RESUMO
Aim: The pathogenesis of chronic diabetes complications has oxidative stress as one of the major elements, and single-nucleotide polymorphisms (SNPs) in genes belonging to antioxidant pathways modulate susceptibility to these complications. Considering that melatonin is a powerful antioxidant compound, our aim was to explore, in a longitudinal cohort study of type 1 diabetes (T1D) individuals, the association of microvascular complications and SNPs in the gene encoding melatonin receptor 1A (MTNR1A). Methods: Eight SNPs in MTNR1A were genotyped in 489 T1D individuals. Besides cross-sectional analyses of SNPs with each one of the microvascular complications (distal polyneuropathy, cardiovascular autonomic neuropathy, retinopathy, and diabetic kidney disease), a longitudinal analysis evaluated the associations of SNPs with renal function decline in 411 individuals followed up for a median of 8 years. In a subgroup of participants, the association of complications with urinary 6-sulfatoxymelatonin (aMT6s) concentration was investigated. Results: The group of individuals with a renal function decline ≥ 5 mL min-1 1.73 m-2 year-1 presented a higher frequency of the A allele of rs4862705 in comparison with nondecliners, even after adjustment for confounding variables (OR = 1.84, 95% CI = 1.20-2.82; p = 0.0046). No other significant associations were found. Conclusions: This is the first study showing an association between a variant in a gene belonging to the melatonin system and renal function decline in the diabetic setting.
Assuntos
Diabetes Mellitus Tipo 1 , Melatonina , Humanos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/genética , Antioxidantes , Receptores de Melatonina , Estudos Transversais , Estudos Longitudinais , RimRESUMO
Purpose: To evaluate the knowledge of diabetic patients towards the connection between diabetes mellitus (DM) and oral diseases. Oral status was also assessed in order to evaluate the correlation among patients' perception and their oral health. Material and Methods: A sample of 132 diabetic subjects answered a questionnaire containing 12 questions addressing their knowledge, attitudes and practices related to oral health. Oral examination accessed the presence of cavity carious lesions, residual roots, dental biofilm, calculus, gingivitis, tooth mobility and gingival recession. Results: Fifty-four percent of the sample had never been instructed by their health professionals that DM could cause oral diseases. However, 66% presumed being more vulnerable to develop oral illnesses and 57.5% answered that they assumed having no oral disturbances at that moment. In contrast, intraoral clinical examination showed that 99% presented at least one oral injury such as caries lesions, plaque/calculus, gingival inflammation, tooth mobility, residual root and xerostomia. Conclusions: Health care professionals usually neglect oral status in diabetic patients. Above all, there is a huge gap between patients' perceptions towards oral health and their real oral status. This study highlights the need of developing new models of prevention that properly address the important clinical relation between oral diseases and DM.(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Saúde Bucal , Complicações do Diabetes , Diabetes Mellitus/prevenção & controle , Doenças da Boca/prevenção & controle , Estudos TransversaisRESUMO
OBJECTIVES: To demonstrate the use of a multinational diabetes registry for comparing indices of diabetes management among countries with differing levels of income, healthcare systems and ethnic backgrounds. METHODS: A cross-sectional study was conducted among 1742 people with type 2 diabetes attending diabetes clinics in London, Ontario, Canada, and Bogota, Colombia. The data were extracted from the Global Registry and Surveillance System for Diabetes (GRAND). RESULTS: Canadian patients were diagnosed with diabetes at significantly younger ages than Colombian patients (49 years and 53 years, respectively) and were heavier (body mass indices of 33 and 28, respectively). The Colombian patient population had significantly higher mean glycated hemoglobin (A1C) levels (9.4% vs. 8.6%) and fewer patients (22% vs. 26%) at the glycemic target (A1C <7.0%) than Canadian patients. In Colombia, 1 or more diabetes-related complications were present in 51% of the study population compared with 37% in Canada. Newly diagnosed Colombians had higher mean A1C levels (9.1% vs. 8.7%) and low-density lipoprotein-C levels (3.3 mmol/L vs. 2.5 mmol/L) than did newly diagnosed Canadians. CONCLUSIONS: A multination diabetes registry collecting standardized data facilitates transnational comparison of diabetes clinical parameters for the purpose of identifying potential gaps in care.