Urinary MMP-9/UCr association with albumin concentration and albumin-creatinine-ratio in Mexican patients with type 2 diabetes mellitus.

BACKGROUND: Chronic kidney disease is one of the most common complications of type 2 diabetes mellitus (T2DM), causing an increased risk of cardiovascular morbidity and mortality. Matrix metalloproteinase (MMP) activity has been proposed as useful biomarker for diabetic renal and vascular complications. METHODS: A cross-sectional study was conducted among T2DM patients who attended a public secondary hospital in Mexico. We performed clinical, biochemical, and microbiological assessments, as well chronic kidney disease diagnosis according to the KDIGO guideline. Urinary MMP-9 was quantified by ELISA and adjusted using urinary creatinine (UCr). RESULTS: A total of 111 patients were included. Most participants were women (66%). Mean age was 61 ± 10 years and median T2DM duration was estimated at 11 years. Through multivariate analysis, MMP-9/UCr was found to be associated with albumin concentration and albumin to creatinine ratio. DISCUSSION: Validation of non-invasive biomarkers of chronic kidney disease among T2DM patients is necessary. Here, we demonstrate MMP-9/UCr as a potential biomarker of albumin concentration and albumin to creatinine ratio in Mexican patients with T2DM.

Association of urinary activity of MMP-9 with renal impairment in Mexican patients with type 2 diabetes mellitus.

BACKGROUND: Diabetic kidney disease is the most common cause of chronic kidney disease (CKD). An early event in diabetic kidney disease is alteration of the glomerular basement membrane and the mesangial expansion. Matrix metalloproteinases (MMP) are a family of endopeptidases responsible for controlling the pathophysiological remodeling of tissues, including renal tissues. MMP-9 in human urine has been proposed as a marker of diabetic nephropathy and urinary tract infections (UTI). METHODS: A cross-sectional study was conducted in type 2 diabetes mellitus (T2DM) patients who receive first level medical attention in Mexico. We used ELISA to measure MMP-9 levels in the urine of subjects with T2DM ≥ 18 years of age, who fulfilled the clinical requirements for calculation of glomerular filtration rate (GFR), according to the K/DOQI guide, in an attempt to identify whether MMP-9 levels in T2DM differ in patients with and without renal impairment. Univariate and multivariable analyses were performed in order to identify the association between MMP-9 and renal impairment. RESULTS: Included in the study were 34 (45%) subjects with renal impairment and 42 (55%) without. In the group with renal impairment, 10 subjects corresponded to stages 1-2 and 24 subjects corresponded to stage 3, according to their values of GFR and urinary albumin, following that proposed by the K/DOQI. No differences were found relating to sex, age, having or not having a partner, education, being able to read and write a message and duration of T2DM. Moreover, no differences were found between the groups in terms of weight, height, body mass index, waist size in general and frequency of UTI. In contrast, serum creatinine and urinary albumin were higher in the group with renal impairment, while GFR was greater in the group without renal impairment. Levels of MMP-9 were greater in women compared to men. Through univariate analysis in the general population, the presence of MMP-9 and that of its percentile 90 (P90) P90 were associated with the renal impairment group; however, in patients without UTI, only the presence of MMP-9 was associated with the renal impairment group, and no association was found with its P90. Multivariate analysis revealed an association between MMP-9 and its P90 with renal impairment. DISCUSSION: It is necessary to validate sensitive and non-invasive biological markers of CKD. We demonstrate that the presence and P90 of urinary MMP-9 are associated with renal impairment in Mexican patients with T2DM. While high levels of MMP-9 were associated to females and UTI, the presence of UTI was not associated with the incidence of renal impairment.

Acute Consumption of Resistant Starch Reduces Food Intake but Has No Effect on Appetite Ratings in Healthy Subjects.

Previous studies have shown the benefits of native banana starch (NBS) supplementation in improving glucose metabolism and reducing body weight (BW) in humans. However, the effect of this starch on appetite regulation is unknown. The aim of this study was to examine the effects of NBS rich resistant starch on subjective measurements of appetite, energy intake, and appetite hormones in healthy subjects. Postprandial glucose and insulin responses were also assessed. In a randomized, single-blind, crossover study, 28 healthy young subjects consumed a beverage containing either 40 g of NBS or 40 g of digestible corn starch (DCS) on two separate occasions. Effects on appetite were estimated using visual analogue scales (VAS) and satiety hormone responses. At the end of the intervention, participants were provided with a pre-weighed ad libitum homogeneous test meal. After a washout period of 1 week, subjects received the alternative treatment. NBS supplementation induced a reduction in food intake, glucose area under the curve (AUC)-180 min, and insulin AUC-180 min. However, there was no associated effect on the subjective appetite ratings or gut hormones. NBS supplementation may help to reduce meal size and control BW.

Association of Urinary Activity of MMP-2 with Microalbuminuria in an Isolated Sample of Subjects Living in High Altitude Rural Locations in México.

Hernández-Hernández, Magda Elena, Jaime Morales-Romero, Clara Luz Sampieri, Diego Jesús Luna Lozano, Isidra del Carmen Valencia Lezama, Mónica Janett Muñoz Contreras, and Arturo Rodríguez Hernández. Association of urinary activity of MMP-2 with microalbuminuria in an isolated sample of subjects living in high altitude rural locations in México. High Alt Med Biol. 18:209-218, 2017.-Matrix metalloproteinases (MMP) are implicated in remodeling of the renal extracellular matrix. In a cross-sectional study we evaluated renal impairment in general population of high-altitude rural locations in México. Multivariable analysis was performed to identify the association between MMP-2 and MMP-9 and microalbuminuria. Twenty-eight (20.9%) subjects with renal impairment (WRI) and 106 (79.1%) without renal impairment were included. No differences were found relating to sex, location, marital status, current habits, weight, height, body mass index, waist size in males, creatinine in males, and uric acid. In contrast, differences were found among age, level of education, waist size in general and in females, creatinine in general and in females, urinary albumin, urea, glucose, total cholesterol, and triglycerides. Proportions of hypertension, type 2 diabetes mellitus, central abdominal obesity, hypertriglyceridemia, and hypercholesterolemia were greater in the group WRI. Presence of urinary MMP-2 or of both urinary gelatinases and arbitrary unit (AU) values ≥P90 were associated with microalbuminuria. We conclude that AU values ≥P90 of urinary MMP-2 (OR = 20.1, p = 0.002) is associated with microalbuminuria.

Hypoglycemic effect of Carica papaya leaves in streptozotocin-induced diabetic rats.

BACKGROUND: Traditional plant treatment for diabetes has shown a surging interest in the last few decades. Therefore, the purpose of this study was to assess the hypoglycemic effect of the aqueous extract of C. papaya leaves in diabetic rats. Several studies have reported that some parts of the C. papaya plant exert hypoglycemic effects in both animals and humans. METHODS: Diabetes was induced in rats by intraperitoneal administration of 60 mg/kg of streptozotocin (STZ). The aqueous extract of C. papaya was administered in three different doses (0.75, 1.5 and 3 g/100 mL) as drinking water to both diabetic and non-diabetic animals during 4 weeks. RESULTS: The aqueous extract of Carica papaya (0.75 g and 1.5 g/100 mL) significantly decreased blood glucose levels (p<0.05) in diabetic rats. It also decreased cholesterol, triacylglycerol and amino-transferases blood levels. Low plasma insulin levels did not change after treatment in diabetic rats, but they significantly increased in non-diabetic animals. Pancreatic islet cells were normal in non-diabetic treated animals, whereas in diabetic treated rats, C. papaya could help islet regeneration manifested as preservation of cell size. In the liver of diabetic treated rats, C. papaya prevented hepatocyte disruption, as well as accumulation of glycogen and lipids. Finally, an antioxidant effect of C. papaya extract was also detected in diabetic rats. CONCLUSIONS: This study showed that the aqueous extract of C. papaya exerted a hypoglycemic and antioxidant effect; it also improved the lipid profile in diabetic rats. In addition, the leaf extract positively affected integrity and function of both liver and pancreas.

Sedentarismo, obesidad y salud mental en la población española de 4 a 15 años de edad / Inactivity, obesity and mental health in the spanish population from 4 to 15 years of age

Fundamento: Un estilo de vida activo y el mantenimiento de un peso saludable son dos de los principales determinantes del bienestar desde una perspectiva de salud pública. El objetivo del trabajo es evaluar el grado de asociación entre la actividad física y el índice de masa corporal (IMC) con el bienestar emocional y la salud mental de los escolares en España. Método: Se evaluó el estado de salud mental a través del Cuestionario de Capacidades y Dificultades (SDQ), la práctica de actividad física durante el tiempo libre y el IMC en un total de 6.803 escolares de 4 a 15 años de edad, participantes en la Encuesta Nacional de Salud de España 2006. El grado de asociación entre variables fue estimado a través de un análisis de regresión logística multinomial. Resultados: Entre los escolares sedentarios son más frecuentes los problemas de salud mental (OR 2,10), en concreto problemas emocionales (OR 1,84), los problemas de conducta (OR 1,53), los problemas con los compañeros (OR 2,35) y las dificultades de relación social (OR 1,36). Un índice de masa corporal (IMC) que denota obesidad se asocia a peor salud mental general (OR 1,58), mostrando los escolares obesos en mayor medida problemas emocionales (OR 1,52) y problemas con compañeros (OR 2,43). Conclusiones: En los escolares españoles un IMC saludable se asocia con mayor bienestar psicológico, aunque un estilo de vida activo es en mayor grado un buen indicador del estado de salud mental(AU)

Background: An active lifestyle and a good weight status are two major health determinants from a public health perspective. Aim: To evaluate the degree of association between physical activity, weight status and the emotional and mental health of Spanish schoolchildren. Method: Mental health status was assessed through the Strengths and Difficulties Questionnaire (SDQ), also leisure time physical activity and body mass index (BMI) in a total of 6 803 children from 4 to 15 years participating in the Spanish National Health Survey 2006. The degree of association between. these variables was estimated by a multinomial logistic regression analysis. Results: Among sedentary schoolchildren are more common mental health problems (OR 2.10), emotional problems (OR 1.84), conduct problems (OR 1.53), problems with peers (OR 2.35) and social relationship difficulties (OR 1.36). Obesity is associated with poor general mental health (OR 1.58), and obese schoolchildren show more often emotional problems (OR 1.52) and problems with peers (OR 2.43). Conclusions: In the Spanish schoolchildren, a healthy BMI is associated with increased mental well-being, although an active lifestyle is the best indi ator of a good mental health status(AU)

[Inactivity, obesity and mental health in the Spanish population from 4 to 15 years of age]. / Sedentarismo, obesidad y salud mental en la población española de 4 a 15 años de edad.

BACKGROUND: An active lifestyle and a good weight status are two major health determinants from a public health perspective. AIM: To evaluate the degree of association between physical activity, weight status and the emotional and mental health of Spanish schoolchildren. METHOD: Mental health status was assessed through the Strengths and Difficulties Questionnaire (SDQ), also leisure time physical activity and body mass index (BMI) in a total of 6 803 children from 4 to 15 years participating in the Spanish National Health Survey 2006. The degree of association between. these variables was estimated by a multinomial logistic regression analysis. RESULTS: Among sedentary schoolchildren are more common mental health problems (OR 2.10), emotional problems (OR 1.84), conduct problems (OR 1.53), problems with peers (OR 2.35) and social relationship difficulties (OR 1.36). Obesity is associated with poor general mental health (OR 1.58), and obese schoolchildren show more often emotional problems (OR 1.52) and problems with peers (OR 2.43). CONCLUSIONS: In the Spanish schoolchildren, a healthy BMI is associated with increased mental well-being, although an active lifestyle is the best indicator of a good mental health status.

Effects of native banana starch supplementation on body weight and insulin sensitivity in obese type 2 diabetics.

Few fiber supplements have been studied for physiological effectiveness. The effects of native banana starch (NBS) and soy milk (control) on body weight and insulin sensitivity in obese type 2 diabetics were compared using a blind within-subject crossover design. Subjects undertook two phases of 4-week supplementation either with NBS or soy milk. Patients on NBS lost more body weight than when they were on control treatment. Plasma insulin and HOMA-I were reduced after NBS consumption, compared with baseline levels, but not significantly when compared to the control treatment. Results support the use of NBS as part of dietary fiber supplementation.

Intraluminal-restricted 17 beta-estradiol exerts the same myocardial protection against ischemia/reperfusion injury in vivo as free 17 beta-estradiol.

Several in vitro studies show that in animals and isolated cells, 17 beta-estradiol induces cardiovascular protective effects and it has also been observed that it reduces coronary heart disease risk. However, the use of estrogens to improve or protect cardiovascular function in humans has been controversial, this might be explained by the wide variety of effects, because estrogen receptors (ER) are expressed ubiquitously. Therefore, a cell-specific targeting therapeutic approach might be necessary. 17 beta-Estradiol was coupled to a large modified dextran through an aminocaproic spacer. For this study we used intact and gonadectomized male Wistar rats, 15 days after surgical procedure. Intravascular administration of 17 beta-estradiol-macromolecular conjugate, prior to coronary reperfusion diminishes the area of damage induced by coronary ischemia reperfusion (I/R) injury on an in vivo model. This effect was observed at 17 beta-estradiol sub-physiological concentrations [0.01 nmol/L], it is mediated by luminal endothelial ER alpha activation. 17 beta-Estradiol-macromolecular conjugate decreases phosphorylation level of PKC alpha and Akt, as part of the process to induce myocardial protection against coronary I/R. We proved that the hormone-macromolecular conjugate labeled with [3H]estradiol remained confined in the intravascular space the conjugate was not internalized into organs like heart, lung or liver. It is noteworthy that the 17 beta-estradiol-macromolecular conjugate has a slow renal elimination, which might increase its pharmacological advantage. We concluded that the stimulus of endothelial estrogen receptors is enough to decrease the myocardial damage induced by coronary reperfusion.