Nutritional and Metabolic Diseases Commons^™

Obesity And Metabolic Phenotypes (Metabolically Healthy And Unhealthy Variants) Are Significantly Associated With Prevalence Of Elevated C-Reactive Protein And Hepatic Steatosis In A Large Healthy Brazilian Population, Sameer Shaharyar, Lara Roberson, Omar Jamal, Adnan Younus, Shozab Ali, Arthur Agatston, Khurram Nasir Baptist Health Medical Group

All Publications

BACKGROUND:Among the obese, the so-called metabolically healthy obese (MHO) phenotype is thought to confer a lower CVD risk as compared to obesity with typical associated metabolic changes. The present study aims to determine the relationship of different subtypes of obesity with inflammatory-cardiometabolic abnormalities.METHODS:We evaluated 5,519 healthy, Brazilian subjects (43 ± 10 years, 78% males), free of known cardiovascular disease. Those with (MRF) were considered metabolically healthy, and those with BMI ≥ 25 kg/m(2) and/or waist circumference meeting NCEP criteria for metabolic syndrome as overweight/obese (OW). High sensitivity C reactive protein (hsCRP) was measured to assess underlying inflammation and hepatic steatosis …

Is Metabolic Syndrome Predictive Of Prevalence, Extent, And Risk Of Coronary Artery Disease Beyond Its Components? Results From The Multinational Coronary Ct Angiography Evaluation For Clinical Outcome: An International Multicenter Registry (Confirm), Ricardo Cury

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No abstract provided.

Simultaneous Surgical Repair Of A Tibialis Anterior Tendon Rupture And Diabetic Charcot Neuroarthropathy Of The Midfoot: A Case Report, John Stapleton

John J Stapleton DPM, FACFAS

The combination of simultaneous rupture of a tibialis anterior tendon and Charcot neuroarthropathy of the midfoot in a diabetic patient is a rare and challenging condition that can lead to major complications if not addressed appropriately. This article discusses a tibialis anterior tendon rupture that may have developed before or after the incidence of the diabetic Charcot neuroarthropathy midfoot deformity and raises awareness to potential spontaneous tendon ruptures that may be associated with the diabetic Charcot foot.

The Mechanisms Of Weight Gain In Sleep-Deprived Individuals, Chaya Rosen

The Science Journal of the Lander College of Arts and Sciences

The obese population in America has grown during the last century. During these years as well, American’s have been sleeping less. Cross sectional studies show that there is a correlation of the two factors, and indeed find a greater number of overweight individuals amongst the sleep-deprived population. Though they are unclear, studies attempt to establish possible mechanisms through which weight gain occurs. Results of studies show that sleep deprivation may influence leptin and ghrelin levels, which can cause hunger, and excessive caloric intake. Sleep-deprived individuals also have an increased opportunity to eat during the wakeful nighttime hours. In the sleep-restricted …

Insulin Pumps: Beyond Basal-Bolus, Richard Millstein, Nancy Mora Becerra, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Insulin pumps are a major advance in diabetes management, making insulin dosing easier and more accurate and providing great flexibility, safety, and efficacy for people who need basal-bolus insulin therapy. They are the preferred treatment for people with type 1 diabetes and many with type 2 diabetes who require insulin. This article reviews the basics of how insulin pumps work, who benefits from a pump, and how to manage inpatients and outpatients on insulin pumps.

Program Active Ii: Design And Methods For A Multi-Center Community-Based Depression Treatment For Rural And Urban Adults With Type 2 Diabetes, Mary De Groot, Jay H. Shubrook, Frank Schwartz, W. Guyton Hornsby Jr., Yegan Pillay, Chandan Saha

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Objective: Depression affects one in four adults with type 2 diabetes (T2DM) and is associated with worsened diabetes complications, increased health care costs and early mortality. Rural and low-income urban areas, including the Appalachian region, represent an epicenter of the T2DM epidemic. Program ACTIVE II is a comparative effectiveness treatment trial designed to test whether a combination of cognitive behavioral therapy (CBT) and community-based exercise (EXER) will offer greater improvements in diabetes and depression outcomes compared to individual treatment approaches and usual care (UC). The secondary aims are to assess changes in cardiovascular risk factors across groups and to …

Regulation Of Ghrelin: A Possible Treatment Option For Obesity And Diabetes, Sarah Picciotto

The Science Journal of the Lander College of Arts and Sciences

Obesity is a mounting problem in America today. One major concern about obesity is that it is a risk factor for type 2 diabetes, a disease that impairs insulin sensitivity and secretion. This interferes with blood glucose levels and can cause hyperglycemia, which is when there is too much circulating glucose in the blood. Ghrelin, an amino acid peptide responsible for appetite stimulation and energy balance, plays a direct role in insulin secretion and glucose metabolism. In many experiments, elevated ghrelin levels are associated with decreased insulin secretion from pancreatic islet cells. Although ghrelin concentration is decreased in obese individuals …

Regulation Of Pancreatic Β-Cell Function By The Renin-Angiotensin System In Type 2 Diabetes, Robin C. Shoemaker

Theses and Dissertations--Pharmacology and Nutritional Sciences

Diet-induced obesity promotes type 2 diabetes (T2D). Drugs that inhibit the renin-angiotensin system (RAS) have been demonstrated in clinical trials to decrease the onset of T2D. Previously, we demonstrated that mice made obese from chronic consumption of a high-fat (HF) diet have marked elevations in systemic concentrations of angiotensin II (AngII). Pancreatic islets have been reported to possess components of the renin-angiotensin system (RAS), including angiotensin type 1a receptors (AT1aR), the primary receptor for AngII, and angiotensin converting-enzyme 2 (ACE2), which negatively regulates the RAS by catabolizing AngII to angiotensin-(1-7) (Ang-(1-7)). These two opposing proteins have been implicated in the …

Can A Vegetarian Diet Improve Quality Of Life In Type 2 Diabetics, Compared To Other Diabetic Diets?, Carly A. Kindbom

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine if a vegetarian diet is more effective in improving quality of life in Type 2 Diabetics compared to other diabetic diets.

STUDY DESIGN: Review of two randomized control trials published in 2011 and 2013, and one prospective clinical intervention study published in 2010.

DATA SOURCES: Data sources were articles published in peer review journals found using PubMed and Cochrane Databases.

OUTCOMES MEASURED: Quality of life was measured by amount of weight loss from baseline and Obesity and Weight-Loss Quality of Life (OWLQOL) questionnaires.

RESULTS: Ferdowsian et al (2010) reported …

Sglt2 Inhibitors For Type 2 Diabetes Mellitus Treatment, Raymond A. Plodkowski, Megan E. Mcgarvey, Heather M. Huribal, Keith Reisinger-Kindle, Bradley Kramer, Mordecai Solomon, Quang T. Nguyen

College of Osteopathic Medicine (TUN) Publications and Research

SGLT2 inhibitors are plausible second-line drugs that provide powerful additional A1c-lowering effects while inducing weight loss without hypoglycemia.

Association Of Abc (Hba1c, Blood Pressure, Ldl-Cholesterol) Goal Attainment With Depression And Health-Related Quality Of Life Among Adults With Type 2 Diabetes, Bijal M. Shah, Dylan J. Mezzio, Jackie Ho, Eric J. Ip

Faculty Publications & Research of the TUC College of Pharmacy

Aims: To determine the relationship between ABC goal attainment, depression, and health-related quality of life (HRQoL) among a national sample of patients with type 2 diabetes (T2DM).

Methods: A retrospective, cross-sectional analysis was performed examining 808 non-pregnant patients ≥ 20 years old with T2DM from the National Health and Nutrition Examination Survey (NHANES) 2007-2012. ABC goals were defined as HbA1c < 7%, BP < 130/80mmHg, and LDL-C < 100mg/dL. Patient characteristics associated with ABC goal attainment were examined.

Results: Overall, 23.7% of participants achieved simultaneous ABC goals. Severe depression was significantly associated with lower rates of ABC goal attainment compared to those with no depression (5.0% vs. 25.4%, p = 0.048). ABC goal attainment rates …

Impact Of Starch Source On Equine Hindgut Microbial Ecology, Brittany Elizabeth Davis Harlow

Theses and Dissertations--Animal and Food Sciences

Grain inclusion in equine diets can allow starch to reach the hindgut where bacteria compete for the substrate. The hypothesis was that starch introduction would cause a source-dependent press disturbance in equine fecal microflora. Fecal cell suspensions were prepared by differential centrifugation and re-suspension in media with ground corn, oats or wheat. At 24 h, corn had more amylolytics and Group D Gram-positive cocci (GPC), and fewer lactate-utilizing (LU) bacteria and lactobacilli than oats, with wheat being intermediate. Predominant amylolytics were identified by their 16S RNA gene sequence as Enterococcus faecalis (corn, wheat) and Streptococcus bovis (oats). In an in …

Empagliflozin In The Treatment Of Type 2 Diabetes: Evidence To Date, Jay H. Shubrook, Babak Baradar Bokaie, Sarah E. Adkins

Faculty Publications & Research of the TUC College of Osteopathic Medicine

In the last decade, researchers have gained a greater understanding of the pathophysiologic mechanisms of type 2 diabetes as a chronic and progressive disease. One of the more recent treatment targets is the kidney. The kidneys become maladaptive in diabetes by increasing the reabsorption of glucose above the normal physiologic renal threshold. This discovery has led to the development of the sodium/glucose cotransporter 2 inhibitors (SGLT2). These agents readjust the renal threshold for glucose reabsorption to a lower level and decrease glucose reabsorption, while increasing urinary glucose when the glucose is above the renal threshold and subsequently lowering plasma glucose. …

Sodium Glucose Co-Transporter 2 Inhibitors In The Treatment Of Type 2 Diabetes Mellitus, Eden Miller, Jay H. Shubrook

Faculty Publications & Research of the TUC College of Osteopathic Medicine

Type 2 diabetes mellitus (T2DM) is a chronic, progressive disease, control of which typically requires multiple therapies. Current guidelines suggest that, in addition to improving glycemic control, antihyperglycemic therapy should be chosen on the basis of its effects on body weight and the risk of hypoglycemia. The newest class of oral antihyperglycemic agents, the sodium glucose cotransporter 2 (SGLT2) inhibitors, reduces renal glucose reabsorption and increases urinary glucose excretion via an insulin-independent mechanism of action. SGLT2 inhibitors have been shown to improve glycemic control and to reduce body weight and systolic blood pressure, and their use is associated with a …

Examining The Relationship Between Type And Extent Of After-School Care Use And High Bmi In Children Ages 5-17, Morgan E.B. Chojnacki

DNP Projects

Objectives: The purpose of this study was to examine the relationship between body mass index (BMI) and after-school care use in school age children and adolescents in Kentucky. The specific aims of this study were to examine differences in BMI groups (high versus normal/low) by: a) type and b) extent of after-school care use.

Methods: Parents of children age 5-17 years were administered a 21-item survey which assessed the amount of time their children spent in specific types of after-school care. BMI of the child/adolescent participants were obtained at the time of the survey. High BMI was defined …

Liver Perilipin 5 Expression Worsens Hepatosteatosis But Not Insulin Resistance In High Fat-Fed Mice, Michelle B. Trevino, David Mazur-Hart, Yui Machida, Timothy King, Joseph Nadler, Elena V. Galkina, Arjun Poddar, Sucharita Dutta, Yumi Imai

Mathematics & Statistics Faculty Publications

Perilipin 5 (PLIN5) is a lipid droplet (LD) protein highly expressed in oxidative tissues, including the fasted liver. However, its expression also increases in nonalcoholic fatty liver. To determine whether PLIN5 regulates metabolic phenotypes of hepatosteatosis under nutritional excess, liver targeted overexpression of PLIN5 was achieved using adenoviral vector (Ad-PLIN5) in male C57BL/6J mice fed high-fat diet. Mice treated with adenovirus expressing green fluorescent protein (GFP) (Ad-GFP) served as control. Ad-PLIN5 livers increased LD in the liver section, and liquid chromatography with tandem mass spectrometry revealed increases in lipid classes associated with LD, including triacylglycerol, cholesterol ester, and phospholipid classes, …

Comparing Must And The Nri Tools In The Identification Of Malnutrition In Heart Failure Patients, Cassondra D. Degener

DNP Projects

The purpose of this project was to test the performance of albumin, NRI and MUST screening tools in comparison to the standardized measure of prealbumin among HF patients admitted to the University of Kentucky Chandler Medical Center. Inclusion criteria included all HF patients with the 428 diagnostic code, admitted from January 1, - December 31, 2013, ages 18 and older, with all laboratory values available specified in the data collection tool (Appendix A). A retrospective electronic medical record (EMR) review was performed for 100 patients who met the inclusion criteria. All data were collected through the University of Kentucky’s secure …

Effect Of Tai Chi Exercise Combined With Mental Imagery Theory In Improving Balance In A Diabetic And Elderly Population, Abdulrahman Alsubiheen, Jerrold S. Petrofsky, Noha S. Daher, Everett Lohman, Edward Balbas

College of Health & Human Services (TUN) Publications and Research

BACKGROUND: One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects the sensation in the feet and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group.
MATERIAL AND METHODS: Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 40–80 years of age were recruited. All subjects in both groups attended a Yang style of TC class using MI strategies, 2 sessions a week …

Tracking Energy Balance In Adolescents: Levels Of Compliance, Energy Flux, And Learning, Senlin Chen, Xihe Zhu, Gregory J. Welk, Youngwon Kim

Human Movement Sciences Faculty Publications

Background/Objective: Advancing knowledge about energy balance (EB) is important for helping to reverse the obesity epidemic in many modern societies. This study examined adolescents' experience and perception of using an objective self-monitoring tool (SenseWear armband; SWA) and a portable diet journal to track EB for 7 days.

Methods: Forty-five 6th grade students in a midwestern state of the United States [Caucasian: n = 34, 76%; age: 11.7 ± 1.8 years; body mass index (BMI): 20.84 ± 3.94] participated in the study. The SWA, diet journal, and semistructured individual interview were used to measure energy expenditure (EE) and physical activity (PA), …

Potential Role Of Protein Kinase Cbeta In High Fat Diet-Induced Adipose Dysfunction By Regulating Autophagy Levels, Neil Mehta

Williams Honors College, Honors Research Projects

Obesity is the most common nutritional disorder in the United States and worldwide. Public health efforts and other anti-obesity measures clearly have not controlled the obesity epidemic. There is a great need to understand the pathogenic mechanisms underlying fat accumulation. Research of the past decade supports a prominent role for diet-induced adipose tissue dysfunction in the development and/or progression of obesity and associated insulin resistance. Potential mechanisms for the development of adipose tissue dysfunction include ectopic (visceral) fat accumulation, genetic factors, and alterations in autophagy and inflammatory processes. However, the molecular mechanisms linking dietary fat intake with alterations in adipose …