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(searched for: Lipids and Cardiovascular Organ Damage in Type 2 Diabetes Mellitus)
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Adithya Biswas, Chitra Srinivasan
International Journal of Research in Pharmaceutical Sciences, Volume 11, pp 1160-1164; doi:10.26452/ijrps.v11i1.1951

Abstract:
The incidence of Diabetes Mellitus is increasing worldwide, with almost 1/3 of adults being affected. It is the major contributor to the morbidity of a man with its multi-organ system complications. Control of blood glucose levels is vital to decrease organ damage and complications. Routine diagnostic tests conducted are blood glucose, lipid profile, renal function tests, HbA1c, and insulin assays with a baseline CBC (Complete Blood Count). HbA1c values continue to be the gold standard for the assessment of glycemic control. The RDW (Red Cell Distribution Width) is a parameter of Complete Blood Count. Several studies have shown elevated RDW values in patients with poor glycemic control and as an early marker for Diabetic nephropathy and cardiovascular complications. 610 patients with type 2 Diabetes Mellitus attending the Diabetic Clinic in Saveetha Medical College were included in a cross-sectional study to compare HbA1c values with RDW values with age and gender. The ratio of patients with poor HbA1c levels: acceptable HbA1c levels of glycemic control was1:4 in the age group 25 years and below. The ratio rose to 1:1 in the 36-45 years age group with a reversal of ratio to 4:1 in patients >65years of age. There was a significant correlation between the values of HbA1c with age - with the number of patients increasing with age and showing elevated HbA1c levels. There was no significant correlation between the values of RDW and age. There was a significant positive correlation between HbA1c and RDW- (p = 0.003, < 0.05 standard). For patients with HbA1c values between 6.2- 6-8 %, there was a particularly strong positive correlation with RDW values. In conclusion, there was a significant positive correlation between values of RDW and HbA1c, which emphasis that RDW is a good predictive factor for glycemic control.
Michaela Kozakova, Carlo Palombo
Cardiology and Cardiovascular Medicine, Volume 4; doi:10.26502/fccm.92920132

Sciprofile linkS.I. Ismailov, S.U. Muminova
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), Volume 15, pp 644-648; doi:10.22141/2224-0721.15.8.2019.191689

Abstract:
A literature review describes the role of dyslipidemia in the development of nephropathy in patients with type 2 diabetes mellitus. Chronic hyperlipidemia in diabetes is accompanied by damage and dysfunction of various organs and tissues due to a specific generalized change in the microvasculature or microangiopathy. Micro- and macroangiopathies lead to increased cardiovascular mortality in patients with type 2 diabetes mellitus. In patients with diabetes and chronic kidney disease, dyslipidemia can be exacerbated by hyperglycemia and insulin resistance. Control of dyslipidemia is an important therapeutic target, normalization of lipid metabolism and glycemic status reduces the risk of renal complications in type 2 diabetes mellitus.
Maryem Ben Salem, Hanen Affes, Raouia Dhouibi, Slim Charfi, Mouna Turki, Serria Hammami, Fatma Ayedi, Zouheir Sahnoun, Khaled Mounir Zeghal, Kamilia Ksouda
Archives of Physiology and Biochemistry pp 1-11; doi:10.1080/13813455.2019.1670213

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Melvin R. Hayden
Adipobiology, Volume 10, pp 41-54; doi:10.14748/adipo.v10.6539

Abstract:
Background Obesity and aging are increasing globally and are known to be associated with adipose tissue and vascular stiffness, which are emerging as risk factors for the development of cardiometabolic and neurodegenerative diseases such as atherosclerosis, hypertension, type 2 diabetes mellitus (T2DM), metabolic syndrome, and Alzheimer’s disease. Therefore, we wished to test the hypothesis that the descending thoracic aorta may demonstrate aberrant ultrastructural remodeling that is ameliorated by empagliflozin, a sodium/glucose cotransporter 2 (SGLT2) inhibitor. Methods Ten-week-old female wild-type control (C57BLKS/J) and db/db (BKS.Cg-Dock7m+/+Leprdb/J) mice were divided into three groups: lean untreated controls (CKC, n= 6), untreated db/db controls (DBC, n= 6) and DBC treated with empagliflozin (EMPA treated with 10 mg/kg/day for 10 weeks) (DBE, n= 6). Results This study focuses on ultrastructural remodeling of tunica adventitia and tunica adiposa (periadventitial adipose tissue) of the descending aorta in both DBC and DBE mice. In DBC mice (untreated db/db controls), major observational remodeling included differentiation from thermogenic brown adipose tissue to white adipose tissue with hypertrophy of white adipocytes; ruptured plasma membranes and liberation of toxic lipids into the matrix, which incited inflammation with mast cells and macrophages. These changes were ameliorated in DBE mice (DBC treated with empagliflozin). Conclusion Aberrant ultrastructural findings in DBC versus CKC and the amelioration with EMPA may provide better understanding how obesity and T2DM promote increased risk of vascular stiffness; a milieu for developing cardiovascular disease and target end-organ damage including nerve, retina, kidney and brain. Additionally, these findings may help us to better understand why obesity and T2DM result in the loss of homeostatic anticontractile function of tunica adiposa .
Cardiovascular Diabetology, Volume 18; doi:10.1186/s12933-019-0865-6

Abstract:
The relationship between dyslipidemia, inflammation and CV organ damage in type 2 diabetes mellitus (T2DM) is complex. Insulin resistance and inflammatory cytokines interleukins (ILs) increase plasma triglycerides (TG). ILs also up-regulate expression of matrix-metalloproteinases (MMPs) that, together with TG, decrease high density lipoprotein cholesterol (HDL) levels. High TG, low HDL, increased ILs and MMPs trigger structural and functional changes in different parts of cardiovascular (CV) system. To understand better the role of lipids and inflammation in CV organ damage, the present study investigated the inter-relationships between lipids, ILs and MMPs, as well as the associations of lipids, ILs and MMPs with various CV measures, both in diabetic and non-diabetic population (nonT2DM). In T2DM patients (N = 191) and nonT2DM subjects (N = 94) were assessed carotid intima-media thickness (cIMT) and inter-adventitial diameter (IADiam), carotid wave speed (ccaWS), carotid-femoral pulse wave velocity (cfPWV), left ventricular (LV) mass, LV systolic (s') and early diastolic (e') longitudinal velocities of mitral annulus, together with glycemic control, lipid profile, IL-6, IL-18 and MMP-12. T2DM patients, as compared to nonT2DM subjects, had significantly higher plasma levels of IL-6, IL-18, MMP-12 and lower HDL (P < 0.05-0.0001). They had also higher cIMT, IADiam, ccaWS, cfPWV and LV mass, and lower e' velocity (P < 0.005-0.0001). Both in T2DM patients and nonT2DM subjects, MMP-12 increased with IL-6 (r = 0.43 and 0.39; P < 0.0001) and IL-18 (r = 0.32 and 0.42; P < 0.0001), and HDL decreased with MMP-12 (r = - 0.29 and - 0.42; P < 0.0001). In both populations, MMP-12 was directly associated with IADiam, ccaWS, cfPWV and LV mass (r = 0.42, 0.32, 0.26 and 0.29; P < 0.0001 in T2DM patients, and r = 0.39, 0.28, 0.32 and 0.27; P < 0.01-0.0001 in nonT2DM subjects). In multivariate analysis, MMP-12 remained independently related to IADiam, ccaWS, cfPWV and LV mass in T2DM patients, and to IADiam only in nonT2DM subjects. This cross-sectional study demonstrated a direct association between ILs and MMP-12, as well as an inverse association between MMP-12 and HDL, both in T2DM patients and in nonT2DM subjects. In T2DM patients, who had higher levels of ILs and MMP-12, the latter was independently related to several structural and functional markers of preclinical CV organ damage.
Barbora Nussbaumerova, Hana Rosolova, Miroslav Krizek, Frantisek Sefrna, Jaroslav Racek, Ludek Müller, Sciprofile linkChristian Sindberg
Biological Trace Element Research, Volume 183, pp 192-199; doi:10.1007/s12011-017-1128-6

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Der Diabetologe, Volume 13, pp 313-321; doi:10.1007/s11428-017-0233-7

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Allan Flyvbjerg
Published: 9 December 2016
by Wiley
Textbook of Diabetes pp 541-553; doi:10.1002/9781118924853.ch37

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Hui Huang, Jing Weng, Sciprofile linkMong-Heng Wang
Published: 1 September 2016
Prostaglandins & Other Lipid Mediators, Volume 125, pp 80-89; doi:10.1016/j.prostaglandins.2016.05.004

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