Medicine and Health Sciences Commons^™

Global Variation In Diabetes Diagnosis And Prevalence Based On Fasting Glucose And Hemoglobin A1c, Ncd Risk Factor Collaboration (Ncd-Risc), Bin Zhou, Kate E. Sheffer, James E. Bennett, Edward W. Gregg, Goodarz Danaei, Rosie K. Singleton, Jonathan E. Shaw, Gladys Maestre, Jesus D. Melgarejo

School of Medicine Publications and Presentations

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed …

Tuberculosis Presentation And Outcomes In Older Hispanic Adults From Tamaulipas, Mexico, Belinda Medrano, Miryoung Lee, Gretchen L. Gemeinhardt, Javier E. Rodríguez-Herrera, Moncerrato García-Viveros, Blanca I. Restrepo

School of Medicine Publications and Presentations

Older people are at high risk of developing and dying from pulmonary infections like tuberculosis (TB), but there are few studies among them, particularly in Hispanics. To address these gaps, we sought to identify host factors associated with TB and adverse treatment outcomes in older Hispanics by conducting a cross-sectional study of TB surveillance data from Tamaulipas, Mexico (2006–2013; n = 8381). Multivariable logistic regressions were assessed for older adults (OA ≥65 years) when compared to young (YA, 18–39 years) and middle-aged adults (40–64 years). We found that the OA had features associated with a less complicated TB (e.g., lower …

Cardiovascular Risk Of Metabolically Healthy Obesity In Two European Populations: Prevention Potential From A Metabolomic Study, Dongmei Wei, Vannina González Marrachelli, Jesus D. Melgarejo, Chia-Te Liao, Angie Hu, Stefan Janssens, Peter Verhamme, Lucas Van Aelst, Thomas Vanassche, Josep Redon

School of Medicine Publications and Presentations

Background

A new definition of metabolically healthy obesity (MHO) has recently been proposed to stratify the heterogeneous mortality risk of obesity. Metabolomic profiling provides clues to metabolic alterations beyond clinical definition. We aimed to evaluate the association between MHO and cardiovascular events and assess its metabolomic pattern.

Methods

This prospective study included Europeans from two population-based studies, the FLEMENGHO and the Hortega study. A total of 2339 participants with follow-up were analyzed, including 2218 with metabolomic profiling. Metabolic health was developed from the third National Health and Nutrition Examination Survey and the UK biobank cohorts and defined as systolic blood …

Differential Role Of Type 2 Diabetes As A Risk Factor For Tuberculosis In The Elderly Versus Younger Adults, Blanca I. Restrepo, Julia M. Scordo, Genesis P. Aguillón-Durán, Doris Ayala, Ana P. Quirino-Cerrillo, Raúl Loera-Salazar, America Cruz-González, Jose A. Caso, Mateo Joya-Ayala, Esperanza M. García-Oropesa, Alejandra B. Salinas

School of Medicine Publications and Presentations

The elderly are understudied despite their high risk of tuberculosis (TB). We sought to identify factors underlying the lack of an association between TB and type 2 diabetes (T2D) in the elderly, but not adults. We conducted a case–control study in elderly (≥65 years old; ELD) vs. younger adults (young/middle-aged adults (18–44/45–64 years old; YA|MAA) stratified by TB and T2D, using a research study population (n = 1160) and TB surveillance data (n = 8783). In the research study population the adjusted odds ratio (AOR) of TB in T2D was highest in young adults (AOR 6.48) but waned with age …

Editorial: The Biology And Management Of Chronic Diseases In Mexican Americans, Eron G. Manusov, Belinda M. Reininger, Alfredo Ulloa-Aguirre, John Blangero

School of Medicine Publications and Presentations

No abstract provided.

Whole Genome Sequence Association Analysis Of Fasting Glucose And Fasting Insulin Levels In Diverse Cohorts From The Nhlbi Topmed Program, Daniel Dicorpo, Sheila M. Gaynor, Emily M. Russell, Kenneth E. Westerman, Laura M. Raffield, Marcio Almeida, Juan M. Peralta, John Blangero, Joanne E. Curran, Ravindranath Duggirala

School of Medicine Publications and Presentations

The genetic determinants of fasting glucose (FG) and fasting insulin (FI) have been studied mostly through genome arrays, resulting in over 100 associated variants. We extended this work with high-coverage whole genome sequencing analyses from fifteen cohorts in NHLBI’s Trans-Omics for Precision Medicine (TOPMed) program. Over 23,000 non-diabetic individuals from five race-ethnicities/populations (African, Asian, European, Hispanic and Samoan) were included. Eight variants were significantly associated with FG or FI across previously identified regions MTNR1B, G6PC2, GCK, GCKR and FOXA2. We additionally characterize suggestive associations with FG or FI near previously identified SLC30A8, TCF7L2, and ADCY5 regions as well …

Collar-Button Abscess As A Complication Of Infected Hematoma In The Setting Of Uncontrolled Type 2 Diabetes, Jennifer Adams, Daniel Habenicht, Savvas Poulos

School of Medicine Publications and Presentations

Introduction: Collar-button abscesses are deep space infections of the hand.

Case presentation: We present a case of a 66-year-old man who developed an acute collar-button abscess of the hand after a concrete bench fell onto the dorsal aspect of his hand. The hand abscess was managed successfully with intravenous antibiotics and operative intervention.

Discussion: While such infections comprise a small percentage of hand infections, insufficient or delayed treatment results in permanent hand disfiguration and dysfunction. This case highlights an uncommon dorsal-to-volar pattern of hand abscess extension.

Conclusion: Knowledge of the anatomy of the hand is essential to diagnosis and …

Lrg1 Is An Adipokine That Mediates Obesity-Induced Hepatosteatosis And Insulin Resistance, Sijia He, Jiyoon Ryu, Juanhong Liu, Hairong Luo, Ying Lv, Paul R. Langlais, Jie Wen, Feng Dong, Zhe Sun, Ravindranath Duggirala

School of Medicine Publications and Presentations

Dysregulation in adipokine biosynthesis and function contributes to obesity-induced metabolic diseases. However, the identities and functions of many of the obesity-induced secretory molecules remain unknown. Here, we report the identification of leucine-rich alpha-2-glycoprotein 1 (LRG1) as an obesity-associated adipokine that exacerbates high fat diet–induced hepatosteatosis and insulin resistance. Serum levels of LRG1 were markedly elevated in obese humans and mice compared with their respective controls. LRG1 deficiency in mice greatly alleviated diet-induced hepatosteatosis, obesity, and insulin resistance. Mechanistically, LRG1 bound with high selectivity to the liver and promoted hepatosteatosis by increasing de novo lipogenesis and suppressing fatty acid β-oxidation. LRG1 …

Diabetes Mellitus Correlates With Increased Biological Age As Indicated By Clinical Biomarkers, Nadine Bahour, Briana Cortez, Hui Pan, Hetal Shah, Alessandro Doria, Cristina Aguayo‑Mazzucato

School of Medicine Publications and Presentations

Chronological age (CA) is determined by time of birth, whereas biological age (BA) is based on changes on a cellular level and strongly correlates with morbidity, mortality, and longevity. Type 2 diabetes (T2D) associates with increased morbidity and mortality; thus, we hypothesized that BA would be increased and calculated it from biomarkers collected at routine clinical visits. Deidentified data was obtained from three cohorts of patients (20-80 years old)-T2D, type 1 diabetes (T1D), and prediabetes-and compared to gender- and age-matched non-diabetics. Eight clinical biomarkers that correlated with CA in people without diabetes were used to calculate BA using the Klemera …

Sacubitril/Valsartan Inhibits Obesity-Associated Diastolic Dysfunction Through Suppression Of Ventricular-Vascular Stiffness, Annayya R. Aroor, Srinivas Mummidi, Juan C. Lopez-Alvarenga, Nitin Das, Javad Habibi, Guanghong Jia, Guido Lastra, Bysani Chandrasekar

School of Medicine Publications and Presentations

Objective: Cardiac diastolic dysfunction (DD) and arterial stiffness are early manifestations of obesity-associated prediabetes, and both serve as risk factors for the development of heart failure with preserved ejection fraction (HFpEF). Since the incidence of DD and arterial stiffness are increasing worldwide due to exponential growth in obesity, an effective treatment is urgently needed to blunt their development and progression. Here we investigated whether the combination of an inhibitor of neprilysin (sacubitril), a natriuretic peptide-degrading enzyme, and an angiotensin II type 1 receptor blocker (valsartan), suppresses DD and arterial stiffness in an animal model of prediabetes more effectively than valsartan …

Hyperglycemia And Dyslipidemia: Reduced Hla-Dr Expression In Monocyte Subpopulations From Diabetes Patients, Blanca I. Restrepo, Marcel Twahirwa, Chinnaswamy Jagannath

School of Medicine Publications and Presentations

Immune dysfunction contributes to the higher risk of communicable and non-communicable diseases among diabetics. HLA-DR expression is a robust marker of immune competence in mononuclear cells, including antigen presentation to CD4 lymphocytes. Given the high prevalence of obesity among diabetics, we evaluated the independent association between hyperglycemia and dyslipidemias with respect to HLA-DR expression in blood monocytes from type 2 diabetes patients. The monocytes from individuals with (n=16) or without diabetes (n=25) were phenotyped by flow cytometry to assess the differential expression of HLA-DR on their three subpopulations (classical, intermediate and non-classical monocytes). Diabetes was independently associated with lower HLA-DR …

Human Monocyte-Derived Macrophage Responses To M. Tuberculosis Differ By The Host’S Tuberculosis, Diabetes Or Obesity Status, And Are Enhanced By Rapamycin, Blanca I. Restrepo, Arshad Khan, Vipul K. Singh, Erica De Leon, Genesis P. Aguillón-Durán, Eder Ledezma-Campos, David H. Canaday, Chinnaswamy Jagannath

School of Medicine Publications and Presentations

Human macrophages play a major role in controlling tuberculosis (TB), but their anti-mycobacterial mechanisms remain unclear among individuals with metabolic alterations like obesity (TB protective) or diabetes (TB risk). To help discern this, we aimed to: i) Evaluate the impact of the host’s TB status or their comorbidities on the anti-mycobacterial responses of their monocyte-derived macrophages (MDMs), and ii) determine if the autophagy inducer rapamycin, can enhance these responses. We used MDMs from newly diagnosed TB patients, their close contacts and unexposed controls. The MDMs from TB patients had a reduced capacity to activate T cells (surrogate for antigen presentation) …

Observing Growth Effects Of Pigment Epithelium-Derived Factor On Human Retinal Pericytes In Vitro, Anjalee Choudhury, Andrew Tsin, Zachary Perez, Fransisco Elisarraras

School of Medicine Publications and Presentations

The purpose of this study is to investigate and determine the role of PEDF in the pathogenesis of diabetic retinopathy as induced by advanced glycation end-products (AGEs). Human retinal pericytes were isolated from donors and will be measured for cell proliferation under the influence of PEDF both in the presence and absence of AGEs. Expected outcomes involve both the maintenance and increased survival of HRPs after treatment with PEDF under stimulated hyperglycemic conditions.

Physical Activity And Its Association With Depression In The Diabetic Hispanic Population, Sukaina Rizvi, Ali M. Khan

School of Medicine Publications and Presentations

Introduction Hispanics are the largest ethnic minority group in the United States. The prevalence of depression and co-morbid depression in the Hispanic population is well-recognized. The positive association between physical activity and psychological health improves mood, emotional well-being, and prognostic outcome.

Objectives There are two aspects of our research paper. First, it critically reviews the available literature showing the correlation between physical exercise and depression. Second, it analyzes the association between exercise and depression in uncontrolled diabetic Hispanics using data collected from the local community intervention program.

Method A chi-square analysis was conducted to examine whether levels of physical activity …

Diabetes Screen During Tuberculosis Contact Investigations Highlights Opportunity For New Diabetes Diagnosis And Reveals Metabolic Differences Between Ethnic Groups, Blanca I. Restrepo, Léanie Kleynhans, Alejandra B. Salinas, Bassent Abdelbary, Happy Tshivhula, Genesis P. Aguillón-Durán, Carine Kunsevi-Kilola, Gloria Salinas, Kim Stanley, Juan C. Lopez-Alvarenga

School of Medicine Publications and Presentations

Type 2 diabetes (T2D) is a prevalent risk factor for tuberculosis (TB), but most studies on TB-T2D have focused on TB patients, been limited to one community, and shown a variable impact of T2D on TB risk or treatment outcomes. We conducted a cross-sectional assessment of sociodemographic and metabolic factors in adult TB contacts with T2D (versus no T2D), from the Texas-Mexico border to study Hispanics, and in Cape Town to study South African Coloured ethnicities. The prevalence of T2D was 30.2% in Texas-Mexico and 17.4% in South Africa, with new diagnosis in 34.4% and 43.9%, respectively. Contacts with T2D …

Chelation Therapy To Prevent Diabetes-Associated Cardiovascular Events, Denisse Diaz, Vivian Fonseca, Y. Wady Aude, Gervasio A. Lamas

School of Medicine Publications and Presentations

Purpose of review

For over 60 years, chelation therapy with disodium ethylene diamine tetraacetic acid (EDTA, edetate) had been used for the treatment of cardiovascular disease (CVD) despite lack of scientific evidence for efficacy and safety. The Trial to Assess Chelation Therapy (TACT) was developed and received funding from the National Institutes of Health (NIH) to ascertain the safety and efficacy of chelation therapy in patients with CVD.

Recent findings

This pivotal trial demonstrated an improvement in outcomes in postmyocardial infarction (MI) patients. Interestingly, it also showed a particularly large reduction in CVD events and all-cause mortality in the prespecified …

Interphotoreceptor Retinoid-Binding Protein Implications In Diabetic Retinopathy, Kevin Bermea

School of Medicine Publications and Presentations

The interphotoreceptor retinoid-binding protein (IRBP) is the most abundant protein in the interphotoreceptor matrix (IPM) and its levels decrease beginning in the early stages of diabetes. IRBP participates in the delivery of retinoids between retinal cells to carry out the visual cycle and also protects those retinoids against degradation in the IPM. IRBP deficiency is related to several conditions such as retinitis pigmentosa, cone-rod dystrophy, increased oxidative stress in the photoreceptors, and myopia. Decreased IRBP levels in diabetes could be due to the secretion of inflammatory cytokines and a direct effect of hyperglycemia on the photoreceptors. It is known that …

Kaposi Sarcoma Incidence In Females Is Nearly Four-Fold Higher In The Lower Rio Grande Valley Compared To The Texas Average, Wendy Innis-Whitehouse, Xiaohui Wang, Nicolas Restrepo, Carlos Salas, Katia Moreno, Alvaro Restrepo, Megan Keniry

School of Medicine Publications and Presentations

The Lower Rio Grande Valley (LRGV) is located on U.S.-Mexican border with a population that is 90% Hispanic [1]. Comprised of Hidalgo, Cameron, Starr and Willacy counties, this region has the highest poverty rate and one of the highest incidences of Type 2 diabetes in the United States [2], [3], [4]. Previous studies demonstrated a high prevalence of Human Herpes Virus 8 (HHV8) in the LRGV [5], [6], [7]. HHV8 infection has been causally linked to Kaposi Sarcoma (KS) [8]. Here, we retrospectively examine the incidence of KS in the LRGV in a set of HIV-negative Hispanic patients. Strikingly, the …

Transition From Pre-Diabetes To Diabetes And Predictors Of Risk In Mexican-Americans, Shenghui Wu, Joseph B. Mccormick, Joanne E. Curran, Susan P. Fisher-Hoch

School of Medicine Publications and Presentations

Background: No studies have examined risk factors for the transition from pre-diabetes to diabetes in populations with widespread obesity and diabetes. We determined proximal changes and factors affecting the transition among Mexican-Americans with pre-diabetes.

Methods: Participants with pre-diabetes (n=285) were recruited from our randomly sampled population-based Cameron County Hispanic Cohort. These participants were followed for an average of 27 months with repeat examination every 3 to 4 months. Metabolic health was defined as having less than 2 metabolic abnormalities (e.g., hypertension, elevated low-density lipoprotein, etc). Diabetes was identified as fasting blood glucose ≥126 mg/dL, glycated hemoglobin ≥6.5% and/or on hypoglycemic …

The Arg59trp Variant In Angptl8 (Betatrophin) Is Associated With Total And Hdl-Cholesterol In American Indians And Mexican Americans And Differentially Affects Cleavage Of Angptl3, Robert L. Hanson, Fatjon Leti, Darwin Tsinajinnie, Sayuko Kobes, Sobha Puppala, Joanne E. Curran, Laura Almasy, Donna M. Lehman, John Blangero, Ravi Duggirala, Johanna K. Distefano

School of Medicine Publications and Presentations

We previously identified a locus linked to total cholesterol (TC) concentration in Pima Indians on chromosome 19p. To characterize this locus, we genotyped >2000 SNPs in 1838 Pimas and assessed association with log(TC). We observed evidence for association with log(TC) with rs2278426 (3.5% decrease/copy of the T allele; P=5.045×10(-6)) in the ANGPTL8 (angiopoietin-like 8) gene. We replicated this association in 2413 participants of the San Antonio Mexican American Family Study (SAMAFS: 2.0% decrease per copy of the T allele; P=0.005842). In a meta-analysis of the combined data, we found the strongest estimated effect with rs2278426 (P=2.563×10(-7)). The variant T allele …

Lipidomic Risk Score Independently And Cost-Effectively Predicts Risk Of Future Type 2 Diabetes: Results From Diverse Cohorts, Manju Mamtani, Hemant Kulkarni, Gerard Wong, Jacquelyn M. Weir, Christopher K. Barlow, Thomas D. Dyer, Laura Almasy, Michael C. Mahaney, Anthony G. Comuzzie, David C. Glahn, Sarah Williams-Blangero, Ravindranath Duggirala, John Blangero, Joanne E. Curran

School of Medicine Publications and Presentations

Background: Detection of type 2 diabetes (T2D) is routinely based on the presence of dysglycemia. Although disturbed lipid metabolism is a hallmark of T2D, the potential of plasma lipidomics as a biomarker of future T2D is unknown. Our objective was to develop and validate a plasma lipidomic risk score (LRS) as a biomarker of future type 2 diabetes and to evaluate its cost-effectiveness for T2D screening.

Methods: Plasma LRS, based on significantly associated lipid species from an array of 319 lipid species, was developed in a cohort of initially T2D-free individuals from the San Antonio Family Heart Study (SAFHS). The …

Prevalence And Incidence Rates Of Dementia And Cognitive Impairment No Dementia In The Mexican Population: Data From The Mexican Health And Aging Study, Silvia Mejía-Arango, Luis Miguel Gutierrez

School of Medicine Publications and Presentations

Objective

To estimate the prevalence and incidence of dementia and cognitive impairment without dementia (CIND) in the Mexican population.

Methods

The MHAS study is a prospective panel study of health and aging in Mexico with 7,000 elders that represent 8 million subjects nationally. Using measurements of cognition and activities of daily living of dementia cases and CIND were identified at baseline and follow up. Overall incidence rates and specific rates for sex, age and education were calculated.

Results

Prevalence was 6.1% and 28.7% for dementia and CIND, respectively. Incidence rates were 27.3 per 1,000 person-years for dementia and 223 per …