One of the proposed mechanisms for the development of diabetic nephropathy (DN) is the increase of end products of advanced glycosylation (AGEs), which bind to its receptor (RAGE), favoring nephron ...cellular damage. An isoform of this receptor is soluble RAGE (sRAGE), which can antagonize AGE-altered intracellular signaling. It has known that green tea extract (GTE) increases the expression of sRAGE, but it is unknown whether this could improve kidney function. The objective of this study was to evaluate the effect of the administration of GTE on the concentrations of sRAGE, renal function, and metabolic profile in patients with type 2 diabetes mellitus (T2DM) and DN. A randomized, double-blinded, placebo-controlled clinical trial was carried out in 39 patients who received GTE (400 mg every 12 h) or placebo for 3 months. sRAGE levels, renal function, and metabolic parameters were determined before and after the intervention. In the GTE group, there were statistically significant increase on sRAGE (320.55 ± 157.63 pg/mL vs. 357.59 ± 144.99 pg/mL;
= .04) and glomerular filtration rate (GFR; 66.44 ± 15.17 mL/min/1.73 m
vs. 71.70 ± 19.33 mL/min/1.73 m
;
= .04), and a statistically significant decrease in fasting serum glucose (7.62 ± 3.00 mmol/L vs. 5.86 ± 1.36 mmol/L;
≤ .01) and triacylglycerols (1.91 ± 0.76 mmol/L vs. 1.58 ± 0.69;
= .02). Administration of GTE increases the serum concentration of sRAGE and the GFR and decreases the concentration of fasting serum glucose and triacylglycerols. The study was registered in ClinicalTrials.gov with the identifier NCT03622762.
Obesity, a major health issue worldwide, is associated with increased cardiovascular risk, endothelial dysfunction, and arterial stiffness. Tadalafil has been demonstrated to improve vascular ...parameters.
To evaluate the effect of a single 20 mg dose of tadalafil on flow-mediated dilation and hemodynamic and arterial stiffness markers.
A randomized, double-blind, placebo-controlled study was conducted on 80 participants (41 assigned to placebo and 39 to tadalafil) with grade 1 obesity, to evaluate the acute effect of a single dose of 20 mg of tadalafil on flow-mediated dilation and hemodynamic and arterial stiffness markers.
Tadalafil did not modify flow-mediated dilation. However, it significantly lowered systolic blood pressure (SBP) (130.6±17.1 vs. 125.0±12.7 mmHg, p=0.011), diastolic blood pressure (82.7±18.2 vs. 76.5±11.8 mmHg, p≤0.001), central systolic blood pressure (116.33±19.16 vs. 109.90±15.05 mmHg, p=0.001), the augmentation index (69.1±17.1 vs. 65.7±14.4, p=0.012), and brachial-ankle pulse wave velocity (1229.7±218.4 vs. 1164.0±181.7, p=0.001).
A single dose of tadalafil did not modify flow-mediated dilation in patients with grade 1 obesity but improved blood pressure and brachial-ankle pulse wave velocity.
Background
Obesity is a global health problem, it is associated with diabetes, hypertension, and cardiovascular diseases
1
and negative hemodynamic effects have been observed
2
. Tadalafil has ...shown an improvement in endothelial function
3
the aim of the present investigation was to evaluate its effects on hemodynamic parameters in patients with grade I–II obesity.
Objective
To evaluate the acute effect of tadalafil on hemodynamic and arterial stiffness parameters.
Methods
A double blind clinical trial, randomized, was carried out in patients with grade I–II obesity. Seventy patients were allocated to receive placebo or a single dose of 20 mg of tadalafil; hemodynamic (Omron HEM 9000, UNEXEF) and arterial stiffness (Omrom VP1000) parameters were determined before and 24 hours after intervention. The values are expressed in mean ± SD. Wilcoxon rank test and U de Mann-Whitney were applied.
p
< 0.05 was considerated as statistically significant.
Results
Both groups were comparable in the baseline. After the intervention a statistically significant changes were shown in the tadalafil group in the diastolic blood pressure (DBP), (.001); second systolic shoulder 2 (SYS2), (.003); augmentation index (Aix), (.049); and braquial-ankle pulse wave velocity (BAPWV), (.005). After that, changes between groups were analyzed and only DBP (−2.39,
p
= .017) and BAPWV (
p
= .028) were statistically significant. No changes were observed in flow mediated dilatation (FMD).
Conclusion
Tadalafil modifies DBP and BAPWV but it had not effect on FMD in the acute administration.
Introduction/objectives
First-degree relatives (FDR) of patients with rheumatoid arthritis (RA) are at increased risk of RA diagnosis. Magnetic resonance imaging (MRI) has been proposed as a useful ...tool to detect subclinical synovitis and bone abnormalities as predictors of progression to RA. The presence of grade ≥ 2 bone erosions in RA MRI scoring system (RAMRIS) was reported to be RA-specific. We aim to describe the prevalence and characteristics of MRI findings in RA patients and FDR.
Methods
A cross-sectional and exploratory study of 60 individuals was performed in 38 RA patients and 22 FDR with hand arthralgia without clinical arthritis and positive rheumatoid factor or anticitrullinated protein antibodies. All patients underwent an MRI and were evaluated for synovitis, bone erosion, and bone marrow edema. We evaluated second to fifth metacarpophalangeal joints of the dominant hand according to RAMRIS.
Results
Among the total population, eighteen (30%) subjects had grade ≥ 2 bone erosions, and 42 (70%) had at least one erosion of any grade. In patients with grade ≥ 2 bone erosions, 12 (31.6%) were from RA patients and 6 (27.2%) from FDR (
p
= 0.72). In patients with erosions of any grade, 26 (68.4%) were from RA patients and 15 (68.2%) were from FDR (
p
= 0.98).
Conclusion
A high prevalence of bone erosions was found in RA patients’ FDR who had symptoms without clinical arthritis and positive serology. MRI might be helpful in this population for an early detection of RA-specific erosions. The prognosis and the treatment decisions in these subjects should be elucidated.
Key points:
• First-degree relatives (FDR) of rheumatoid arthritis (RA) patients with positive serology and joint symptoms constitute a select subpopulation of individuals with an increased risk of developing RA.
• Magnetic resonance imaging (MRI) of FDR shows a high prevalence of bone erosions of any grade, grade
≥
2 erosions, and synovitis.
• MRI might be helpful in FDR of RA patients to screen for the presence of RA-specific erosions or clinically undetectable synovitis.
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