Background It has been demonstrated that activated islet stellate cells (ISCs) play a critical role in islet fibrogenesis and significantly contribute to the progression of type 2 diabetes mellitus. However, the key molecules responsible for ISCs activation have not yet been determined. This study aimed to identify the potential key genes involved in diabetes-induced activation of ISCs. Method Stellate cells were isolated from three 10-week-old healthy male Wistar rats and three Goto-Kakizaki (GK) rats. Cells from each rat were primary cultured under the same condition. A Genome-wide transcriptional sequence of stellate cells was generated using the Hiseq3000 platform. The identified differentially expressed genes were validated using quantitative real-time PCR and western blotting in GK rats, high fat diet (HFD) rats, and their controls. Results A total of 204 differentially expressed genes (DEGs) between GK. ISCs and Wistar ISCs (W.ISCs) were identified, accounting for 0.58% of all the 35,362 genes detected. After the Gene Ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses, the mRNA levels of these genes were further confirmed by real-time PCR in cultured ISCs. We then selected Fos , Pdpn , Bad as the potential key genes for diabetes-induced activation of ISCs. Finally, we confirmed the protein expression levels of FOS, podoplanin, and Bad by western blotting and immunofluorescence in GK rats, HFD rats, and their controls. The results showed that the expression level of FOS was significantly decreased, while podoplanin and Bad were significantly increased in GK.ISCs and HFD rats compared with controls, which were consistent with the expression of α-smooth muscle actin. Conclusions A total of 204 DEGs were found between the GK.ISCs and W.ISCs. After validating the expression of potential key genes from GK rats and HFD rats, Fos , Pdpn , and Bad might be potential key genes involved in diabetes-induced activation of ISCs.
Vigorous to maximal aerobic interval training (INT) has received remarkable interest in improving cardiometabolic outcomes for type 2 diabetes patients recently, yet with inconsistent findings. This meta-analysis was aimed to quantify its effectiveness in type 2 diabetes. Randomized controlled trials (RCTs) were identified by searches of 3 databases to October 2017, which evaluated the effects of INT with a minimal training duration of 8 weeks vs. moderate-intensity continuous training (MICT) or non-exercise training (NET) among type 2 diabetes patients on outcomes including cardiorespiratory fitness, glycemic control, body composition, blood pressure, and lipid profiles. Weighted mean differences with 95% confidence intervals (CIs) were calculated with the random-effects model. Nine datasets from 7 RCTs with 189 patients were included. Compared with MICT, INT improved maximal oxygen consumption (VO2max) by 2.60 ml/kg/min (95% CI: 1.32 to 3.88 ml/kg/min, P <0.001) and decreased hemoglobin A1c (HbA1c) by 0.26% (95% CI: -0.46% to -0.07%, P = 0.008). These outcomes for INT were also significant vs. energy expenditure-matched MICT, with VO2max increased by 2.18 ml/kg/min (P = 0.04) and HbA1c decreased by 0.28% (P = 0.01). Yet their magnitudes of changes were larger compared with NET, with VO2max increased by 6.38 ml/kg/min (P <0.001) and HbA1c reduced by 0.83% (P = 0.004). Systolic blood pressure could be lowered by INT compared with energy expenditure-matched MICT or NET (both P <0.05), but other cardiometabolic markers and body composition were not significantly altered in general. In conclusion, despite a limited number of studies, INT improves cardiometabolic health especially for VO2max and HbA1c among patients with type 2 diabetes, and might be considered an alternative to MICT. Yet the optimal training protocols still require to be established.
Although step counters are increasingly being used in walking programmes to promote sedentary behavior changes in adults, their effectiveness remains unknown. The aim of this meta-analysis of randomized controlled trials (RCTs) was to assess the effectiveness of step counter use in reducing sedentary time among adults. English-language RCTs from 3 databases were searched up to December 2014. Studies were included if they evaluated the effects of step counter use in adult populations and reported outcomes in sedentary time. Summary estimates (Cohen d with 95% confidence intervals [CIs]) were pooled using a random-effects model. Subgroup analyses and random-effects meta-regression analyses based on the characteristics of participants or interventions were conducted to explore their associations with sedentary time changes. Fifteen RCTs with a total sample size of 3262 adults were included. Step counter use was associated with a small but significant overall effect in reducing sedentary time (d = −0.20, 95% CI −0.33 to −0.07), equating to a reduction in sedentary time of ∼23 min/d compared with controls. Subgroup analyses showed that step counter use with a step goal was associated with significantly reduced sedentary time (d =− 0.32, 95% CI −0.53 to −0.11), whereas without, it had only a trend. A greater reduction in sedentary time was observed among step counter users employing objective methods than those employing subjective methods for measurement (P = 0.03). Effects of covariates on sedentary time changes were generally unclear. Step counter use is associated with reduced sedentary time among adults. Future studies are required to specify the step goal use and to employ objective as well as subjective methods for measuring both total and domain-specific sedentary time.
BACKGROUND Dyslipidaemia is a potential independent risk factor for cerebrovascular disease in patients with diabetes. The aim of this study was to investigate dyslipidaemia, treatment and control of dyslipidaemia among diabetic patients with ischemic stroke in a Chinese hospital. METHODS A total of 1046 type 2 diabetic patients were assigned to diabetes with (n = 522) and diabetes without stroke groups. The two groups were matched by gender, age and diabetes duration. Lipid and lipoprotein profile were measured. Serum level and control of lipids were assessed and classified according to American Diabetes Association (ADA) guidelines and an intensified low density lipoprotein-cholesterol (LDL-C) target recommended in Chinese dyslipidaemia control criteria. RESULTS Diabetic patients suffering stroke displayed not only poorly-controlled lipid and lipoprotein profiles, including the significantly lower proportion of patients achieving intensified LDL-C target of < 2.07 mmol/L (80 mg/dl), and high density lipoprotein-cholesterol (HDL-C) target (14.4% vs 21.0%, P = 0.005; 45.8% vs 51.9%, P = 0.048 respectively), but also less adherence to therapy prescribed for dyslipidaemia (30.8% vs 41.0%, P = 0.001), when compared with diabetic patients without stroke. For the diabetic women with stroke, situation of dyslipidaemia was worse, with significantly lower serum level of HDL-C and apoA1, higher LDL-C level and higher ratio of apoB/apoA1 when compared with diabetic counterparts without stroke. CONCLUSIONS Many diabetic patients with ischemic stroke remain uncontrolled for dyslipidaemia. Intensified LDL-C and overall lipid lowering clinical goals are potential precautions taken against ischemic stroke among diabetic patients in China.
Objective
To investigate the correlation of different levels of exercise on metabolic control and chronic complications in patients with type 2 diabetes in China.
Methods
A total of 5 961 patients with type 2 diabetes were selected from 50 representative centers across China for this survey during April to July in 2010. Patients were divided into three groups according their compliance to exercise: full (2 096), partial (2 398) and poor (1 466) compliance. Analysis of variance and Chi-square test were used to test the differences of measurement data and counts data among the three groups, respectively, and Logistic regression models was used to analyze the interdependency between exercise and patients with hypoglycemia.
Results
Fasting blood glucose, 2 h postprandial blood glucose, HbA1c, total cholesterol, triglycerides, body mass index, systolic blood pressure, diastolic blood pressure of patients in the full compliance group were significantly lower than those of partial and poor compliance group (numerical comparison are as follows (7.7±2.8) vs (8.2±2.9) vs (8.6±3.5) mmol/L, (10.8±4.2) vs (11.7±4.4) vs 12.2±4.8) mmol/L, HbA1c (8.0±2.1) vs (8.3±2.2) vs (8.7±2.3) %, (4.8±1.3) vs (4.9±1.5) vs (4.8±1.4) mmol/L, (1.9±1.6) vs (2.1±1.7) vs (2.3±2.0) mmol/L, (24.1±3.7) vs (24.6±4.0) vs (24.8±4.7) kg/m2, (129±16) vs (130±17) vs (132±18) mmHg, (78±10) vs (79± 10) vs (80± 11) mmHg, 1 mmHg=0.133 kPa, F=3.658-37.799, P<0.05) . The morbidity of diabetic peripheral vascular disease, diabetic nephropathy, diabetic peripheral neuropathy, diabetic retinopathy and diabetic foot of patients in the full compliance group were less than poor compliance group (numerical comparison are as follows (12.51% vs 15.96%) , (12.56% vs 18.69%) , (24.50% vs 29.33%) , (28.84% vs 33.63%) , (4.11% vs 9.14%) , χ2=8.580, 25.547, 10.715, 9.629, 47.724, P<0.05) .
Conclusions
Patients with regular exercise has better glycemic control, blood pressure, lipid and body mass index. Furthermore, the prevalence of diabetic complications is lower.
Key words:
Diabetes mellitus, type 2; Exercise; Metabolic indicators; Complications
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