Growth differentiation factor 15 (GDF15) is a strong predictor of cardiovascular morbidity and mortality found to be both marker and target of impaired glucose metabolism. GDF15 increases following ...glucose administration and is up-regulated in obesity and diabetes. We investigate here the relationship between GDF15 and beta cell function.
In this cross-sectional study we evaluated GDF15 concentrations in 160 obese subjects (BMI 35–63 kg/m2, age 39.4 ± 18.6 years, m/f 38/122) who underwent a 75 g oral glucose tolerance test (OGTT). Based on the OGTT results, the cohort was divided into two groups: 1) normal fasting glucose and normal glucose tolerance (n = 80), 2) impaired fasting glucose, impaired glucose tolerance or type 2 diabetes (n = 80). The relationship of GDF15 to fasting and OGTT-based dynamic insulin sensitivity and insulin secretion parameters was evaluated.
GDF15 was higher in the prediabetes and diabetes groups and correlated with HbA1c, glucose, insulin as well as baseline and dynamic indices of insulin sensitivity and estimated beta cell function. Multiple regression analysis revealed that age, waist-to-height ratio, glomerular filtration rate and prehepatic beta cell function, but not the grade of impairment of glucose metabolism, were independent predictors of GDF15. Subgroup analysis showed that of all parameters of glucose metabolism only C-peptide, fasting prehepatic beta cell function and insulinogenic index remained significantly related to GDF15 in both groups.
We conclude that in patients with severe obesity, GDF15 strongly relates to beta cell function and should be further investigated as a potential therapeutic target and biomarker guiding treatment options.
•The cardiovascular risk marker GDF15 is up-regulated in obesity and diabetes.•We studied GDF15 levels in 160 obese subjects with or without prediabetes/diabetes.•We found prehepatic beta cell function to be a strong predictor of GDF15 levels.•GDF15 could be a therapeutic target in the preservation of beta cell compensation.
Acute pancreatitis (AP) is the third most common gastrointestinal disease resulting in hospital admission, with over 70% of AP admissions being mild cases. In the USA, it costs 2.5 billion dollars ...annually. The most common standard management of mild AP (MAP) still is hospital admission. Patients with MAP usually achieve complete recovery in less than a week and the severity predictor scales are reliable. The aim of this study will be to compare three different strategies for the management of MAP.
This is a randomised, controlled, three-arm multicentre trial. Patients with MAP will be randomly assigned to group A (outpatient), B (home care) or C (hospital admission). The primary endpoint of the trial will be the treatment failure rate of the outpatient/home care management for patients with MAP compared with that of hospitalised patients. The secondary endpoints will be pain relapse, diet intolerance, hospital readmission, hospital length of stay, need for intensive care unit admission, organ failure, complications, costs and patient satisfaction. The general feasibility, safety and quality checks required for high-quality evidence will be adhered to.
The study (version 3.0, 10/2022) has been approved by the Scientific and Research Ethics Committee of the 'Institut d'Investigació Sanitaria Pere Virgili-IISPV' (093/2022). This study will provide evidence as to whether outpatient/home care is similar to usual management of AP. The conclusions of this study will be published in an open-access journal.
ClinicalTrials.gov Registry (NCT05360797).
Ce livre propose une sélection de travaux présentés lors du colloque international qui s'est tenu à l'Université de Perpignan Via Domitia en mars 2012 en présence d'Enrique Vila-Matas et de son ...traducteur André Gabastou. On y trouvera, outre un texte inédit de l'auteur, des contributions de spécialistes de son œuvre qui montrent combien la géographie, qu'elle soit mentale ou physique, littéraire ou virtuelle, est un motif particulièrement fécond pour cet écrivain funambule qui n'a pas d'équivalent et dont les textes, même soumis à l'étude, ne laissent pas d'être vertigineux.
L’energia no es crea ni es destrueix; només es transforma1. Els éssers vius obeïm aquest principi i com a tal, el trànsit d’energia que ens permet viure pot descriure’s en termes de balanç energètic ...(figura 1). Aquest és dependent de la ingesta i l’emmagatzematge energètics, així com del seu consum. En conseqüència, la relació entre els seus elements ens permet predir si un individu mantindrà constant o no el seu pes corporal.
