratio, and frequencies of obesity, hypertension, diabetes, and dyslipidemia. Furthermore, bivariate logistic regression model revealed that the Q4 of HGI was a significant predictor of high CAVI (⩾9.0) independent of the presence of diabetes.</p><p><strong>Conclusion: </strong>High HGI is associated with systemic arterial stiffening independent of hyperglycemia. This index is therefore expected to be not only a predictor of hypoglycemia, but also a therapeutic guide for atherosclerosis.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 9","pages":"1479164120958625"},"PeriodicalIF":2.4,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120958625","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38427325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High cardiovascular risk of patients with type 2 diabetes is only partially attributed to angiographic burden of atherosclerosis.","authors":"Simone Battermann,&nbsp;Andrea Milzi,&nbsp;Rosalia Dettori,&nbsp;Kathrin Burgmaier,&nbsp;Nikolaus Marx,&nbsp;Mathias Burgmaier,&nbsp;Sebastian Reith","doi":"10.1177/1479164120953612","DOIUrl":"https://doi.org/10.1177/1479164120953612","url":null,"abstract":"<p><strong>Background: </strong>Patients with type 2 diabetes (T2DM) are at high risk for cardiovascular events and present more severe coronary artery disease (CAD). The Gensini and COURAGE scores are established angiographic instruments to assess CAD severity, which may also predict future cardiovascular risk. However, it is unclear if these scores are able to depict the increased risk of patients with T2DM and stable CAD (T2DM-SAP).</p><p><strong>Methods: </strong>We performed quantitative coronary angiography and assessed the Gensini and COURAGE scores in 124 patients with T2DM-SAP. Angiographic data were compared to patients with stable angina without T2DM (Non-DM-SAP, <i>n</i> = 74), and to patients with acute coronary syndrome and T2DM (T2DM-ACS, <i>n</i> = 53).</p><p><strong>Results: </strong>T2DM-SAP patients had similar Gensini and COURAGE-scores compared to Non-DM-SAP-patients (Gensini: 14.44 ± 27.34 vs 11.49 ± 26.99, <i>p</i> = 0.465; COURAGE: 3.48 ± 4.49 vs 3.60 ± 4.72, <i>p</i> = 0.854). In contrast, T2DM-SAP patients had significantly lower Gensini (14.44 ± 27.34 vs 30.94 ± 48.74, <i>p</i> = 0.003) and lower COURAGE (3.48 ± 4.49 vs 5.30 ± 4.63, <i>p</i> = 0.016) scores compared to T2DM-ACS-patients.</p><p><strong>Conclusion: </strong>Both the Gensini and the COURAGE score fail to predict the high cardiovascular risk of patients with T2DM-SAP. Therefore, these scores should be used with caution in the assessment of future risk of patients with T2DM. However, among T2DM-ACS patients, both scores are increased, reflecting the high cardiovascular risk in this patient population.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 9","pages":"1479164120953612"},"PeriodicalIF":2.4,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120953612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38410203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary flow impairment in asymptomatic patients with early stage type-2 diabetes: Detection by FFR_CT.","authors":"Monija Mrgan, Bjarne Linde Nørgaard, Damini Dey, Jørgen Gram, Michael Hecht Olsen, Jeppe Gram, Niels Peter Rønnow Sand","doi":"10.1177/1479164120958422","DOIUrl":"10.1177/1479164120958422","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the occurrence of physiological significant coronary artery disease (CAD) by coronary CT angiography (CTA) derived fractional flow reserve (FFR_CT) in asymptomatic patients with a new diagnosis (<1 year) of type-2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>FFR_CT-analysis was performed from standard acquired coronary CTA data sets. The per-patient minimum distal FFR_CT-value (d-FFR_CT) in coronary vessels (diameter ⩾1.8 mm) was registered. The threshold for categorizing FFR_CT-analysis as abnormal was a d-FFR_CT ⩽0.75. Total plaque volume and volumes of calcified plaque, non-calcified plaque, and low-density non-calcified plaque (LD-NCP) were assessed by quantitative plaque analysis.</p><p><strong>Results: </strong>Overall, 76 patients; age, mean (SD): 56 (11) years; males, <i>n</i> (%): 49(65), were studied. A total of 57% of patients had plaques. The d-FFR_CT was ⩽0.75 in 12 (16%) patients. The d-FFR_CT, median (IQR), was 0.84 (0.79-0.87). Median (range) d-FFR_CT in patients with d-FFR_CT ⩽0.75 was 0.70 (0.6-0.74). Patients with d-FFR_CT⩽0.75 versus d-FFR_CT >0.75 had numerically higher plaque volumes for all plaques components, although only significant for the LD-NCP component.</p><p><strong>Conclusion: </strong>Every sixth asymptomatic patient with a new diagnosis of T2DM has hemodynamic significant CAD as evaluated by FFR_CT. Flow impairment by FFR_CT was associated with coronary plaque characteristics.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 9","pages":"1479164120958422"},"PeriodicalIF":2.4,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/cf/10.1177_1479164120958422.PMC7919222.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38528122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes is not a risk factor for myocardial infarction in patients without coronary artery disease: A study from the Western Denmark Heart Registry.","authors":"Christine Gyldenkerne,&nbsp;Kevin Kw Olesen,&nbsp;Pernille G Thrane,&nbsp;Morten Madsen,&nbsp;Troels Thim,&nbsp;Morten Würtz,&nbsp;Lisette O Jensen,&nbsp;Bent Raungaard,&nbsp;Per L Poulsen,&nbsp;Hans E Bøtker,&nbsp;Michael Maeng","doi":"10.1177/1479164120941809","DOIUrl":"https://doi.org/10.1177/1479164120941809","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is considered a risk factor for myocardial infarction. However, we have previously found that diabetes was not a short-term risk factor for myocardial infarction in the absence of obstructive coronary artery disease.</p><p><strong>Methods: </strong>We conducted a cohort study of patients undergoing coronary angiography from 2003 to 2012 and followed them by cross-linking Danish health registries. Patients were stratified according to coronary artery disease and diabetes. Endpoints included myocardial infarction, cardiac death, all-cause death and coronary revascularization.</p><p><strong>Results: </strong>86,202 patients were included in total (diabetes: <i>n</i> = 12,652). Median follow-up was 8.8 years. Using patients with neither coronary artery disease nor diabetes as reference (cumulative myocardial infarction incidence 2.6%), the risk of myocardial infarction was low and not substantially increased for patients with diabetes alone (3.2%; hazard ratio 1.202, 95% confidence interval 0.996-1.451), was increased for patients with coronary artery disease alone (9.3%; hazard ratio 2.75, 95% confidence interval 2.52-3.01) and was highest for patients with both coronary artery disease and diabetes (12.3%; hazard ratio 3.79, 95% confidence interval 3.43-4.20). Similar associations were observed for cardiac death and coronary revascularization.</p><p><strong>Conclusion: </strong>Diabetes patients without coronary artery disease by coronary angiography have a low risk of myocardial infarction, not substantially increased compared to patients with neither coronary artery disease nor diabetes. In the presence of coronary artery disease, however, diabetes increases the risk of myocardial infarction.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 4","pages":"1479164120941809"},"PeriodicalIF":2.4,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120941809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38201869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between interarm blood pressure differences and diabetic retinopathy in patients with type 2 diabetes.","authors":"Ji Hyun Lee,&nbsp;Ye An Kim,&nbsp;Young Lee,&nbsp;Woo-Dae Bang,&nbsp;Je Hyun Seo","doi":"10.1177/1479164120945910","DOIUrl":"https://doi.org/10.1177/1479164120945910","url":null,"abstract":"<p><strong>Background: </strong>The effect of interarm blood pressure difference on the development of diabetic retinopathy, proteinuria and chronic kidney disease remains unknown. We investigated to determine the impact of interarm blood pressure difference on the prevalence of diabetic retinopathy, proteinuria and chronic kidney disease in patients with type 2 diabetes.</p><p><strong>Methods: </strong>The study included 563 patients with diabetes, who were evaluated with a simultaneous bilateral blood pressure measurement. The cutoff values for interarm blood pressure difference were 5, 10 and 15 mmHg. Logistic regression analysis was used to explore the relation between interarm blood pressure difference and diabetic retinopathy, proteinuria and chronic kidney disease.</p><p><strong>Results: </strong>Diabetic patients with systolic interarm blood pressure difference ⩾5, ⩾10 and ⩾15 mmHg showed an increased risk of diabetic retinopathy [adjusted odds ratio = 1.48 (95% confidence interval = 1.01-2.18), odds ratio = 1.80 (95% confidence interval = 0.99-3.22), odds ratio = 2.29 (95% confidence interval = 1.00-5.23)] after adjustment. There were significant associations between interarm blood pressure difference ⩾5 and ⩾10 mmHg and proteinuria [odds ratio = 1.68 (95% confidence interval = 1.15-2.44), 1.89 (95% confidence interval = 1.05-3.37)].</p><p><strong>Conclusion: </strong>The association between interarm blood pressure difference and the presence of diabetic retinopathy emerged even for systolic interarm blood pressure difference ⩾5 mmHg without interaction of systolic blood pressure. Systolic interarm blood pressure difference should be considered a surrogate marker for vascular complication in patients with type 2 diabetes.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 7","pages":"1479164120945910"},"PeriodicalIF":2.4,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120945910","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38223792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the number of preventable cardiovascular disease events in the United States using the EMPA-REG OUTCOME trial results and National Health and Nutrition Examination Survey.","authors":"Nathan D Wong,&nbsp;Wenjun Fan,&nbsp;Jonathan Pak","doi":"10.1177/1479164120945674","DOIUrl":"https://doi.org/10.1177/1479164120945674","url":null,"abstract":"<p><strong>Aim: </strong>We examined eligibility and preventable cardiovascular disease events in US adults with diabetes mellitus from the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME).</p><p><strong>Methods: </strong>We identified adults with diabetes mellitus eligible for EMPA-REG OUTCOME based on trial eligibility criteria available from the National Health and Nutrition Examination Surveys, 2007-2016. We estimated composite cardiovascular disease endpoints, as well as all-cause deaths, death from cardiovascular disease and hospitalizations for heart failure from trial treatment and placebo event rates, the difference indicating the preventable events.</p><p><strong>Results: </strong>Among 29,629 US adults aged ⩾18 years (representing 231.9 million), 4672 (27.3 million) had diabetes mellitus, with 342 (1.86 million) meeting eligibility criteria of EMPA-REG OUTCOME. We estimated from trial primary endpoint event rates of 10.5% and 12.1% in the empagliflozin and placebo groups, respectively, that based on the 'treatment' of our 1.86 million estimated EMPA-REG OUTCOME eligible subjects, 12,066 (95% confidence interval: 10,352-13,780) cardiovascular disease events could be prevented annually. Estimated annual preventable deaths from any cause, cardiovascular causes and hospitalizations from heart failure were 17,078 (95% confidence interval: 14,652-19,504), 14,479 (95% confidence interval: 12,422-16,536) and 9467 (95% confidence interval: 8122-10,812), respectively.</p><p><strong>Conclusion: </strong>Empagliflozin, if provided to EMPA-REG OUTCOME eligible US adults, may prevent many cardiovascular disease events, cardiovascular and total deaths, as well as heart failure hospitalizations.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 4","pages":"1479164120945674"},"PeriodicalIF":2.4,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120945674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38204008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systolic dysfunction in asymptomatic type 2 diabetic patients, a harbinger of microvascular complications: A cross-sectional study from North India.","authors":"Shankar Roy,&nbsp;Ravi Kant,&nbsp;Barun Kumar,&nbsp;Meenakshi Khapre,&nbsp;Mukesh Bairwa","doi":"10.1177/1479164120944134","DOIUrl":"https://doi.org/10.1177/1479164120944134","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of the study was to estimate the prevalence of sub-clinical left ventricular dysfunction among asymptomatic diabetic patients, while the secondary objectives were to determine its association with microvascular complications and to find correlation with the baseline clinical and demographic parameters.</p><p><strong>Material and methodology: </strong>This was a cross-sectional study conducted on 226 type 2 diabetic patients who did not have any diagnosed cardiac disease, baseline ECG abnormality or cardiac symptoms. Two-dimensional strain echocardiography was performed to estimate the prevalence of left ventricular systolic dysfunction by measuring global longitudinal strain rate (cutoff < 18). Its association with microvascular complications was analysed with SPSS 23 software. Other baseline clinical parameters and demographic profile were also analysed.</p><p><strong>Result: </strong>Among 226 patients (151 males, 75 females), cardiac abnormality was found in 29.2% patients. Diabetic microvascular complications (e.g. neuropathy, retinopathy and nephropathy) were strongly associated with it (each with <i>p</i> < 0.0001) in addition to dyslipidaemia, history of hypertension, higher body mass index and poor glycaemic parameters. Among them, proteinuria showed a linear inverse relationship without any specific cutoff value.</p><p><strong>Conclusion: </strong>It was found that sub-clinical left ventricular dysfunction was found in significantly high proportion among patients with microvascular complications. Hence, routine screening of all diabetics for such complications and subsequently high-risk patients undergoing strain echocardiography can be a very cost-effective diagnostic, therapeutic and prognostic modality.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 4","pages":"1479164120944134"},"PeriodicalIF":2.4,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120944134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38193716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EP4 signalling is essential for controlling islet inflammation by causing a shift in macrophage polarization in obesity/type 2 diabetes.","authors":"Mika Yasui-Kato,&nbsp;Suthomwong Patlada,&nbsp;Masayuki Yokode,&nbsp;Kaeko Kamei,&nbsp;Manabu Minami","doi":"10.1177/1479164120945675","DOIUrl":"https://doi.org/10.1177/1479164120945675","url":null,"abstract":"<p><p>Activation of the prostaglandin E₂ receptor EP4 alters polarization of adipose tissue macrophages towards the anti-inflammatory M2 phenotype to suppress chronic inflammation. However, the role of EP4 signalling in pancreatic macrophages that affect insulin secretion is unclear. We examined the role of EP4 signalling in islet inflammation in vitro and in vivo. Obese diabetic <i>db/db</i> mice were treated with an EP4-selective agonist or vehicle for 4 weeks. Islet morphology did not significantly differ and glucose-stimulated insulin secretion was increased, whereas the pancreatic M1/M2 ratio was decreased in the EP4 agonist-treated group compared to the vehicle group. Because EP4 activation in MIN6 cells did not affect insulin secretion, we used a MIN6/macrophage co-culture system to evaluate the role of EP4 signalling in islet inflammation and subsequent inhibition of insulin release. Co-culture with M1-polarized macrophages markedly suppressed insulin expression in MIN6 cells; however, modulation of M1 polarization by the EP4 agonist significantly reversed the negative impact of co-cultivation on insulin production. The enhanced expression levels of pro-inflammatory cytokines in co-cultured MIN6 cells were markedly inhibited by EP4 agonist treatment of M1 macrophages. Thus, EP4 activation may suppress islet inflammation and protect β-cell function by altering inflammatory macrophages in the diabetic pancreas.</p>","PeriodicalId":11092,"journal":{"name":"Diabetes & Vascular Disease Research","volume":"17 4","pages":"1479164120945675"},"PeriodicalIF":2.4,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1479164120945675","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38204007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}