Increased vulnerability of older adults to DM and its CVD complications: proposal for assessment, management and monitoring by diagnostic methods

Ezekiel Uba Nwose, Phillip Taderera Bwititi, Ross Stuart Richards

Abstract


The national institute of health on aging has made research funding calls for basic, clinical and epidemiological studies into the increased vulnerability of older adults to diabetes mellitus and its cardiovascular complications. One of the indicated outcomes is the impact of age on diagnosis and management of the disease co-morbidity, including elucidation of the role of aging mechanisms that underlie the increased vulnerability of older adults. A cursory review of literature reveals that although there is information about aging and oxidative stress, little has been validated for adoption in the context of pathology-based evidence. Therefore, the objective of this hypothesis paper is to revisit the topic of ‘biochemical basis of metabolism’ in aging and diseases. The concepts of ‘aging-induced oxidative stress’ and ‘antioxidant-vitamins’ basis of diabetes progression’ are briefly linked  to propose that increase in oxidative damage is a potential additive outcome underlying increased vulnerability of older adults to diabetes mellitus and its cardiovascular complications. Further, the prospect of oxidative damage indices is re-presented as a hypothesis for validation to provide pathology evidence-based guidance to seek appropriate clinical laboratory criteria. The validation process would delineate reference values in vulnerable older adults relative to young and middle aged groups with a view to enable assessment, management and monitoring by diagnostic methods.


Keywords


Aging, already known methods, Clinical practice, CVD complication, Diabetes mellitus, Oxidative stress markers, Pathology evidence-base

Full Text:

PDF

References


VanPutte C, Regan J, Russo A. Aging. In: VanPutte C, Regan J, Russo A, eds. Seeley’s Anatomy & Physiology. 9th ed. United States of America: McGraw Hill; 2011.

Coppack SW, Jensen MD, Miles JM. In vivo regulation of lipolysis in humans. J Lipid Res. 1994;35(2):177-93.

Large V, Arner P. Regulation of lipolysis in humans. Pathophysiological modulation in obesity, diabetes, and hyperlipidaemia. Diabetes Metab. 1998;24(5):409-18.

Richards RS, Nwose EU, Bwititi P. Biochemical basis of circadian rhythms and diseases: with emphasis on post-traumatic stress disorder. Med Hypotheses. 2011;77(4):605-9.

Cao JJ. Effects of obesity on bone metabolism. J Orthop Surg Res. 2011;6:30.

Froy O, Miskin R. Effect of feeding regimens on circadian rhythms: implications for aging and longevity. Aging. 2010;2(1):7-27.

Bubenik GA, Konturek SJ. Melatonin and aging: prospects for human treatment. J Physiol Pharmacol. 2011;62(1):13-9.

New Zealand Guidelines Group. New Zealand cardiovascular risk charts, 2009. Available at: http://www.health.govt.nz/publication/new-zealand-cardiovascular-risk-charts. Accessed 28 April 2014.

The Framingham Study. Cardiovascular disease (10-year risk), 2014. Available at: http://www.framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk.php. Accessed 28 March 2014.

BUPA. How does your health age stack up against your real age? BUPA Australia Pty Ltd, 2010. Available at: http://www.bupa.com.au/health-and-wellness/tools-and-apps/tools-and-calculators/quick-health-age-check. Accessed 26 December 2013.

Bwititi PT, Nwose EU. Screening of cardiovascular disease risk in diabetes: questions concerning prediabetes and low-mid income countries. North Am J Med Sci. 2014;6(6):284-6.

Zs-Nagy I. Aging of cell membranes: facts and theories. Interdiscipl Topics Gerontol. 2014;39:62-85.

Zs-Nagy I. On the role of intracellular physicochemistry in quantitative gene expression during aging and the effect of centrophenoxine. A review. Arch Gerontol Geriatr. 1989;9(3):215-29.

Krautwald M, Munch G. Advanced glycation end products as biomarkers and gerontotoxins - a basis to explore methylglyoxal-lowering agents for Alzheimer’s disease? Exp Gerontol. 2010;45(10):744-51.

Jenny NS. Inflammation in aging: cause, effect, or both? Discov Med. 2012;13(73):451-60.

Sohal RS, Orr WC. The redox stress hypothesis of aging. Free Radic Biol Med. 2012;52(3):539-55.

Nwose EU, Bwititi PT, Chalada MJ. Oxidative stress research: a framework to relate basic science to clinical practice. Oxid Antioxid Med Sci. 2013;2(4):225-9.

Nwose E, Richards R, Kerr P, Tinley R, Jelinek H. Oxidative damage indices for the assessment of subclinical diabetic macrovascular complications. Br J Biomed Sci. 2008;65(3):136-41.

Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615-25.

Zinman B. Pathways leading to diabetic microvascular complications and the latest therapies CME, 2003. Available at: http://www.medscape.com/viewprogram/2636?src=search. Accessed 12 April 2007.

Bensaad K, Tsuruta A, Selak MA, Vidal MN, Nakano K, Bartrons R, et al. TIGAR, a p53-inducible regulator of glycolysis and apoptosis. Cell. 2006;126(1):107-20.

Nwose EU, Jelinek HF, Richards RS, Kerr PG. Erythrocyte oxidative stress in clinical management of diabetes and its cardiovascular complication. Br J Biomed Sci. 2007;64(1):35-43.

McMullin MF. The molecular basis of disorders of the red cell membrane. J Clin Pathol. 1999;52(4):245-8.

Boada J, Cuesta E, Riog T, Gámez A, Carbonell T, Ventura F, et al. Enhanced antioxidant defences and resistance to TNF-alpha in a glycolysis-depleted lung epithelial cell line. Free Radic Biol Med. 2002;33(10):1409-18.

Ceconi C, Boraso A, Cargnoni A, Ferrari R. Oxidative stress in cardiovascular disease: myth or fact? Arch Biochem Biophys. 2003;420(2):217-21.

Bell DSH. Chronic complications of diabetes. South Med J. 2002;95(1):30-4.

de Haan JB, Crack PJ, Flentjar N, Iannello RC, Hertzog PJ, Kola I. An imbalance in antioxidant defense affects cellular function: the pathophysiological consequences of a reduction in antioxidant defence in glutathione peroxidase-1 (Gpx-1) knockout mouse. Redox Rep. 2003;8(2):69-79.

Young IS, Woodside JV. Antioxidants in health and disease. J Clin Pathol. 2001;54(3):176-86.

de Haan JB, Witting PK, Stefanovic N, Pete J, Daskalakis M, Kola I, et al. Deficiency in the antioxidant enzyme glutathione peroxidase-1 (Gpx1) does not increase atherosclerosis in C57BL/J6 mice fed a high fat diet. J Lipid Res. 2006;47(6):1157-67.

Nwose EU, Jelinek HF, Richards RS, Kerr PG. The ‘vitamin E regeneration system’ (VERS) and an algorithm to justify antioxidant supplementation in diabetes - a hypothesis. Med Hypotheses. 2008;70(5):1002-8.

Kagan VE, Tyurina YY. Recycling and redox cycling of phenolic antioxidants. Ann NY Acad Sci. 1998;854(1):425-34.

Baker L. Antioxidants taken with junk food can make it safer. (UniSci Daily), 2002. Available at: http://unisci.com/stories/20022/0617021.htm. Accessed 4 June 2008.

Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, Dolor RJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007;115(11):1481-501.

Niemann B, Chen Y, Teschner M, Li L, Silber RE, Rohrbach S. Obesity induces signs of premature cardiac aging in younger patients: the role of mitochondria. J Am Coll Cardiol. 2011;57(5):577-85.

Monahan KD, Eskurza I, Seals DR. Ascorbic acid increases cardiovagal baroreflex sensitivity in healthy older men. Am J Physiol Heart Circ Physiol. 2004;286(6):H2113-7.

Johnson ML, Lanza IR, Short DK, Asmann YW, Nair KS. Chronically endurance-trained individuals preserve skeletal muscle mitochondrial gene expression with age but differences within age groups remain. Physiol Rep. 2014;2(12):pii: e12239.

Ji LL. Exercise at old age: does it increase or alleviate oxidative stress? Ann N Y Acad Sci. 2001;928:236-47.

Ridker PM, Brown NJ, Vaughan DE, Harrison DG, Mehta JL. Established and emerging plasma biomarkers in the prediction of first atherothrombotic events. Circulation. 2004;109(25 Suppl 1):IV6-19.

Richards RS, Nwose EU. Blood viscosity at different stages of diabetes pathogenesis. Br J Biomed Sci. 2010;67(2):67-70.

Nwose EU. Towards optimizing medical nutrition therapy with laboratory methods. In: Nwose EU, eds. Oxidative Stress Concepts in Clinical Practice. 10th ed. Germany: LAP Lambert Academic Publishing; 2010.