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10.1371/journal.pone.0185371 http://scihub22266oqcxt.onion/10.1371/journal.pone.0185371 C5650138!5650138 !29053727     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29053727 &cmd=llinks): Failed to open stream: HTTP request failed! 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Impaired glucose metabolism in subjects with the Williams-Beuren syndrome: A five-year follow-up cohort study |pdf=|usr=}}{{29053727 }} gab.com Text Impaired glucose metabolism in subjects with the Williams-Beuren syndrome: A five-year follow-up cohort study JO: PLoS One http://www.kidney.de/pget.php?&tw=1&pmid=29053727 #FOAvip OBJECTIVE: The Williams-Beuren syndrome (WS) is associated with impaired glucose metabolism (IGM) early in adulthood. However, the pathophysiology of IGM remains poorly defined, due to the lack of longitudinal studies investigating the contribution of ?-cell dysfunction and impaired insulin sensitivity. This study aimed at assessing incidence of IGM and the underlying mechanisms in WS adults. METHODS: This observational, longitudinal (5-year), cohort study enrolled thirty-one consecutive WS subjects attending a tertiary referral center. An oral glucose tolerance test (OGTT) was performed yearly and used to classify patients as normal or IGM, including impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) and diabetes mellitus (DM), and to calculate surrogate measures of insulin secretion and/or sensitivity. RESULTS: IGM patients were 18 (58.1%, three DM) at baseline and 19 (61.3%, five DM) at end-of-follow-up. However, 13 individuals changed category of glucose homeostasis in both directions during follow-up (8 progressors, 5 regressors) and 18 did not (8 non-progressors, 10 non-regressors). New cases of IGM and DM were 11.1 and 2.53 per 100 persons-year, respectively, and were treated non-pharmacologically. In the whole cohort and, to a higher extent, in progressors, indices of early-phase insulin secretion and insulin sensitivity decreased significantly from baseline to end-of-follow-up, with concurrent reduction of the oral disposition index and insulin secretion-sensitivity index-2 (ISSI-2), compensating insulin secretion for the level of insulin resistance. No baseline measure independently predicted progression, which correlated with change from baseline in ISSI-2. Compared with patients with normal glucose homeostasis, IGT subjects had impaired insulin sensitivity, whereas insulin secretion was reduced only in those with IFG+IGT or DM. CONCLUSIONS: IGM incidence is high in young adults with WS, suggesting the need of early screening and timed intervention. As in classical type 2 diabetes, impaired insulin sensitivity and ?-cell dysfunction contribute, in this sequence, to progression to IGM and DM. Twit Text FOAVip Impaired glucose metabolism in subjects with the Williams-Beuren syndrome: A five-year follow-up cohort study ????PLoS One http://www.kidney.de/pget.php?&tw=1&pmid=29053727 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=29053727 #FOAvip English Wikipedia <ref>{{Cite pmid|29053727 }}</ref> Impaired glucose metabolism in subjects with the Williams-Beuren syndrome: A five-year follow-up cohort study #MMPMID29053727 Lunati ME ; Bedeschi MF ; Resi V ; Grancini V ; Palmieri E ; Salera S ; Lalatta F ; Pugliese G ; Orsi E PLoS One 2017[]; 12 (10 ): e0185371 PMID29053727 show ga OBJECTIVE: The Williams-Beuren syndrome (WS) is associated with impaired glucose metabolism (IGM) early in adulthood. However, the pathophysiology of IGM remains poorly defined, due to the lack of longitudinal studies investigating the contribution of ?-cell dysfunction and impaired insulin sensitivity. This study aimed at assessing incidence of IGM and the underlying mechanisms in WS adults. METHODS: This observational, longitudinal (5-year), cohort study enrolled thirty-one consecutive WS subjects attending a tertiary referral center. An oral glucose tolerance test (OGTT) was performed yearly and used to classify patients as normal or IGM, including impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) and diabetes mellitus (DM), and to calculate surrogate measures of insulin secretion and/or sensitivity. RESULTS: IGM patients were 18 (58.1%, three DM) at baseline and 19 (61.3%, five DM) at end-of-follow-up. However, 13 individuals changed category of glucose homeostasis in both directions during follow-up (8 progressors, 5 regressors) and 18 did not (8 non-progressors, 10 non-regressors). New cases of IGM and DM were 11.1 and 2.53 per 100 persons-year, respectively, and were treated non-pharmacologically. In the whole cohort and, to a higher extent, in progressors, indices of early-phase insulin secretion and insulin sensitivity decreased significantly from baseline to end-of-follow-up, with concurrent reduction of the oral disposition index and insulin secretion-sensitivity index-2 (ISSI-2), compensating insulin secretion for the level of insulin resistance. No baseline measure independently predicted progression, which correlated with change from baseline in ISSI-2. Compared with patients with normal glucose homeostasis, IGT subjects had impaired insulin sensitivity, whereas insulin secretion was reduced only in those with IFG+IGT or DM. CONCLUSIONS: IGM incidence is high in young adults with WS, suggesting the need of early screening and timed intervention. As in classical type 2 diabetes, impaired insulin sensitivity and ?-cell dysfunction contribute, in this sequence, to progression to IGM and DM. |Adult [MESH] |Cohort Studies [MESH] |Disease Progression [MESH] |Female [MESH] |Follow-Up Studies [MESH] |Glucose/*metabolism [MESH] |Homeostasis [MESH] |Humans [MESH] |Insulin Secretion [MESH] |Insulin/metabolism [MESH] |Longitudinal Studies [MESH] |Male [MESH] |Williams Syndrome/*metabolism [MESH]Impaired glucose metabolism in subjects with the Williams-Beuren syndr(epmc).pdf DeepDyve Pubget Overpricing