Homeostatic microbiome disruption as a cause of insulin secretion disorders. Candida albicans, a new factor in pathogenesis of diabetes: A STROBE compliant cross-sectional study.

The study aimed to test the hypothesis that homeostatic microbiome (HM) disorders lead to the increased indirect influence of certain microorganisms (MO) in the gastrointestinal tract, causing a disorder of insulin secretion, insulin resistance, and diabetes. We highlighted Candida and certain types of bacteria since previous in vitro research showed they significantly affect insulin secretion and can cause insulin resistance in obese patients with metabolic syndrome. After determining the type of MO present in the throat swab and the stool, the oral glucose tolerance test (OGTT) test, and analysis of glucose and insulin secretion were performed in patients (n = 38) who were positive for certain types of MO compared to negative patients. Finally, all patients were divided into two groups: overweight patients (body mass index [BMI] < 30) and obese patients (BMI > 30). These two groups were compared for the percentage of certain types of MO to determine which MO can affect an increase in obesity and BMI. The presence of Diphtheroids in the throat (60.5%) reduces insulin secretion in patients compared with the negative group (194.5: 332.4) and the difference was statistically significant (P = .030). The presence of Candida in the throat (10%) increases insulin secretion, but the difference was statistically insignificant. The presence of Candida in the stool (28.9%) also increases insulin secretion and the difference was statistically significant (P = .038). Cumulative results (throat + stool) were similar (180: 332, P = .022). Analysis of BMI showed that the percentage of Diphtheroids in the throat decreases with increased body weight (53.8: 75%) while the percentage of Candida (38.5: 8.3%) and Enterobacter (61.5: 25%) increases, but these differences were statistically insignificant (P > .05). Diphtheroids in the throat can reduce insulin secretion by synthesizing their metabolites. Candida albicans is a conditional pathogen and as a significant indirect factor induces increased insulin secretion and insulin resistance. There are indications that elevated levels of Candida in the intestinal system can cause increased body weight of patients. C albicans should be considered a new factor in the pathogenesis of diabetes.

Silent myocardial ischaemia in treated hypertensives with and without left ventricular hypertrophy.

BACKGROUND: Silent ischaemia has been reported to be associated with an increased risk of myocardial infarction and sudden death in a wide range of patient groups. The aim of this study was to examine the prevalence of silent ischaemia in hypertensive patients with and without left ventricular hypertrophy (LVH). METHODS: Twenty hypertensive patients participating in the Anglo-Scandinavian Cardiac Outcomes Trial with echocardiographic LVH (11 males, nine females), and 20 age, sex, blood pressure, and drug treatment-matched hypertensive patients without LVH underwent 24-h combined ambulatory blood pressure and electrocardiographic (ECG) monitoring. Ischaemic events were defined by the 'rule of 3 x 1'-asymptomatic ST-depression >/= 1 mm (0.1 mV), lasting at least 1 min, and with a duration of at least 1 min between two events. RESULTS: Thirteen patients with LVH had ischaemic events, whilst only four without LVH demonstrated ischaemia. Median numbers of events (seven versus zero; P < 0.01) and median total ischaemic area (0.25 versus 0 mV*min/day; P < 0.01) were significantly increased amongst hypertensive patients with LVH by comparison to those without LVH. CONCLUSION: Despite similar levels of established risk factors for atherosclerotic coronary artery disease, the prevalence of silent ischaemia was markedly increased amongst hypertensive patients with LVH by comparison to those with normal left ventricular dimensions. Ambulatory ECG monitoring may have a use in the identification of those at greatest risk of cardiovascular complications and sudden death, amongst hypertensive patients with persistent cardiac hypertrophy despite anti-hypertensive therapy.