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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Accelerated atherosclerosis is commonly observed in diabetes mellitus as well as in some kidney diseases. This may be partly due to platelet hyperactivity. Serotonin (5-HT) is thought to play a role in platelet/vessel wall interactions and to be implicated in the pathogenesis of atherosclerosis. The aim of the study was to evaluate platelet aggregation and peripheral serotonergic system in patients with diabetic nephropathy. The studies were performed in 37 patients with diabetic nephropathy (age 53.5 +/- 14.9) and healthy volunteers (age 44.2 +/- 12.3). Platelet aggregation (in PRP according to Born) induced by collagen (2 micrograms/ml), ADP (5 microM), epinephrine (10 microM) arachidonic acid (0.25 mM) and 5-HT (1 microM) was found to be significantly enhanced in diabetic relative to controls. Whole blood 5-HT was significantly lower in diabetics patients, whereas plasma 5-HT was significantly higher in diabetic patients when compared to controls. Since serotonin can amplify platelet aggregatory responses to various agonists, platelet hyperactivity in diabetes may be in part due to an enhanced availability of this amine. Disturbances in peripheral serotonergic system together with platelet hyperaggregability may be associated with an increased incidence of cardiovascular complications in diabetes.
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PMID:[Blood platelet function, plasma serotonin and lipid metabolism in patients with diabetic nephropathy]. 852 96

To investigate the role of hyperinsulinemia/insulin resistance in vasomotor tone regulation, we studied the effects of vasoactive substances on tension and intracellular free calcium concentration ([Ca2+]i) of aortic smooth muscle derived from rats that were made hyperinsulinemic by insulin infusion and from Zucker obese rats with insulin resistance. The tension and [Ca2+]i of fura 2-loaded aortic strip preparations without endothelium were simultaneously measured by using a fluorimeter. Ten male Wistar rats received a continuous subcutaneous infusion of insulin (18 nmol x kg(-1) x day(-1)) for 2 weeks with osmotic minipumps (INS group). A control group of 10 rats received vehicle. The plasma immunoreactive insulin concentration in the INS group increased to 930 +/- 54 pmol/l. The increase in [Ca2+]i and tension by KCl and phenylephrine (PE) were lower in the INS group without alteration of the [Ca2+]i-tension relationship. The responses to serotonin (5-HT) in the INS group were similar to those in the control group. In contrast, responses to KCl, PE and 5-HT were markedly enhanced in Zucker obese rats compared with those in Zucker lean rats. The pretreatment of aortic preparations from lean rats with Bay K8644 significantly enhanced the responses to KCl to the level observed in the preparations from obese rats; however, Bay K 8644 failed to affect the responses to KCl in obese rats. These results suggest that enhanced vascular contractile responses to vasoactive substances, possibly due to altered function of the voltage-dependent Ca2+ channel in vascular smooth muscle, may play an important role in the pathogenesis of hypertension in the insulin resistance syndrome.
Diabetes 1996 Jul
PMID:Augmented contractile function and abnormal Ca2+ handling in the aorta of Zucker obese rats with insulin resistance. 867 92

Although the fa/fa Zucker rat shows many of the features of type II diabetes, the absence of consistent cardiovascular complications in this model may be due to the absence of significant hyperglycaemia. We studied the consequences of streptozotocin (STZ)-induced insulin deficiency and hyperglycaemia on vascular reactivity in the fa/fa Zucker rat. Hyperinsulinaemic obese Zucker rats were rendered diabetic by injection of STZ (50-60 mg/kg intraperitoneally, i.p.), and vascular tissue was removed for study 10-12 weeks later. In isolated aorta, there was no difference in the phenylephrine (PE) concentration-response relation between lean and obese control animals, but the concentration-response curve was shifted to the left in diabetic animals, (pD2 7.56 +/- 0.04 in STZ diabetic animals, n = 8; 7.4 +/- 0.04 in obese control, n = 9, p < 0.05). The maximum response was also enhanced in both aorta and perfused mesentery of STZ-treated animals. In contrast, the potency of serotonin (5-HT) in inducing contractions of isolated aorta were enhanced in tissues from obese as compared with lean animals (pD2 6.63 +/- 0.06, n = 9; 6.17 +/- 0.07, n = 7 respectively; p < 0.01) and was attenuated in animals with STZ-induced diabetes (pD2 6.31 +/- 0.09, n = 8, p = 0.05). The differential effects of hyperglycaemia on PE-and 5-HT-induced vasoconstriction suggest that the long-lasting modulation of vasoconstrictor responses induced by increases in blood glucose level may be specific for some agonists.
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PMID:Effects of streptozotocin-induced diabetes on vascular reactivity in genetically hyperinsulinaemic obese Zucker rats. 876 57

A rat model of alloxan-induced diabetes was used to investigate the effect of diabetic state on serotonin (5-HT) levels in peripheral body compartments, gastrointestinal (GI) and platelet, and the metabolic response of these compartments to serotonin precursor (5-hydroxytryptophan, 5-HTP) loading in diabetes. In all segments of diabetic gut a massive reduction in 5-HT concentration (to 45-64% at 6th week after induction of diabetes, with further progression to 30-52% at 14th week) was shown. After parenteral loading with 5-HTP for 6 days (30 mg/kg per day) 5-HT concentration in all parts of the GI tract returned to the control values (82-108%), indicating reduced serotonin precursor availability in diabetes. Platelet serotonin levels (PSL) in diabetic rats demonstrated a slight gradual reduction that became significant at 14th week of diabetic state. On the mentioned 5-HTP challenge only blunted response of PSL in diabetics, as contrasted to control animals (54% vs. 113%) was shown, indicating possible suppression of the membrane 5-HT transporter. The observed alterations in peripheral 5-HT homeostasis in diabetic rats as well as the possibility of their reversal by 5-HTP treatment could be of clinical interest.
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PMID:Reduction of gastrointestinal serotonin in alloxan-diabetic rats: reversal by 5-hydroxytryptophan treatment. 878 20

To determine the pathogenic role of serotonin (5-HT), we investigated 5-HT metabolism in undergoing hemodialysis (HD). Mean value of platelet 5-HT in patients undergoing HD was significantly lower than that of normal controls (0.22 + or - 0.16 pmol/10(5) platelets versus 0.35 + or - 0.13 pmol/10(5) platelets, p <0.02). While platelet uptake of 5-HT in normal controls reached a plateau in each experiment after incubation with authentic 5-HT for 60 min, platelet uptake of 5-HT in patients undergoing HD reached various levels. We found significantly lower platelet 5-HT levels in patients with diabetes mellitus (DM) after HD compared with those in patients with chronic glomerulonephritis (p <0.05). The pathogenic role of serotonergic amplifying mechanism especially in patients with DM should be investigated. Second, we investigated plasma 11-dehydro-thromboxane B2 (11-DTXB2) levels in patients undergoing HD. Mean level of plasma 11-DTXB2 concentration in patients after HD was significantly higher than in patients before HD (32.8 + or - 17.0 pg/ml versus 23.7 + or - 7.2 pg/ml, p <0.02). Increased plasma levels of 11-DTXB2 after HD were regarded as an indication of hypercoagulation. Our results provide evidence that several factors such as hypercoagulation, heparin, 5-HT uptake of platelet, or causal diseases of renal failure could be responsible for the lower platelet 5-HT levels in patients undergoing HD.
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PMID:Serotonin metabolism in patients undergoing hemodialysis. 886

An increased oxidative stress has been suggested to contribute to disturbances in the regulation of coronary flow and the increased cardiac risk in diabetes. Using the isolated perfused heart of streptozotocin-diabetic rats we could recently show [21] that the basal and the maximal coronary flow (tested by infusion of sodium nitroprusside) are not altered in diabetes, but that the 5-HT stimulated endothelial dependent increase in coronary flow becomes progressively impaired. This defect of the endothelium dependent vasodilatation was prevented by perfusion of the hearts with superoxide dismutase and pre-treatment of the diabetic rats with tocopherol-acetate. Perfusion of the hearts with indomethacin to inhibit the synthesis of vasoconstricting prostaglandin endoperoxides did not improve the disturbed 5-HT induced, endothelium dependent increase in coronary flow. Furthermore, acute variations of the glucose concentration in the perfusion medium did not affect the coronary flow significantly. In myocardium, the constitutive endothelial NO synthetase was nearly exclusively expressed with the highest activity in endothelium, as determined from experiments using isolated cardiac endothelial cells. The activity of NO synthetase determined by conversion of arginine to citrulline was significantly increased in diabetes. In line with this observation, the concentration of arginine in plasma was reduced, but that of citrulline elevated. Additionally, the renal elimination of nitrite was enhanced in diabetes. These data suggest that the impaired endothelium dependent relaxation observed in the diabetic myocardium is presumably not caused by a diminished synthesis and release of NO, but by an accelerated inactivation of NO by superoxide anions. We suggest that the increased NO generation reflects a compensatory mechanism to balance the enhanced inactivation of NO.
Diabetes Res Clin Pract 1996 Jul
PMID:Impairment of endothelium dependent relaxation in the diabetic rat heart: mechanisms and implications. 886 53

The effect and mechanism of action of serotonin (5-HT) were studied in the pulmonary circulation of normal and diabetic rabbits. 5-HT (10, 50 and 100 nmol/l) produced a concentration-dependent increase in rabbit pulmonary arterial tension. Pulmonary arterial rings from diabetic rabbits were more responsive to 5-HT compared to those from normal rabbits. The pressor effects of 5-HT in normal and diabetic pulmonary arterial rings were totally abolished by either the 5-HT receptor antagonist, ketanserin (200 nmol/l) or the calcium channel blocker, verapamil (5.5 nmol/l). On the other hand, the cyclo-oxygenase inhibitor, indomethacin (0.4 nmol/l), significantly potentiated the pressor response of 5-HT in normal but not in diabetic pulmonary arterial rings. The lipoxygenase inhibitor, nordihydroguaiaretic acid (NDGA, 20 nmol/l), significantly enhanced the 5-HT-induced pressor response in normal rings while significantly attenuating those responses in diabetic rings. NG-nitro-L-arginine methyl ester (100 nmol/l), an inhibitor of nitric oxide synthase, significantly potentiated the contractile response of 5-HT in normal as well as diabetic pulmonary arterial rings. The results of this study indicate that 5-HT induces pulmonary hypertension in normal as well as in diabetic rabbits. In addition, experimentally induced diabetes exaggerates the pressor response of 5-HT and therefore may increase the risk of pulmonary hypertension. Furthermore, 5-HT alone or in combination with indomethacin, NDGA and a nitric oxide synthase inhibitor may be used to induce experimental pulmonary hypertension and possibly pulmonary edema.
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PMID:Hyperglycemia increased the responsiveness of isolated rabbit's pulmonary arterial rings to serotonin. 893 Nov

Since reduced levels of brain serotonin are known to cause behavioural abnormalities, to which diabetics are also prone, we investigated the effect, in rats, of chronic diabetes on brain serotonin concentration and on the numbers of 5-HT(1A) and 5-HT2 receptors in cerebral cortex and brainstem. Our data show that streptozotocin induces a longlasting hyperglicemia that is associated with a decrease in cerebral concentration of serotonin and with an accompanying increase in the maximum number of 5-HT(1A) and 5-HT2 receptors in the brain areas studied. Our results may suggest that changes in serotonergic transmission in the CNS play a role in diabetes-related behavioural abnormalities.
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PMID:Streptozotocin-induced diabetes provokes changes in serotonin concentration and on 5-HT1A and 5-HT2 receptors in the rat brain. 909 60

Dexfenfluramine increases serotonergic activity by stimulating serotonin (5-hydroxytryptamine; 5-HT) release into brain synapses, inhibiting its reuptake into presynaptic neurons and by directly stimulating postsynaptic serotonin receptors. On the basis of the serotonin hypothesis of appetite control, these actions would be expected to reduce appetite and, consequently, bodyweight. Studies conducted in animals and in overweight patients with and without associated disorders have confirmed the weight-reducing efficacy and good tolerability of dexfenfluramine. In 3-month clinical studies in obese patients, weight reductions with dexfenfluramine 15mg twice daily combined with dietary support were significantly higher than those achieved with placebo and similar to those with ephedrine/caffeine 20/20mg 3 times daily, sibutramine 10mg once daily and fluoxetine 60 mg/day. Furthermore, dexfenfluramine recipients with non-insulin-dependent diabetes mellitus, hyperlipidaemia or hypertension consistently show improvements in glycaemic control, blood lipid profiles and blood pressure. 12-month trial results indicate that most weight loss occurs in the initial 6 months and appears to be maintained for a further 6 months. Weight regain after withdrawal of treatment in 12-month studies demonstrates that dexfenfluramine is effective in maintaining a stable bodyweight at a lower level than placebo and in limiting food intake over this time period. Commonly reported adverse events with dexfenfluramine include diarrhoea, tiredness, dry mouth and somnolence; these symptoms are generally mild and transient. Approximately 7 and 10% of dexfenfluramine recipients in short and long term studies withdrew because of adverse events. Dexfenfluramine was better tolerated than ephedrine/caffeine and fluoxetine in short term studies. Obesity is a chronic condition that is accompanied by a number of metabolic complications. It is a significant health problem in developed countries, and as a major risk factor for many chronic diseases, including diabetes and cardiovascular disease, the economic burden of this condition is considerable. As with other chronic conditions, there is a role for pharmacological intervention in patients with severe obesity. However, drugs should be considered as only one component of a weight-control programme, since additional lifestyle modification is required to maintain weight loss. The promising data on the long term efficacy and tolerability of dexfenfluramine as well as its favourable effects on risk factors associated with obesity requires confirmation in long term studies. In the meantime, dexfenfluramine should be considered a valuable adjunct to a reduced-calorie diet in the management of severe obesity, particularly in patients with associated disorders and those unsuccessful with conventional weight loss measures. Available data support the use of the drug for up to 1 year to maintain weight loss and thus dexfenfluramine should be considered for long term administration.
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PMID:Dexfenfluramine. An updated review of its therapeutic use in the management of obesity. 911 19

The direct influence of indoleamines on ovarian peptide hormones and growth factor secretion, in contrast to steroidogenesis, is yet to be thoroughly investigated. The aim of our in vitro experiments was to investigate the influence of melatonin and serotonin (5-hydroxy-tryptamine) (0.01-10 micrograms/ml) on the release of insulin-like growth factor-I (IGF-I), oxytocin and progesterone by cultured human granulosa cells. It was observed that both melatonin and serotonin stimulate IGF-I release. Melatonin also stimulated oxytocin output. Serotonin increased oxytocin secretion only at the highest dose (10 micrograms/ml). Both melatonin and serotonin were potent inhibitors of progesterone release. The present results suggest a possible involvement of the indoleamines melatonin and serotonin in the direct regulation of growth factor, nonapeptide and steroid hormone secretion by human ovarian cells.
Exp Clin Endocrinol Diabetes 1997
PMID:Melatonin and serotonin regulate the release of insulin-like growth factor-I, oxytocin and progesterone by cultured human granulosa cells. 913 42


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