SUMMARY Sodium accumulates in the interstitium and promotes inflammation through poorly defined mechanisms. We describe a pathway by which sodium enters dendritic cells (DCs) through amiloride-sensitive channels including the alpha and gamma subunits of the epithelial sodium channel and the sodium hydrogen exchanger 1. This leads to calcium influx via the sodium calcium exchanger, activation of protein kinase C (PKC), phosphorylation of p47phox, and association of p47phox with gp91phox. The assembled NADPH oxidase produces superoxide with subsequent formation of immunogenic isolevuglandin (IsoLG)-protein adducts. DCs activated by excess sodium produce increased interleukin-1β (IL-1β) and promote T cell production of cytokines IL-17A and interferon gamma (IFN-γ). When adoptively transferred into naive mice, these DCs prime hypertension in response to a sub-pressor dose of angiotensin II. These findings provide a mechanistic link between salt, inflammation, and hypertension involving increased oxidative stress and IsoLG production in DCs.

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OBJECTIVETo determine the prevalence of Distal Sensory neuropathy in asymptomatic Type 2 Diabetes mellitus. METHODOLOGYPatients with type 2 diabetes mellitus attending outpatient Department of Government Vellore Medical College Hospital without symptoms of peripheral neuropathy were included in this study. The presence of diabetic neuropathy was diagnosed using Michigan Neuropathy Screening Instrument (MNSI) Score. RESULTSA total of 400 patients with type 2 diabetes mellitus were studied of which 216 (54%) were males and 184 (46%) were females. Mean age of males was significantly higher than females (51±9.1 years vs. 44±7.6 years, p<0.05). The mean BMI of females was significantly higher for females than males (28.4±4.2 vs. 25.3±2.9, p<0.05). In our study, 72 patients (18%) had asymptomatic peripheral neuropathy. CONCLUSIONPeripheral neuropathy is common in asymptomatic diabetic patients. All patients with diabetes mellitus needs active screening for peripheral neuropathy to reduce the morbidity associated with it.

BACKGROUNDTo determine the prevalence of impaired fasting glucose in adult population attending medicine outpatient clinic at Government Vellore Medical College, Vellore and correlate with risk factors. MATERIALS AND METHODSAdult population aged more than 30 years attending outpatient clinic at medicine department were randomly assessed for presence of impaired fasting glucose according to ADA criteria 2016 and related for presence of risk factors like age, weight, body mass index, waist circumference, and waist-hip ratio. RESULTSTotally, 985 subjects were studied. This included 496 (50.3%) males and 489 (49.6%) females. The prevalence of impaired fasting glucose in the Vellore population attending medicine OPD was found to be 15%. The prevalence of impaired fasting glucose among male subjects were found to be 17% and among female subjects were 13%. The prevalence of impaired fasting glucose was higher among both the male and female subjects with higher waist-hip ratio and BMI >25. Only female subjects with increased waist circumference had increased prevalence of impaired fasting glucose and not male subjects. CONCLUSIONThis study revealed that the prevalence of impaired fasting glucose in Vellore population is high (15%) and is an under-diagnosed condition. The traditional risk factors like body mass index, waist-hip ratio are good predictors for development of diabetes mellitus in the Vellore district. But waist circumference can only predict among female population.