Diabetes in Asia Ramachandran, Ambady, Dr; Wan Ma, Ronald Ching, MRCP; Snehalatha, Chamukuttan, DSc
The Lancet (British edition),
01/2010, Letnik:
375, Številka:
9712
Journal Article
Recenzirano
Summary Prevalence of type 2 diabetes has rapidly increased in native and migrant Asian populations. Diabetes develops at a younger age in Asian populations than in white populations, hence the ...morbidity and mortality associated with the disease and its complications are also common in young Asian people. The young age of these populations and the high rates of cardiovascular risk factors seen in Asian people substantially increase lifetime risk of cardiovascular disease. Several distinctive features are apparent in pathogenetic factors for diabetes and their thresholds in Asian populations. The economic burden due to diabetes at personal, societal, and national levels is huge. National strategies to raise public awareness about the disease and to improve standard of care and implementation of programmes for primary prevention are urgently needed.
A mathematical–chemical approach using alkyl biradicals has been used to enumerate isomers of alkenes, alkylcyclopropanes, and alkyl triradicals for alkylcyclobutadienes. In this non-recursive ...enumeration method for the number of constitutional isomers of methyl alkanes (branched-chain alkanes with all branches to be CH
3
), a methyl alkane of
n
carbon atoms is formed from
a
number of methyldiyl radicals:CH
2
,
b
number of 1,1-ethanediyl radicals:CH–CH
3
,
c
number of 2,2-propanediyl radical:C–(CH3)
2
, and 2 methyl radicals ·CH3, where
a, b, and c
are solutions of a Diophantine equation
a
+ 2
b
+ 3
c
+ 2 =
n
. This algorithm does not have to use any previous data on alkyl biradicals and alkanes. Intuitively, in a hydrocarbon isomer series, the number of constitutional isomers of a hydrocarbon of
n
+ 1 carbon atoms should be larger than that of having
n
carbon atoms, except at the beginning of the series. A graphical proof showed that the conjecture is erroneous for symmetrical methyl alkanes. In addition, the graphical proof showed that even and odd isomer series of symmetrical methyl alkanes are equivalent, i.e., having the equal number of isomers and form equivalent pairs with each pair containing the same number of symmetrical isomers. To my knowledge, this characteristic of a hydrocarbon isomer series has not been reported in the literature since Cayley’s publication on the mathematical theory of isomers.
Background: Sarcopenia can predispose individuals to falls, fractures, hospitalization, and mortality. The prevalence of sarcopenia depends on the population studied and the definition used for the ...diagnosis. Objective: This systematic review and meta-analysis aimed to investigate the association between sarcopenia and mortality and if it is dependent on the population and sarcopenia definition. Methods: A systematic search was conducted in MEDLINE, EMBASE, and Cochrane from 1 January 2010 to 6 April 2020 for articles relating to sarcopenia and mortality. Articles were included if they met the following criteria – cohorts with a mean or median age ≥18 years and either of the following sarcopenia definitions: Asian Working Group for Sarcopenia (AWGS and AWGS2019), European Working Group on Sarcopenia in Older People (EWGSOP and EWGSOP2), Foundation for the National Institutes of Health (FNIH), International Working Group for Sarcopenia (IWGS), or Sarcopenia Definition and Outcomes Consortium (SDOC). Hazard ratios (HR) and odds ratios (OR) were pooled separately in meta-analyses using a random-effects model, stratified by population (community-dwelling adults, outpatients, inpatients, and nursing home residents). Subgroup analyses were performed for sarcopenia definition and follow-up period. Results: Out of 3,025 articles, 57 articles were included in the systematic review and 56 in the meta-analysis (42,108 participants, mean age of 49.4 ± 11.7 to 86.6 ± 1.0 years, 40.3% females). Overall, sarcopenia was associated with a significantly higher risk of mortality (HR: 2.00 95% CI: 1.71, 2.34; OR: 2.35 95% CI: 1.64, 3.37), which was independent of population, sarcopenia definition, and follow-up period in subgroup analyses. Conclusions: Sarcopenia is associated with a significantly higher risk of mortality, independent of population and sarcopenia definition, which highlights the need for screening and early diagnosis in all populations.
Intersubjective cultural representation refers to a collective’s common representation of a culture. Such representation provides a meaningful basis for individuals to develop identification with the ...culture. Specifically, the more an individual’s personal values are aligned with values intersubjectively represented to be important to a culture, the more strongly the individual would identify with the culture. Consideration of the role of intersubjective representation in cultural identification has implications for future research on the development of cultural identity, especially in multicultural contexts.
The researcher, motivated by personal core concerns and reflections on visual empowerment teaching, participated in a Southeast Asian migrant worker filmmaking teaching project. This project ...attempted to cross boundaries through self-narrative documentary filming, employing engaged pedagogy theory that integrate critical pedagogy, multicultural education, and feminist theory. The study focuses on the "inter-subjective teacherstudent relationship" as its core teaching philosophy. Using a "problemposing dialogue" teaching method, the instructor listens to the life experiences and stories of migrant worker learners. The research employs a case study approach to collect data, exploring how learning supporters and the learner co-construct videos with non-mainstream consciousness and viewpoints. The participant is an Indonesian female migrant worker sheltered in a resettlement center due to special circumstances. The research conclusions are as follows: First, the teaching process, through continuous and repeated "
The increasing prevalence of diabetes and its complications, such as cardiovascular and kidney disease, remains a huge burden globally. Identification of biomarkers for the screening, diagnosis, and ...prognosis of diabetes and its complications and better understanding of the molecular pathways involved in the development and progression of diabetes can facilitate individualized prevention and treatment. With the advancement of analytical techniques, metabolomics can identify and quantify multiple biomarkers simultaneously in a high-throughput manner. Providing information on underlying metabolic pathways, metabolomics can further identify mechanisms of diabetes and its progression. The application of metabolomics in epidemiological studies have identified novel biomarkers for type 2 diabetes (T2D) and its complications, such as branched-chain amino acids, metabolites of phenylalanine, metabolites involved in energy metabolism, and lipid metabolism. Metabolomics have also been applied to explore the potential pathways modulated by medications. Investigating diabetes using a systems biology approach by integrating metabolomics with other omics data, such as genetics, transcriptomics, proteomics, and clinical data can present a comprehensive metabolic network and facilitate causal inference. In this regard, metabolomics can deepen the molecular understanding, help identify potential therapeutic targets, and improve the prevention and management of T2D and its complications. The current review focused on metabolomic biomarkers for kidney and cardiovascular disease in T2D identified from epidemiological studies, and will also provide a brief overview on metabolomic investigations for T2D.
One of the challenges in polymer science has been to prepare large-polymer single crystals. We demonstrate a visible light-triggered quantitative topochemical polymerization reaction based on a ...conjugated dye molecule. Macroscopic-size, high-quality polymer single crystals are obtained. Polymerization is not limited to single crystals, but can also be achieved in highly concentrated solution or semicrystalline thin films. In addition, we show that the polymer decomposes to monomer upon thermolysis, which indicates that the polymerization-depolymerization process is reversible. The physical properties of the polymer crystals enable us to isolate single-polymer strands via mechanical exfoliation, which makes it possible to study individual, long polymer chains.
An experimental study on the catalytic combustion of dimethyl ether under various oxidation conditions through a preheated tubular catalytic reactor filled with a lab-made Pt-γ-Al
2
O
3
catalyst is ...presented in this paper. Both the transient variance of temperature distribution during the ignition process and the stationary results as the reactor reaches stable are delineated. The catalytic reactor is mounted in a tubular furnace to preheat and maintain an isothermal boundary. The reaction profiles and ignition processes are characterized by monitoring the temporal temperature traces, which is the steady-state axial distribution of temperature in the reactor. The average axial reaction temperature for different fuel quantities with various isothermal boundaries of the reactor was also evaluated. During the light-off process, the main exothermal reaction zone shift is found. The results demonstrate that a higher equivalence ratio of reactants produces a higher temperature, resulting in more heat transferring upstream and causes a higher conversion ratio. For the same equivalence ratio, a higher isothermal boundary temperature will result in a higher conversion ratio. The more extended reactor is required in one of the two conditions of a lower equivalence ratio of reactants and a lower isothermal boundary of the reactor. Finally, the energy balance and exergy analysis for the reactor was also performed; the results will be the basis for improving and optimizing designs.
Background and Aims
Type 2 diabetes is an important risk factor for nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis. Current international guidelines recommend the use of noninvasive ...tests as initial assessments for NAFLD, but the role of noninvasive tests as monitoring tools has not been established. We aimed to study the role of transient elastography as a monitoring tool in patients with type 2 diabetes.
Approach and Results
We recruited patients with type 2 diabetes without viral hepatitis or excessive alcohol intake from a complication screening facility in Hong Kong in 2013‐2014 and repeated the assessments in 2016‐2018. The primary endpoint was an increase of liver stiffness measurement (LSM) to ≥10 kPa. The secondary endpoint was the change in the controlled attenuation parameter (CAP). A total of 611 patients with type 2 diabetes and a valid LSM (mean age, 57.7 ± 10.9 years; 342 men 56.0%) were included in this study (568 also had a valid CAP). Overall, there was moderate correlation between the baseline and follow‐up LSM (r = 0.689, P < 0.001). Among 487 patients with a baseline LSM <10 kPa, 21 (4.3%) had a follow‐up LSM ≥10 kPa. Baseline body mass index, alanine aminotransferase (ALT), and ∆ALT were independent factors associated with LSM increase. Among 124 patients with a baseline LSM ≥10 kPa, 70 (56.5%) had a follow‐up LSM <10 kPa. Among 198 patients with a CAP <248 dB/m at baseline, 103 (52.0%) had a CAP increased to ≥248 dB/m.
Conclusions
The prevalence and incidence of NAFLD in patients with type 2 diabetes are high. Although advanced fibrosis is common in this population, few patients progress to advanced fibrosis in 3 years. Future studies should define the optimal surveillance interval in patients with diabetes.
A novel, rapid and sensitive liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was developed and validated for the evaluation of exemestane pharmacokinetics and its metabolites, ...17β-dihydroexemestane (active metabolite) and 17β-dihydroexemestane-17-O-β-D-glucuronide (inactive metabolite) in human plasma. Their respective D3 isotopes were used as internal standards. Chromatographic separation of analytes was achieved using Thermo Fisher BDS Hypersil C18 analytic HPLC column (100 × 2.1 mm, 5 μm). The mobile phase was delivered at a rate of 0.5 mL/min by gradient elution with 0.1% aqueous formic acid and acetonitrile. The column effluents were detected by API 4000 triple quadrupole mass spectrometer using electrospray ionisation (ESI) and monitored by multiple reaction monitoring (MRM) in positive mode. Mass transitions 297 > 121 m/z, 300 > 121 m/z, 299 > 135 m/z, 302 > 135 m/z, 475 > 281 m/z, and 478 > 284 m/z were monitored for exemestane, exemestane-d3, 17β-dihydroexemestane, 17β-dihydroexemestane-d3, 17β-dihydroexemestane-17-O-β-D-glucuronide, and 17β-dihydroexemestane-17-O-β-D-glucuronide-d3 respectively. The assay demonstrated linear ranges of 0.4-40.0 ng/mL, for exemestane; and 0.2-15.0 ng/mL, for 17β-dihydroexemestane and 17β-dihydroexemestane-17-O-β-D-glucuronide, with coefficient of determination (r2) of > 0.998. The precision (coefficient of variation) were ≤10.7%, 7.7% and 9.5% and the accuracies ranged from 88.8 to 103.1% for exemestane, 98.5 to 106.1% for 17β-dihydroexemestane and 92.0 to 103.2% for 17β-dihydroexemestane-17-O-β-D-glucuronide. The method was successfully applied to a pharmacokinetics/dynamics study in breast cancer patients receiving exemestane 25 mg daily orally. For a representative patient, 20.7% of exemestane in plasma was converted into 17β-dihydroexemestane and 29.0% of 17β-dihydroexemestane was inactivated as 17β-dihydroexemestane-17-O-β-D-glucuronide 24 hours after ingestion of exemestane, suggesting that altered 17-dihydroexemestane glucuronidation may play an important role in determining effect of exemestane against breast cancer cells.
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