Academic literature on the topic 'Adiponektin, Diabetes mellitus, Altern'

A zsírszövetben az inzulinreceptor jelátviteli folyamatait auto-, para- és endokrin hatásokkal szabályozó számos fehérje termelődik és szekretálódik. Ezek közül több, így a tumornekrózis-faktor-α és szolúbilis receptor formái, az sTNFR1 és sTNFR2, a rezisztin, retinolkötő fehérje-4, plazminogénaktivátor-inhibitor, lipokain-1 gátolja az inzulin jelátviteli folyamatait és inzulinrezisztenciát okoz, elsősorban a zsírszövetben, a májban, az izomszövetben, az agyban, az endothelsejtekben, valamint a hasnyálmirigy β-sejtjeiben. Más fehérjék, így az adiponektin, visfatin, vaspin, omentin, apelin és chemerin pedig javítják az inzulinreceptor jelátvitelét. Az összefoglalás áttekinti az inzulinreceptor jelátviteli folyamatainak főbb részleteit és kitér az elhízásban, valamint a 2-es típusú cukorbetegségben észlelhető inzulin- és citokinrezisztenciák patomechanizmusában a közelmúltban megismert molekuláris tényezőkre (például a suppressor of cytokine signaling fehérje család).

A nem alkoholos eredetű zsírmáj és a steatohepatitis a kóros májműködés leggyakoribb oka. A szerzők áttekintik a kórkép fő kóroki tényezőit, kialakulásának lehetséges hátterét, klinikumát, valamint a kórisme felállításának nehézségeit. Nagy az igény olyan, nem invazív biomarkerek (TNF-α adiponektin, lipidperoxidáció termékei, citokeratin-18, hialuronsav), pontrendszerek (Fibrotest, APRI), vizsgálatok (Fibroscan) kidolgozására, amelyek a betegség előrehaladását, a gyulladást és a fibrosist jelzik. Mind ez idáig megfelelően hatékony kezelés nem ismert. A terápia részben a kiváltó tényezők eliminálását (testsúlycsökkentés), az anyagcserezavar (diabetes mellitus, hyperlipidaemia) kezelését célozza meg, részben a májvédelmet (antioxidánsok) helyezi előtérbe. Orv. Hetil., 2010, 47, 1940–1945.

3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors atau yang biasa disebut sebagai statin, merupakan obat yang sudah digunakan sejak 30 tahun silam dan merupakan salah satu obat yang paling sering digunakan untuk terapi dislipidemia. Menurut hasil terbaru dari banyak studi observasional, randomized controlled trials (RCTs) dan meta-analyses telah mengonfirmasi adanya korelasi kejadian diabetes melitus (new-onset diabetes mellitus/NODM) setelah inisiasi penggunaan statin. Mekanisme spesifik terkait pengaruh statin terhadap kejadian diabetes melitus masih belum sepenuhnya dipahami, namun gangguan fungsi sel beta pankreas melalui calcium channel blockade, berkurangnya sensitivitas jaringan terhadap insulin akibat berkurangnya ekspresi GLUT 4, rendahnya kadar adiponektin dan mungkin mekanisme lainnya diduga menjadi faktor pencetus NODM. Sebagaimana yang kita tahu, statin digunakan dalam terapi dislipidemia serta pencegahan baik primer maupun sekunder terhadap kejadian penyakit kardiovaskular melalui efek pleiotropiknya. Namun, dengan adanya keterkaitan kejadian NODM maka makna protektif penggunaan statin menjadi berkurang. Pada artikel ini akan dibahas mengenai kemungkinan mekanisme statin terkait kejadian NODM dan makna penggunaanya sebagai pencegahan penyakit kardiovaskular.

Altern ist an sich ein kardiovaskulärer Risikofaktor. Die Gefäßveränderungen sind charakterisiert durch eine Intima- und Mediaverdickung mit Zunahme der Steifigkeit und Anstieg der Pulswellengeschwindigkeit. Am Herzen kommt es mit zunehmendem Alter zu einer veränderten Massen-Volumenbeziehung mit Abnahme der diastolischen Funktion. Diese Veränderungen sind zum Teil bedingt durch einen «natürlichen» Alterungsprozess, wahrscheinlich spielt aber auch eine Abnahme der körperlichen Aktivität im Alter eine wichtige Rolle. Bezüglich kardiovaskulärer Risikofaktoren nimmt der Nikotinabusus im Alter ab, dafür werden arterielle Hypertonie und Diabetes mellitus häufiger. Die Bekämpfung der kardiovaskulären Risikofaktoren ist im Alter besonders wichtig, da das Risiko von Akutkomplikationen erhöht ist. Dabei stehen die Lebensstilfaktoren mit regelmäßiger körperlicher Aktivität ebenso im Vordergrund wie bei jüngeren Patienten. Auch ein Rauchstopp bringt bis zu einem Alter von 75–80 Jahren wesentliche gesundheitliche Vorteile. Antioxidativ wirksame Vitamine bringen als Supplement keinen sicheren Schutz vor der Gefäßalterung. Aspirin ist in der Sekundärprävention bis ins hohe Alter wirksam. Betablocker und ACE-Hemmer werden nach Myokardinfarkt bei älteren Patienten eher zu wenig eingesetzt. Die Statine tragen ebenfalls bis zu einem Alter von 80 Jahren zum Schutz vor kardiovaskulären Komplikationen bei. Der Myokardinfarkt verläuft bei älteren Patienten häufig stumm und mit atypischer Symptomatik. Die interventionelle Therapie ist bei älteren gleich erfolgreich wie bei jüngeren Patienten, aber mit einer erhöhten Komplikationsrate verbunden. Die ambulante kardiale Rehabilitation ist auch beim älteren Patienten sinnvoll mit positiven physischen und psychischen Auswirkungen, insbesondere auch bei sozialer Isolation.

Eine nichtalkoholische Fettlebererkrankung (NAFLD) umfasst ein großes Erkrankungsspektrum, das meistens asymptomatisch ist. Bekanntermaßen ist die NAFLD mit metabolischem Syndrom, Diabetes mellitus, Atherosklerose der Arteria carotis sowie endothelialer Dysfunktion assoziiert und damit wiederum stark mit Hirnschäden und kognitiven Beeinträchtigungen verbunden. Aber inwieweit führt die NAFLD zu im MRT sichtbaren, strukturellen Gehirnveränderungen?

Abstract: Obesity has quite a lot of risk factors for the incidence of metabolic diseases such as insulin resistance, diabetes mellitus, dyslipidemia, and metabolic syndrome. The accumulation of adipocytes causes the formation of chronic inflammatory mediators, and disrupts adipokine derived from adipocytes. These inflammatory mediators cause hepatocytes to secrete several types of proteins such as C-reactive protein and fetuin A into the blood circulation that are thought to cause insulin resistance in obesity cases. This study was aimed to determine the relationship among levels of hs-CRP, adiponectin, and fetuin A, and insulin resistance in adult male subjects with central obesity. This was an observational study with a cross sectional design. Subjects were young adult males with central obesity at Prof. Dr. R. D. Kandou Hospital, Manado. The results showed that 30 subjects had a mean hs-CRP level of 0.18 mg/dL (±0.16) which was higher than normal value. There was a positive and significant correlation between hs-CRP and HOMA-IR (r=0.380, p<0.023). There was a negative and insignificant correlation between adiponectin and Homa IR (r =-0.278, p=0.136), and there was no significant correlation between fetuin A and HOMA IR (r -0.048, p=0.801). In conclusion, among young adult males with central obesity there was an increase in hs-CRP level above normal value and there was a significant relationship between increased hs-CRP and insulin resistanceKeywords: fetuin-A, high sensitive C-reactive protein, adiponectin, HOMA-IR, central obesity Abstrak: Obesitas memiliki faktor risiko yang cukup banyak terhadap kejadian penyakit metabolik seperti resistensi insulin, diabetes melitus, dislipidemia, dan sindrom metabolik. Akumulasi adiposit menyebabkan terbentuknya mediator inflamasi kronik sehingga sintesis adipokin oleh adiposit terganggu. Mediator inflamasi tersebut juga menyebabkan hepatosit menyekresi beberapa jenis protein seperti C-reaktif protein dan fetuin A ke dalam sirkulasi darah yang diduga meyebabkan resistensi insulin pada kasus obesitas. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar hs-CRP, adiponektin, dan fetuin A dengan resistensi insulin pada subjek pria dewasa dengan obesitas sentral. Jenis penelitian ialah observasional dengan desain potong lintang. Subyek penelitian ialah pria dewasa muda dengan obesitas sentral di RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 30 subyek dengan rerata kadar hs-CRP 0,18 mg/dl (±0,16) lebih tinggi dari nilai normal. Terdapat hubungan korelasi positif dan bermakna antara hs-CRP dan HOMA-IR (r=0,380, p<0,023); hubungan korelasi negatif dan tidak bermakna antara adiponektin dan Homa IR (r=-0,278, p=0,136); tidak didapatkan hubungan bermakna antara Fetuin A dengan HOMA IR (r=-0.048 dan p=0,801). Simpulan penelitian ini ialah pada pria dewasa muda dengan obesitas sentral terdapat peningkatan kadar hs-CRP melebihi nilai normal dan terdapat hubungan bermakna antara peningkatan hs-CRP dengan resistensi insulin.Kata kunci: fetuin-A, high sensitive C-reactive protein, adiponectin, HOMA-IR, obesitas sentral

Background: Adiponectin circulates in the blood in three different multimer isoforms, of which the high molecular weight form (HMW) is presumed to mediate insulin sensitivity. We examined whether adiponectin oligomer distribution is associated with aging and type 2 diabetes (T2D) in octogenarians without characteristic features of metabolic syndrome. Methods: The study included 154 octogenarians (58 men, 96 women), 24 normoglycemic middle-aged controls (11 men, 13 women; mean age 44 years), and 33 middle-aged individuals (14 men, 19 women; mean age 55 years) with T2D. Based on oral glucose tolerance test 62 octogenarians had normal, 63 impaired glucose tolerance, and 29 octogenarians had newly detected T2D. Serum adiponectin multimer isoforms were measured after overnight fast by enzyme-linked immunosorbent assays. Results:Compared to the normoglycemic middle-aged control group, male normoglycemic octogenarians revealed significantly higher total adiponectin and all adiponectin isoforms. The same was true for females with the exception of low molecular weight (LMW) adiponectin, which was not statistically higher in octogenarians. Male and female octogenarians with T2D had significantly higher levels of total, HMW, and middle molecular weight (MMW) adiponectin, but not LMW adiponectin, than middle-aged individuals with T2D. Female, but not male, octogenarians revealed significantly lower total adiponectin than normoglycemic octogenarians. Compared with normoglycemic octogenarians, male and female octogenarians with T2D were characterized by significantly lower LMW adiponectin. In male and female octogenarians, total adiponectin and all multimer isoforms were directly correlated with HDL cholesterol. LMW adiponectin in octogenarians of both sexes was inversely correlated with glucose level at 2-hour oral glucose tolerance test. Conclusions: Serum levels of total adiponectin as well as its HMW and MMW isoforms were significantly higher in octogenarians with normoglycemia or T2D than in corresponding middle-aged control groups. In male and female octogenarians without metabolic syndrome, T2D was associated with lower LMW adiponectin, while the HMW and MMW isoforms were not statistically different
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich

Background: Adiponectin circulates in the blood in three different multimer isoforms, of which the high molecular weight form (HMW) is presumed to mediate insulin sensitivity. We examined whether adiponectin oligomer distribution is associated with aging and type 2 diabetes (T2D) in octogenarians without characteristic features of metabolic syndrome. Methods: The study included 154 octogenarians (58 men, 96 women), 24 normoglycemic middle-aged controls (11 men, 13 women; mean age 44 years), and 33 middle-aged individuals (14 men, 19 women; mean age 55 years) with T2D. Based on oral glucose tolerance test 62 octogenarians had normal, 63 impaired glucose tolerance, and 29 octogenarians had newly detected T2D. Serum adiponectin multimer isoforms were measured after overnight fast by enzyme-linked immunosorbent assays. Results:Compared to the normoglycemic middle-aged control group, male normoglycemic octogenarians revealed significantly higher total adiponectin and all adiponectin isoforms. The same was true for females with the exception of low molecular weight (LMW) adiponectin, which was not statistically higher in octogenarians. Male and female octogenarians with T2D had significantly higher levels of total, HMW, and middle molecular weight (MMW) adiponectin, but not LMW adiponectin, than middle-aged individuals with T2D. Female, but not male, octogenarians revealed significantly lower total adiponectin than normoglycemic octogenarians. Compared with normoglycemic octogenarians, male and female octogenarians with T2D were characterized by significantly lower LMW adiponectin. In male and female octogenarians, total adiponectin and all multimer isoforms were directly correlated with HDL cholesterol. LMW adiponectin in octogenarians of both sexes was inversely correlated with glucose level at 2-hour oral glucose tolerance test. Conclusions: Serum levels of total adiponectin as well as its HMW and MMW isoforms were significantly higher in octogenarians with normoglycemia or T2D than in corresponding middle-aged control groups. In male and female octogenarians without metabolic syndrome, T2D was associated with lower LMW adiponectin, while the HMW and MMW isoforms were not statistically different.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Gojaznost se najčešće definiše kao uvećanje udela masne mase u ukupnoj telesnoj masi. Danas gojaznost poprima pandemijske razmere i karakter globalnog zdravstveno-socijalnog problema jer predstavlja faktor rizika za razvoj masovnih nezaraznih bolesti, pre svega tipa 2 šećerne bolesti (T2DM) i kardiovaskularnih bolesti. Adipokini su molekule koje luči masno tkivo i koji imaju značajnu ulogu u regulaciji mnogobrojnih procesa u ljudskom organizmu. Adiponektin (ADN) je adipokin sa antidijabetogenim, antiinflamatornim i antiaterogenim dejstvom. Tokom razvoja, pre svega, centralnog tipa gojaznosti dolazi do poremećaja u sekretornom profilu masnog tkiva, nastaje pad serumske koncentracije ADN i dolazi do razvoja mnogobrojnih kardiometaboličkih poremećaja. Cilj rada je ispitivanje značaja određivanja serumskog ADN u proceni kardiometaboličkog profila i utvrđivanje povezanosti njegovog nivoa sa procenjenim desetogodišnjim rizikom za razvoj T2DM kod gojaznih osoba. Studija preseka sprovedena na Klinici za endokrinologiju, dijabetes i bolesti metabolizma, Kliničkog centra Vojvodine je obuhvatila 65 ispitanika sa hiperalimentacionim tipom gojaznosti. Kod ispitanika je procenjen desetogodišnji rizik za razvoj T2DM i sprovedena su odgovarajuća antropometrijska, laboratorijska i morfološka ispitivanja. Ispitanici sa sniženim serumskim ADN su imali nepovoljniji kardiometabolički profil u odnosu na ispitanike sa normalnom vrednošću serumskog ADN dok nije bilo razlike u nivou desetogodišnjeg rizika za razvoj T2DM između navedenih grupa. Takođe, ispitanici sa metaboličkim sindromom (MS) i ispitanici sa nealkoholnom masnom bolešću jetre (NAFLD) su imali niži serumski ADN u odnosu na osobe bez MS i osobe bez NAFLD. Kod gojaznih osoba postoji značajna povezanost serumskog ADN sa većim brojem pokazatelja kardometaboličkog profila ali ne i sa procenjenim desetogodišnjim rizikom za razvoj T2DM.
Obesity is often defined as the significant increase in proportion of fat mass in total body mass. Nowadays, obesity exhibits pandemic proportions and acquires character of the global health and social problem, as it represents the risk factor for the development of non-communicable diseases, especially type 2 diabetes mellitus (T2DM) and cardiovascular diseases. Adipokines are molecules secreted by adipose tissue which play an important role in the regulation of various processes in the human organism. Adiponectin (ADN) is an adipokine with anti-diabetic, anti-inflammatory and anti-atherogenic effects. During development of, above all, central obesity, disorders in the secretory profile of adipose tissue are arising, decline in serum concentrations of ADN advents, which leads to occurrence of numerous cardiometabolic disorders. The aim of study is to examine the significance of determining serum ADN in assessing the cardiometabolic profile, and determining its association with the estimated ten-year risk of developing T2DM in obese persons. Cross-sectional study conducted at the Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Center of Vojvodina, included 65 persons with hyperalimentation type of obesity. Ten-year risk of developing T2DM was assessed and appropriate anthropometric, laboratory and morphological evaluations were performed. Persons with lower serum ADN had worse cardiometabolic profile compared to those with normal serum ADN value, while there was no difference in the level of ten-year risk of developing T2DM between two groups. Also, subjects with metabolic syndrome (MS) and subjects with nonalcoholic fatty liver disease (NAFLD) had lower serum ADN compared to persons without MS and to those without NAFLD. There is a significant association of serum ADN with a larger number of cardiometabolic profile indicators but not with the estimated ten-year risk of developing T2DM.