Prevalence of metabolic syndrome in Gwalior region of Central India: A comparative study using NCEP ATP III, IDF and Harmonized criteria.

BACKGROUND: The aim of this study is to determine the prevalence of Metabolic syndrome (MetS) in the people of Gwalior. Three criteria viz., National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, International Diabetes Federation (IDF) criteria and Harmonized criteria for MetS were employed to assess the prevalence of metabolic syndrome in this region, their concordance with respect to this population was recorded. METHODS: The cross-sectional study involved the people, who had attended the Diabetes clinic at the Centre for Translational Research, Jiwaji University during 2015-2017. A total of 1190 participants within the age group of 20-79 years of either gender were included in the study. Anthropometric parameters, blood pressure, blood glucose and lipid profile of all subjects were assessed. Student's 't' test, Kappa statistics and Binary logistic regression model were used to analyze the data. RESULTS: The percentage of prevalent MetS was found to be 72.7, 50.2 and 53.9 following Harmonized criteria, NCEP ATPIII and IDF criteria respectively. The prevalence was found to be maximum in centrally obese female population, aged between 51 and 60 years with the presence of hyperglycemia and reduced HDL- C. Harmonized and IDF criteria showed good agreement (κ 0.85). Regression analysis showed that, high body mass index, hypertension and dyslipedimia were the most critical predictive risk factors of MetS. CONCLUSIONS: Maximum prevalence of MetS was recorded when the Harmonized criteria was followed. A good agreement was observed between Harmonized vs. IDF criteria. MetS if detected early especially in apparently healthy subjects; paves way for preventive measures to be designed in order to avert the incidence of diabetes and other risks related to cardio vascular disease.

Chitosan encapsulated nanocurcumin induces GLUT-4 translocation and exhibits enhanced anti-hyperglycemic function.

AIM: The present study was undertaken to develop a Curcumin nanoparticle system with chitosan as a hydrophilic carrier. In addition, the anti-diabetic potential of curcumin loaded chitosan nanoparticles were assessed in comparison to those of free curcumin by examining the anti-hyperglycemic efficacy using in vitro assays. METHODS: Curcumin loaded chitosan nanoparticles were prepared and characterized for particle size by transmission electron microscopy, FT-IR, differential scanning calorimetry and therapeutic effects of curcumin loaded chitosan nanoparticles were evaluated by measuring the level of GLUT-4 present at the plasma membrane in L6myc myotubes followed by western blotting. Additionally, anti-inflammatory potential of curcumin loaded chitosan nanoparticles were assessed by enzyme immunoassay using appropriate ELISA kits. KEY FINDINGS: Transmission electron microscopy revealed an average nanocurcumin particle size of 74 nm. Under in vitro conditions, treatment with chitosan-nanocurcumin (CS-NC) caused a substantial increase in the GLUT-4 translocation to the cell surface in L6 skeletal muscle cells and the effect was associated with increased phosphorylation of AKT (Ser-473) and its downstream target GSK-3ß (Ser-9). SIGNIFICANCE: The therapeutic potential of nanocurcumin is prominent than that of curcumin alone. Nanocurcumin could improve the solubility of curcumin and may prolong its retention in the systemic circulation.

Bougainvillea spectabilis Exhibits Antihyperglycemic and Antioxidant Activities in Experimental Diabetes.

The study investigates the effects of aqueous extract of Bougainvillea spectabilis leaves on blood glucose, glycosylated hemoglobin, lipid profile, oxidative stress, and on DNA damage, if any, as well as on liver and kidney functions in streptozotocin-induced diabetes in Wistar rats. Daily administration of the aqueous extract of B spectabilis leaves for 28 days resulted in significant reduction in hyperglycemia and hyperlipidemia as evident from restoration of relevant biochemical markers following extract administration. The extract also exhibited significant antioxidant activity as evidenced from the enzymatic and nonenzymatic responses and DNA damage markers. The extract restored kidney and liver functions to normal and proved to be nontoxic. A marked improvement in the histological changes of tissues was also observed. The present study documented antihyperglycemic, antihyperlipidemic, and antioxidative potentials of the aqueous extract of B spectabilis leaves without any toxicity in streptozotocin-treated Wistar rats.

Status of antioxidant and lipid peroxidation in type 2 diabetic human subjects diagnosed with and without metabolic syndrome by using NCEP-ATPIII, IDF and WHO criteria.

BACKGROUND: Antioxidants play a very crucial role in terms of disease incidence and its complications. Type 2 diabetes and metabolic syndrome (MetS) are now more prevalent than any other disorder. In this regard this study focuses on type 2 diabetic subjects with MetS having highest incidence of cardiovascular disease. Hence the aim of the study was to reveal the level of antioxidants and lipid peroxidation in MetS and non-MetS groups of type 2 diabetic subjects characterized by three different criteria. METHODS: Present study was based on 70 type 2 diabetic subjects and 20 healthy controls. The metabolic syndrome criteria were defined by National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATPIII), International Diabetes Federation (IDF), and World Health Organization (WHO). The selected subjects were of similar age group. The participants were selected from a diabetic camp being run in the University Campus. The antioxidant enzymes estimated were reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) while Thiobarbituric acid reactive substances (TBARS) measured as a marker of lipid peroxidation. RESULTS: The level of GSH, CAT, SOD decreases in non-MetS and MetS subjects as compared to normal. When comparison was made for GSH & SOD in the mentioned groups resulted a significant differences in non-MetS and MetS compared with normal subjects. TBARS levels was increased in non-MetS and MetS group of subjects. The results indicate reduction in antioxidant enzymes and elevation of lipid peroxidation in type 2 diabetic subjects with or without MetS defined by using any of the International criteria. CONCLUSIONS: The study revealed that absolute reduction of antioxidant and involvement of lipid peroxidation in MetS group may lead to progressive intensification of cardiovascular disease in type 2 diabetic subjects irrespective of using any criteria.

Anti-hyperglycemic and anti-hyperlipidemic potential of a polyherbal preparation "Diabegon" in metabolic syndrome subject with type 2 diabetes.

BACKGROUND: In the present study, "Diabegon" a poly-herbal preparation, with hypoglycemic activity, was evaluated for its preventive effect in metabolic syndrome subjects with type 2 diabetes and also to reveal its side effects, on liver and kidney. MATERIALS AND METHODS: Type 2 diabetic subjects with metabolic syndrome (N=58) were categorized on the basis of age and fasting blood glucose. The grouping was as follows: Group I (35-50 yrs), Group II (51-65 yrs), Group III >65 yrs, Group IV FBS<145.9, Group V FBS>145. Each group was administered 4 gm of diabegon daily. Blood glucose levels, lipid profile, liver and kidney function of the subjects were regularly monitored within 3 months of interval to 18 months. RESULTS: The reduction in fasting blood glucose level ranged from 12.3% (P<0.05) to 42% (P<0.001) after 18 month of therapy whereas in postprandial blood glucose, the decrease ranged from 28% (P<0.05) to 32% (P<0.05) after 18 month of therapy. Overall reductions in the individual parameters of the metabolic syndrome subjects were significantly higher in Group I. Cholesterol level decreased from 11% to 27.2% (P<0.001), triglyceride levels decreased from 24% to 55%, VLDL and LDL levels reduced by 60% & 54% respectively after 18 months of therapy. The HDL-C level increased in all groups. Moreover, diabegon administration for 1.5 years exhibited no alteration in liver and kidney function tests, which indicate its non-toxicity. CONCLUSION: Our study suggests that diabegon could be included as a preventive treatment in metabolic syndrome subjects with type 2 diabetes especially for long term treatment as it efficiently shows anti-hyperglycemic and anti-lipidemic effects with no adverse impacts on the liver and kidney.

Prevalence of metabolic syndrome in type 2 diabetes mellitus using NCEP-ATPIII, IDF and WHO definition and its agreement in Gwalior Chambal region of Central India.

UNLABELLED: The aim of study was to determine the prevalence of metabolic syndrome (MetS) in people with type 2 diabetes mellitus (T2DM). National Cholesterol Education Program (NCEP) ATPIII Criteria, International Diabetes Federation and the World Health Organization (WHO) definitions were used in quantifying the metabolic syndrome and also the concordance between these three criteria's used for identifying metabolic syndrome. METHODS: This cross-sectional study involved 700 type 2 diabetic subjects from the urban areas of Gwalior Chambal region (Central India). Subjects in the age group of 28- 87 yrs were included in the study. Type I diabetics, pregnant ladies and those with chronic viral and bacterial infections and serious metabolic disorders were excluded from the study. Fasting blood glucose, Blood lipids (T-cholesterol, triglyceride, HDL-cholesterol) were assessed and anthropometry blood pressure were measured from all the subjects. RESULTS: The Prevalence of metabolic syndrome was found to be 45.8%, 57.7% and 28% following NCEP-ATPIII Criteria, IDF and WHO definitions, respectively. Using all the three definitions the prevalence was higher in women in all age groups. ATP III and IDF criteria showed good agreement (k 0.68) compared to ATP III with WHO (k 0.54) and IDF with WHO (k 0.34) criteria. Highest prevalence was observed following IDF definition. CONCLUSIONS: A good agreement was observed between ATPIII and IDF criteria. Maximum prevalence of Metabolic syndrome was recorded when IDF criteria was followed. NCEP-ATPIII criteria for the diagnosis of MetS and this criterion reflected equal importance to the every variable and showed a good agreement between the different criteria used.

Postoperative bacteremia in periodontal flap surgery, with and without prophylactic antibiotic administration: A comparative study.

OBJECTIVES: Many a times in clinical periodontology, the decision whether to prescribe prophylactic antibiotics or not, is perplexing.The present study was conducted to compare the bacteremias induced after periodontal flap surgeries with and without prophylactic antibiotics. MATERIALS AND METHODS: The occurrence of postoperative bacteremia following periodontal flap surgery was studied in 30 patients. On these patients, 30 quadrant wise flap surgeries were carried out without any preoperative prophylactic antibiotics and 30 surgeries carried out after prophylactic administration of amoxycillin preoperatively. A blood sample was taken from each patient at the time of maximum surgical trauma and was cultured for micro-organisms and antibiotic sensitivity. RESULTS: 18 out of 60 blood samples were positive for micro-organisms. There was a significant reduction in post operative bacteremia after amoxycillin prophylaxis (x(2) - 7.96 with P<0.01) as post operative bacteremia was found in 14 of the non medicated patients as compared to only 4 of the pre medicated patients. The micro-organisms encountered in the study are as follows:- 1) Staphylococcus albus coagulase negative, 2) Klebsiella, 3) Psedomonas aerugenosa, 4) Streptococcus viridans, 5) Alpha hemolytic streptococcus, 6) Neisseria catarrhalis CONCLUSION: On the basis of the study, it is concluded that the incidence of postoperative bacteremia following periodontal flap surgery is not as high as previously reported. The clinical results show that Amoxicillin is highly effective in reducing postoperative bacteremia in periodontal flap surgery and thus in preventing the possible sequelae (Infective Endocarditis and other systemic maladies) in susceptible patients. However, cefotaxime and cephalexin may prove to be more effective in preventing the same.