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 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Optic nerve disease has been reported in patients with renal failure. A toxic aetiology has been postulated. The incidence of this complication of renal failure has not been determined. We observed 60 patients with renal failure on dialysis for 24 months to determine the incidence of optic neuropathy. Four patients developed typical acute ischaemic optic neuropathy. Their case notes were reviewed in order to determine the pathogenesis. Each patient had long-standing renal failure and its sequelae of anaemia and hypertension. The immediate causes of ischaemia were hypotension in 1, severe anaemia in 1, and generalised atherosclerosis in 2 patients.
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PMID:Optic neuropathy in uraemic patients on dialysis. 832 6

Advanced glycosylation end products (AGEs) are a potentially useful marker for monitoring glycemic control, predicting the risk of diabetes- and aging-associated clinical complications, and monitoring the treatment of patients with micro- and macrovascular diseases, including retinopathy, atherosclerosis, nephropathy, and neuropathy. AGEs or AGE-proteins are derived from nonenzymatically glycated proteins (Amadori products) after further cross-linking with other proteins and additional rearrangement. AGE-proteins can be assayed by either radioreceptor or immunoassays in blood and tissues. No commercial kit is available at this time.
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PMID:Advanced glycosylation end products: a new disease marker for diabetes and aging. 841 Apr 84

The hallmark of diabetes mellitus, whether type I or type II, is hyperglycemia. Clinical complications associated with diabetes are most likely the consequence of hyperglycemia via both altered metabolic pathways and nonenzymatic glycation of proteins. The nonenzymatic glycation of proteins is accelerated in diabetes due to elevated blood glucose concentration. The Amadori product of nonenzymatic glycation will further cross-link with other proteins to form advanced glycosylation end products (AGEs). The reaction of AGEs with long-lived proteins, such as collagen, and the uptake of AGEs by the receptors on macrophages, endothelial cells, and platelets are major reasons for the development of various clinical complications in diabetes. Several markers have been identified for the screening, diagnosis, and monitoring of the disease. Autoantibodies against beta cells are the best markers for mass screening and for early detection of type I diabetes. In addition to glycated hemoglobin, AGEs and blood glycated proteins of various half-lives could be used for monitoring glycemic control. Several abnormal metabolites have been identified as potential markers for monitoring the severity of various clinical complications. The most interesting findings in diabetic markers could be AGEs. The amount of AGEs found in the tissues could be related to the extent of micro- and macrovascular damage and might prove useful for monitoring the treatment of patients at early stages of either nephropathy, atherosclerosis, retinopathy, or neuropathy.
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PMID:Review of diabetes: identification of markers for early detection, glycemic control, and monitoring clinical complications. 841 Apr 89

Recently, a high plasma level of lipoprotein(a) [LP(a)] has been considered an independent risk factor for atherosclerosis and its sequelae, particularly myocardial infarction. Patients with non-insulin-dependent diabetes mellitus (NIDDM) have an increased mortality rate from cardiovascular and cerebrovascular disease. Therefore, plasma concentrations of Lp(a) were determined and the relationship between fasting plasma Lp(a) level and diabetic control was investigated in NIDDM patients without any diabetic complications. Fasting plasma Lp(a) levels were measured using enzyme-linked immunosorbent assay kits [Terumo Medical Corp, Elkton, MD, Lp(a)] in 61 NIDDM subjects (30 men aged 56 +/- 2.0 years, 31 women aged 53 +/- 2.1 years [mean +/- SEM]) who were without any diabetic macroangiopathy and microangiopathy such as retinopathy, nephropathy, and neuropathy and in 56 healthy age- and sex-matched controls. Plasma Lp(a) levels were significantly higher in the diabetic group than in the control group (23.5 +/- 2.5 v 11.7 +/- 1.4 mg/dL [mean +/- SEM], P < .001). There was no significant correlation between log-transformed plasma Lp(a) levels and other factors such as age, sex, body mass index (BMI), blood pressure, duration of diabetes, fasting plasma glucose (FPG) level, glycosylated hemoglobin (HbA1C) level, and plasma lipid levels except for low-density lipoprotein cholesterol (LDL-C) levels in diabetic patients. A significant positive correlation was noted in diabetic patients between the changes of log Lp(a) and HbA1C levels after a 3-month follow-up period (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alteration of lipoprotein(a) concentration with glycemic control in non-insulin-dependent diabetic subjects without diabetic complications. 841 45

We have reappraised studies on morbidity and mortality in continuous ambulatory peritoneal dialysis (CAPD), comparing it with hemodialysis (HD), the standard treatment for end-stage renal disease (ESRD). More hospitalization is required for CAPD, the difference being related to peritonitis, to the more frequent presence of some risk factors (such as diabetes and atherosclerosis) in the patients selected for CAPD, and to the lack of experience in the early years of CAPD practice. CAPD patients have less acute morbidity during treatment that not always requires hospitalization: hypotension, hypertension, arrhythmias, and myocardial ischemia. Cardiac performance is also better in CAPD patients, who develop less myocardial hypertrophy than HD patients. Hospitalization due to infectious disease not referable to technique, beta 2-microglobulin related morbidity, signs of uremic neuropathy, osteodystrophy, and malnutrition are similar in both groups. Method survival is better for HD, the difference being completely accounted for by peritonitis. Patient survival adjusted for pre-treatment differences is similar in CAPD and HD, and this is not an artifact of more drop-outs on CAPD. A high incidence of peritonitis is accompanied by an increased risk of death. Older patients have a lesser risk of death on CAPD than on HD. Diabetics have a worse survival than non-diabetics, with no difference between the two methods. Although patient survivals on CAPD and HD are the same, differences in the mode of blood purification have an interesting impact on particular aspects of morbidity.
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PMID:Morbidity and mortality of CAPD and hemodialysis. 844 38

Of the various types of diabetes mellitus, non-insulin-dependent diabetes (NIDDM) is by far the most common and is increasing rapidly in many populations around the world. It is a heterogeneous disorder, characterized by a genetic predisposition and interaction between insulin resistance and decreased pancreatic beta-cell function. There is a strong association between the presence of obesity and low levels of physical exercise and the development of NIDDM. However, NIDDM may also develop in lean individuals and the incidence increases significantly with increasing age. A diagnosis of impaired glucose tolerance or gestational diabetes is a strong predictor for future development of NIDDM and should signal appropriate interventions to prevent or delay the progression to NIDDM. NIDDM is frequently associated with other conditions such as hypertension, hypertriglyceridemia and decreased high-density lipoprotein which are additional risk factors for atherosclerosis and cardiovascular disease. The 'insulin resistance syndrome', which includes obesity, NIDDM, hypertension, hyperinsulinemia and dyslipidemia is a major and increasing cause of morbidity and mortality in many populations. In addition, people with NIDDM and poor glycemic control may develop severe microvascular complications of diabetes, including retinopathy, nephropathy and neuropathy. Appropriate diet, weight control and increased physical activity will increase insulin sensitivity in insulin resistant patients and are effective treatments for patients with NIDDM or may prevent the development of NIDDM in susceptible individuals. If these measures are unsuccessful, then oral hypoglycemic agents or insulin therapy may be required.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:NIDDM--the devastating disease. 852 17

The ageing of connective tissues involves modifications of collagen, which are currently generating much interest amongst protein researchers. Protein glycation, a non-enzymic reaction involving sugar, appears to play a role in the evolution of age-related physical changes and diabetic complications-retinopathy, neuropathy, renal failure and atherosclerosis. Our studies show that the glycation of human corneal and scleral collagen produces increases in the collagen intermolecular spacing-these increases are similar to those we previously reported on the ageing of collagen in these tissues. The present investigation employs X-ray diffraction to look at the structural effects of various substances that are believed in inhibit protein glycation. Aspirin-like compounds and certain vitamins successfully prevented the sugar-induced molecular changes from occurring in corneal and scleral collagen, suggesting that such compounds could have a useful role in this aspect of ageing.
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PMID:Vitamins and analgesics in the prevention of collagen ageing. 883 72

For decades, research interest has focused on hypertriglyceridemia and hypercholesterolemia, because of their association with atherosclerosis. Recently, however, increasing attention has been paid to rare hypolipidemic states that can cause adverse consequences in young patients. Studies of genetic disorders of fat transport have afforded new insights into the mechanisms involved in intestinal lipid handling and lipoprotein metabolism. This article reviews briefly the current state of knowledge about inherited lipoprotein deficiencies, including abetalipoproteinemia, hypobetalipoproteinemia and chylomicron retention disease. These disorders share many common characteristics: they all cause fat malabsorption, low levels of circulating lipids and fat-soluble vitamins, failure to thrive in early childhood, ataxic neuropathy and visual impairment. However, their etiology is genetically different. Abetalipoproteinemia is caused by the absence of microsomal transfer protein, whereas hypobetalipoproteinemia is due to defects in the apolipoprotein B gene. The etiopathogenesis of chylomicron retention disease is as yet unexplained. Research on these rare, inherited fat disorders of absorption will continue to provide significant advances in our understanding of human physiology and may yield novel therapeutic approaches to atherosclerosis.
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PMID:The genetic basis of primary disorders of intestinal fat transport. 888 69

Recently, the number of diabetic patients in Japan has increased and reached 6 millions, and it was estimated that 1.5 million diabetic patients were suffering from diabetic complications of microangiopathy (neuropathy, retinopathy and nephropathy) and macroangiopathy. According to the study for the causes of death among Japanese diabetic patients during 10 years from 1981 to 1990, mean longevity of diabetic patients was shorter of 9.4 years in men and 13.5 years in women than those of non-diabetics. Forty percent of diabetic patients died from the vascular diseases (ischemic heart disease 14.6%, cerebrovascular disease 13.5% and renal disease 11.2%). The frequency of death due to ischemic heart disease was almost double in diabetic patients in comparison to non-diabetics in Japan. From the data obtained from the study of Japanese-American, more than 50% of them showed abnormal glucose tolerance and the frequency of ischemic heart disease was higher twice than that of Japanese. Diabetes has been recognized as one of the important risk factors for atherosclerosis, and so many factors, such as hyperglycemia, glycation, dyslipidemia, hyperinsulinemia, insulin resistance, hypertension and obesity in diabetes, are related to atherosclerosis. The relation of these factors will be introduced. Clinically, it is very important to make a check list of these factors and make an effort to diminish them for prevention of atherosclerosis of diabetic patients.
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PMID:[Diabetes and atherosclerosis]. 895 31

As the result of an increase in the ageing of the population and an expected rise in age-specific incidence, the number of elderly patients with diabetes mellitus will increase in most developed countries. However, in elderly diabetic patients, the difference in prevalence of late complications such as microalbuminuria, neuropathy and atherosclerosis with that in the normal population tends to disappear. In contrast retinopathy is a frequently occurring complication among elderly diabetics which does not appear in the normal population. As a result there will be an increase in demand for health care by the elderly diabetic population in future and epidemiological research can help find a solution to this problem. Estimation of the prevalence of known and unknown diabetes mellitus over time, and of the late complications, in different age groups is recommended. In addition, further research needs to be done on the risk factors for the age-related increase of glucose impairment and diabetes mellitus and on the risk factors for late complications in the elderly patient.
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PMID:Epidemiology of type II diabetes mellitus and ageing of the population: health policy implications and recommendations for epidemiological research. 911 45


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