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Browsing by Subject "Diabetes"

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Open Access
A surgical model of short bowel syndrome induces a long-lasting increase in pancreatic beta-cell mass
(F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología, 2015) Pérez-Arana, G.; Camacho-Ramírez, A.; Segundo-Iglesias, M.C.; Lechuga-Sancho, A.M.; Sancho-Maraver, E.; Aguilar-Diosdado, M.
Several surgical techniques are used nowadays as a severe treatment for obesity and diabetes mellitus type 2. These techniques are aggressive due to drastic changes in the nutrient flow and non-reversible modifications on the digestive tube. In this paper we present the effects of a massive intestinal resection on the pancreas. Results have shown that short bowel technique is less aggressive to normal anatomy and physiology of the intestinal tract than Gastric bypass or biliopancreatic diversion (e.g.). In this paper we reproduce a model of short bowel syndrome (SIC), with similar surgical conditions and clinical complications as seen in human cases. This work was conducted on normal Wistar rats, with no other concurrent factors, in order to determine the effects on normal pancreas islets. We measured pancreatic implications by histomorphometric studies, which included beta-cell mass by immunocytochemistry, and apoptosis/proliferation test with TUNEL technique and Ki-67. Briefly, we reported on an increased relative area of the islets of the pancreas, as well as an increase in the average size of islets in the SIC versus the control group. Furthermore we stated that this increase in size of the pancreatic islets is due to the mechanisms of proliferation of beta cells in animals undergoing SIC. These goals could reveal a direct influence of surgical modification of the digestive tract over the pancreatic beta cell homeostasis. In this sense, there are many potential stimulators of intestinal adaptation, including peptide hormones and growth components which are associated or involved as effectors of the endocrine pancreas.
Open Access
Alloxan-induced hyperglycemia causes rapid-onset and progressive dental caries and periodontitis in F344 rats
(F. Hernández y Juan F. Madrid. Universidad de Murcia. Departamento de Biología Celular e Histología, 2012) Nakahara, Yutaka; Sano, Tomoya; Kodama, Yasushi; Ozaki, Kiyokazu; Matsuura, Tetsuro
We have previously shown that diabetes increases dental caries, and periodontitis might be a secondary change resulting from dental caries in spontaneous diabetic rodent models. However, the lesions in these models were slow to manifest, and the intensity and frequency were mild and varied among individuals. The goal of this study was to confirm the reproducibility of caries development in chemically induced diabetic rats and investigate whether alloxan, which induces immediate and severe hyperglycemia in experimental animals, increases the lesions. Female F344 rats were examined 13 and 26 weeks after dosing of alloxan. Alloxan injection induced severe hyperglycemia in two-thirds of the rats. Progressive molar caries and periodontitis were already induced in all diabetic rats 13 weeks after dosing of alloxan, although the lesions were not observed in nondiabetic rats. Histopathologically, dental caries initially developed in the crown, then spread into the dental root, entered the periodontal connective tissue via the apical foramen, and progressed to periodontitis. In conclusion, alloxan-induced severe hyperglycemia is capable of causing rapid-onset and progressive dental caries and periodontitis in rats.
Open Access
Alteraciones del metabolismo hidrocarbonado en pacientes con infarto agudo de miocardio : valor pronóstico de la hemoglobina glicosilada y papel en la predicción del desarrollo de alteraciones de la regulación de la glucosa
(2014-09-08) Gea García, José Higinio de; Galcerá Tomás, José; Departamento de Medicina Interna
INTRODUCCION Las alteraciones del metabolismo hidrocarbonado (MHC) no conocidas previamente, incluida la diabetes mellitus (DM) son frecuentes en los pacientes con infarto agudo de miocardio (IAM) y es importante su detección precoz ya que puede mejorar el pronóstico. De esta forma, en un ingreso por un IAM no debiera perderse la oportunidad de establecerse el diagnóstico y el subsiguiente inicio del tratamiento. Desafortunadamente, la estrategia óptima para identificar las alteraciones del MHC en el contexto de un IAM no está totalmente establecida. OBJETIVOS Los objetivos principales del presente estudio fueron dirigidos a verificar la hipótesis de que la determinación precoz de la Hemoglobina glicosilada (HbA1c) en pacientes con IAM es relevante: - En la caracterización pronóstica tanto en los pacientes con DM conocida, de novo o en los pacientes sin DM. - Una mejor identificación de la DM no conocida en los pacientes que ingresan por IAM. - Identificación de aquellos pacientes que en ausencia de una alteración del MHC al ingreso son propensos a desarrollarla ulteriormente. MATERIAL Y MÉTODOS Estudio observacional, prospectivo y longitudinal de los pacientes que ingresaron en la Unidad Coronaria del Hospital Clínico Universitario Virgen de la Arrixaca (Murcia) con el diagnóstico de IAM. El periodo de estudio comprende desde Enero de 1999 hasta Enero de 2008. Al ingreso se recogieron variables clínicas y analíticas, incluyendo la HbA1c. Se realizó un seguimiento convencional a largo plazo de los pacientes para conocer su evolución y si habían desarrollado alguna alteración del MHC. A un subgrupo de pacientes se les realizó al año del IAM una sobrecarga oral de glucosa (SOG) para un estudio detallado del metabolismo de la glucosa. RESULTADOS Durante el periodo de estudio ingresaron 1.795 pacientes por un IAM. Entre todos los pacientes, 622 presentaban DM previamente conocida y en 159 casos se estableció el diagnóstico de DM de novo utilizando una HbA1c% al ingreso ≥6,5%. A los pacientes sin alteración del MHC (1.014), y una vez excluidos los fallecidos, se les realizó un seguimiento de aproximadamente 7 años. De los 951 pacientes estudiados, en 126 casos se confirmó el diagnóstico de DM, en 766 casos no habían sido diagnosticados de DM ni refirieron estar siendo tratados, mientras que en los 59 restantes no dispusimos de datos suficientes para documentar la existencia de algún grado de alteración del MHC. En el subgrupo de pacientes, 138, que se les realizó la SOG: 38 presentaron un MHC normal y el resto fueron clasificados como 38 con alteración de la glucosa en ayunas, 39 con intolerancia a la glucosa y 23 con DM. Tras los análisis realizados, en nuestro estudio, la HbA1c al ingreso se asoció independientemente con: - La aparición de DM en los pacientes a los que se les realizó un seguimiento convencional (OR:2,62, p<0,001). - La aparición de DM entre aquellos pacientes que se les realizó una SOG al año del IAM (OR:7,28, p=0,009). - La mortalidad en todos los pacientes independientemente de la situación metabólica al ingreso. CONCLUSIONES El presente estudio confirma la alta prevalencia de las alteraciones del MHC en la Región de Murcia entre los pacientes que presentan un IAM, tanto de DM previamente conocida como de novo. Así mismo, de nuestros hallazgos se desprende la utilidad de la HbA1c en la identificación de pacientes con DM de novo con un valor igual o superior a 6,5%. Por último, nuestro estudio evidencia que la HbA1c en el momento del ingreso, se asocia de forma independiente con la mortalidad a largo plazo (en pacientes con o sin DM, y en aquellos con DM de novo al ingreso) y la ulterior aparición de DM. INTRODUCTION Previously unknown disorders in carbohydrate metabolism (MHC), including diabetes mellitus (DM), are common in patients with acute myocardial infarction (AMI), and thus early detection is important because it can improve the prognosis. Also, in an income for AMI should not be missed the opportunity to establish the diagnosis and the subsequent treatment initiation. Unfortunately, the optimal strategy for identifying MHC disorders in a context of AMI, is not fully established. OBJECTIVES This study was designed to test the hypothesis that early determination of glycosylated hemoglobin (HbA1c) in patients with AMI is relevant and useful through the following: - In the prognostic characterization both in patients with known DM, de novo, or in patients without DM. - Better identification of the unknown DM in patients admitted for AMI. - Identification of patients that in the absence of MHC disorder are subsequently prone to develop the disease. MATERIAL AND METHODS Observational, prospective, longitudinal study of patients admitted to the Coronary Care Unit of the Clinical Hospital Universitario Virgen de la Arrixaca (Murcia) with the diagnosis of AMI, over a study period of January 1999 to January 2008. At admission clinical and laboratory variables were recorded, including HbA1c. Conventional long-term follow-up of patients was done in order to evaluate the changes and determine whether they had developed any alteration of MHC. A year after the AMI, a subgroup of patients underwent an oral glucose tolerance test (OGTT) for a detailed study of glucose metabolism. RESULTS During the study period, 1,795 patients were admitted for AMI. Of these, 622 had previously been diagnosed with DM and in 159 cases the diagnosis of DM was established de novo using HbA1c (≥ 6.5% at admission). Patients without alteration of MHC (1,014), and excluding the deceased, were monitored for about 7 years. Of the 951 patients studied, 126 cases of DM diagnosis were confirmed; in 766 cases DM had been diagnosed or reported to be being treated, while the remaining 59 did not provide sufficient data to document the existence of some degree of alteration of MHC. In the subgroup of patients, for 138 who underwent OGTT, 38 had normal MHC and the rest were classified as 38 with impaired fasting glucose, 39 with glucose intolerance, and 23 with DM. Following the analysis performed in our study, HbA1c at admission was independently associated with: - The appearance of DM in patients who underwent a conventional follow-up (OR: 2.62, p < 0.001). - The appearance of DM among patients who underwent OGTT one year after AMI (OR: 7.28, p = 0.009). - The mortality in all patients regardless of the metabolic status at admission. CONCLUSIONS This study confirms the high prevalence of abnormal MHC in Murcia among patients with AMI, both previously known as de novo DM. Our findings indicate the usefulness of HbA1c in identifying patients with de novo DM with a value equal to or greater than 6.5%. Finally, our study shows that HbA1c at admission was independently associated with long-term mortality (in patients with or without DM and those with de novo DM) and the subsequent development of DM.
Open Access
Alteraciones psicosociales de la diabetes, relación con calidad de vida, control metabólico y complicaciones crónicas
(Universidad de Murcia, 2020-02-24) Martínez Martínez, Mariana; Illán Gómez, Fátima; Escuela Internacional de Doctorado
Introducción y objetivos: La diabetes mellitus (DM) es una enfermedad crónica caracterizada por la presencia de hiperglucemia y complicaciones vasculares. Con mucha frecuencia las enfermedades crónicas asocian problemas psicológicos. Por este motivo, en la actualidad existe un interés creciente en el diagnóstico y manejo de los aspectos psicológicos de la DM. El cuidado del paciente con diabetes debe responder a una visión multidimensional que valore conjuntamente los resultados clínicos y psicológicos. En la actualidad la evaluación de los aspectos psicológicos y la calidad de vida relacionada con la salud (CRS) debe ser una herramienta indispensable en el manejo de la DM. Los objetivos fundamentales de este trabajo consisten en evaluar la prevalencia de ansiedad, depresión y distress específico de diabetes en una muestra de pacientes con DM, así como analizar la relación existente entre dichos problemas psicosociales con la calidad de vida, bienestar emocional, control glucémico y complicaciones crónicas. También se estudian las posibles diferencias entre pacientes con DM tipo 1 y 2. Material y métodos: Se realizó un estudio observacional transversal en una población de pacientes con DM. Los pacientes debían ser mayores de 18 años con más de 2 años de evolución de su diabetes. Se recogieron variables epidemiológicas (edad, sexo, nivel de estudios, TSI), datos clínicos (peso, talla, HbA1c, edad de aparición de la DM, años de evolución, tratamiento, complicaciones,...) y se pasaron una serie de cuestionarios autoadministrados para el cribado de Distress emocional específico de diabetes (DDS), Bienestar emocional (WHO-10 WBI), Calidad de vida específico para DM (EsDQOL), Ansiedad y Depresión (HAD) y Miedo a las hipoglucemias (HSF-II). Resultados: La muestra estaba compuesta por 348 pacientes (168 DM tipo 1 y 180 DM tipo 2). El 48.5% eran mujeres y el 51.5 % restante eran hombres con una edad media de 50.72±15.80 años y un tiempo medio de evolución de la enfermedad era de 17.52±10.58 años. La HbA1c media fue de 7.19±1.19%. El 28.2% llevaba tratamiento con antidiabéticos orales (ADO) exclusivamente, el 9.7% ADO asociado a insulina basal y 62.1% múltiples dosis de insulina. Las complicaciones crónicas estaban presentes en el 34.1%. Un 50.3% de pacientes tenía distress específico de diabetes, un 31.9% ansiedad y un 16.3% depresión. No se hallaron diferencias en prevalencia de depresión y ansiedad entre pacientes con DM tipo 1 y 2. La prevalencia de distress fue ligeramente mayor en pacientes con DM tipo 1 (54.4% DM1 vs 46.3% DM2). La presencia de alteraciones psicosociales era mayor en los pacientes que habían desarrollado complicaciones crónicas. Las personas con una formación académica superior y mayores ingresos económicos presentaban menos alteraciones psicosociales. Los pacientes insulinizados tenían mayores tasas de distress, aunque no de depresión y ansiedad. No se halló relación entre presencia de alteraciones psicosociales y control glucémico. La mayoría de pacientes tenía buena calidad de vida (CV) (61.2%) y bienestar emocional (57.1%). La proporción de pacientes con buena CV fue mayor en pacientes con DM tipo 2 (66.7%) que en DM tipo 1 (56%). La CV disminuía ante la presencia de ansiedad, depresión y distress de diabetes. Una mayor edad actual, mayor edad de debut, mayores cifras de hemoglobina glicosilada, existencia de complicaciones crónicas o insulinización del paciente también empeoraban la CV. El miedo a las hipoglucemias estaba presente en el 16.7% de nuestros pacientes. El porcentaje era claramente mayor en pacientes con DM tipo 1 (23.3%), frente a pacientes con DM tipo 2 (9.7%). Los pacientes que presentaban miedo a las hipoglucemias tenían mayores tasas de distress de diabetes (68% vs 46.1%, p=0.00), ansiedad (55.8% vs 26.2%, p=0.00) y depresión (26.9% vs 13.3%, p=0.01), así como menor bienestar emocional (22% vs 48.6%, p=0.00) y calidad de vida (26.9% vs 68.8%, p= 0.00). Los pacientes con miedo a las hipoglucemias tenían un debut más temprano y más años de evolución de su DM, presentaban menos ingresos económicos y se realizaban autocontroles más frecuentemente. No se objetivaron diferencias en prevalencia de miedo a las hipoglucemias entre pacientes con distinto nivel de estudios. Conclusiones: En nuestra población, un 50.3% de pacientes tenía distress específico de diabetes, un 31.9% ansiedad y un 16.3% depresión. La existencia de ansiedad, depresión y distress empeoraba la CV de los pacientes. Los pacientes con complicaciones crónicas tenían mayor prevalencia de depresión, ansiedad y distress. El mal control metabólico, la necesidad de insulina y la presencia de complicaciones crónicas también empeoraban la CV en nuestros pacientes. Mientras que los pacientes con DM tipo 1 tenían una mayor prevalencia de distress, los pacientes con DM tipo 2 tenían una mejor CV. En el manejo del paciente diabético es de vital importancia mantener una visión multidimensional del individuo que incluye el cribado y diagnóstico de problemas psicológicos, que como corrobora nuestro estudio tienen una alta prevalencia y empeoran la calidad de vida de los pacientes. Introduction and objectives: Diabetes mellitus is a chronic disease characterized by the presence of hyperglycemia and vascular complications. Chronic diseases often associate psychological problems. Currently there is great interest in the diagnosis and management of the psychological aspects of DM. The care of the patient with diabetes must respond to a multidimensional vision that jointly assesses the clinical and psychological results. The evaluation of psychological aspects and health-related quality of life should be an indispensable tool in the management of DM. The main objectives of this work are to assess the prevalence of anxiety, depression and specific diabetes distress in a sample of patients with DM, as well as analyze the relationship between these psychosocial problems with quality of life, emotional well-being, glycemic control and chronic complications The possible differences between patients with type 1 and 2 DM are also studied. Material and methods: A cross-sectional observational study was carried out in a population of patients with DM. The patients had to be older than 18 years with more than 2 years of evolution of their diabetes. Epidemiological variables (age, sex, level of studies, TSI), clinical data (weight, height, HbA1c, age of onset of DM, years of evolution, treatment, complications,...) were collected and the patients filled out self-administered questionnaires for the screening of Diabetes Distress (DDS), Emotional well-being (WHO-10 WBI), Specific quality of life for DM (EsDQOL), Anxiety and Depression (HAD) and Fear of hypoglycemia (HSF-II). Results: The sample consisted of 348 patients (168 DM1 and 180 DM2). The 48.5% were women and the 51.5% were men with an average age of 50.72±15.80 years and an average time of disease progression was 17.52±10.58 years. The mean HbA1c was 7.19±1.19%. The 28.2% of patients had treatment with ADO exclusively, the 9.7% ADO associated with basal insulin and the 62.1% multiple doses of insulin. Chronic complications were present in 34.1% of patients. The 50.3% of patients had diabetes distress, the 31.9% had anxiety and the 16.3% had depression. No differences were found in the prevalence of depression and anxiety among patients with DM1 and DM2. The prevalence of distress is higher in patients with type 1 DM (54.4% DM1 vs. 46.3% DM2). The presence of psychosocial alterations was greater in patients who had developed chronic complications. People with a higher academic background and higher economic income had fewer psychosocial disorders. Insulinized patients had higher rates of distress, although not depression and anxiety. No relationship was found between the presence of psychosocial disorders and glycemic control. The majority of patients had a good quality of life (61.2%) and emotional well-being (57.1%). The proportion of patients with good quality of life was higher in patients with DM2 (66.7%) than in DM1 (56%). CV decreased in the presence of, depression, diabetes distress. Older current age, older debut age, higher HbA1c levels, chronic complications or insulinization of the patient also made CV worse. Fear of hypoglycemia was present in 16.7% of our patients. The percentage was clearly higher in patients with DM1 (23.3%), compared to patients with DM2 (9.7%). Patients who were afraid of hypoglycemia had higher rates of diabetes distress (68% vs. 46.1%, p = 0.00), anxiety (55.8% vs. 26.2%, p = 0.00) and depression (26.9% vs. 13.3%, p = 0.01), as well as lower emotional well-being (22% vs. 48.6%, p = 0.00) and quality of life (26.9% vs. 68.8%, p = 0.00). Patients with fear of hypoglycemia had an earlier debut and more years of evolution of their DM, had less income and were self-monitoring more frequently. There were no differences in the prevalence of fear of hypoglycemia between patients with different levels of education. Conclusions: In our population, the 50.3% of patients have specific diabetes distress, the 31.9% anxiety and the 16.3% depression. The existence of anxiety, depression and distress worsened the CV of the patients. Patients with chronic complications had a higher prevalence of depression, anxiety and distress. The poor metabolic control, the need for insulin and the presence of chronic complications also worsened the CV in our patients. While patients with DM1 had a higher prevalence of distress, patients with DM2 had a better CV. In the management of the diabetic patient it is of vital importance to maintain a multidimensional vision of the individual that includes the screening and diagnosis of psychological problems, which as corroborated by our study have a high prevalence and worsen the quality of life of the patients.
Metadata only
Análisis de B2-Microglobulina, N-acetíl-B-D-Glucosaminidasa, insulina, calcio iónico y la determinación combinada de glucosa y fructosamina en humor vítreo para el diagnóstico postmortem de diabetes mellitus y su comparación con otros marcadores bioquímicos / María Begoña Guillem Izquierdo ; director Eduardo Osuna Carrillo de Albornoz.
(Murcia : Universidad de Murcia, Departamento de Ciencias Sociosanitarias, Area de Medicina Legal y Forense,, 2003) Guillem Izquierdo, María Begoña
Open Access
Annexins as disease modifiers
(Murcia : F. Hernández, 2010) Fatimathas, Lux; Moss, Stephen E.
The annexins are a family of calciumdependent phospholipid binding proteins which are present in all eukaryotes. There are currently 12 identified human annexins all of which contain unique calcium binding sites, encoded in the highly conserved annexin repeat motifs within the C terminal core. In addition to the C terminal core the annexins contain a significantly more variable N terminal head. It is this domain which endows each annexin with unique functions in a diverse range of cellular processes including; endo- and exocytosis, cytoskeletal regulation and membrane conductance and organisation. Given their involvement in such a variety of processes it is not surprising that the annexins have also been implicated in a range of disease pathologies. Although there is no singular disease state directly attributed to a dysregulation in annexin function, several pathological conditions are suggested to be modified by the annexins. In this review we shall focus on the growing evidence for the role of the annexins in the progression of cancer, diabetes and the autoimmune disorder anti-phospholipid syndrome.
Open Access
Antidiabetic effect of Atriplex halimus L. (Sp. Pl. 2: 1052 (1753)) long and short term treatment against streptozotocin induced diabetes in rats
(Universidad de Murcia. Servicio de publicaciones, 2022) Bounouar, Elaid; Missoun, Fatiha; Ouda Amari, Nesrine; Zohra Belabaci, Fatima; Belabaci, Senia; Zohra Sekkal, Fatima; Djebli, Noureddine
El objetivo fue evaluar la actividad antidiabética de hojas de Atriplex halimus en ratas diabéticas modelo. Para evaluar se utilizó la glicemia, pérdida de peso, volumen de consumo de agua, parámetros bioquímicos. estudio histológico. Las investigaciones fitoquímicas indican la presencia de flavonoides, taninos, saponinas, mucílagos, glucósidos. proteínas. Los resultados muestran que el tratamiento con extracto acuoso de A. halimus presenta reducción significativa de los niveles de glucosa en sangre en ratas de los grupos D100. D200, en comparación con el grupo diabético,. protege. las ratas de complicaciones diabéticas. El estudio histológico del páncreas lo confirman por la mejora en los islotes de Langerhans de rata tratada con este extracto vegetal. Atriplex halimus parece ser una planta prometedora para futuros ensayos preclínicos. clínicos en la diabetes de tipo I.
Open Access
Autopercepción de la enfermedad en pacientes diagnosticados de diabetes mellitus tipo 2 que acuden a consulta de enfermería
(Murcia: Servicio de Publicaciones de la Universidad de Murcia, 2012) Martínez Castillo, Antonio
Que el paciente se autoidentifique con la enfermedad que le ha sido diagnosticada y sea consciente de ella es fundamental para una correcta intervención sanitaria. El objetivo del presente trabajo es conocer si los pacientes diabéticos se autoidentifican con su enfermedad y comprobar si esto influye en el control metabólico. Material y método: Estudio descriptivo realizado a los pacientes diabéticos que acudieron a consulta de enfermería. Las variables fueron: autoidentificación como diabético, hemoglobina glicosilada, sexo, edad, situación laboral, nivel de estudios, convivir o no con pareja/cónyuge, años de diagnóstico y tipo de tratamiento. Se realizó análisis estadístico inferencial mediante los test de X2 y t de student. Resultados: El 23,6% de la muestra no se autoidentifica con la diabetes. No existe significación estadística entre esta variable y las cifras de hemoglobina glicosilada. Sin embargo, sí existe relación con la edad y los años de diagnóstico. En el resto de variables tampoco se hallan datos significativos. Conclusiones: Existe un alto porcentaje de pacientes que no son conscientes de su patología, algo que aumenta con la edad y disminuye con los años de diagnóstico. No existen diferencias en el control metabólico entre los que sí se autoidentifican y los que no.
Open Access
Bariatric surgery influences β-Cell turnover in non obese rats
(Universidad de Murcia. Departamento de Biología Celular e Histología, 2017) Camacho Ramírez, Alonso; Blandino Rosano, Manuel; Segundo Iglesias, M. Carmen; Lechuga Sancho, Alfonso M.; Aguilar Diosdado, Manuel; Pérez Arana, Gonzalo M.; Prada Oliveira, J. Arturo
Background. The aim of this study was to investigate the relation between the different bariatric surgeries and pancreatic β-cell turnover. Material and Methods. We used healthy adult male Wistar rats to undergo the different techniques. Three surgical techniques were developed (malabsorptive, Sleeve gastrectomy and Roux-Y Gastric Bypass-), together with two control groups (Sham and fasting control). Pancreatic β-cell mass was measured, as well as apoptosis, proliferation and neogenesis related to cellular turnover. Otherwise, we measured the functional issues to elucidate the physiological role that these surgical techniques trigger in the carbohydrate metabolism (e.g. food intake, weight gain, intraperitoneal glucose tolerance test, and basal glycaemia). Results included the differences in phenotypes of the rat after the surgery. The rats did not show important differences in glycaemic parameters between the surgical groups. The β-cell mass presented modifications related with proliferation processes. A significant increase of β-cell mass in the malabsorptive technique was reported. On the other hand, the peripheral resistance to insulin tended to be reduced in rats which underwent malabsorptive and mixed techniques. Conclusion. This work showed an increase in β-cell mass after the resection of an important portion of small bowel. The Roux-Y Gastric Bypass produced a non-significant increase in β-cell mass. We considered that these implications of surgery over the endocrine pancreas must be one of the mechanisms related to the improvement of type 2 Diabetes mellitus following bariatric surgery.
Open Access
Body Composition, Physical Fitness, Physical Activity and Nutrition in Polish and Spanish Male Students of Sports Sciences: Differences and Correlations
(MDPI, 2019-03-30) López Sánchez, Guillermo Felipe; Radziminski, Łukasz; Skalska, Maria; Jastrz˛ebska, Joanna; Smith, Lee; Wakuluk, Dorota; Jastrz˛ebski, Zbigniew; Ciencias Sociosanitarias
It is important to study differences in body composition, physical fitness and lifestyle behaviours between university students from different countries to develop country- specific recommendations on health promotion to provide to students when transitioning to university. The present study aimed to analyse differences in body composition, physical fitness and lifestyle behaviours between Polish and Spanish students of Sports Sciences. One-hundred-and-eighty-six male students participated (81 from Poland and 105 from Spain). Polish males were on average 21.5 ± 1.9 yrs old and Spanish males 21.5 ± 2.5. The body composition variables measured were body weight (kg), fat-free mass (FFM, kg and %), fat mass (FM, kg and %), total body water (TBW, kg and %), basal metabolic rate (BMR, kcal), body mass index (BMI, kg/m2), fat-free mass index (FFMI, kg/m2) and fat mass index (FMI, kg/m2). The physical fitness variables measured were squat jump (SJ, height in cm, power in watts and w/kg), countermovement jump (CMJ, height in cm, power in watts and w/kg), running speed (10, 20 and 30 m (time in s)), and progressive aerobic cardiovascular endurance run (PACER, stage, final speed in km/h, distance in m, VO2max in mL/kg/min). Lifestyle variables measured were vigorous physical activity (VPA, days/week, min/week), moderate physical activity (MPA, days/week, min/week), walking (days/week, min/week), sitting (min/week), meals/day, vegetables/day, fruits/day, seafood/week, dairy products/week, sweets, chips, fast food/week, litres of liquid/day, litres of sugary drinks/day, alcohol/week and cigarettes/day. In comparison to Spanish students, Polish students had greater FFM (kg), greater TBW (kg), higher BMR, greater power in SJ, greater height and power in CMJ, lower times in running speed tests (10 and 20 m) and greater consumption of vegetables and liquids. In comparison to Polish students, Spanish students participated in more physical activity, and consumed more seafood, more dairy products, less sugary drinks, less alcohol and less tobacco. VPA and consumption of vegetables and liquids had positive influences on body composition and physical fitness. According to these results, universities should promote a healthy lifestyle in order to improve body composition and physical fitness in male students studying sport science. In the cases of Spain and Poland, special attention should be paid to the weak points detected in this study. This would be useful for avoiding future risk of diseases such as obesity or diabetes.
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Bone regeneration in critical-sized mandibular symphysis defects using bioceramics with or without bone marrow mesenchymal stem cells in healthy, diabetic, osteoporotic, and diabetic-osteoporotic rats
(Elsevier SCI LTD, 2022) Camacho Alonso, Fabio; Tudela Mulero, M.R.; Pérez-Sayáns, M.; Mercado Díaz, A.M.; Navarro Cámara, José Antonio; Buendía Marín, Antonio Julián; Dermatología, Estomatología, Radiología y Medicina Física
Objectives: To compare new bone formation in mandibular critical-sized bone defects (CSBDs) in healthy, diabetic, osteoporotic, and diabetic-osteoporotic rats filled with bioceramics (BCs) with or without bone marrow mesenchymal stem cells (BMSCs). Methods: A total of 64 adult female Sprague-Dawley rats were randomized into four groups (n = 16 per group): Group 1 healthy, Group 2 diabetic, Group 3 osteoporotic, and Group 4 diabetic-osteoporotic rats. Streptozotocin was used to induce type 1 diabetes in Group 2 and 4, while bilateral ovariectomy was used to induce osteoporosis in Group 3 and 4. The central portion of the rat mandibular symphysis was used as a physiological CSBD. In each group, eight defects were filled with BC (hydroxypatatite 60% and β-tricalcium phosphate 40%) alone and eight with BMSCs cultured on BC. The animals were sacrificed at 4 and 8 weeks, and the mandibles were processed for micro-computed tomography to analyze radiological union and bone mineral density (BMD); histological analysis of the bone union; and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). Results: In all groups (healthy, diabetics, osteoporotics, and diabetics-osteoporotics), the CSBDs filled with BC + BMSCs showed greater radiological bone union, BMD, histological bone union, and more VEGF and BMP-2 positivity, in comparison with CSBDs treated with BC alone (at 4 and 8 weeks).
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Bone union formation in the rat mandibular symphysis using hydroxyapatite with or without simvastatin: effects on healthy, diabetic, and osteoporotic rats
(Springer Heidelberg, 2020-01-11) Camacho Alonso, Fabio; Martínez Ortiz, C.; Plazas Buendía, L.; Mercado Díaz, A.M.; Vilaplana Vivo, C.; Merino, J.J:; Martínez Beneyto, Yolanda; Navarro Cámara, José Antonio; Buendía Marín, Antonio Julián; Dermatología, Estomatología, Radiología y Medicina Física
Objective The objective is to compare new bone formation in critical defects in healthy, diabetic, and osteoporotic rats filled with hydroxyapatite (HA) alone and HA combined with simvastatin (SV). Materials and methods A total of 48 adult female Sprague-Dawley rats were randomized into three groups (n = 16 per group): Group, 1 healthy; Group 2, diabetics; and Group 3, osteoporotics. Streptozotocin was used to induce type 1 diabetes in Group 2, while bilateral ovariectomy was used to induce osteoporosis in Group 3. The central portion of the rat mandibular symphysis was used as a physiological critical bone defect. In each group, eight defects were filled with HA alone and eightwithHA combined with SV. The animals were sacrificed at 4 and 8 weeks, and the mandibles were processed for micro-computed tomography to analyze radiological union and bone mineral density (BMD); histological analysis of the bone union; and immunohistochemical analysis, which included immunoreactivity of vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2). Results In all groups (healthy, diabetics, and osteoporotics), the defects filled with HA+ SV presented greater radiological bone union, BMD, histological bone union, and more VEGF and BMP-2 positivity, in comparison with bone defects treated with HA alone. Conclusions Combined application ofHAand SVimproves bone regeneration in mandibular critical bone defects compared with application of HA alone in healthy, diabetic, and osteoporotic rats. Clinical relevance This studymight help to patients with osteoporosis or uncontrolled diabetes type 1, but future studies should be done.
Open Access
Calycosin accelerates wound healing in diabetic rats by alleviating oxidative stress and promoting angiogenesis
(2026) Min Lu; Lifen Xue; Mi Zhou; Meifeng Zhang; Huifeng Zhu; Wei Lu; Biología Celular e Histología; Universidad de Murcia, Departamento de Biología Celular e Histología
Background. Angiogenesis is a physiological process of diabetic wound healing. Although calycosin has been reported to exert protective effects on diabetic nephropathy, its role and mechanisms in diabetic wound healing remain unclear. This study investigates the effects of calycosin on wound healing and angiogenesis, and the role of the Nrf2/HO-1 pathway in mitigating oxidative stress in diabetic rats. Methods. In vivo, type 2 diabetes (T2DM) in Sprague-Dawley (SD) rats was induced by a high-fat diet for six weeks combined with a single intraperitoneal injection of 45 mg/kg streptozotocin (STZ). The anesthetized diabetic rats underwent a full skin excision on the back and were then treated with calycosin for two weeks to evaluate the protective effect of calycosin on oxidative stress associated with the Nrf2/HO-1 pathway in diabetic wound rats. In vitro, damage to Human Umbilical Vein Vascular Endothelial Cells (HUVECs) was induced by high glucose, and then treated with calycosin or combined with Nrf2 agonist to evaluate whether calycosin affects cell activity and inhibits oxidative damage via the Nrf2/HO-1 pathway. Results. Our results indicate that calycosin promotes angiogenesis by activating the Nrf2/HO-1 signaling pathway and upregulating downstream antioxidant genes, thereby accelerating wound healing. In vitro studies have also shown that Nrf2/HO-1 signaling activation can enhance the promoting effect of calycosin on cell activity and the inhibitory effect on oxidative stress in HUVECs induced by high glucose. Conclusion. Our results show that calycosin can accelerate wound healing by promoting angiogenesis and inhibiting oxidative stress mediated by the Nrf2/HO 1 pathway, which provides a theoretical basis for the treatment of refractory diabetic wounds.
Open Access
Caracterización genética y molecular de los diferentes tipos de diabetes tipo MODY y su correlación genotipo-fenotipo
(Universidad de Murcia, 2025-03-05) Expósito García, Marta; Antonio Miguel Hernández Martínez; Ruiz Espejo, Francisco; Sarabia Meseguer, María Desamparados; Escuela Internacional de Doctorado
Las diabetes tipo MODY son un subgrupo heterogéneo de trastornos heredados de forma autosómica dominante y causados por alteraciones en distintos loci génicos. Es la forma más común de diabetes monogénica, suponiendo a escala global un porcentaje de un 1-5% de todas las diabetes diagnosticadas. Estos trastornos suelen debutar a una edad temprana (antes de los 25 años) con hiperglucemias que pueden ser desde asintomáticas o moderadas hasta graves. El fenotipo clínico depende del gen que se vea afectado en cada uno de los casos, habiéndose descrito hasta la fecha del estudio 14 genes implicados en el desarrollo de las diabetes MODY. Este estudio tiene como objetivo principal evaluar la utilidad clínica del análisis genético de los principales genes implicados en la diabetes tipo MODY en pacientes de la Región de Murcia. Se analizó el rendimiento diagnóstico y la utilidad de los criterios empleados, correlacionando las variantes identificadas con sus fenotipos clínicos y categorizándolas desde un punto de vista molecular y clínico. Asimismo, se reclasificaron y priorizaron las variantes de significado clínico desconocido (VUS) mediante algoritmos específicos, y se realizó un análisis de haplotipos en familias con variantes patogénicas recurrentes y así estudiar las variantes con efecto fundador. Se incluyeron pacientes y familias seleccionados según criterios clínicos de sospecha de MODY, como historia familiar y debut temprano de hiperglucemia. Las muestras de ADN se analizaron mediante secuenciación masiva del exoma y se confirmaron las variantes puntuales por metodología Sanger y los grandes reordenamientos por MLPA. Los genes de estudio fueron: ABCC8, APPL1, BLK, CEL, GCK, HNF1A, HNF1B, HNF4A, INS, KCNJ11, KLF11, NEUROD1, PAX4 y PDX1. Las variantes genéticas identificadas se clasificaron según el punto de vista molecular y clínico según recomendaciones de la ACMG. Las variantes de significado clínico desconocido (VUS) fueron reevaluadas y priorizadas mediante herramientas bioinformáticas y algoritmos de priorización. Para el estudio del efecto fundador, se realizó el estudio de microsatélites en variantes recurrentes. El estudio genético se llevó a cabo en 150 familias de la Región de Murcia, de las cuales 25 (16,67%) tenían una variante patogénica (VP) o probablemente patogénica (VPP) y 21 (14%) tenían una VUS. Los resultados mostraron que las mutaciones en GCK (38,89%) y HNF1A (33,33%), representaron la mayoría de los casos, seguidas de HNF4A (11,11%) y CEL, INS y HNF1B (5,56% cada uno). Se observaron diferencias estadísticamente significativas entre pacientes con y sin diabetes MODY cuando se estudiaron los antecedentes familiares, la edad de desarrollo de la diabetes y el índice de masa corporal. La calculadora de probabilidad EXETER es una herramienta útil si se usa junto con otros parámetros, como criterio de inclusión para el estudio genético. El análisis de haplotipo de la variante c.1072C>T en el gen GCK, presente en tres familias no emparentadas, estimó que la variante apareció hace 380 años aproximadamente en la Región de Murcia. Asimismo, el análisis de las VUS permitió reclasificar una VUS a VPP y se priorizaron 5 VUS. Este estudio subraya la importancia de la caracterización genética y molecular para el correcto diagnóstico de la diabetes tipo MODY, mejorando la precisión diagnóstica y permitiendo terapias personalizadas. El descubrimiento de un posible efecto fundador resalta la influencia de los factores geográficos y demográficos en la distribución genética de la enfermedad. La priorización y reclasificación de las VUS, mediante enfoques integrados, constituye un avance significativo para interpretar su impacto clínico
Open Access
Cardiac ischemia and reperfusion in spontaneously diabetic rats with and without application of EGb 761, I. cardiomyocytes
(Murcia : F. Hernández, 2008) Schneider, Rick; Welt, Klaus; Aust, Wolfram; Löster, Heinz; Fitzl, Günther
Diabetic cardiomyopathy is known to result in increased mortality after ischemic events. Permanently increased oxidative stress with formation of oxygen-free radicals plays a key role in the development of specific heart muscle disease. Associated lesions include structural alterations to cardiomyocytes. Antioxidative treatment in addition to the usual insulin substitution would seem sensible in preventing or delaying long-term diabetic complications and protecting the myocardium against acute ischemic events. We investigated the effects of radical scavenger Ginkgo biloba extract EGb 761 against diabetes-induced damage to cardiomyocytes and additional ischemia/ reperfusion injury in spontaneously diabetic BioBreeding/Ottawa Karlsburg (BB/OK) rats, as a model of diabetic myocardium infarction. Morphological and morphometric parameters of heart muscles were analyzed by light and electron-microscopic techniques. We used immunohistochemistry to evaluate parameters of oxidative stress (superoxide dismutase [SOD]) and inducible nitric oxide synthase (iNOS) protein expression. Our results indicated that A) Diabetic myocardium appears more vulnerable to ischemia/ reperfusion damage concerning ultrastructure of cardiomyocytes (sarcomeres, vacuoles, mitochondria), expression of antioxidative enzymes (CuZnSOD, MnSOD), and iNOS than normal myocardium; B) Pretreatment of diabetic myocardium with EGb and additional ischemia/reperfusion leads to a relative improvement in myocardial ultrastructure compared to unprotected myocardium. In summary, EGb appears to be promising as an adjuvant therapeutic drug in diabetics with respect to ischemic myocardium injury. It may contribute to the prevention of late diabetic complications in diabetic cardiomyopathy.
Open Access
Cardiac ischemia and reperfusion in spontaneously diabetic rats with and without application of EGb 761: II. Interstitium and microvasculature
(Murcia : F. Hernández, 2009) Schneider, Rick; Welt, Klaus; Aust, Wolfram; Löster, Heinz; Fitzl, Günther
Besides alterations in cardiomyocytes themselves, diabetic cardiopathy is characterized by interstitial and microvascular disorders. On the assumption that a specific heart muscle disease develops due to permanently increased oxidative stress on liberation of oxygen-free radicals, adjuvant application of antioxidative therapeutics appears promising in preventing or delaying long-term diabetic complications and protecting the myocardium against acute ischemia. We have investigated the effects of Ginkgo biloba extract (EGb 761), a radical scavenger, against diabetesinduced myocardial interstitium and microvasculature damage, and against additional ischemia/reperfusion injury in spontaneously diabetic BioBreeding/Ottawa Karlsburg (BB/OK) rats modelling diabetic cardiac infarction. Morphological and morphometric parameters in the heart muscle were evaluated by light and electron microscope. We used immunohistochemistry to investigate collagen protein expression as a marker for tissue remodelling together with endothelial nitric oxide synthase (eNOS) protein expression as a marker for endothelial-dependent vasodilation. We also evaluated inflammation response caused by neuropeptide Substance P and interacting mast cells in the diabetic heart. Our results revealed that A) Diabetic myocardium appears more vulnerable to ischemia/reperfusion injury than normal myocardium with regard to myocardial interstitium and microvessel ultrastructure, as well as eNOS protein expression; B) Inflammation response increases in diabetic animals exposed to ischemia/reperfusion injury compared to controls; C) Pre-treatment of diabetic myocardium with EGb results in an improvement of impaired endothelial-dependent vasodilation in diabetes and additional ischemia/ reperfusion, diminished mast cell and substance P accumulation, and better preserved myocardial ultrastructure compared to unprotected myocardium. In conclusion, EGb may act as a potent therapeutic adjuvant in diabetics with respect to ischemic myocardial injury, and may contribute to preventing late complications in diabetic cardiopathy.
Open Access
Cardiovascular autonomic neuropathy in spontaneously diabetic rats with and without application of EGb 761
(Murcia : F. Hernández, 2010) Schneider, Rick; Welt, Klaus; Aust, Wolfram; Kluge, Regina; Löster, Heinz; Fitzl, Günther
Cardiovascular autonomic neuropathy causes abnormalities in the diabetic heart with various clinical sequelae, including exercise intolerance, arrhythmias and painless myocardial infarction. Little is known about (ultra)structural alterations of the myocardial nervous network. On the assumption that this diabetes-specific neuropathy develops due to permanently increased oxidative stress by liberation of oxygen-free radicals, adjuvant application of antioxidative therapeutics appears promising in preventing or delaying long-term diabetic complications. We have investigated the effects of Ginkgo biloba extract (EGb 761), a radical scavenger, against diabetes-induced myocardial nervous damage in spontaneously diabetic BioBreeding/Ottawa Karlsburg (BB/OK) rats. Morphological and morphometric parameters were evaluated by electron microscopy. We used immunohistochemistry to investigate protein expression of protein gene product 9.5, S100 protein, and thyroxin hydroxylase as a neuronal marker. Alterations of cardiac sympathetic activity were measured using the in vivo 123I-metaiodobenzylguanidine imaging, and the immunofluorescent labeling of beta1-adrenergic receptors and adenylate cyclase. Our results revealed that A) Diabetes results in slight to moderate ultrastructural alterations (hydrops, disintegration of substructure) of autonomic nerve fibers and related Schwann cells in untreated BB diabetic rats; B) Cardiac sympathetic integrity and activity is impaired due to alterations in the presynaptic nerve terminals and the postsynaptic ß1-AR-AC coupling system; C) Pretreatment of diabetic myocardium with EGb results in an improvement of most of these parameters compared to unprotected myocardium. In conclusion, EGb may act as a potent therapeutic adjuvant in diabetics with respect to cardiovascular autonomic neuropathy, which may contribute to the prevention of late complications in diabetes.
Open Access
Cell cycle inhibitor p57 expression in normal and diabetic rat placentas during some stages of pregnancy
(F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología, 2012) Acar, Nuray; Turkay Korgun, Emin; Ustunel, Ismail
Placentomegaly, an abnormal increase in the size of the placenta, is commonly seen in human diabetic pregnancies and diabetic animal experimental models. Proper placental development depends on the proliferation and differentiation of trophoblasts. However, our knowledge about the mitotic regulators that play key roles in synchronizing these events is limited. p57 is a cyclin-dependent kinase (CDK) inhibitor acting in the G1/S transition of the cell cycle. There is no data regarding p57 expression in either rat or human diabetic placentas. The purpose of this study was to investigate p57 expression in control and diabetic rat placentas at different stages of pregnancy. Diabetes was induced by streptozotocin on the first day of pregnancy, and placentas were taken on days 11, 13, 17, and 21 of pregnancy. Our results showed that on day 11, p57 immunostaining intensity was stronger in control group placentas compared to the diabetic group. On day 13, p57 immunostaining intensity increased in both groups, but increased more in the diabetic group. On day 17, p57 immunostaining intensity decreased in both the control and diabetic groups compared to day 13, yet the intensity remained higher in control placentas compared to diabetic placentas. On day 21 of pregnancy, p57 immunostaining intensity increased in the control group and it decreased from the day 17 level in the diabetic group. Western blot results showed consistency with immunohistochemistry results. Our study shows different expression patterns of p57 between control and diabetic rat placentas, which indicate p57 may play a role in abnormal placental formation resulting in placentomegaly arising from diabetes
Open Access
Changes of calcium/calmodulin-dependent protein kinase II expression in dorsal root ganglia during maturation in long-term diabetes
(F. Hernández y Juan F. Madrid. Universidad de Murcia: Departamento de Biología Celular e Histología, 2014) Ferhatovic, Lejla; Jelicic Kadic, Antonia; Boric, Matija; Puljak, Livia
Calcium/calmodulin-dependent protein kinase II (CaMKII) is considered one of the key intracellular signaling proteins for development of neuropathy. We analyzed the expression of total CaMKII (tCaMKII) and its alpha, beta, gamma and delta isoforms in dorsal root ganglia (DRG) in a rat model of Diabetes mellitus type I (DM1), 6 months and 1 year after diabetes induction. Diabetes was induced with streptozotocin and confirmed by measuring glucose levels and weight increase. Immunohistochemistry was performed for detection of tCaMKII and its isoforms in L4 and L5 DRGs. A significant decrease of CaMKII alpha and beta isoforms was noted 6 months after diabetes induction, while CaMKII gamma and delta were significantly decreased after 12 months in diabetic rats compared to controls. Analysis of neuronal subgroups based on the neuronal diameter revealed that the expression of alpha, beta and delta isoforms decreased only in small-diameter neurons. In conclusion, a significant decrease of specific CaMKII isoforms in small-diameter DRG neurons may suggest involvement of CaMKII alpha, beta and delta in the development of complex events responsible for the development of neuropathy in long-term diabetes during maturation. CaMKII is a part of the neuronal pathway that regulates the firing properties of excitable cells, especially neurons, and decreased CaMKII activity may be responsible for generation of aberrant signals, hyperalgesia and neuropathic pain.
Open Access
Characteristics of lymphatic endothelial cells in physiological and pathological conditions
(Murcia : F. Hernández, 2005) Ji, R.C.
Impairment of lymphatic structure and function, e.g., inadequate endothelial permeability and intercellular openings, abnormal lymphangiogenesis and overexpression for immunoreactive agents, will result in tumor metastasis, autoimmune response alteration and accumulation of interstitial fluid and proteins. Recently, several novel molecules have been identified that allow a more precise distinction between lymphatic and blood vascular endothelium. The differences in expression of endothelial markers on the lymphatic vessel strongly suggest the possibility that there will be important divergence in the differentiating and regenerating responses in lymphatic behavior to various pathological processes. Undoubtfully, molecular techniques would also lead to the definition of unique markers found on lymphatic endothelial cells (LECs) in lymphaticassociated diseases which are mostly involved in lymphangiogenesis. This review is mainly concentrated on the characteristics of LECs in diabetes, wound healing, lymphedema and tumor, especially in the experimental models that have offered insight into the LEC role in these diseases affecting the lymphatic system. Increased knowledge of the molecular signaling pathways driving lymphatic development and lymphangiogenesis should boost the impact of therapeutics on the diseases. Although the field about the mechanisms that control the formation and lineagespecific differentiation and function of lymphatic vessels has experienced rapid progress in the past few years, an understanding of the basis of the differences and their implications in the pathological conditions will require much more investigation.