Nutritional and Metabolic Diseases Commons^™

Early Aggressive Insulin Therapy In Type 2 Diabetes, Bryan Johnson

Physician Assistant Scholarly Project Posters

Metformin has been proven beneficial for the first-line treatment of type 2 diabetic mellitus (T2DM) due to its efficacy and low adverse effect profile. Current US guidelines do not address the use of early intensive insulin use in T2DM. Treatment plans are slowly adjusted over the months until the A1C goal is met. Insulin is initiated several years after the time of T2DM diagnosis and utilized as second-line therapy. Dual therapy of insulin and metformin have shown regression of T2DM in certain patient populations. However, the linear relationship between diabetes and cardiovascular disease does not show greater improvement with dual …

Delaying Diabetes In The Native American Population, Seth Tramm

Physician Assistant Scholarly Project Posters

Diabetes is a debilitating disease process caused by the body’s inability to control blood glucose levels. With over 30 million diabetics in the United States and another 85 million prediabetics, the effects of this disease are wide-spread and far-reaching. Native American/Alaska Native populations have a nearly two-fold increase in prevalence of diabetes when compared to non-native populations. Risk factors for diabetes in all populations include modifiable risks such as obesity, diet, and physical inactivity as well as non-modifiable factors such as age, family history, and ethnicity. Studies have shown that early identification of symptoms, coupled with proper and intentional treatment …

Pyocyanin, A Virulence Factor Produced By Sepsis-Causing Pseudomonas Aeruginosa, Promotes Adipose Wasting And Cachexia, Nika Larian

Theses and Dissertations--Pharmacology and Nutritional Sciences

Sepsis is a leading cause of death among critically ill patients that results in metabolic alterations including hypercatabolism, lipoatrophy, and muscle wasting, contributing to the development of cachexia. Septic cachexia is associated with loss of body weight, fat mass, and lean mass and dysregulated immune function. There are currently no efficacious treatment strategies for septic cachexia, and nutritional interventions have limited success in preventing hypercatabolic wasting. Pyocyanin is a virulence factor produced by sepsis-causing Pseudomonas aeruginosa that has been shown to activate the aryl hydrocarbon receptor (AhR), increase inflammation, and produce reactive oxygen species. Thus, pyocyanin represents a novel mechanistic …

Case–Control Research Study Of Auto-Brewery Syndrome, Barbara Jean Cordell, Anup Kanodia, Gregory K. Miller

Faculty Publications

Background: Auto-brewery syndrome (ABS), also known as Gut Fermentation Syndrome and Endogenous Ethanol Fermentation, is afflicting people worldwide, but little is known about ABS patients’ demographics, health history, lifestyle factors, and diet.

Method: We conducted a broad-based case–control survey study on 52 patients known to have a diagnosis of ABS and their household members. The research compares the symptomatic group (N ¼ 28) to the asymptomatic group (N ¼ 18) regarding lifestyle and health, diet, and medical history.

Results: With a response rate of 88% and using rank-sum tests, the data demonstrate that patients with ABS have …

Exploring The Utility Of Muac In Classifying Adult Metabolic Syndrome Using Nhanes 2015-16, Hayley Boucher

Williams Honors College, Honors Research Projects

INTRODUCTION: Metabolic syndrome (MetS) is a constellation of cardiometabolic risk factors that, when presented in tandem, increases the risk of heart disease and insulin resistance. Finding a simple and validated screening method is critical to proactively intervene and attenuate the development of cardiometabolic diseases and improving healthcare outcomes. PURPOSE: This study defined and validated a risk criterion for MetS using MUAC as an alternative criterion for MetS classification risk. METHODS: The sample was derived from National Health & Nutrition Examination Survey 2015-2016 data of adults over 18 years (N = 9,971). MetS was defined using the NCEP ATP III 2005 …

Current Assessment And Intervention Strategies For Childhood Obesity Used By Pediatric Care Providers, Jennifer Bivins

DNP Projects

Childhood obesity rates in the United States have tripled since the 1970s in the U.S. (CDC, 2018). Due to the persistent rise in obesity rate sin children and the possible health risks associated with obesity, it is important for pediatric providers to appropriately assess and treat childhood obesity. There is limited data on what pediatric providers in the primary care setting are doing to address this growing health problem. PURPOSE: The purpose of this study was to determine current assessment and intervention strategies for childhood obesity used by pediatric health care providers at the University of Kentucky, General Pediatric clinic. …

Evaluation Of The New Onset Diabetic Education Program For Navajo Adults, Denise S. Bartley

Nursing ETDs

The prevalence of diabetes mellitus (DM) is higher in American Indians/Alaska Natives (AI/AN) than in any other racial or ethnic group in the United States (U.S. Department of Health and Human Services [USDHHS] Centers for Disease Control and Prevention [CDC], 2018). In response to this escalating health issue, the U.S. government funded a number of DM education and treatment programs focusing on AI/AN populations. The purpose of this study was to evaluate the New Onset Diabetes Education Program (NODEP) based at Northern Navajo Medical Center (NNMC) in Shiprock, N.M.

The Navajo philosophy of learning was used as a guiding framework. …

Autoimmune Hyperphosphatemic Tumoral Calcinosis In A Patient With Fgf23 Autoantibodies., Mary Scott Roberts, Peter D. Burbelo, Daniela Egli-Spichtig, Farzana Perwad, Christopher J. Romero, Shoji Ichikawa, Emily G. Farrow, Michael J. Econs, Lori C. Guthrie, Michael T. Collins, Rachel I. Gafni

Manuscripts, Articles, Book Chapters and Other Papers

Hyperphosphatemic familial tumoral calcinosis (HFTC)/hyperostosis-hyperphosphatemia syndrome (HHS) is an autosomal recessive disorder of ectopic calcification due to deficiency of or resistance to intact fibroblast growth factor 23 (iFGF23). Inactivating mutations in FGF23, N-acetylgalactosaminyltransferase 3 (GALNT3), or KLOTHO (KL) have been reported as causing HFTC/HHS. We present what we believe is the first identified case of autoimmune hyperphosphatemic tumoral calcinosis in an 8-year-old boy. In addition to the classical clinical and biochemical features of hyperphosphatemic tumoral calcinosis, the patient exhibited markedly elevated intact and C-terminal FGF23 levels, suggestive of FGF23 resistance. However, no mutations in FGF23, KL, or FGF receptor 1 …

Effects Of Hydrogen Sulfide In Hyperhomocysteinemia-Mediated Skeletal Muscle Myopathy., Avisek Majumder

Electronic Theses and Dissertations

Although hyperhomocysteinemia (HHcy) occurs due to a deficiency in cystathionine-β-synthase (CBS), causing skeletal muscle myopathy, it is still unclear whether this effect is mediated through oxidative, endoplasmic reticulum (ER) stress, both or something else. Cystathionine γ-lyase (CSE) and CBS are the main H₂S producing enzymes, which produce Hydrogen sulfide (H₂S) from Hcy in the transsulfuration reaction. H₂S is an anti-oxidant compound and patients with a CBS deficiency cannot produce enough H₂S, thus rendering them vulnerable to excess Hcy-mediated damage. Both in-vitro (C2C12 cells) and in-vivo (CBS+/- mice) models were used to …

Effective Measures Of Weight Gain Five Years Post-Kidney Transplantation, Tara Calico Cherry

Theses and Dissertations (ETD)

BACKGROUND: Weight gain is commonly observed post-kidney transplantation and is associated with unfavorable health outcomes, such as graft loss, new onset diabetes, and cardiovascular disease. The purpose of this study was to determine the most effective measure for assessing body composition after kidney transplantation.

DESIGN: The study was a descriptive correlational follow-up study from a single kidney transplant site.

SUBJECTS: A total of 45 eligible patients from a 2007-2011 parent study were selected, ages of 37 to 78.

MEASUREMENTS: Body composition was obtained 5–8 years posttransplant via anthropometric measures (waist circumference, body mass index, and dual energy X-ray …

Epidermal Growth Factor Receptor (Egfr) Inhibition By Polychlorinated Biphenyls Contributes To Non-Alcoholic Fatty Liver Disease (Nafld)., Josiah Hardesty

Electronic Theses and Dissertations

This dissertation describes how poly-chlorinated biphenyls (PCBs) exacerbate the pathogenesis of non-alcoholic fatty liver disease (NAFLD). While PCBs were banned in 1979, they still persist in contaminated biota, including food, and are detected in human plasma and adipose. The body burden of PCBs is associated with elevation of liver enzymes and necrosis markers in humans, characteristic of NAFLD. PCB exposure in high-fat diet fed mice leads to steatohepatitis that recapitulate the findings seen in exposed humans. The global estimate of people diagnosed with NAFLD is up to 1 in 4 people, unrelated to dietary or genetic factors. The hepatic mechanisms …

A Program To Treat Hepatitis B In North Korea: A Model Of Antiviral Therapy In A Resource-Poor Setting, Marcia Ann Kilsby, Alice Unah Lee, Heidi Linton, David C. Hilmers

Faculty Publications

Despite the well-proven, safe and effective therapies for hepatitis B infection, delivery of treatment remains a significant challenge in resource-poor settings. Geopolitical and economic restrictions present additional difficulties in providing care in North Korea. However, treatment of patients with chronic hepatitis B remains a top priority for both the North Korean Ministry of Public Health and international agencies working in North Korean hepatitis healthcare facilities. Working in partnership, a path was created to institute this much-needed program. A consortium of United States and Australian humanitarian non-governmental organizations along with generous individual and corporate donors working in concert with local and …

Orotic Aciduria, Aliah L. Fonteh

Fidei et Veritatis: The Liberty University Journal of Graduate Research

Orotic acid is an intermediate found in the pathway for pyrimidine synthesis. The mitochondrial enzyme dihydroorotate dehydrogenase (DHODH) catalyzes the production of orotic acid by the conversion of the compound dihydroorotate to orotic acid. Orotic acid is commonly produced by this reaction in erythrocytes, hepatocytes, and kidney cells. Chemical modification of orotic acid in the pyrimidine pathway will generate nucleotides involved in DNA and RNA synthesis. Orotic aciduria can occur as a secondary manifestation due to a defect in an enzyme or transporter within the urea cycle, due to competitive inhibition by anti-cancer drugs such as allopurinol and 6-azauridine, or …

Human-Like Hyperplastic Prostate With Low Zip1 Induced Solely By Zn Deficiency In Rats., Louise Y. Fong, Ruiyan Jing, Karl J. Smalley, Zi-Xuan Wang, Cristian Taccioli, Sili Fan, Hongping Chen, Hansjuerg Alder, Kay Huebner, John L. Farber, Oliver Fiehn, Carlo M. Croce

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Prostate cancer is a leading cause of cancer death in men over 50 years of age, and there is a characteristic marked decrease in Zn content in the malignant prostate cells. The cause and consequences of this loss have thus far been unknown. We found that in middle-aged rats a Zn-deficient diet reduces prostatic Zn levels (P = 0.025), increases cellular proliferation, and induces an inflammatory phenotype with COX-2 overexpression. This hyperplastic/inflammatory prostate has a human prostate cancer-like microRNA profile, with up-regulation of the Zn-homeostasis-regulating miR-183-96-182 cluster (fold change = 1.41-2.38; P = 0.029-0.0003) and down-regulation of the Zn …

Unhealthy Lifestyle And The Risk Of Metabolic Syndrome- The Romanian Experience, Angela Cozma, Adela Sitar-Taut, Laura Urian, Adriana Fodor, Ramona Suharoschi, Crina Muresan, Vasile Negrean, Dorel Sampelean, Dumitru Zdrenghea, Dana Pop, Leucuta Daniel, Olga Hilda Orasan

Journal of Mind and Medical Sciences

Background. Metabolic syndrome (MetS) represents a clustering of metabolic risk factors for cardiovascular disease. Many studies have shown the influence of an unhealthy lifestyle on the risk of MetS, yet some aspects remain controversial. Aim of the study: to investigate the relationship between an unhealthy lifestyle and the risk of MetS.

Materials and Methods. The study was conducted using a sample of 181 patients, 54 (29.8%) males and 127 (70.2%) females, aged 59.95±10.8 years. The baseline survey involved the completion of structured questionnaires and clinical examination.

Results. Rural environment, lower education level, past smoking, the absence of fruit/vegetables in the …

Epidemiology Of Diabetic Foot Infection In The Metro-Detroit Area With A Focus On Independent Predictors For Pathogens Resistant To Recommended Empiric Antimicrobial Therapy, Oryan Henig, Jason M. Pogue, Raymond Cha, Paul E. Kilgore, Umar Hayat, Mahmoud Ja'ara, Raza Muhamad Ali, Salman Mahboob, Rahul Pansare, Kathryn Deeds, Bushra Joarder, Hyndavi Kandala, Sorabh Dhar, Keith S. Kaye

Department of Pharmacy Practice

Background. The polymicrobial nature of diabetic foot infection (DFI) and the emergence of antimicrobial resistance have complicated DFI treatment. Current treatment guidelines for deep DFI recommend coverage of methicillin-resistant Staphylococcus aureus (MRSA) and susceptible Enterobacteriaceae. This study aimed to describe the epidemiology of DFI and to identify predictors for DFI associated with multidrug-resistant organisms (MDROs) and pathogens resistant to recommended treatment (PRRT).

Methods. Adult patients admitted to Detroit Medical Center from January 2012 to December 2015 with DFI and positive cultures were included. Demographics, comorbidities, microbiological history, sepsis severity, and antimicrobial use within 3 months before DFI were obtained …

Justice Served Fresh: Associations Between Food Insecurity, Community Gardening, And Property Value, Micajah Daniels, Courtney Coughenour Ph.D

McNair Poster Presentations

Numerous stakeholders in Nevada have used a variety of efforts to combat the growth of food insecurity facing Nevadans. The purpose of this research project is to understand the association between food insecurity, community gardens, and property value. Following the wealth of scholarship on these topics and data collected from community garden agencies in Southern Nevada, the research questions for this project include: (1) Where are community gardens located in SNV? (2) What efforts community gardens agencies are doing to address food insecurity (most interested in their efforts using community gardens)? (3) What are the perceptions of supports and barriers …

Geographic Differences In Obesity Prevalence And Its Risk Factors Among Asian Americans: Findings From The 2013–2014 California Health Interview Survey, Shaoqing Gong, Kesheng Wang, Ying Li, Arsham Alamian

ETSU Faculty Works

Geography disparities exist in obesity and obesity related conditions. This study aimed to examine the geographic differences in obesity prevalence and its risk factors among Asian Americans in California. Data (n = 4,000) from the 2013–2014 California Health Interview Survey were used. Obesity (≥27.5 kg/m2) was defined according to the World Health Organization Asian body mass index cut points in Asian groups. Results suggest that 66.5% of Asians lived in urban areas. Among Asian adults, obesity prevalence was highest in Filipinos (33.8%) and lowest in Koreans (12.8%). Compared to rural Vietnamese, obesity prevalence was higher for urban Vietnamese (8.3% vs. …

Cellular Senescence And Their Role In Liver Metabolism In Health And Disease: Overview And Future Directions, Matthew Schade, Jacqueline A. Sanabria, Rodrigo Aguilar, Milad Modarresi, Brad Gillon, Zach Hunter, Jacqueline Fannin, Amrita Mallick, Henri Brunengraber, Juan Sanabria

Surgery

Chronic liver disease has globally risen mainly due to a prevalent Hepatitis C Virus (HCV) infection rate and an epidemic of obesity. It is estimated by the year 2030, 2.2 billion people around the world will be overweight and 1.1 billion people will be obese. Diabetes and obesity are the main risk factors for the development of the metabolic syndrome and in the liver of Non-Alcoholic Fatty Liver Disease (NAFLD) which could progress to NASH related cirrhosis and liver malignancy. At present there is not effective therapy for NASH besides loss of weight and exercise. Furthermore, optimal management of HCC …

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …