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BACKGROUND: This study aimed to synthesize and quantitatively examine Health State Utility Values (HSUVs) for Type 2 Diabetes Mellitus (T2DM) and its complications, providing a robust meta-regression framework for selecting appropriate HSUV estimates. METHOD: We conducted a systematic review to extract HSUVs for T2DM and its complications, encompassing various influencing factors. Relevant literature was sourced from a review spanning 2000-2020, supplemented by literature from PubMed, Embase, and the Web of Science (up to March 2024). Multivariate meta-regression was performed to evaluate the impact of measurement tools, tariffs, health status, and clinical and demographic variables on HSUVs. RESULTS: Our search yielded 118 studies, contributing 1044 HSUVs. The HSUVs for T2DM with complications varied, from 0.65 for cerebrovascular disease to 0.77 for neuropathy. The EQ-5D-3L emerged as the most frequently employed valuation method. HSUV differences across instruments were observed; 15-D had the highest (0.89), while HUI-3 had the lowest (0.70) values. Regression analysis elucidated the significant effects of instrument and tariff choice on HSUVs. Complication-related utility decrement, especially in diabetic foot, was quantified. Age <70 was linked to increased HSUVs, while longer illness duration, hypertension, overweight and obesity correlated with reduced HSUVs. CONCLUSION: Accurate HSUVs are vital for the optimization of T2DM management strategies. This study provided a comprehensive data pool for HSUVs selection, and quantified the influence of various factors on HSUVs, informing analysts and policymakers in understanding the utility variations associated with T2DM and its complications.
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Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/complicaciones , Estado de Salud , Calidad de Vida , Complicaciones de la Diabetes/psicología , Años de Vida Ajustados por Calidad de Vida , Análisis de RegresiónRESUMEN
Diabetic wounds pose a significant challenge in modern healthcare due to their chronic and complex nature, often resulting in delayed healing, infections, and, in severe cases, amputations. In recent years, nanotherapeutic approaches have emerged as promising strategies to address the unique pathophysiological characteristics of diabetic wounds. This review paper provides a comprehensive overview of the latest advancements in nanotherapeutics for diabetic wound treatment. We discuss various nanomaterials and delivery systems employed in these emerging therapies. Furthermore, we explore the integration of biomaterials to enhance the efficacy of nanotherapeutic interventions. By examining the current state-of-the-art research, challenges, and prospects, this review aims to offer valuable insights for researchers, clinicians, and healthcare professionals working in the field of diabetic wound care.
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Cicatrización de Heridas , Humanos , Cicatrización de Heridas/efectos de los fármacos , Nanomedicina , Animales , Sistemas de Liberación de Medicamentos/métodos , Materiales Biocompatibles/química , Materiales Biocompatibles/farmacología , Nanoestructuras/química , Nanoestructuras/uso terapéutico , Diabetes Mellitus/terapia , Diabetes Mellitus/tratamiento farmacológico , Complicaciones de la Diabetes/terapiaRESUMEN
Diabetes mellitus is a complex chronic disease, considered as one of the most common metabolic disorders worldwide, posing a major threat to global public health. Ferroptosis emerges as a novel mechanism of programmed cell death, distinct from apoptosis, necrosis, and autophagy, driven by iron-dependent lipid peroxidation accumulation and GPx4 downregulation. A mounting body of evidence highlights the interconnection between iron metabolism, ferroptosis, and diabetes pathogenesis, encompassing complications like diabetic nephropathy, cardiomyopathy, and neuropathy. Moreover, ferroptosis inhibitors hold promise as potential pharmacological targets for mitigating diabetes-related complications. A better understanding of the role of ferroptosis in diabetes may lead to an improvement in global diabetes management. In this review, we delve into the intricate relationship between ferroptosis and diabetes development, exploring associated complications and current pharmacological treatments.
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Diabetes Mellitus , Ferroptosis , Hierro , Ferroptosis/fisiología , Humanos , Hierro/metabolismo , Animales , Diabetes Mellitus/metabolismo , Complicaciones de la Diabetes/metabolismo , Peroxidación de LípidoRESUMEN
Background: Mitochondrial dysfunction plays a crucial role in Type 2 Diabetes Mellitus (T2DM) and its complications. However, the genetic pathophysiology remains under investigation. Through multi-omics Mendelian Randomization (MR) and colocalization analyses, we identified mitochondrial-related genes causally linked with T2DM and its complications. Methods: Summary-level quantitative trait loci data at methylation, RNA, and protein levels were retrieved from European cohort studies. GWAS summary statistics for T2DM and its complications were collected from the DIAGRAM and FinnGen consortiums, respectively. Summary-data-based MR was utilized to estimate the causal effects. The heterogeneity in dependent instrument test assessed horizontal pleiotropy, while colocalization analysis determined whether genes and diseases share the same causal variant. Enrichment analysis, drug target analysis, and phenome-wide MR were conducted to further explore the biological functions, potential drugs, and causal associations with other diseases. Results: Integrating evidence from multi-omics, we identified 18 causal mitochondrial-related genes. Enrichment analysis revealed they were not only related to nutrient metabolisms but also to the processes like mitophagy, autophagy, and apoptosis. Among these genes, Tu translation elongation factor mitochondrial (TUFM), 3-hydroxyisobutyryl-CoA hydrolase (HIBCH), and iron-sulfur cluster assembly 2 (ISCA2) were identified as Tier 1 genes, showing causal links with T2DM and strong colocalization evidence. TUFM and ISCA2 were causally associated with an increased risk of T2DM, while HIBCH showed an inverse causal relationship. The causal associations and colocalization effects for TUFM and HIBCH were validated in specific tissues. TUFM was also found to be a risk factor for microvascular complications in T2DM patients including retinopathy, nephropathy, and neuropathy. Furthermore, drug target analysis and phenome-wide MR underscored their significance as potential therapeutic targets. Conclusions: This study identified 18 mitochondrial-related genes causally associated with T2DM at multi-omics levels, enhancing the understanding of mitochondrial dysfunction in T2DM and its complications. TUFM, HIBCH, and ISCA2 emerge as potential therapeutic targets for T2DM and its complications.
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Diabetes Mellitus Tipo 2 , Análisis de la Aleatorización Mendeliana , Mitocondrias , Humanos , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/complicaciones , Mitocondrias/metabolismo , Mitocondrias/genética , Estudio de Asociación del Genoma Completo , Sitios de Carácter Cuantitativo , Predisposición Genética a la Enfermedad , Complicaciones de la Diabetes/genética , MultiómicaRESUMEN
Objective: To study the impact of diabetes on bronchiectasis. Methods: From January 1 2017 to December 31 2021, data of 1 310 inpatients with bronchiectasis were retrospectively collected from Shanghai Pulmonary Hospital, Tongji University. This cohort inclueded 78 patients with bronchiectasis and diabetes (bronchiectasis-diabetes group) and 1 232 patients of bronchiectasis without diabetes (simple bronchiectasis group). To mitigate confounding variables, 269 patients with bronchiectasis but without diabetes (bronchiectasis non-diabetes group) were matched with 78 patients of bronchiectasis with diabetes (bronchiectasis-diabetes group) using the propensity score method in a 1â¶4 ratio. A comparative analysis of clinical characteristics, laboratory test results, pathogenic infections, and disease severity was performed between the two groups. Analysis of continuous variables was performed using either a t-test or non-parametric test, while categorical data was assessed using the chi-square test. Results: The mean age of individuals in the bronchiectasis-diabetes group (62.99±8.09 years) was significantly higher than that of subjects in the simple bronchiectasis group (57.05±13.07 years) (t=-6.012, P<0.001). After propensity score matching, the pre-albumin level in the bronchiectasis-diabetes group (188.44±71.65 g/L) was found to be lower than in the bronchiectasis non-diabetes group (208.17±62.50 g/L) (t=2.023, P=0.044). In addition, the hospitalization cost for the bronchiectasis-diabetes group [1.59 (1.34, 2.15) Ten thousand yuan] was higher than that in the bronchiectasis non-diabetes group [1.39 (1.23, 1.62) Ten thousand yuan] (U=-3.744, P<0.001).The severity of mMRC in the bronchiectasis-diabetes group was significantly higher than that in the bronchiectasis non-diabetes group (χ2=25.392, P<0.001), and the frequency of previous hospitalization due to aggravation and acute exacerbation within the previous year were higher than in bronchiectasis non-diabetes group (χ2=34.031, 40.841, respectively, P<0.001). In additional, the BSI score was significantly increased in patients with bronchiectasis-diabetes compared to those with bronchiectasis non-diabetes (8.07±4.07 vs. 10.44±3.82) (P<0.001). Furthermore, fasting blood glucose concentration, urine glucose level, and BSI score exhibited positive correlations, whereas pre-albumin concentration showed a negative correlation with the BSI score (all P<0.05). Conclusion: Compared to those without diabetes, patients of bronchiectasis with diabetes have poorer nutritional status, more severe symptoms, increased risk of acute exacerbation, higher BSI score severity, and greater financial burden.
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Bronquiectasia , Humanos , Bronquiectasia/etiología , Bronquiectasia/fisiopatología , Persona de Mediana Edad , Femenino , Masculino , Diabetes Mellitus , Anciano , Puntaje de Propensión , Complicaciones de la Diabetes , Factores de RiesgoRESUMEN
BACKGROUND: Diabetes mellitus has emerged as a pressing global concern, with a notable increase in recent years. Despite advancements in treatment, existing medications struggle to halt the progression of diabetes and its associated complications. Increasing evidence underscores inflammation as a significant driver in the onset of diabetes mellitus. Therefore, perspectives on new therapies must consider shifting focus from metabolic stress to inflammation. High mobility group box (HMGB-1), a nuclear protein regulating gene expression, gained attention as an endogenous danger signal capable of sparking inflammatory responses upon release into the extracellular environment in the late 1990s. PURPOSE: Given the parallels between inflammatory responses and type 2 diabetes (T2D) development, this review paper explores HMGB-1's potential involvement in onset and progression of diabetes complications. Specifically, we will review and update the understanding of HMGB-1 and its inflammatory pathways in insulin resistance, diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy. CONCLUSIONS: HMGB-1 and its receptors i.e. receptor for advanced glycation end-products (RAGE) and toll-like receptors (TLRs) present promising targets for antidiabetic interventions. Ongoing and future projects in this realm hold promise for innovative approaches targeting HMGB-1-mediated inflammation to ameliorate diabetes and its complications.
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Proteína HMGB1 , Hipoglucemiantes , Receptor para Productos Finales de Glicación Avanzada , Transducción de Señal , Humanos , Proteína HMGB1/metabolismo , Proteína HMGB1/antagonistas & inhibidores , Animales , Receptor para Productos Finales de Glicación Avanzada/metabolismo , Receptor para Productos Finales de Glicación Avanzada/antagonistas & inhibidores , Hipoglucemiantes/uso terapéutico , Mediadores de Inflamación/metabolismo , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/metabolismo , Antiinflamatorios/uso terapéutico , Terapia Molecular Dirigida , Nefropatías Diabéticas/metabolismo , Nefropatías Diabéticas/tratamiento farmacológico , Resistencia a la Insulina , Receptores Toll-Like/metabolismo , Retinopatía Diabética/metabolismo , Retinopatía Diabética/tratamiento farmacológico , Retinopatía Diabética/etiología , Retinopatía Diabética/prevención & control , Neuropatías Diabéticas/metabolismo , Neuropatías Diabéticas/etiología , Neuropatías Diabéticas/tratamiento farmacológico , Complicaciones de la Diabetes/metabolismo , Complicaciones de la Diabetes/tratamiento farmacológicoRESUMEN
OBJECTIVE: To evaluate the frequency of cachexia and its associated factors using the Asian Working Group for Cachexia (AWGC) criteria in elderly patients with diabetes and chronic diseases. METHODS: The subjects were diabetic outpatients of ≥65 years of age who were managed at Ise Red Cross Hospital. Patients with chronic disease (chronic heart failure, cancer, or chronic renal failure). Cachexia was evaluated based on the AWGC criteria and was defined as a body mass index (BMI) <21 kg/m2 and one or more of the following: anorexia, elevated C-reactive protein, and decreased grip strength. A logistic regression analysis was used to identify cachexia-related factors, with cachexia as the dependent variable, and various variables (basic attributes, blood glucose-related parameters, diabetic complications, comorbidities, and treatment) as explanatory variables. RESULTS: Two hundred forty-two patients (male, n=164; female, n=78) were included in the study. Forty patients (16.5%) had cachexia. A logistic analysis revealed that age (odds ratio (OR), 1.16; P<0.001), type 1 diabetes (OR, 15.25; P=0.002), diabetic retinopathy (OR, 5.72; P=0.001), and physical frailty (OR, 7.06; P<0.001) were associated with cachexia. CONCLUSION: Elderly diabetics with chronic diseases were more likely to have cachexia. According to the AWGC criteria, the frequency of cachexia was 16.5% in elderly patients with diabetes and chronic diseases. Additionally, type 1 diabetes, diabetic retinopathy, age, and physical frailty were identified as factors associated with cachexia. In elderly diabetes patients with chronic diseases, it is therefore important to raise awareness regarding cachexia when these related factors are diagnosed.
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Caquexia , Humanos , Caquexia/diagnóstico , Caquexia/etiología , Anciano , Masculino , Femenino , Enfermedad Crónica , Anciano de 80 o más Años , Diabetes Mellitus , Complicaciones de la DiabetesRESUMEN
Advanced glycation end products (AGEs) are a diverse range of compounds that are formed when free amino groups of proteins, lipids, and nucleic acids are carbonylated by reactive carbonyl species or glycosylated by reducing sugars. Hyperglycemia in patients with diabetes can cause an overabundance of AGEs. Excess AGEs are generally acknowledged as major contributing factors to the development of diabetic complications because of their ability to break down the extracellular matrix directly and initiate intracellular signaling pathways by binding to the receptor for advanced glycation end products (RAGE). Inflammation and oxidative stress are the two most well-defined pathophysiological states induced by the AGE-RAGE interaction. In addition to oxidative stress, AGEs can also inhibit antioxidative systems and disturb iron homeostasis, all of which may induce ferroptosis. Ferroptosis is a newly identified contributor to diabetic complications. This review outlines the formation of AGEs in individuals with diabetes, explores the oxidative damage resulting from downstream reactions of the AGE-RAGE axis, and proposes a novel connection between AGEs and the ferroptosis pathway. This study introduces the concept of a vicious cycle involving AGEs, oxidative stress, and ferroptosis in the development of diabetic complications.
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Complicaciones de la Diabetes , Ferroptosis , Productos Finales de Glicación Avanzada , Estrés Oxidativo , Especies Reactivas de Oxígeno , Receptor para Productos Finales de Glicación Avanzada , Humanos , Productos Finales de Glicación Avanzada/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Complicaciones de la Diabetes/metabolismo , Animales , Receptor para Productos Finales de Glicación Avanzada/metabolismo , Transducción de SeñalRESUMEN
Periodontitis and diabetes mellitus exhibit a bidirectional relationship. This narrative review descriptively outlines the role of chlorhexidine in the periodontal treatment of diabetic patients, focusing on its antimicrobial mechanisms against microbial communities and its antiplaque effects. Although chlorhexidine is proven to be effective in combating microbial presence and improving gingivitis with substantial supporting evidence, its impact on glycemic control and insulin resistance in diabetic patients remains contentious. Additionally, the effectiveness of chlorhexidine as an adjunctive chemotherapeutic in the periodontal treatment of gestational diabetes has not yet been studied, highlighting a gap in research that necessitates further prospective studies and randomized controlled trials. Considering the interconnection between periodontal inflammation and glycemic levels, this article finally advocates for collaborative care between dental and medical professionals to manage periodontitis in diabetic patients effectively.
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Antiinfecciosos Locales , Clorhexidina , Periodontitis , Humanos , Clorhexidina/uso terapéutico , Clorhexidina/administración & dosificación , Periodontitis/tratamiento farmacológico , Periodontitis/complicaciones , Antiinfecciosos Locales/uso terapéutico , Antiinfecciosos Locales/administración & dosificación , Complicaciones de la Diabetes/tratamiento farmacológico , Diabetes Mellitus/tratamiento farmacológicoRESUMEN
OBJECTIVES: To determine whether tooth loss affects all-cause and cause-specific mortality in a nationally representative sample of adults with diabetes mellitus (DM) in the United States. METHODS: This prospective cohort study involved 8207 participants aged 30 years or older at baseline, all diagnosed with diabetes mellitus and enrolled in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Tooth loss was stratified into 28 teeth (complete), 20-27 teeth (tooth loss), 9-19 teeth (lacking functional), 1-8 teeth (severe tooth loss) and edentulism. To estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for all-cause and specific-cause mortality in diabetes mellitus participants according to tooth loss, multivariate cox proportional hazards regression models were used. Relationships between mortality and quartiles of mean tooth loss levels were analyzed, with the lowest quartile as the baseline for comparisons. RESULTS: During a median of 6.92 years of follow-up, 2317 deaths were documented. After multivariate adjustments, higher tooth loss levels were significantly and non-linearly associated with higher risks of all-cause, CVD-related and DM-related mortality among participants with DM. When compared with the reference group of mean tooth loss levels, the highest quartile showed significantly increased risks: all-cause mortality (HR, 2.11; 95 % CI, 1.53-2.91, P-trend < 0.001), CVD-related mortality (HR, 3.24, 95 % CI, 1.54-6.85, P-trend < 0.001) and DM-related mortality (HR, 2.78, 95 % CI, 1.15-6.68, P-trend < 0.001). CONCLUSIONS: Tooth loss is associated with an increased risk of all-cause, CVD-related and diabetes mellitus mortality among adults with diabetes mellitus in the US. CLINICAL SIGNIFICANCE: This study presents evidence for physicians and dentists that higher tooth loss was significantly associated with increased risk of all-cause, CVD-related and diabetes mellitus mortality in a dose-response manner among adults with diabetes mellitus. Therefore, assessment of survival in individuals with diabetes mellitus could pay attention to the tooth loss.
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Causas de Muerte , Diabetes Mellitus , Encuestas Nutricionales , Pérdida de Diente , Humanos , Pérdida de Diente/complicaciones , Masculino , Femenino , Estados Unidos/epidemiología , Persona de Mediana Edad , Estudios Prospectivos , Adulto , Diabetes Mellitus/mortalidad , Factores de Riesgo , Anciano , Modelos de Riesgos Proporcionales , Enfermedades Cardiovasculares/mortalidad , Enfermedades Cardiovasculares/complicaciones , Complicaciones de la Diabetes/complicacionesRESUMEN
Diabetic encephalopathy (DE), a significant micro-complication of diabetes, manifests as neurochemical, structural, behavioral, and cognitive alterations. This condition is especially dangerous for the elderly because aging raises the risk of neurodegenerative disorders and cognitive impairment, both of which can be made worse by diabetes. Despite its severity, diagnosis of this disease is challenging, and there is a paucity of information on its pathogenesis. The pivotal roles of various cellular pathways, activated or influenced by hyperglycemia, insulin sensitivity, amyloid accumulation, tau hyperphosphorylation, brain vasculopathy, neuroinflammation, and oxidative stress, are widely recognized for contributing to the potential causes of diabetic encephalopathy. We also reviewed current pharmacological strategies for DE encompassing a comprehensive approach targeting metabolic dysregulations and neurological manifestations. Antioxidant-based therapies hold promise in mitigating oxidative stress-induced neuronal damage, while anti-diabetic drugs offer neuroprotective effects through diverse mechanisms, including modulation of insulin signaling pathways and neuroinflammation. Additionally, tissue engineering and nanomedicine-based approaches present innovative strategies for targeted drug delivery and regenerative therapies for DE. Despite significant progress, challenges remain in translating these therapeutic interventions into clinical practice, including long-term safety, scalability, and regulatory approval. Further research is warranted to optimize these approaches and address remaining gaps in the management of DE and associated neurodegenerative disorders.
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Hipoglucemiantes , Humanos , Animales , Hipoglucemiantes/uso terapéutico , Complicaciones de la Diabetes/terapia , Complicaciones de la Diabetes/metabolismo , Estrés Oxidativo/fisiología , Encefalopatías/terapia , Encefalopatías/etiología , Encefalopatías/metabolismoRESUMEN
Diabetes and its complications significantly affect individuals' quality of life. The etiology of diabetes mellitus and its associated complications is complex and not yet fully understood. There is an increasing emphasis on investigating the effects of endocrine disruptors on diabetes, as these substances can impact cellular processes, energy production, and utilization, ultimately leading to disturbances in energy homeostasis. Mitochondria play a crucial role in cellular energy generation, and any impairment in these organelles can increase susceptibility to diabetes. This review examines the most recent epidemiological and pathogenic evidence concerning the link between endocrine disruptors and diabetes, including its complications. The analysis suggests that endocrine disruptor-induced mitochondrial dysfunction-characterized by disruptions in the mitochondrial electron transport chain, dysregulation of calcium ions (Ca2+), overproduction of reactive oxygen species (ROS), and initiation of signaling pathways related to mitochondrial apoptosis-may be key mechanisms connecting endocrine disruptors to the development of diabetes and its complications.
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Diabetes Mellitus , Disruptores Endocrinos , Mitocondrias , Humanos , Disruptores Endocrinos/efectos adversos , Disruptores Endocrinos/toxicidad , Mitocondrias/efectos de los fármacos , Mitocondrias/metabolismo , Diabetes Mellitus/inducido químicamente , Diabetes Mellitus/metabolismo , Animales , Complicaciones de la Diabetes/metabolismo , Complicaciones de la Diabetes/inducido químicamente , Especies Reactivas de Oxígeno/metabolismo , Exposición a Riesgos Ambientales/efectos adversosRESUMEN
Cataracts are the world's leading cause of blindness, and diabetes is the second leading risk factor for cataracts after old age. Despite this, no preventative treatment exists for cataracts. The altered metabolism of excess glucose during hyperglycaemia is known to be the underlying cause of diabetic cataractogenesis, resulting in localised disruptions to fibre cell morphology and cell swelling in the outer cortex of the lens. In rat models of diabetic cataracts, this damage has been shown to result from osmotic stress and oxidative stress due to the accumulation of intracellular sorbitol, the depletion of NADPH which is used to regenerate glutathione, and the generation of fructose metabolites via the polyol pathway. However, differences in lens physiology and the metabolism of glucose in the lenses of different species have prevented the translation of successful treatments in animal models into effective treatments in humans. Here, we review the stresses that arise from hyperglycaemic glucose metabolism and link these to the regionally distinct metabolic and physiological adaptations in the lens that are vulnerable to these stressors, highlighting the evidence that chronic oxidative stress together with osmotic stress underlies the aetiology of human diabetic cortical cataracts. With this information, we also highlight fundamental gaps in the knowledge that could help to inform new avenues of research if effective anti-diabetic cataract therapies are to be developed in the future.
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Catarata , Complicaciones de la Diabetes , Presión Osmótica , Estrés Oxidativo , Polímeros , Catarata/metabolismo , Catarata/etiología , Catarata/patología , Humanos , Animales , Complicaciones de la Diabetes/metabolismo , Polímeros/metabolismo , Cristalino/metabolismo , Cristalino/patología , Sorbitol/metabolismo , Hiperglucemia/metabolismo , Hiperglucemia/complicaciones , Glucosa/metabolismoRESUMEN
Diabetes mellitus (DM) is a chronic metabolic disease that predisposes to chronic damage and dysfunction of various organs, including leading to erectile dysfunction (ED) and asthenospermia. Literature suggests that ginseng plays an important role in the treatment and management of DM. Ginseng may have a therapeutic effect on the complications of DM-induced ED and asthenospermia. The study aimed to explore the mechanisms of ginseng in the treatment of DM-induced ED and asthenospermia following the Traditional Chinese Medicine (TCM) theory of "treating different diseases with the same treatment." This study used network pharmacology and molecular docking to examine the potential targets and pharmacological mechanism of Ginseng for the treatment of DM-induced ED and asthenospermia. The chemical ingredients and targets of ginseng were acquired using the Traditional Chinese Medicine Systems Pharmacology database and analysis platform. The targets of DM, ED, and asthenospermia were extracted with the GeneCards and Online Mendelian Inheritance in Man databases. A protein-protein interaction network analysis was constructed. The Metascape platform was applied for analyzing the gene ontology and Kyoto Encyclopedia of Genes and Genomes pathways. AutoDock Vina was used to perform molecular docking. Network pharmacology revealed that the main active components of the target of action were kaempferol, beta-sitosterol, ginsenoside rh2, stigmasterol, and fumarine. Core targets of the protein-protein interaction network included TNF, IL-1ß, AKT1, PTGS2, BCL2, and JUN. Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that they were mainly involved in AGE-RAGE signaling pathway in diabetic complications, TNF signaling pathway, Lipid and atherosclerosis. The interactions of core active components and targets were analyzed by molecular docking. Ginseng may play a comprehensive therapeutic role in the treatment of DM-induced ED and asthenospermia through "multicomponent, multi-target, and multi-pathway" biological mechanisms such as inflammation and oxidative stress.
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Astenozoospermia , Disfunción Eréctil , Simulación del Acoplamiento Molecular , Farmacología en Red , Panax , Masculino , Humanos , Panax/química , Disfunción Eréctil/tratamiento farmacológico , Astenozoospermia/tratamiento farmacológico , Medicina Tradicional China/métodos , Medicamentos Herbarios Chinos/farmacología , Medicamentos Herbarios Chinos/uso terapéutico , Mapas de Interacción de Proteínas , Complicaciones de la Diabetes/tratamiento farmacológico , Diabetes Mellitus/tratamiento farmacológico , Sitoesteroles/farmacologíaRESUMEN
Aim: To identify hotspots in this field and provide insights into future research directions. Methods: Publications were retrieved from the Web of Science Core Collection database. R Bibliometrix software, VOSviewer and CiteSpace were used to perform the bibliometric and visualization analyses. Results: The analysis comprised 468 publications from 58 countries, with the United States, China and India being the leading contributors. 'Gene therapy', 'nanoparticles' and 'insulin therapy' are the primary focuses. 'Green synthesis', 'cytotoxicity', 'bioavailability' and 'diabetic foot ulcers' have gained prominence, signifying high-intensity areas of interest expected to persist as favored research topics in the future. Conclusion: This study delves into recent frontiers and topical research directions and provides valuable references for further research in this field.
Diabetes mellitus and its complications are substantial global public health concerns given their elevated mortality rates and economic impact. As an emerging technology of the 21st century, nanotechnology plays a crucial role in the diagnosis, monitoring and treatment of diabetes and its complications, offering advantages such as targeting specificity, excellent biocompatibility and high bioavailability. Bibliometrics can analyze the distribution and correlation of authors/countries/institutions in the published literature of a particular research field. It can also objectively and reliably analyze research hotspots, evolutionary trends and anticipate future developments in a given field. This marks the inaugural bibliometric study delving into the application of nanomedicines in diabetes mellitus and its complications from 2001 to 2023. Our results found that nanotechnology research on diabetes and its complications began in 2001 and is still in a continuous development phase. The United States, China and India being the leading contributors in this field. Zhejiang University has the most research in this area, and ACS Nano is the most popular journal. Zhang Y and Wang X are the most valuable authors. 'Gene therapy', 'nanoparticles' and 'insulin therapy' are the primary focus areas in this field. 'Green synthesis', 'cytotoxicity', 'bioavailability' and 'diabetic foot ulcers' will be the promising interests in the future. This study supplements the research data in this field, offering new perspectives and references for scholars focusing on diabetes and its complications.
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Bibliometría , Diabetes Mellitus , Nanotecnología , Humanos , Diabetes Mellitus/tratamiento farmacológico , Nanotecnología/métodos , Complicaciones de la Diabetes , Nanopartículas , Terapia Genética , Insulina , Nanomedicina/métodos , AnimalesRESUMEN
BACKGROUND The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has been increasing in recent years, becoming a cause of community-acquired infection. Interestingly, its role in malignancy recently started to be considered after a noticed increase in reported cases and studies discussing the potential association. CASE REPORT In the present case, the patient had known and uncontrolled diabetes mellitus and a history of multiple abscesses that were previously treated by incision and drainage. The patient received a diagnosis of severe pneumonia, and MRSA was found in blood cultures. Further tests for HIV, hemagglutinin type 1, and neuraminidase type 1 (H1N1) were negative. The D test was also performed for macrolide-inducible resistance and was negative, indicating the need for intravenous administration of clindamycin. An echocardiogram ruled out endocarditis. Subsequently, the patient experienced progressive back pain and weakness involving the lower limbs. A pathological fracture was discovered, along with nerve root compression. An urgent posterior spine fixation was then performed by a neurosurgeon. A biopsy was collected at the site of the pathological fracture, and histopathological tests indicated a plasma cell neoplasm. CONCLUSIONS MRSA is known to cause serious and dangerous infections, including necrotizing pneumonia. Furthermore, a link between MRSA and plasma cell dyscrasia has been considered in several reports. This necessitates the need for further studies to clarify this hidden association, which may help in the course and prognosis of these patients.
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Staphylococcus aureus Resistente a Meticilina , Humanos , Masculino , Neumonía Estafilocócica , Pronóstico , Persona de Mediana Edad , Fracturas Espontáneas/etiología , Infecciones Comunitarias Adquiridas/microbiología , Complicaciones de la DiabetesRESUMEN
The disturbance of the inflammatory microenvironment is a frequent pathological trait of diabetic wounds, contributing to the emergence of numerous chronic illnesses. This is crucial in both the development and recovery of wounds caused by diabetes. This study aims to perform a bibliometric analysis of research on the inflammatory microenvironment within the domain of diabetic wounds (DW) over the past 10 years. The objective is to map out the current global research landscape, pinpoint the most significant areas of study and offer guidance for future research avenues. Our research involved querying the Web of Science Core Collection (WoSCC) database for all pertinent studies on the inflammatory microenvironment in diabetic wounds (DW). We utilized bibliometric tools such as CiteSpace, VOSviewer and R (version 4.3.1) to identify and highlight the most impactful studies in the field. The study encompassed a review of 1454 articles published from 2014 to 2023, highlighting China and the United States as pivotal nations in the research of the inflammatory microenvironment in diabetic wounds (DW). Within this sphere, the University of Michigan and Harvard University in the United States, along with Shanghai Jiaotong University in China, emerged as the most prolific institutions. WANG Y from China was identified as the most productive author, while KUNKEL SL from the United States received the most citations. The research primarily focuses on topics such as wound healing, repair processes, angiogenesis, oxidative stress and macrophage activity. Additionally, "macrophage" and "delivery" were pinpointed as the leading subjects with promising research potential in this area. Research on the inflammatory microenvironment of diabetic wounds is rapidly advancing through active international collaboration. The study of new mechanisms related to the inflammatory microenvironment and the development of novel materials for repair based on this microenvironment represent emerging fields of future research, particularly in terms of translational applications. This may offer guidance and novel perspectives for further research in the area of the diabetic wound inflammatory microenvironment.
Asunto(s)
Bibliometría , Complicaciones de la Diabetes , Cicatrización de Heridas , Heridas y Lesiones , Humanos , Complicaciones de la Diabetes/inmunología , Inflamación/inmunología , Cicatrización de Heridas/inmunología , Heridas y Lesiones/inmunologíaRESUMEN
Introduction: Fluid overload is a known complication in patients with diabetes mellitus, particularly those with cardiovascular and/or chronic kidney disease (CKD). This study investigates the impact of fluid overload on healthcare utilisation and its association with diabetes-related complications. Method: Electronic medical records from the SingHealth Diabetes Registry (2013-2022) were analysed. Hospitalisations due to fluid overload were identified using International Classification of Diseases, 10th Revision (ICD-10) discharge codes. Trends were examined using Joinpoint regression, and associations were assessed with generalised estimating equation models. Results: Over a period of 10 years, 259,607 individuals treated at primary care clinics and tertiary hospitals were studied. The incidence of fluid overload-related hospitalisations decreased from 2.99% (n=2778) in 2013 to 2.18% (n=2617) in 2017. However, this incidence increased from 2.42% (n=3091) in 2018 to 3.71% (n=5103) in 2022. The strongest associations for fluid overload-related hospitalisation were found with CKD stages G5 (odds ratio [OR] 6.61, 95% confidence interval [CI] 6.26-6.99), G4 (OR 5.55, 95% CI 5.26-5.86) and G3b (OR 3.18, 95% CI 3.02-3.35), as well as with ischaemic heart disease (OR 3.97, 95% CI 3.84-4.11), acute myocardial infarction (OR 3.07, 95% CI 2.97-3.18) and hypertension (OR 3.90, 95% CI 3.45-4.41). Additionally, the prevalence of stage G5 CKD among patients with fluid overload increased between 2018 and 2022. Conclusion: Our study revealed a significant increase in fluid overload-related hospitalisations and extended lengths of stay, likely driven by severe CKD. This underscores an urgent need for initiatives aimed at slowing CKD progression and reducing fluid overload-related hospitalisations in diabetes patients.