TY  - JOUR
A1  - Danquah, Ina
A1  - Dobrucky, C. Lydia
A1  - Frank, Laura K.
A1  - Henze, Andrea
A1  - Amoako, Yaw A.
A1  - Bedu-Addo, George
A1  - Raila, Jens
A1  - Schulze, Matthias Bernd
A1  - Mockenhaupt, Frank P.
A1  - Schweigert, Florian J.
T1  - Vitamin A: potential misclassification of vitamin A status among patients with type 2 diabetes and hypertension in urban Ghana
JF  - The American journal of clinical nutrition : a publication of the American Society for Nutrition, Inc.
N2  - Background: Sub-Saharan Africa is facing a double burden of malnutrition: vitamin A deficiency (VAD) prevails, whereas the nutrition-related chronic conditions type 2 diabetes (T2D) and hypertension are emerging. Serum retinol a VAD marker increases in kidney disease and decreases in inflammation, which can partly be attributed to alterations in the vitamin A transport proteins retinol-binding protein 4 (RBP4) and prealbumin. Kidney dysfunction and inflammation commonly accompany T2D and hypertension.
 Objective: Among urban Ghanaians, we investigated the associations of T2D and hypertension with serum retinol as well as the importance of kidney function and inflammation in this regard.
 Design: A hospital-based, case-control study in individuals for risk factors of T2D, hypertension, or both was conducted in Kumasi, Ghana (328 controls, 197 with T2D, 354 with hypertension, and 340 with T2D plus hypertension). In 1219 blood samples, serum retinol, RBP4, and prealbumin were measured. Urinary albumin and estimated glomerular filtration rate (eGFR) defined kidney function. C-reactive protein (CRP) >5 mg/L indicated inflammation. We identified associations of T2D and hypertension with retinol by linear regression and calculated the contribution of RBP4, prealbumin, urinary albumin, eGFR, and CRP to these associations as the percentages of the explained variance of retinol.
 Results: VAD (retinol <1.05 mu mol/L) was present in 10% of this predominantly female, middle-aged, overweight, and deprived population. Hypertension, but not T2D, was positively associated with retinol (beta: 0.12; 95% CI: 0.08, 0,17), adjusted for age, sex, socioeconomic factors, anthropometric measurements, and lifestyle. In addition to RBP4 (72%) and prealbumin (22%), the effect of increased retinol on individuals with hypertension was mainly attributed to impaired kidney function (eGFR: 30%; urinary albumin: 5%) but not to inflammation.
 Conclusions: In patients with hypertension, VAD might be underestimated because of increased serum retinol in the context of kidney dysfunction. Thus, the interpretation of serum retinol in sub-Saharan Africa should account for hypertension status.
KW  - hypertension
KW  - inflammation
KW  - kidney dysfunction
KW  - type 2 diabetes
KW  - vitamin A deficiency
Y1  - 2015
U6  - https://doi.org/10.3945/ajcn.114.101345
SN  - 0002-9165
SN  - 1938-3207
VL  - 102
IS  - 1
SP  - 207
EP  - 214
PB  - American Society for Nutrition, Inc.
CY  - Bethesda
ER  - 
TY  - JOUR
A1  - Groop, Per-Henrik
A1  - Cooper, Mark E.
A1  - Perkovic, Vlado
A1  - Sharma, Kumar
A1  - Schernthaner, Guntram
A1  - Haneda, Masakazu
A1  - Hocher, Berthold
A1  - Gordat, Maud
A1  - Cescutti, Jessica
A1  - Woerle, Hans-Juergen
A1  - von Eynatten, Maximilian
T1  - Dipeptidyl peptidase-4 inhibition with linagliptin and effects on hyperglycaemia and albuminuria in patients with type 2 diabetes and renal dysfunction: Rationale and design of the MARLINA-T2D trial
JF  - Diabetes & vascular disease research : official journal of the International Society of Diabetes and Vascular Disease
N2  - Efficacy, Safety & Modification of Albuminuria in Type 2 Diabetes Subjects with Renal Disease with LINAgliptin (MARLINA-T2D), a multicentre, multinational, randomized, double-blind, placebo-controlled, parallel-group, phase 3b clinical trial, aims to further define the potential renal effects of dipeptidyl peptidase-4 inhibition beyond glycaemic control. A total of 350 eligible individuals with inadequately controlled type 2 diabetes and evidence of renal disease are planned to be randomized in a 1:1 ratio to receive either linagliptin 5mg or placebo in addition to their stable glucose-lowering background therapy for 24weeks. Two predefined main endpoints will be tested in a hierarchical manner: (1) change from baseline in glycated haemoglobin and (2) time-weighted average of percentage change from baseline in urinary albumin-to-creatinine ratio. Both endpoints are sufficiently powered to test for superiority versus placebo after 24weeks with =0.05. MARLINA-T2D is the first of its class to prospectively explore both the glucose- and albuminuria-lowering potential of a dipeptidyl peptidase-4 inhibitor in patients with type 2 diabetes and evidence of renal disease.
KW  - Dipeptidyl peptidase-4 inhibition
KW  - linagliptin
KW  - type 2 diabetes
KW  - chronic kidney disease
KW  - glycaemic control
KW  - albuminuria
Y1  - 2015
U6  - https://doi.org/10.1177/1479164115579002
SN  - 1479-1641
SN  - 1752-8984
VL  - 12
IS  - 6
SP  - 455
EP  - 462
PB  - Sage Publ.
CY  - London
ER  -