Dataset Information

Central and peripheral pathogenetic forms of type 2 diabetes: a proof-of-concept study.

ABSTRACT:

Hypothesis

Previous studies provide evidence that glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) should not be considered as interchangeable alternatives in the diagnosis of the same type 2 diabetes, but as indicators of its different pathogenetic subtypes. This study was conducted to determine whether a particularly high amount of glucose in either HbA1c form or in fasting plasma would be found in diabetic patients genetically predisposed for either intensive cognitive or intensive muscle metabolic activity, respectively.

Methods

HbA1c and FPG levels, polymorphisms of genes indicating the predisposition to different cognitive activity (the dopamine D2 receptor (DRD2/ANKK1)), muscle activity (peroxisome proliferator-activated receptor gamma, coactivator 1 alpha (PGC1A(PPARGC1A))), and vascular regulation of general metabolic activity (the angiotensin 1 converting enzyme (ACE)) were assessed in diabetic patients and nondiabetic controls.

Results

DRD2/ANKK1 polymorphism that affects baseline central arousal determined HbA1c variations uncorrelated with FPG in total and clinical groups. The mutation of PGC1A mainly affecting peripheral glucose metabolism had an effect on FPG correlated or uncorrelated with HbA1c depending on the effect assessment in the total sample or in the nondiabetic group, respectively. ACE insertion/deletion (I/D) gene polymorphism was associated with both HbA1c and FPG fluctuations, but only in diabetic patients.

Conclusion

The findings provide evidence that the HbA1c and FPG may predict the risks for different subtypes of type 2 diabetes associated with either brain or muscle metabolic activity in genetically vulnerable people.

SUBMITTER: Davydov DM

PROVIDER: S-EPMC8450667 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundClinical tests for detecting central and peripheral shoulder fatigue are limited. The discrimination of these two types of fatigue is necessary to better adapt recovery intervention. The Kinematic Theory of Rapid Human Movements describes the neuromotor impulse response using lognormal functions and has many applications in pathology detection. The ideal motor control is modeled and a change in the neuromuscular system is reflected in parameters extracted according to this theory.ObjectiveThe objective of this study was to assess whether a shoulder neuromuscular fatigue could be detected through parameters describing the theory, if there is the possibility to discriminate central from peripheral fatigue, and which handwriting test gives the most relevant information on fatigue.MethodsTwenty healthy participants performed two sessions of fast stroke handwriting on a tablet, before and after a shoulder fatigue. The fatigue was in internal rotation for one session and in external rotation during the other session. The drawings consisted of simple strokes, triangles, horizontal, and vertical oscillations. Parameters of these strokes were extracted according to the Sigma-Lognormal model of the Kinematic Theory. The evolution of each participant was analyzed through a U-Mann-Whitney test for individual comparisons. A Hotelling's T 2-test and a U-Mann-Whitney test were also performed on all participants to assess the group evolution after fatigue. Moreover, a correlation among parameters was calculated through Spearman coefficients to assess intrinsic parameters properties of each handwriting test.ResultsCentral and peripheral parameters were statistically different before and after fatigue with a possibility to discriminate them. Participants had various responses to fatigue. However, when considering the group, parameters related to the motor program execution showed significant increase in the handwriting tests after shoulder fatigue. The test of simple strokes permits to know more specifically where the fatigue comes from, whereas the oscillations tests were the most sensitive to fatigue.ConclusionThe results of this study suggest that the Sigma-Lognormal model of the Kinematic Theory is an innovative approach for fatigue detection with discrimination between the central and peripheral systems. Overall, there is a possibility to implement the setting for clinics and sports personalized follow-up.