scholarly journals Type IV Collagen 7S Is the Most Accurate Test For Identifying Advanced Fibrosis in NAFLD With Type 2 Diabetes

2020 ◽  
Author(s):  
Hiroshi Ishiba ◽  
Yoshio Sumida ◽  
Yuya Seko ◽  
Saiyu Tanaka ◽  
Masato Yoneda ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type Iv Collagen ◽  
Advanced Fibrosis ◽  
Type Iv ◽  
Type Iv Collagen 7S

scholarly journals PROSPECTS OF NEPHROPROTECTION AGAINST TYPE 2 DIABETES USING THE DPP-4 INHIBITOR VILDAGLIPTIN

2017 ◽  
pp. 8-16
Author(s):  
V. K. Bayrasheva ◽  
A. Y. Babenko ◽  
A. A. Bayramov ◽  
S. G. Chefu ◽  
I. S. Shatalov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type Iv Collagen ◽  
Renal Protection ◽  
Postprandial Glycemia ◽  
Type Iv ◽  
Group A ◽  
Positive Effect ◽  
Continue Therapy

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus (DM), which increases morbidity and mortality. Accumulated evidence, mostly experimental ones that DPP-4 inhibitors have non-glycemic tissue effects including renal protection. Clinical data confirming these effects are insufficient. This makes it relevant to study the influence of iDPP-4 on the renal function in patients with Type 2 diabetes.To study the effects of iDPP vildagliptin on glycemic, metabolic and renal parameters in patients with type 2 diabetes with CKD 1–2 receiving insulin therapy 44 patients were randomized to continue therapy with insulin or insulin + vildagliptin at a dose of 50 mg/day, with the evaluation of results in 6 months.In group of vildagliptin therapy a significant decrease of HbA1c, postprandial glycemia, diastolic blood pressure, HOMA-IR, insulin demand and a reduction in the frequency of hypoglycemia occurred. The positive dynamics of indicators of glomerular functions of the kidney were noted in this group - a significant reduction in albuminuria and a significant increase in eGFR by cystatin C and decreased urinary excretion of type IV collagen. The findings suggest the positive effect of vildagliptin on metabolic status and indicators of glycaemia and hemodynamics as earlier confirmed in clinical studies and the ability of vildagliptin independent from glycemic effects to slow the development of glomerular dysfunction in patients with type 2 diabetes and the initial manifestations of DN. 

scholarly journals Efficacy and Safety of Luseogliflozin in Patient with Type 2 Diabetes Complicated by Hepatic Dysfunction

2020 ◽  
Author(s):  
Hiroaki Seino
Keyword(s):  
Type 2 Diabetes ◽  
Hepatic Dysfunction ◽  
Hepatic Function ◽  
Model Assessment ◽  
Type Iv ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model ◽  
Hs Crp ◽  
Type Iv Collagen 7S

Abstract Background: Improvements in glycemic control and hepatic function are clinically important goals in the treatment of patients with type 2 diabetes mellitus complicated by hepatic dysfunction. The favorable effects of the sodium-glucose co-transporter inhibitor luseogliflozin on hepatic dysfunction were anticipated for humans. Nevertheless, few clinical studies have confirmed its real-world efficacy on hepatic dysfunction. This trial was conducted to assess the safety and efficacy of luseogliflozin in patients with type 2 diabetes mellitus complicated by hepatic dysfunction.Methods: This prospective, single-site, single-arm, open-label trial included 55 subjects. Subjects were administered with luseogliflozin and observed for 52 weeks. The primary endpoints were the change and percent change in aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (γ-GTP), and hemoglobin A1c (HbA1c) from baseline to week 52. The secondary endpoints included body weight, body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose (FPG), homeostatic model assessment beta (HOMA-β), homeostatic model assessment of insulin resistance (HOMA-IR), ferritin, Mac-2 binding protein (M2-BP), fatty liver index (FLI), fibrosis-4 (FIB-4) index, type IV collagen 7S domain, nonalcoholic fatty liver disease (NAFLD) fibrosis score, high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6).Results: AST, ALT, γ-GTP, and HbA1c significantly decreased from baseline to week 52. Body weight, BMI, waist circumference, and FPG also significantly decreased. HOMA-IR significantly decreased but HOMA-β was unchanged. FLI, ferritin, M2-BP, and NAFLD fibrosis scores significantly decreased whereas the FIB-4 index and type IV collagen 7S domain did not significantly change. The hs-CRP and IL-6 levels did not significantly change.Conclusion: Luseogliflozin administration in T2DM patients with hepatic dysfunction was well tolerated, improved hepatic function, reduced liver fat, and attenuated liver injury and fibrosis. The present study might help establish a therapeutic approach for T2DM patients with hepatic dysfunction induced by SGLT2 inhibitors.Trial registration: This study was registered under the University Hospital Medical Information Network Clinical Trial Registry (UMIN-CTR) (No. UMIN000025808) and the Japan Registry of Clinical Trials (No. jRCTs021180017).

scholarly journals Epidemiology, Pathogenesis, and Diagnostic Strategy of Diabetic Liver Disease in Japan

2020 ◽  
Vol 21 (12) ◽  
pp. 4337 ◽  
Author(s):  
Yoshio Sumida ◽  
Toshihide Shima ◽  
Yasuhide Mitsumoto ◽  
Takafumi Katayama ◽  
Atsushi Umemura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Hepatic Fibrosis ◽  
Type Iv Collagen ◽  
Diagnostic Strategy ◽  
Advanced Fibrosis ◽  
Non Invasive ◽  
Type Iv ◽  
Nafld Fibrosis Score ◽  
Type Iv Collagen 7S

Type 2 diabetes (T2D) is closely associated with nonalcoholic fatty liver disease (NAFLD). Nonalcoholic steatohepatitis (NASH), a severe form of NAFLD, can lead to cirrhosis, hepatocellular carcinoma (HCC), and hepatic decompensation. Patients with T2D have twice the risk of HCC incidence compared with those without T2D. Because the hepatic fibrosis grade is the main determinant of mortality in patients with NAFLD, identifying patients with advanced fibrosis using non-invasive tests (NITs) or imaging modalities is crucial. Globally, the fibrosis-4 index (FIB-4 index), NAFLD fibrosis score, and enhanced liver fibrosis test have been established to evaluate hepatic fibrosis. Two-step algorithms using FIB-4 index as first triaging tool are globally accepted. It remains unknown which kinds of NITs or elastography are best as the second step tool. In Japan, type IV collagen 7s or the CA-fibrosis index (comprising type IV collagen 7s and aspartate aminotransferase (AST)) is believed to precisely predict advanced fibrosis in NAFLD. Patients with NAFLD who have high non-invasive test results should be screened for HCC or esophageal varices. Risk factors of rapid fibrosis progression in NAFLD includes age, severe obesity, presence of T2D, menopause in women, and a patatin-like phospholipase domain containing the 3 GG genotype. Patients with NAFLD who have these risk factors should be intensively treated with lifestyle modification or pharmacotherapies for preventing liver-related mortality.

scholarly journals Pathomechanism of Renal Damage in Type 2 Diabetes Mellitus Patients

2013 ◽  
Vol 5 (3) ◽  
pp. 161
Author(s):  
Yuliana Sambara ◽  
Mansyur Arif ◽  
Uleng Bahrun
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Damage ◽  
Type Iv Collagen ◽  
Urinary Albumin ◽  
Diabetic Patients ◽  
Type Iv ◽  
Study Results

BACKGROUND: Hyperglycemia in diabetic patients cause both chronic inflammation and extracellular matrix accumulation that can lead to progressive renal damage. Albumin, Gammaglutamytransferase (GGT) and clusterin in urine are markers to detect damage in glomerulus, cell of the tubules and proximal tubules, respectively.METHODS: This study aimed to evaluate the pathomechanism of haemoglobin A1c (HbA1c), albumin, GGT, clusterin, type IV collagen in urine, and high sensitivity C-reactive protein (hsCRP) in type 2 diabetes mellitus (DM) patients. The study was a cross sectional study involving 82 subjects consisting of 36 males and 46 females, 35-65 years old, divided into 3 groups: uncontrolled DM, controlled DM and non DM. Data were obtained from interviews, physical examinations (weight, height, blood pressure) and laboratory examinations (HbA1c, serum glutamic oxaloacetic (SGOT), serum glutamic pyruvic (SGPT), creatinine, hsCRP, urinary albumin, urinary GGT, urinary clusterin, and urinary type IV collagen). Statistical analysis was performed for correlation, difference and cross tabulation tests.RESULTS: The study results showed there were significant differences (p<0.05) between uncontrolled DM group compared with controlled DM and non DM groups in HbA1c, ratio of urinary type IV collagen and ratio of urinary albumin. However, there were no significant differences between controlled DM and non DM groups. There were positive significant correlations between HbA1c with hsCRP (r=0.223, p<0.05), HbA1c with ratio of urinary type IV collagen/creatinine (r=0.563, p<0.001), HbA1c with ratio of urinary albumin/creatinine (r=0.263, p<0.05), and ratio of urinary type IV collagen/creatinine with ratio urinary albumin/creatinine (r=0.613, p<0.001).CONCLUSION: Results of this study indicated that albumin and type IV collagen in urine play a role in renal damage caused by uncontrolled glucose level in subjects with type 2 DM. The increased concentration of both HbA1c and urinary type IV collagen indicates increased risk factor of glomerulus damage. Urinary type IV collagen is likely to be future potential marker for early detection of renal damage.KEYWORDS: renal damage, HbA1c, hsCRP, type IV collagen, GGT, clusterin, diabetes mellitus

scholarly journals Serum Anti-Collagen IV IgM and IgG Antibodies as Indicators of Low Vascular Turnover of Collagen IV in Patients with Long-Term Complications of Type 2 Diabetes

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 900
Author(s):  
Krasimir Kostov ◽  
Alexander Blazhev
Keyword(s):  
Type 2 Diabetes ◽  
Serum Levels ◽  
Vascular Wall ◽  
Collagen Iv ◽  
Collagen Type Iv ◽  
Non Invasive ◽  
Type Iv ◽  
Antibody Levels

Thickening of the vascular basement membrane (BM) is a fundamental structural change in the small blood vessels in diabetes. Collagen type IV (CIV) is a major component of the BMs, and monitoring the turnover of this protein in type 2 diabetes (T2D) can provide important information about the mechanisms of vascular damage. The aim of the study was through the use of non-invasive biomarkers of CIV (autoantibodies, derivative peptides, and immune complexes) to investigate vascular turnover of CIV in patients with long-term complications of T2D. We measured serum levels of these biomarkers in 59 T2D patients with micro- and/or macrovascular complications and 20 healthy controls using an ELISA. Matrix metalloproteinases-2 and -9 (MMP-2 and MMP-9) were also tested. In the T2D group, significantly lower levels of CIV markers and significantly higher levels of MMP-2 and MMP-9 were found compared to controls. A significant positive correlation was found between IgM antibody levels against CIV and MMP-2. These findings suggest that vascular metabolism of CIV is decreased in T2D with long-term complications and show that a positive linear relationship exists between MMP-2 levels and CIV turnover in the vascular wall.

Type IV Collagen 7s Domain as a Predictor of Poor Efficacy of Portal Vein Embolization Before Major Hepatectomy

Surgery Today ◽  
2005 ◽  
Vol 35 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Jin Shang Wu ◽  
Shoji Kubo ◽  
Hiromu Tanaka ◽  
Taichi Shuto ◽  
Shigekazu Takemura ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Type Iv Collagen ◽  
Major Hepatectomy ◽  
Type Iv ◽  
Type Iv Collagen 7S ◽  
Poor Efficacy

scholarly journals High Prevalence of Advanced Liver Fibrosis Assessed by Transient Elastography Among U.S. Adults With Type 2 Diabetes

2020 ◽  
Author(s):  
Stefano Ciardullo ◽  
Tommaso Monti ◽  
Gianluca Perseghin
Keyword(s):  
Type 2 Diabetes ◽  
African American ◽  
Risk Factor ◽  
Transient Elastography ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
Diabetic Patients ◽  
Advanced Fibrosis ◽  
American Ethnicity

<b>Objective:</b> Type 2 diabetes mellitus (T2DM) is an important risk factor for the progression of metabolic liver disease to advanced fibrosis. Here, we provide an estimate of the prevalence of steatosis and fibrosis in US adults with T2DM based on transient elastography (TE) and identify factors associated with these conditions. <p><b>Research Design and Methods: </b>This is a cross-sectional study of US adults with T2DM participating in the 2017-2018 cycle of the National Health and Nutrition Examination Survey who were evaluated by TE. Hepatic steatosis and fibrosis were diagnosed by the median value of Controlled Attenuation Parameter (CAP) and Liver Stiffness Measurement (LSM), respectively.</p> <p><b>Results:</b> Among the 825 patients with reliable TE exams, 484 (53.7%) were assessed using the M probe and 341 (46.3%) using the XL probe. Liver steatosis (CAP≥274 dB/m), advanced fibrosis (LSM≥9.7 Kpa) and cirrhosis (LSM≥13.6 Kpa) were present in 73.8% (95% CI 68.5%-78.5%), 15.4% (95% CI 12.2%-19.0%) and 7.7% (95% CI 4.8%-11.9%) of patients, respectively. Mean age of patients with advanced fibrosis and cirrhosis was 63.7 ± 2.2 years and 57.8 ± 1.6 years, respectively. In the multivariable logistic regression model, body mass index (BMI), non-African American ethnicity and alanine aminotransferase levels were independent predictors of steatosis, while BMI, non-African American ethnicity, aspartate aminotransferase and gamma-glutamyltranspeptidase levels were independent predictors of advanced fibrosis.</p> <p><b>Conclusions:</b> Prevalence of both liver steatosis and fibrosis are high in patients with T2DM from the US and obesity is a major risk factor. Our results support the screening of these conditions among diabetic patients.</p>

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