Correlation of Adiponectin and Leptin with Insulin Resistance: A Pilot Study in Healthy North Indian Population

The increasing incidence of obesity, leading to metabolic complications is now recognized as a major public-health problem. Insulin resistance is a central abnormality of the metabolic syndrome, or syndrome X, originally hypothesized by Reaven Insulin resistance is more strongly linked to intra abdominal fat than to fat in other depots. Adipose tissue secretes numerous factors (adipokines) known to markedly influence lipid and glucose/insulin metabolism, oxidative stress, and cardiovascular integrity. Some of these adipokines have been shown to directly or indirectly affect insulin sensitivity through modulation of insulin signaling and the molecules involved in glucose and lipid metabolism. A pilot study was conducted with 80 healthy subjects who were non diabetic, non hypertensive and having no family history of hypertension, the aim was to evaluate the correlation of adiponectin and leptin levels with obesity and insulin resistance markers in healthy north Indian adult population. Serum leptin, adiponectin and insulin was estimated by sandwich ELISA method. In our study, Leptin correlated significantly with BMI (P value of 0.0000), WC (P value = 0.007), and HC (P value = 0.000). leptin showed significant positive correlation with fasting insulin (P value 0.002), post prandial insulin (P value = 0.000) and HOMA-IR (P value = 0.002). Adiponectin showed significant positive correlation with triglycerides (P value = 0.038), strong negative correlation with HDL-cholesterol (P value = 0.017). Serum concentrations of leptin are associated with central body fat distribution. Insulin resistance and adiponectin is associated with dyslipidemia and these all disorders may ultimately lead to metabolic syndrome.     

Acetylation Pharmacogenetics and Renal Function in Diabetes Mellitus Patients

Activities of human hepatic drug metabolizing enzymes N-acetyl transferase (NATS) had earlier been recognized as a cause of inter-individual variation in the metabolism of drugs. Therefore acetylation of many drugs in human exhibit genetic polymorphism. The aim of the study was to investigate if acetylator status predispose diabetic mellitus patients more to the complications of renal disease, One hundred and twenty (120) diabetics consisting of (50) Type 1 (T₁) and 70 Type 2 (T₂) diabetes mellitus patients and 100 healthy individuals as controls were classified as slow or rapid acetylator using sulphamethazine (SMZ) as an in vivo probe. The percentage acetylation, recovery of SMZ, creatinine clearance and presence of urinary albumin were determined. A significant difference (P < 0.05) was observed in the percentage of SMZ acetylated between slow and rapid acetylators in control, T₁ and T₂ subjects. The ratios of slow to rapid acetylators for T₁, T₂ and control subjects were 1:4, 3:2 and 2:3 respectively. No significant differences were observed in the percentage of SMZ recovered in the urine of slow and rapid acetylators that are diabetics. The difference in creatinine clearance of slow and rapid acetylators in T₁ and T₂ were significant (P < 0.05). 29% out of 120 (24.2%) diabetics (T₁ and T₂) exhibited albuminuria out of which 25 (86.2%) had slow acetylator status. These findings suggest that slow acetylator status in diabetes mellitus could be a predisposing factor in the development of renal complications. This underscores the need for a rapid pharmacogenetic testing and therapeutic drug monitoring in such patients. However this inference could be further validated with a larger sample size.     

Proxidant and antioxidant status in patients of type II Diabetes Mellitus with IHD

Patients with type II Diabetes Mellitus (NIDDM) are more prone to Ischaemic Heart Disease (IHD). Although, oxygen free radicals are known to contribute to the development of IHD, conflicting reports are available regarding the antioxidant status in patients of NIDDM complicated with IHD. This study was undertaken to investigate the oxidative status in patients of NIDDM and to assess their correlation with plasma glucose, glycosylated haemoglobin and duration of diabetes. The levels of malondialdehyde were significantly increased where as levels of superoxide dismutase, Glutathione peroxidase and vitamin C were significantly decreased in diabetics without complications and non-diabetics with IHD when compared with the controls. The levels of malondialdehyde and Glutathione peroxidase were significantly increased where as levels of superoxide dismutase and vitamin C were significantly decreased in diabetics with IHD when compared with diabetics without complications and non-diabetics with IHD. The implications of the results are discussed.     

Glycemic control modifies the association between microalbuminuria and c-reactive protein in Type 2 Diabetes Mellitus

Microalbuminuria and C-reactive protein reflect closely related components of the same disease process. The present study attempts to evaluate whether any association exists between C-reactive protein and microalbuminuria in Type 2 Diabetes Mellitus patients with poor and adequate glycemic control. It was observed that in diabetics with poor glycemic control, microalbuminuria showed a significant positive correlation with C-reactive protein and the prevalence of microalbuminuria was significantly more at elevated C-reactive protein levels. These parameters were not significant in subjects with adequately controlled disease. Further, there was a significant increase in levels of microalbuminuria in patients with poor glycemic control when compared to well-controlled diabetics at comparative levels of C-reactive protein. This study supports the hypothesis that endothelial dysfunction and inflammatory activity are involved in the pathogenesis of microalbuminuria and underscores the importance of glycemic control in the progression of inflammation in diabetes.     

Efficacy of Tumor Necrosis Factor and Interleukin-10 Analysis in the Follow-up of Nonalcoholic Fatty Liver Disease Progression

Tumor necrosis factor (TNF-α) is a cytokine involved in systemic inflammation during acute phase reactions. The current study was designed to investigate the levels of pro-inflammatory cytokine (TNF-α) along with the anti-inflammatory cytokine (IL-10) during progression of non-alcoholic fatty liver disease (NAFLD) from simple steatosis to non-alcoholic steatohepatitis (NASH) and fibrosis in diabetic patients, and correlate the levels of cytokines with the progression of NAFLD. Fifty-two diabetic patients compared to 18 healthy controls were participated in this study. Based on clinical diagnosis, patients were divided into three groups: simple steatosis, NASH and fibrosis. Serum liver function tests, fasting blood glucose, bilirubin, ALT, AST, TNF-α, IL-10 and lipid profile were measured. TNF-α levels were significantly higher in NAFLD patients compared to control subjects with a significant positive correlation with body mass index and fasting blood glucose (FBG) but with negative correlation with IL-10. Serum IL-10 levels were significantly lower in NAFLD patients compared with controls. A positive correlation between IL-10 and HDL-C with concomitant negative correlation between IL-10 and FBG and triacylglycerides was found. Cytokine analyses showed that there was a prominent imbalance between TNF-α and IL-10 in patients with NAFLD, and this imbalance increase by increasing the progression of NAFLD especially in obese diabetic patients. TNF-α and IL-10 could be used in diagnosis and follow-up of NAFLD stages in a way to avoid liver biopsies in greater proportion of patients.     

Dyslipidemia Associated with Poor Glycemic Control in Type 2 Diabetes Mellitus and the Protective Effect of Metformin Supplementation

The nature of the dyslipidemia associated with diabetes mellitus is complex and is the major risk factor for atherosclerosis and coronary artery disease. Aim of this study was to assess the effect of glycemic control, achieved by metformin, glibenclamide and insulin, on lipid profile in type 2 diabetic patients. One hundred and sixty-five type 2 diabetes mellitus patients were classified into good glycemic control (Group I) and poor glycemic control (Group II) on the basis of their blood HbA1c values. The Group II was characterized with high serum triglyceride (190.46 ± 15.20 mg/dl), total cholesterol (175.3 ± 6.31 mg/dl) as well as high LDL-cholesterol (109.0 ± 5.88 mg/dl). Significant correlations were evident between HbA1c and dyslipidemia, particularly serum TG (r = 0.28, P < 0.05), and between HbA1c and total cholesterol (r = 0.310, P < 0.05). Better glycemic control and improved dyslipidemia were observed in patients on combination therapy of metformin plus glibenclamide.     

Role of Heme Oxygenase, Leptin, Coenzyme Q10 and Trace Elements in Pre-eclamptic Women

The objective of this study to evaluate heme oxygenase (COHb), leptin and coenzyme Q10 (CoQ10) in pre-eclamptic women. Also Zinc, copper, Iron, total iron binding capacity, Ferritin and uric acid were assessed. 120 female subjects were included in this study. They were divided into, 60 female with normal pregnancy attending the outpatient clinic, 60 pre-eclamptic patients were recruited from obstetrics and gynaecology department El-kasr El-Aini hospital. The results showed that in pre-eclampatic group, leptin level was significantly increased while COHb and CoQ10 was significantly decreased. It is concluded that hemeoxygenase, leptin and coenzyme CoQ10 can be considered as new markers for prediction of pre-eclampsia.     

Serum iron, copper and zinc status in maternal and cord blood

Pregnancy is associated with increased demand of all the nutrients like Iron, Copper, Zinc etc. and deficiency of any of these could affect pregnancy, delivery and out come of pregnancy. With this consideration, the study was conducted on 80 mothers and newborns and 20 age matched control women. Out of 80 mothers, 34 had Iron deficiency anemia and their Hb levels were below 9.0 gm/d¹. Pregnant women had significantly lower Iron and Zinc levels while Copper and Total Iron Binding Capacity (TIBC) were significantly higher (P<0.001). Newborns had significantly elevated Iron and Zinc levels and low levels of Copper and TIBC as compared to their mothers irrespective of Iron deficiency anemia. Micronutrient status of newborn was found to be dependent on their mother's micronutrient status. Besides, results also suggest micronutrient interactions, which are reflected in Iron/Zinc, Iron/Copper and Zinc/Copper ratios. In view of this, there is need for proper, adequate and balanced micronutrient supplementation during pregnancy to affect a healthy outcome.     

Salivary proteolytic activities in periodontitis, gingivitis and diabetes mellitus

Elastase activity was found to be significantly increased in periodontitis (0.872±0.4270 absorbance units/mg protein, mean±S. D., 1.05±0.61 units/ml saliva), gingivitis (0.772±0.416 units/mg protein, 1.515±0.952 units/ml) and diabetes (0.549±0.286 units/mg protein, 1.20±0.769 units/ml) compared to normals (0.255±0.089) units/mg protein, 0.264±0.079 units/ml). Chymotryptic activity was not found to be increased in these disease conditions over the normal level (0.284±0.096 units/mg protein). Aminopeptidase activity was elevated only in periodontitis (0.670+0.140 units/mg protein) compared to normals (0.349±0.100 units/mg protein). Trypsin-like activity was also found to be significantly raised in periodontitis compared to normals when Pro-Phe-Arg-p-nitroanilide (0.666±0.204 units/mg protein), Ile-Pro-Arg-p-nitroanilide (1.59±0.260 units/mg protein) and Pyroglu-Pro-Arg-p-nitroanilide (1.82±0.380 units/mg protein) were used as substrates. The normal values with these three substrates were respectively, 0.454±0.110, 1.04±0.231 and 1.15±0.312 units/mg protein. Total protein level in saliva was found to be significantly elevated in gingivitis (209±66.8 mg/dl) and diabetes (204±68.0) compared to normal values (107±20.7). Increase in periodontitis was marginal (127±28.3 mg/dl). Expression of proteolytic activities normalized to protein level was useful in differential diagnosis. Increase in elastase level in saliva is not a specific marker for periodontal diseases.     

Study of the Concentration of Trace Elements Fe,Zn, Cu,Se and Their Correlation in Maternal Serum,Cord Serum and Colostrums

A study of iron, zinc, copper and selenium concentration levels was carried out in three compartments namely, maternal serum (MS), colostrums and cord blood serum (CS) of healthy Indian mothers (n = 42) who delivered healthy normal neonates without any congenital anomalies at Bhabha Atomic Research Centre hospital, Mumbai. Fe, Zn, Cu in maternal serum, cord blood and colostrums were estimated by flame atomic absorption spectrometry while Se was determined by graphite furnace absorption spectrometry. It was seen that there was a significant difference in the level of trace elements in the three compartments. The average levels of Fe in the three compartments were 1,132 ± 519, 2,312 ± 789 and 1,183 ± 602 μg/L while Zn was 514 ± 149, 819 ± 224 and 7,148 ± 2,316 μg/L respectively. Mean Cu values were 1,614 ± 295, 301 ± 77 and 392 ± 174 μg/L respectively while Se values were 70 ± 15, 36 ± 10 and 23 ± 8 μg/L respectively. The results indicated a positive correlation of Fe and Zn concentrations in MS versus CS which were (r = 0.386), (r = 0.572) respectively and Fe levels in MS and colostrums (r = 0.235). A few inter element correlations were found within compartments. Zn and Se showed a negative correlation in both MS (r = −0.489) and colostrums (r = −0.258) while a positive inter correlation of Fe and Zn was seen in MS (r = 0.44) and in CS (r = 0.54). This study gave us an overview of the serum and colostrum values of mother and neonates in Indian population, data of which are scarce.     

Influence of pranayamas and yoga-asanas on serum insulin,blood glucose and lipid profile in type 2 diabetes

A distinguishable feature of type 2 diabetes besides hyperglycemia and deranged lipid profile is an impaired insulin secretion, peripheral insulin resistance and obesity which has become a major health concern worldwide. India with an estimated 31million diabetics in 2000 and 79mllions by the yr 2030 has the highest number of type 2 diabetics in the world. In this study, we aimed to see if yoga-asanas and pranayamas have any influence in modifying certain biochemical parameters. Sixty patients of uncomplicated type 2 diabetes (age 35–60 yrs of 1–10 yrs duration) were divided into two groups: Group 1 (n=30): performed yoga along with the conventional hypoglycemic medicines and group 2 (n=30): patients who only received conventional medicines. Duration of the study was 45 days. Basal recordings of blood glucose (fasting and post-prandial), lipid profile and serum insulin were taken at the time of recruitment and the second reading after forty five days. Results showed a significant improvement in all the biochemical parameters in group 1 while group 2 showed significant improvement in only few parameters, thus suggesting a beneficial effect of yoga regimen on these parameters in diabetic patients.     

Fibrinogen,Lp(a), Microalbuminuria and Left Ventricular Mass Index: Cardiovascular Disease Risk factors in Diabetes

The present work was undertaken to study interrelation of Fibrinogen, Lp(a) and LVMI in Type II diabetes patients with or without nephropathy. 100 Type II Diabetic patients attending OPD/IPD of DMC&H, Ludhiana were included. They were divided in two groups. Group I: 50 patients without microalbuminuria (MAU). Group II: 50 patients with MAU. Fibrinogen (Clauss method), Lp(a) and MAU were estimated on Multichannel Autoanalyzer Hitachi-911 (Roche). LVMI was estimated by echocardiography using formula of Devereux and Reicheck. Type II diabetes patients with MAU had significantly raised levels of Fibrinogen, Lp(a), and LVMI as compared to normoalbuminuric diabetics (P < 0.01). Group II patients had positive correlation between Lp(a) and LVMI but no relation between Fibrinogen and LVMI. MAU, marker of microangiopathy, is associated with higher Fibrinogen and Lp(a) levels. This becomes basis of increase cardiovascular risk as demonstrated by higher mean LVMI in Group II patients.     

“互联网+”时代高校音乐教师教育类课程的实践与研究——以山西师范大学现代文理学院音乐系为例

当前,在众多的高等学校音乐学(教师教育)本科教学的课程设置中,仍然只开设一门音乐教学法(或音乐教育学)之类的理论性课程,长期存在注重音乐专业技能水平、轻视音乐教育科学理论和音乐教育实践的现象。这些现状,直接影响了学生的教学实践能力,进而进一步制约了他们的就业前景。“互联网+”新时代的到来,“互联网+教育”呈现出蓬勃发展的态势。本文的研究,对山西部分高校的音乐学(教师教育)课程加以调查分析,揭示了其在课程结构方面存在的一些问题,依托于新时代互联网技术,以山西师范大学现代文理学院音乐系改革为例,进行课程的重构,提出具有一定理论创新的高师音乐教育课程的结构模型。