Browsing by Subject "diabetes complications"

Sort by: Order: Results:

Now showing items 1-3 of 3
  • Tynjälä, Anniina; Forsblom, Carol; Groop, Per-Henrik; Gordin, Daniel; Harjutsalo, Valma (Helsingin yliopisto, 2020)
    The fact that individuals with type 1 diabetes (T1D) are at greater risk for cardiovascular disease and premature death, can only partly be explained by traditional risk factors. Interestingly, T1D is accompanied by arterial stiffening that correlates with microvascular and macrovascular complications. The aim of this study was to find out whether arterial stiffness predicts all-cause mortality in individuals with T1D. Augmentation index (AIx), a measure of arterial pulse wave reflections, is used to estimate stiffness in the resistance arteries and can be determined non-invasively from pulse wave analysis by applanation tonometry. The data consisted of 906 individuals with T1D from the FinnDiane Study that have been examined for arterial stiffness, cardiovascular risk factors and diabetic complications at baseline between 2001 and 2015. After a median follow-up of 8.2 (5.7-9.7) years, 67 individuals had died according to mortality data from Statistics Finland. They had higher baseline AIx (28 [21-33] vs. 19 [9-27] %, P < 0.001) compared to those alive. This association was independent of related risk factors (age, sex, BMI, HbA1c, triglycerides, renal function and past cardiovascular events) in Cox regression analysis (hazard ratio 1.042 [1.007-1.078], P = 0.017). Arterial stiffness estimated by AIx independently predicted all-cause mortality in T1D. Promising pharmacological agents counteracting arterial stiffness include inhibitors of the renin-angiotensin-aldosterone system and sodium-glucose co-transporter 2, and research data on their effect in individuals with T1D is constantly growing. Our finding suggests that detecting early arterial stiffening individuals with T1D could be useful in targeting a more aggressive treatment for high-risk individuals.
  • Franzén, Markus (Helsingin yliopisto, 2020)
    Bakgrund: Avancerade glykerade slutprodukter (AGEs), som uppstår via icke-enzymatiska reaktioner i vävnader har under senare tid varit fokus för mycket forskning. AGEs ackumulering sker under en människas livstid, men accelereras under oxidativ stress och hyperglykemi. AGEs har implicerats i patogenesen i flertalet kroniska sjukdomar och deras komplikationer. Syftet med denna studie är att utreda hur hudens autofluorescens (SAF), som har verifierat att korrelera med AGEs i huden, korrelerar med morbiditet och levnadsvanor. Metoder: Denna studie baseras på ett material på 166 individer som deltagit mätningen av SAF och som varit med i Helsinki Birth Cohort Study (HBCS). HBCS är en kohortstudie av 13 345 personer födda i Helsingfors mellan åren 1934 och 1944. SAF uppmättes med AGE reader™, Diagnoptics. Faktorer som vi undersökte ifall SAF korrelerar med är: diabetes typ 1 och 2, hypertension samt vaskulär sjukdom. Vi undersökte också ifall SAF påverkas av livsstilsfaktorer såsom alkoholkonsumtion, rökning, BMI och fettprocent. Resultat: I denna studie kunde vi visa att SAF korrelerade med diabetes typ 2 samt inom diabetiker hade personer med vaskulär sjukdom högre SAF. Slutsatsen av detta är att i framtiden möjligen SAF skulle kunna användas som en tilläggsriskfaktor för vaskulär risk hos diabetiker.
  • Keindl, Magdalena; Fedotkina, Olena; du Plessis, Elsa; Jain, Ruchi; Bergum, Brith; Mygind Jensen, Troels; Laustrup Moller, Cathrine; Falhammar, Henrik; Nystrom, Thomas; Catrina, Sergiu-Bogdan; Jorneskog, Gun; Groop, Leif; Eliasson, Mats; Eliasson, Bjorn; Brismar, Kerstin; Nilsson, Peter M.; Berg, Tore Julsrud; Appel, Silke; Lyssenko, Valeriya (2020)
    Type 1 diabetes (T1D) is largely considered an autoimmune disease leading to the destruction of insulin-producing pancreatic beta cells. Further, patients with T1D have 3-4-fold increased risk of developing micro- and macrovascular complications. However, the contribution of immune-related factors contributing to these diabetes complications are poorly understood. Individuals with long-term T1D who do not progress to vascular complications offer a great potential to evaluate end-organ protection. The aim of the present study was to investigate the association of inflammatory protein levels with vascular complications (retinopathy, nephropathy, cardiovascular disease) in individuals with long-term T1D compared to individuals who rapidly progressed to complications. We studied a panel of inflammatory markers in plasma of patients with long-term T1D with (n = 81 and 26) and without (n = 313 and 25) vascular complications from two cross-sectional Scandinavian cohorts (PROLONG and DIALONG) using Luminex technology. A subset of PROLONG individuals (n = 61) was screened for circulating immune cells using multicolor flow cytometry. We found that elevated plasma levels of soluble interleukin-2 receptor alpha (sIL-2R) were positively associated with the complication phenotype. Risk carriers of polymorphisms in the IL2RA and PTPN2 gene region had elevated plasma levels of sIL-2R. In addition, cell surface marker analysis revealed a shift from naive to effector T cells in T1D individuals with vascular complications as compared to those without. In contrast, no difference between the groups was observed either in IL-2R cell surface expression or in regulatory T cell population size. In conclusion, our data indicates that IL2RA and PTPN2 gene variants might increase the risk of developing vascular complications in people with T1D, by affecting sIL-2R plasma levels and potentially lowering T cell responsiveness. Thus, elevated sIL-2R plasma levels may serve as a biomarker in monitoring the risk for developing diabetic complications and thereby improve patient care.