Journal du syndrome métabolique

The secretome is considered a combination of factors produced by cells due to abundant spectrum of autocrine/ paracrine triggers. All these actively synthetizing and secreting factors include proteins, adhesion and intercellular signal molecules, peptides, lipids, free DNAs, microRNAs, and microparticles (MPs). The components of secretome mutually may interact and thereby modify the MPs’ structure and functionality. As a result, communicative ability of endothelial cell derived MPs may sufficiently impaire. Subsequently, cross talk between some components of secretome might modulate delivering cargos of MPs and their regenerative and proliferative capabilities via intercellular signaling networks. The aim of the review is to discuss the effect of various components of secretome on MP-dependent effects on endothelium.

Background: The worldwide prevalence of Type 2 diabetes mellitus is associated with other conditions that trigger metabolic syndrome. Although several studies on the benefits of resveratrol have been carried out, few have assessed this drug in combination with metformin. Objectives: This study looks at the effects that combined metformin/resveratrol therapy has on body weight gain and liver and renal damage of db/db diabetic mice. It also addresses biochemical findings. Method: Diabetic mice were treated with resveratrol (20 mg/kg/day), metformin (150 mg/kg/day) and combined metformin/resveratrol therapy for 5 weeks. Histopathological tissue analyses and biochemical parameters (glucose, insulin, triglycerides and cholesterol), functional liver enzymes (AP, AST and GGT) and renal parameters (urea and uric acid) were examined. Results: Our data clearly showed that combined metformin/resveratrol treatment reduced obesity, glucose and triglyceride levels, as well as improving renal function and partially improving liver function in diabetic mice. Conclusion: The combined therapy may enhance remedial effects in diabetic patients as well as in other metabolic disorders, such as metabolic syndrome.

Objective: Although it was reported that cholecystectomy had complex impact on lipid profile in cholelithiasis, lipoprotein (a) [Lp(a)] was not studied. The present study was therefore conducted on serum Lp(a) status in Bangladeshi patients with cholelithiasis and effect of cholecystectomy on it.
Patients and Methods: Adult patients (n=44) with cholelithiasis and 30 normal controls (NC) were included in the study. The blood sample was taken from fasting patients before cholecystectomy (Serum-I0), gall bladder bile sample during cholecystectomy (Bile-I0) and blood sample again after 2-3 months at follow-up (Serum-II0) and from fasting NC subjects. Lp(a) level was quantitated in serum and bile by immunoturbidimetric method using commercially available research kit. The results were compared statistically by ANOVA, Student’s t-test and Chisquared test using SPSS programme.
Results: The Lp(a) status (mg/dl, Mean ± SD) in controls and patients and their statistical analysis revealed that Lp(a) was much higher in patients compared to controls (NC: 29.07 ± 14.1, Patients Serum-I0: 290.84 ± 110.93, Patients Bile-I0 : 37.12 ± 28.61, Patients Serum-II0: 203.70 ± 90.13) (P<0.001). Lp(a) was lowered after cholecystectomy, but remained elevated in patients Serum-II0 compared to NC significantly (P<0.001). No significant difference was observed for Lp(a) levels between NC and patients Bile-I0 (P=0.173). The proportions of patients for Serum-I0, Bile-I0 and Serum-II0 with Lp(a) levels above and within normal limits and their statistical analyses showed significant associations (P<0.001).
Conclusions: Cholelithiasis had complex impact on Lp(a) status indicating a special function of gall bladder relevant to its metabolism. Further studies are warranted.

Objective: Visceral fat accumulation because of obesity plays a central role in metabolic syndrome and causes cardiovascular disease (CVD).
Methods: The aims of this study were to investigate associations between visceral fat accumulation and adipokines in non-obese type 2 diabetic patients.
Results: In total, 138 type 2 diabetic patients were enrolled, with a mean age of 64 years. Among the participants, 69 were males. We found that serum high-molecular-weight adiponectin level was decreased, C-reactive protein increased, and using homeostatic model assessment of insulin resistance was also increased in non-obese patients with visceral adiposity (body mass index: BMI, <25 kg/m2; visceral fat area: VFA, ≥ 100 cm2) compared with those without visceral adiposity (BMI, <25 kg/m2, VFA, <100 cm2). VFA in non-alcoholic fatty liver disease (NAFLD) was higher than in those with no NAFLD.
Conclusion: We demonstrated that visceral fat accumulation is a risk for CVD in non-obese diabetic patients with visceral adiposity.

Background: Diabetes is one of the commonest non-communicable diseases of the 21st century. Global burden of diabetes in 2010 was estimated at 285 million and projected to increase to 438 million by the year 2030, if no interventions are put in place. The primary health care facilities are the first level of contact for such rising cases of diabetes, despite of this fact there is no study done on the capabilities of primary health care facilities to accommodate diabetic services. Hence, the objective of this study is to assess the readiness of selected primary public hospitals and health centers to accommodate diabetic care in Jimma zone south west Ethiopia.
Methods: Health facility based cross-sectional study design using quantitative and qualitative method of data collection was conducted from Feb 1-March 1, 2013. After checking the completeness, and coding of questionnaires, the quantitative data were entered into computer software and analyzed using SPSS version 20.0.
Results: All of the facilities have at least some of the drugs and medical supplies and other resources required for the diagnosis and management of diabetes never the less there was no specific plan to deal with diabetic management at health facilities. Majority of patients were first diagnosed in other health facilities and referred to the current health institutions for follow up and there is no routine screening for diabetics in adult outpatient department in some health facilities.
Conclusion and recommendation: Required drugs and medical supplies are not regularly fulfilled, health facilities have no plan for diabetic management, and health workers did not get training on management of diabetics. No routine screening at adult patients at outpatient departments. Hence the Woreda and the zone have to work on the capacity of the health workers and health facilities to handle diabetic care at health center level.