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Characterisation of pathological cha...

Zhao, Hailu.

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Characterisation of pathological changes in the pancreas and kidneys in type 2 diabetes mellitus.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	Characterisation of pathological changes in the pancreas and kidneys in type 2 diabetes mellitus./
Author:	Zhao, Hailu.
Description:	210 p.
Notes:	Source: Dissertation Abstracts International, Volume: 63-10, Section: B, page: 4610.
Contained By:	Dissertation Abstracts International63-10B.
Subject:	Health Sciences, Immunology. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3066614
ISBN:	0493859780

Characterisation of pathological changes in the pancreas and kidneys in type 2 diabetes mellitus.
Zhao, Hailu.

Characterisation of pathological changes in the pancreas and kidneys in type 2 diabetes mellitus. - 210 p.

Source: Dissertation Abstracts International, Volume: 63-10, Section: B, page: 4610.

Thesis (Ph.D.)--Chinese University of Hong Kong (People's Republic of China), 2002.

<italic>Objectives</italic>. To characterise the clinicopathological features of islet amyloid and nodular glomerulosclerosis in Chinese patients with Type 2 diabetes.

ISBN: 0493859780Subjects--Topical Terms:

1017716
Health Sciences, Immunology.

Characterisation of pathological changes in the pancreas and kidneys in type 2 diabetes mellitus.
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020 $a 0493859780
035 $a (UnM)AAI3066614
035 $a AAI3066614
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100 1 $a Zhao, Hailu. $3 1257695
245 1 0 $a Characterisation of pathological changes in the pancreas and kidneys in type 2 diabetes mellitus.
300 $a 210 p.
500 $a Source: Dissertation Abstracts International, Volume: 63-10, Section: B, page: 4610.
500 $a Supervisor: Brian Tomlinson.
502 $a Thesis (Ph.D.)--Chinese University of Hong Kong (People's Republic of China), 2002.
520 $a <italic>Objectives</italic>. To characterise the clinicopathological features of islet amyloid and nodular glomerulosclerosis in Chinese patients with Type 2 diabetes.
520 $a <italic>Background</italic>. Type 2 diabetes is a heterogeneous group of complex diseases with two histopathological hallmarks, specifically islet amyloid and nodular glomerulosclerosis. The clinicopathological characteristics of these two characteristic features largely remain unclear.
520 $a <italic>Methods and materials</italic>. The clinical details of 5298 consecutive autopsies at two medical centres in Beijing and one in Hong Kong were reviewed. Of these, 436 consecutive autopsies clinically diagnosed as Type 2 diabetes and on hypoglycaemic treatment were selected. Haematoxylin-eosin stained slides of pancreas (235 cases), kidney (351 cases) and other organs including heart, brain, liver, adrenal and pituitary glands were examined. Congo red stain was performed to identify amyloid deposits in pancreas, kidney and brain. Periodic acid-Schiff stain was done to highlight vascular and renal changes. Immunohistochemistry techniques were applied to identify lymphocytes, macrophages, and ductal cells in the pancreas and extracellular matrix proteins in the diabetic kidneys. Image analysis was operated to quantitate the degree of islet amyloid and the fractional volume of kidney matrix. Relevant clinical data were extracted from the patients' hospital records. The diagnoses of cause of death, Alzheimer's disease, vascular dementia, cardiovascular and renal failure were made by the combination of clinical assessments and histopathological findings.
520 $a <italic>Results</italic>. Islet amyloid was detected in 39.6%, with a mean fractional volume of 36.2 ± 17.0%. The islet amyloid was related to high body mass index, poor glycaemic control and high blood pressures. The other histopathological characteristics of the pancreas in Type 2 diabetes included T-lymphocyte-dominated chronic inflammation, fibrosis, and arteriosclerosis with endothelial damage. Although islet amyloid was not associated with either vascular or Alzheimer's Type dementia, stroke-related vascular dementia occurred in 8.5% of the 235 Type 2 diabetic patients. Islet amyloid did not correlate to nodular glomerulosclerosis.
520 $a Nodular glomerulosclerosis was identified in 37.6%, whereas near-normal renal structures were found in 27.6% and atypical changes in 34.8%. Patients with nodular glomerulosclerosis had a relatively low body mass index (22.3 ± 3.8 kg/m<super>2</super>), but high risk for cardiovascular disease, impaired renal function, and high extracellular matrix fractional volume. Abnormalities in deposition of collagen IV, fibronectin and laminin were found within the nodules and within the thickening basement membranes.
520 $a <italic>Conclusions</italic>. Islet amyloid was associated with obesity, poor glycaemic status and high blood pressure. Therefore, weight management, tight metabolic and blood pressure control, and rational prescriptions may improve islet amyloid. Since islet amyloid was present in only about one-third of these cohorts, other pathologies such as chronic inflammation and arteriosclerosis with endothelial dysfunction may contribute to the pancreatic β cell failure in Type 2 diabetes. Nephropathy in Type 2 diabetes is heterogeneous, with nodular glomerulosclerosis occurring in about one-third of cases examined. Patients with nodular glomerulosclerosis have poor renal and cardiovascular prognosis. In contrast to the obesity-related islet amyloid, nodular glomerulosclerosis is associated with low body mass index. Abnormal production and distribution of extracellular matrix macromolecules is an essential characteristic of nodular glomerulosclerosis. The molecular mechanisms underlying diabetes-associated islet amyloid and nodular glomerulosclerosis warrant further research.
590 $a School code: 1307.
650 4 $a Health Sciences, Immunology. $3 1017716
650 4 $a Health Sciences, Medicine and Surgery. $3 1017756
650 4 $a Health Sciences, Pathology. $3 1017854
690 $a 0564
690 $a 0571
690 $a 0982
710 2 0 $a Chinese University of Hong Kong (People's Republic of China). $3 1249360
773 0 $t Dissertation Abstracts International $g 63-10B.
790 $a 1307
790 1 0 $a Tomlinson, Brian, $e advisor
791 $a Ph.D.
792 $a 2002
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3066614