TY - JOUR A1 - Göldel, Julia M. A1 - Kamrath, Clemens A1 - Minden, Kirsten A1 - Wiegand, Susanna A1 - Lanzinger, Stefanie A1 - Sengler, Claudia A1 - Weihrauch-Blüher, Susann A1 - Holl, Reinhard W. A1 - Tittel, Sascha René A1 - Warschburger, Petra T1 - Access to Healthcare for Children and Adolescents with a Chronic Health Condition during the COVID-19 Pandemic: First Results from the KICK-COVID Study in Germany JF - Children N2 - This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0–10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany. KW - chronic health condition KW - children and adolescents KW - health care KW - COVID-19 pandemic KW - diabetes KW - rheumatic diseases KW - obesity Y1 - 2022 U6 - https://doi.org/10.3390/children10010010 SN - 2227-9067 VL - 10 SP - 1 EP - 11 PB - MDPI CY - Basel, Schweiz ET - 1 ER - TY - THES A1 - Kluth, Oliver T1 - Einfluss von Glucolipotoxizität auf die Funktion der β-Zellen diabetessuszeptibler und –resistenter Mausstämme T1 - Effects of glucolipotoxicity on beta-cells of diabetes-susceptible and diabetes-resistant mouse strains N2 - Ziel der vorliegenden Arbeit war es, die Auswirkungen von Glucose- und Lipidtoxizität auf die Funktion der β-Zellen von Langerhans-Inseln in einem diabetesresistenten (B6.V-Lepob/ob, ob/ob) sowie diabetessuszeptiblen (New Zealand Obese, NZO) Mausmodell zu untersuchen. Es sollten molekulare Mechanismen identifiziert werden, die zum Untergang der β-Zellen in der NZO-Maus führen bzw. zum Schutz der β-Zellen der ob/ob-Maus beitragen. Zunächst wurde durch ein geeignetes diätetisches Regime in beiden Modellen durch kohlenhydratrestriktive Ernährung eine Adipositas(Lipidtoxizität) induziert und anschließend durch Fütterung einer kohlenhydrathaltigen Diät ein Zustand von Glucolipotoxizität erzeugt. Dieses Vorgehen erlaubte es, in der NZO-Maus in einem kurzen Zeitfenster eine Hyperglykämie sowie einen β-Zelluntergang durch Apoptose auszulösen. Im Vergleich dazu blieben ob/ob-Mäuse längerfristig normoglykämisch und wiesen keinen β-Zelluntergang auf. Die Ursache für den β-Zellverlust war die Inaktivierung des Insulin/IGF-1-Rezeptor-Signalwegs, wie durch Abnahme von phospho-AKT, phospho-FoxO1 sowie des β-zellspezifischen Transkriptionsfaktors PDX1 gezeigt wurde. Mit Ausnahme des Effekts einer Dephosphorylierung von FoxO1, konnten ob/ob-Mäuse diesen Signalweg aufrechterhalten und dadurch einen Verlust von β-Zellen abwenden. Die glucolipotoxischen Effekte wurden in vitro an isolierten Inseln beider Stämme und der β-Zelllinie MIN6 bestätigt und zeigten, dass ausschließlich die Kombination hoher Glucose und Palmitatkonzentrationen (Glucolipotoxizität) negative Auswirkungen auf die NZO-Inseln und MIN6-Zellen hatte, während ob/ob-Inseln davor geschützt blieben. Die Untersuchung isolierter Inseln ergab, dass beide Stämme unter glucolipotoxischen Bedingungen keine Steigerung der Insulinexpression aufweisen und sich bezüglich ihrer Glucose-stimulierten Insulinsekretion nicht unterscheiden. Mit Hilfe von Microarray- sowie immunhistologischen Untersuchungen wurde gezeigt, dass ausschließlich ob/ob-Mäuse nach Kohlenhydratfütterung eine kompensatorische transiente Induktion der β-Zellproliferation aufwiesen, die in einer nahezu Verdreifachung der Inselmasse nach 32 Tagen mündete. Die hier erzielten Ergebnisse lassen die Schlussfolgerung zu, dass der β-Zelluntergang der NZO-Maus auf eine Beeinträchtigung des Insulin/IGF-1-Rezeptor-Signalwegs sowie auf die Unfähigkeit zur β- Zellproliferation zurückgeführt werden kann. Umgekehrt ermöglichen der Erhalt des Insulin/IGF-1-Rezeptor-Signalwegs und die Induktion der β-Zellproliferation in der ob/ob-Maus den Schutz vor einer Hyperglykämie und einem Diabetes. N2 - The aim of the project was to investigate the impact of glucose- and fatty acid toxicity on β-cell function in a diabetes susceptible (New Zealand Obese, NZO) and resistant (B6.V-Lepob/ob, ob/ob)mouse model. Specifically, the molecular mechanisms of glucolipotoxicity-induced β-cell failure in the NZO mouse and pathways which contribute to protection of ob/ob mice against diet-induced type 2 diabetes should be elucidated. First, the animals were fed a fat-enriched carbohydrate-free diet which resulted in severe obesity and insulin resistance (lipotoxicity). Subsequently, mice were exposed to a carbohydrate-containing diet to induce conditions of glucolipotoxicity. This sequential dietary regimen provides a convenient method to induce rapid hyperglycaemia with β-cell destruction by apoptosis in a short time frame in NZO mice. In contrast, long-term exposure of ob/ob mice to the same dietary regimen leads to normoglycaemia and a protection against β-cell failure. The molecular mechanism behind carbohydrate-mediated β-cell destruction in NZO mice was an inactivation of the insulin/IGF-1 receptor signaling pathway including loss of phospho-AKT, phospho-FoxO1 and of the β-cell specific transcription factor PDX1. With the exception of FoxO1-dephosphorylation, ob/ob mice maintained this survival pathway and therefore were protected against loss of β-cells. The adverse effects of glucolipotoxicity on β-cells were verified in vitro by treatment of isolated NZO-islets and MIN6-cells under glucolipotoxic conditions. Only the combination of high glucose in the presence of palmitate caused deterioration of NZO-islets and MIN6-cells whereas ob/ob-islets were protected. The investigation of the insulin expression pattern showed, that glucolipotoxic conditions inhibited a glucose-induced increase in insulin expression in both, NZO and ob/ob islets. Furthermore, NZO and ob/ob-islets did not differ in glucose-stimulated insulin secretion. Expression profiling and immunohistochemical analyses of islets from NZO and ob/ob mice before and after carbohydrate intervention revealed a transient induction of a compensatory β-cell proliferation. During a 32 day carbohydrate feeding islet mass of ob/ob mice increased almost 3-fold. In conclusion, β-cell failure in NZO mice was induced via impairment of the insulin/IGF-1 signaling pathway and the inability to adequately increase β-cell mass by proliferation. Conversely, maintenance of the insulin/IGF-1 receptor signaling pathway and the induction of β-cell proliferation protected ob/ob mice against hyperglycaemia and type 2 diabetes. KW - Glucolipotoxizität KW - Beta-Zelle KW - NZO KW - ob/ob KW - Diabetes KW - glucolipotoxicity KW - beta-cell KW - NZO KW - ob/ob KW - diabetes Y1 - 2012 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus-61961 ER - TY - JOUR A1 - Delfan, Maryam A1 - Juybari, Raheleh Amadeh A1 - Gorgani-Firuzjaee, Sattar A1 - Nielsen, Jens Høiriis A1 - Delfan, Neda A1 - Laher, Ismail A1 - Saeidi, Ayoub A1 - Granacher, Urs A1 - Zouhal, Hassane T1 - High-Intensity Interval Training Improves Cardiac Function by miR-206 Dependent HSP60 Induction in Diabetic Rats JF - Frontiers in Cardiovascular Medicine N2 - Objective: A role for microRNAs is implicated in several biological and pathological processes. We investigated the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on molecular markers of diabetic cardiomyopathy in rats. Methods: Eighteen male Wistar rats (260 ± 10 g; aged 8 weeks) with streptozotocin (STZ)-induced type 1 diabetes mellitus (55 mg/kg, IP) were randomly allocated to three groups: control, MICT, and HIIT. The two different training protocols were performed 5 days each week for 5 weeks. Cardiac performance (end-systolic and end-diastolic dimensions, ejection fraction), the expression of miR-206, HSP60, and markers of apoptosis (cleaved PARP and cytochrome C) were determined at the end of the exercise interventions. Results: Both exercise interventions (HIIT and MICT) decreased blood glucose levels and improved cardiac performance, with greater changes in the HIIT group (p < 0.001, η2: 0.909). While the expressions of miR-206 and apoptotic markers decreased in both training protocols (p < 0.001, η2: 0.967), HIIT caused greater reductions in apoptotic markers and produced a 20% greater reduction in miR-206 compared with the MICT protocol (p < 0.001). Furthermore, both training protocols enhanced the expression of HSP60 (p < 0.001, η2: 0.976), with a nearly 50% greater increase in the HIIT group compared with MICT. Conclusions: Our results indicate that both exercise protocols, HIIT and MICT, have the potential to reduce diabetic cardiomyopathy by modifying the expression of miR-206 and its downstream targets of apoptosis. It seems however that HIIT is even more effective than MICT to modulate these molecular markers. KW - diabetes KW - apoptosis KW - miRNAs KW - exercise KW - cardiomyopathy Y1 - 2022 U6 - https://doi.org/10.3389/fcvm.2022.927956 SN - 2297-055X VL - 9 SP - 1 EP - 11 PB - Frontiers CY - Lausanne, Schweiz ER -