Similarities in serum acylcarnitine patterns in type 1 and type 2 diabetes mellitus and in metabolic syndrome.

BACKGROUND/AIMS: In type 1 diabetes (T1D), type 2 diabetes (T2D) and metabolic syndrome (MetS), the associated complex metabolomic changes in the involvement of carnitine metabolism in total carnitine ester level has already been documented; here we extended the investigations to the individual acylcarnitines. METHODS: The fasting serum acylcarnitine concentrations were determined in 49 T1D, 38 T2D and 38 MetS patients and 40 controls by isotope dilution electrospray ionization tandem mass spectrometry. RESULTS: The acylcarnitine profiles of the 3patient groups shared elements with the controls. Considerably higher levels of almost all short-chain acylcarnitines (p < 0.05) and lower levels of some long-chain acylcarnitines were detected in T2D and MetS patients. The amounts of C3 and C4 carnitine were higher and most of the medium-chain and long-chain acylcarnitine levels were lower (p < 0.05) in T1D and MetS patients than in the controls. In T1D and T2D, the levels of C3 and C4 acylcarnitines were markedly elevated and some long-chain acylcarnitines were lower than the controls (p < 0.05). Moreover, significantly lower concentrations of free- and total carnitine were observed in T1D patients (p < 0.05). CONCLUSIONS: Profound alterations were detected in acylcarnitine profiles in the 3 patient groups. Similarities in the patterns suggest different degrees of involvement of the same metabolic systems in a systems biology approach.

Apolipoprotein A5 IVS3+476A allelic variant associates with increased trigliceride levels and confers risk for development of metabolic syndrome in Hungarians.

BACKGROUND: Metabolic syndrome consists of multiple risk factors that are increasing the cardiovascular mortality. The T-1131C variant of the apolipoprotein A5 gene, associated with increased triglycerides, has been found to confer risk for cardiovascular diseases and metabolic syndrome. Because other naturally occurring variants of the gene also correlate with elevated triglycerides, the possible role of 2 common variants, the IVS3+G476A and T1259C, with metabolic syndrome was investigated. METHODS AND RESULTS: A total of 213 metabolic syndrome patients and 142 healthy controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism. Serum triglycerides were increased in carriers compared with non-carriers in both groups (p<0.001); serum cholesterol levels were similar in all genotypes. The IVS3+476A allele frequency was increased in metabolic syndrome patients compared with controls (8.05 vs 2.47%; p<0.05), whereas the 1259C allele frequency did not differ between the groups. Multiple logistic regression analyses adjusted for age, gender, serum total cholesterol, acute myocardial infarction and stroke revealed that the IVS3+476A variant confers risk for development of metabolic syndrome (odds ratio =3.529, 95% confidence interval 1.308-9.029, p=0.009), but the 1259C allele had no such an effect. CONCLUSIONS: Carrying the IVS3+473A allele is associated with elevated triglycerides and confers risk for development of metabolic syndrome, a combination that represents increased risk for development of atherogenic vascular diseases.

[The role of continuous glucose monitoring in the therapy of diabetes mellitus]. / A folyamatos cukormér vizsgálatok helye a diabetes mellitus kezelésének ellenorzésében.

INTRODUCTION: Continuous glucose monitoring system is a wide spreading method in the control of the therapy of diabetes, nowadays recording the fluctuation of the glucose level between two measurements during the classical glucose measurements. PATIENTS AND METHOD: 79 measurements of 53 diabetic patients were analysed. 48/53 (90.5%) (30 women, 18 men, mean age: 26.3 +/- 16.8 years) were patients with type 1 diabetes, 5/53 (9.5%) (4 women, 1 man, mean age: 58.4 +/- 6.2 years) were patients with type 2 diabetes. After delineating the technical details of this technique, results of the measurements recorded in the authors' patients population are presented reviewing the advantages and disadvantages of the method. During the average measurements of 3-4 days MiniMed apparatus were used. RESULTS: The method proved to be useful in detecting the down-phenomenon and the asymptomatic hypoglycemic events mainly, however, long hyperglycemic periods were seen several times. The method led to change of therapy in 64.5% of all measurements, but the authors present unsuccessful measurements due to the error of the sensor and cases when the results did not help the therapeutic decision. CONCLUSIONS: Authors describe a wide range of indications of the usage of this method based on their own and other authors' experience presenting its applicability and limits. It is highlighted that the method is not effective in patients with type 2 diabetes. Presenting their results the authors emphasize that this method provides extra information compared to the classical measurements leading to a better glycemic control and life expectancy in type 1 diabetes patients.