@phdthesis{Zapp2021, author = {Zapp, Benedikt Alexander}, title = {Einfluss der Nikotinamid N-Methyltransferase-Aktivit{\"a}t auf die Glukoseaufnahmerate weißer und brauner Adipozyten}, doi = {10.25972/OPUS-21952}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-219529}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Die Nikotinamid N-Methyltransferase (NNMT) wurde als wichtiger Regulator des Energiemetabolismus in Fettzellen beschrieben. So bewahrt ein NNMT Knock-down M{\"a}use vor einer nahrungsinduzierten Adipositas und bei reduzierter NNMT-Expression in weißen 3T3-L1 Adipozyten zeigen diese einen erh{\"o}hten zellul{\"a}ren Sauerstoffverbrauch. F{\"u}r den Adipozytenstoffwechsel ist die insulinstimulierte Glukoseaufnahme wesentlich. Um den Einfluss eines NNMT-Knock-downs auf diese zu untersuchen wurde unter Nutzung der Substratspezifit{\"a}ten des prokaryotischen und eukaryotischen Isoenzyms der Glukose-6-phosphat-Dehydrogenase ein enzymatisch-photometrischer Assay zur Messung der Glukoseaufnahmerate in adh{\"a}renten weißen 3T3-L1 und braunen Adipozytenkulturen entwickelt. Mit lentiviraler Transduktion wurde in den Adipozytenkulturen ein persistenter NNMT-Knock-down induziert. Die NNMT-Aktivit{\"a}t wurde mit einem fluoreszenzbasierten Assay gemessen und die Glukoseaufnahmerate in deren Abh{\"a}ngigkeit bestimmt. Die Reduktion der NNMT-Aktivit{\"a}t verminderte die Glukoseaufnahmerate der 3T3-L1 Adipozyten sowohl basal, wie auch unter Insulinstimulation. Braune Adipozyten hingegen zeigten bei verringerter NNMT-Aktivit{\"a}t eine erh{\"o}hte insulinstimulierte Glukoseaufnahmerate, aber keinen Unterschied der basalen Glukoseaufnahmerate. Dieser differenzielle Einfluss auf die Glukoseaufnahme weißer und brauner Adipozyten st{\"a}rkt die wichtige Rolle der NNMT, die ihr zur Regulation des Fettzellstoffwechsels zugeschrieben wird und enth{\"u}llt erstmals eine direkte Wirkung auf braune Adipozyten.}, subject = {Weiße Fettzelle}, language = {de} } @article{YurdadoganMalschKotsevaetal.2021, author = {Yurdadogan, Tino and Malsch, Carolin and Kotseva, Kornelia and Wood, David and Leyh, Rainer and Ertl, Georg and Karmann, Wolfgang and M{\"u}ller-Scholden, Lara and Morbach, Caroline and Breuning, Margret and Wagner, Martin and Gelbrich, G{\"o}tz and Bots, Michiel L. and Heuschmann, Peter U. and St{\"o}rk, Stefan}, title = {Functional versus morphological assessment of vascular age in patients with coronary heart disease}, series = {Scientific Reports}, volume = {11}, journal = {Scientific Reports}, number = {1}, doi = {10.1038/s41598-021-96998-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265810}, year = {2021}, abstract = {Communicating cardiovascular risk based on individual vascular age (VA) is a well acknowledged concept in patient education and disease prevention. VA may be derived functionally, e.g. by measurement of pulse wave velocity (PWV), or morphologically, e.g. by assessment of carotid intima-media thickness (cIMT). The purpose of this study was to investigate whether both approaches produce similar results. Within the context of the German subset of the EUROASPIRE IV survey, 501 patients with coronary heart disease underwent (a) oscillometric PWV measurement at the aortic, carotid-femoral and brachial-ankle site (PWVao, PWVcf, PWVba) and derivation of the aortic augmentation index (AIao); (b) bilateral cIMT assessment by high-resolution ultrasound at three sites (common, bulb, internal). Respective VA was calculated using published equations. According to VA derived from PWV, most patients exhibited values below chronological age indicating a counterintuitive healthier-than-anticipated vascular status: for VA(PWVao) in 68\% of patients; for VA\(_{AIao}\) in 52\% of patients. By contrast, VA derived from cIMT delivered opposite results: e.g. according to VA\(_{total-cIMT}\) accelerated vascular aging in 75\% of patients. To strengthen the concept of VA, further efforts are needed to better standardise the current approaches to estimate VA and, thereby, to improve comparability and clinical utility.}, language = {en} } @article{WinterAndelovicKampfetal.2021, author = {Winter, Patrick M. and Andelovic, Kristina and Kampf, Thomas and Hansmann, Jan and Jakob, Peter Michael and Bauer, Wolfgang Rudolf and Zernecke, Alma and Herold, Volker}, title = {Simultaneous measurements of 3D wall shear stress and pulse wave velocity in the murine aortic arch}, series = {Journal of Cardiovascular Magnetic Resonance}, volume = {23}, journal = {Journal of Cardiovascular Magnetic Resonance}, number = {1}, doi = {10.1186/s12968-021-00725-4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259152}, pages = {34}, year = {2021}, abstract = {Purpose Wall shear stress (WSS) and pulse wave velocity (PWV) are important parameters to characterize blood flow in the vessel wall. Their quantification with flow-sensitive phase-contrast (PC) cardiovascular magnetic resonance (CMR), however, is time-consuming. Furthermore, the measurement of WSS requires high spatial resolution, whereas high temporal resolution is necessary for PWV measurements. For these reasons, PWV and WSS are challenging to measure in one CMR session, making it difficult to directly compare these parameters. By using a retrospective approach with a flexible reconstruction framework, we here aimed to simultaneously assess both PWV and WSS in the murine aortic arch from the same 4D flow measurement. Methods Flow was measured in the aortic arch of 18-week-old wildtype (n = 5) and ApoE\(^{-/-}\) mice (n = 5) with a self-navigated radial 4D-PC-CMR sequence. Retrospective data analysis was used to reconstruct the same dataset either at low spatial and high temporal resolution (PWV analysis) or high spatial and low temporal resolution (WSS analysis). To assess WSS, the aortic lumen was labeled by semi-automatically segmenting the reconstruction with high spatial resolution. WSS was determined from the spatial velocity gradients at the lumen surface. For calculation of the PWV, segmentation data was interpolated along the temporal dimension. Subsequently, PWV was quantified from the through-plane flow data using the multiple-points transit-time method. Reconstructions with varying frame rates and spatial resolutions were performed to investigate the influence of spatiotemporal resolution on the PWV and WSS quantification. Results 4D flow measurements were conducted in an acquisition time of only 35 min. Increased peak flow and peak WSS values and lower errors in PWV estimation were observed in the reconstructions with high temporal resolution. Aortic PWV was significantly increased in ApoE\(^{-/-}\) mice compared to the control group (1.7 ± 0.2 versus 2.6 ± 0.2 m/s, p < 0.001). Mean WSS magnitude values averaged over the aortic arch were (1.17 ± 0.07) N/m\(^2\) in wildtype mice and (1.27 ± 0.10) N/m\(^2\) in ApoE\(^{-/-}\) mice. Conclusion The post processing algorithm using the flexible reconstruction framework developed in this study permitted quantification of global PWV and 3D-WSS in a single acquisition. The possibility to assess both parameters in only 35 min will markedly improve the analyses and information content of in vivo measurements.}, language = {en} } @article{WeigandRonchiVanselowetal.2021, author = {Weigand, Isabel and Ronchi, Cristina L. and Vanselow, Jens T. and Bathon, Kerstin and Lenz, Kerstin and Herterich, Sabine and Schlosser, Andreas and Kroiss, Matthias and Fassnacht, Martin and Calebiro, Davide and Sbiera, Silviu}, title = {PKA Cα subunit mutation triggers caspase-dependent RIIβ subunit degradation via Ser\(^{114}\) phosphorylation}, series = {Science Advances}, volume = {7}, journal = {Science Advances}, number = {8}, doi = {10.1126/sciadv.abd4176}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270445}, year = {2021}, abstract = {Mutations in the PRKACA gene are the most frequent cause of cortisol-producing adrenocortical adenomas leading to Cushing's syndrome. PRKACA encodes for the catalytic subunit α of protein kinase A (PKA). We already showed that PRKACA mutations lead to impairment of regulatory (R) subunit binding. Furthermore, PRKACA mutations are associated with reduced RIIβ protein levels; however, the mechanisms leading to reduced RIIβ levels are presently unknown. Here, we investigate the effects of the most frequent PRKACA mutation, L206R, on regulatory subunit stability. We find that Ser\(^{114}\) phosphorylation of RIIβ is required for its degradation, mediated by caspase 16. Last, we show that the resulting reduction in RIIβ protein levels leads to increased cortisol secretion in adrenocortical cells. These findings reveal the molecular mechanisms and pathophysiological relevance of the R subunit degradation caused by PRKACA mutations, adding another dimension to the deregulation of PKA signaling caused by PRKACA mutations in adrenal Cushing's syndrome.}, language = {en} } @phdthesis{Weigand2021, author = {Weigand, Isabel}, title = {Consequences of Protein Kinase A mutations in adrenocortical cells and tumours}, doi = {10.25972/OPUS-16064}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-160646}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Adrenal Cushing's Syndrome (CS) is a rare but life-threatening disease and therefore it is of great importance to understand the pathogenesis leading to adrenal CS. It is well accepted that Protein Kinase A (PKA) signalling mediates steroid secretion in adrenocortical cells. PKA is an inactive heterotetramer, consisting of two catalytic and two regulatory subunits. Upon cAMP binding to the regulatory subunits, the catalytic subunits are released and are able to phosphorylate their target proteins. Recently, activating somatic mutations affecting the catalytic subunit a of PKA have been identified in a sub-population of cortisol-producing adenomas (CPAs) associated with overt CS. Interestingly, the PKA regulatory subunit IIb has long been known to have significantly lower protein levels in a sub-group of CPAs compared to other adrenocortical tumours. Yet, it is unknown, why these CPAs lack the regulatory subunit IIb, neither are any functional consequences nor are the underlying regulation mechanisms leading to reduced RIIb levels known. The results obtained in this thesis show a clear connection between Ca mutations and reduced RIIb protein levels in CPAs but not in other adrenocortical tumours. Furthermore, a specific pattern of PKA subunit expression in the different zones of the normal adrenal gland is demonstrated. In addition, a Ca L206R mutation-mediated degradation of RIIb was observed in adrenocortical cells in vitro. RIIb degradation was found to be mediated by caspases and by performing mutagenesis experiments of the regulatory subunits IIb and Ia, S114 phosphorylation of RIIb was identified to make RIIb susceptible for degradation. LC-MS/MS revealed RIIb interaction partners to differ in the presence of either Ca WT and Ca L206R. These newly identified interaction partners are possibly involved in targeting RIIb to subcellular compartments or bringing it into spatial proximity of degrading enzymes. Furthermore, reducing RIIb protein levels in an in vitro system were shown to correlate with increased cortisol secretion also in the absence of PRKACA mutations. The inhibiting role of RIIb in cortisol secretion demonstrates a new function of this regulatory PKA subunit, improving the understanding of the complex regulation of PKA as key regulator in many cells.}, subject = {Cushing-Syndrom}, language = {en} } @article{WeichWernerBucketal.2021, author = {Weich, Alexander and Werner, Rudolf A. and Buck, Andreas K. and Hartrampf, Philipp E. and Serfling, Sebastian E. and Scheurlen, Michael and Wester, Hans-J{\"u}rgen and Meining, Alexander and Kircher, Stefan and Higuchi, Takahiro and Pomper, Martin G. and Rowe, Steven P. and Lapa, Constantin and Kircher, Malte}, title = {CXCR4-Directed PET/CT in Patients with Newly Diagnosed Neuroendocrine Carcinomas}, series = {Diagnostics}, volume = {11}, journal = {Diagnostics}, number = {4}, issn = {2075-4418}, doi = {10.3390/diagnostics11040605}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234231}, year = {2021}, abstract = {We aimed to elucidate the diagnostic potential of the C-X-C motif chemokine receptor 4 (CXCR4)-directed positron emission tomography (PET) tracer \(^{68}\)Ga-Pentixafor in patients with poorly differentiated neuroendocrine carcinomas (NEC), relative to the established reference standard \(^{18}\)F-FDG PET/computed tomography (CT). In our database, we retrospectively identified 11 treatment-na{\"i}ve patients with histologically proven NEC, who underwent \(^{18}\)F-FDG and CXCR4-directed PET/CT for staging and therapy planning. The images were analyzed on a per-patient and per-lesion basis and compared to immunohistochemical staining (IHC) of CXCR4 from PET-guided biopsies. \(^{68}\)Ga-Pentixafor visualized tumor lesions in 10/11 subjects, while \(^{18}\)F-FDG revealed sites of disease in all 11 patients. Although weak to moderate CXCR4 expression could be corroborated by IHC in 10/11 cases, \(^{18}\)F-FDG PET/CT detected significantly more tumor lesions (102 vs. 42; total lesions, n = 107; p < 0.001). Semi-quantitative analysis revealed markedly higher 18F-FDG uptake as compared to \(^{68}\)Ga-Pentixafor (maximum and mean standardized uptake values (SUV) and tumor-to-background ratios (TBR) of cancerous lesions, SUVmax: 12.8 ± 9.8 vs. 5.2 ± 3.7; SUVmean: 7.4 ± 5.4 vs. 3.1 ± 3.2, p < 0.001; and, TBR 7.2 ± 7.9 vs. 3.4 ± 3.0, p < 0.001). Non-invasive imaging of CXCR4 expression in NEC is inferior to the reference standard \(^{18}\)F-FDG PET/CT.}, language = {en} } @phdthesis{vonderHeide2021, author = {von der Heide, Sina}, title = {Zusammenh{\"a}nge zwischen der Immunantwort und den myokardialen Heilungsprozessen (Remodeling) bei Patienten nach akutem transmuralen Erstinfarkt bzw. nach akuter Myokarditis}, doi = {10.25972/OPUS-24879}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-248790}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Die h{\"a}ufigste Form der Herzinsuffizienz in Deutschland ist die dilatative Kardiomyopathie, wobei bei ca. 6/100.000 Einwohnern pro Jahr keine eindeutige Ursache erkennbar ist und somit eine idiopathische DCM diagnostiziert wird. Ein Faktor zur Entstehung einer idiopathischen DCM k{\"o}nnten Autoantik{\"o}rper gegen den β1-adrenergen Rezeptor sein. Bei ca. 30\% der Patienten, die an einer DCM ({\"A}quivalent in der ETiCS-Studie: erste akute Myokarditis = AMitis) leiden, sowie bei ca. 13\% der Patienten, die an einer isch{\"a}mischen Kardiomyopathie ({\"A}quivalent in der ETiCS-Studie: erster akuter Myokardinfarkt = FAMI) leiden, konnten in {\"a}lteren Arbeiten β1-AAk nachgewiesen werden. Im Rahmen der ETiCS-Studie erfolgte erstmals eine prospektive Beobachtung entsprechender Patientenkollektive {\"u}ber 12 Monate mit Blutentnahme und klinischen Kontrollen zum Zeitpunkt 0 Monate (=Baseline), 2-3 Monate (Follow-Up 1), 6 Monate (FUP2) und 12 Monate (FUP3). Zu diesen Zeitpunkten wurden anhand der gewonnenen Blutproben der β1-AAk-Status sowie die immunologischen Marker der FAMI- und AMitis-Patienten bestimmt und mit der kardialen LV-Pumpfunktion korreliert. Zentrales Thema dieser Arbeit war es, Zusammenh{\"a}nge zwischen der β1-AAk-Ausbildung in Abh{\"a}ngigkeit von individuellen Zytokinprofilen und der Entwicklung der LV-Pumpfunktion nach dem jeweiligen kardialen Ereignis zu untersuchen, wobei FAMI- und AMitis-Patienten miteinander verglichen wurden. Dar{\"u}ber hinaus wurde auch der Einfluss der CTLA-4-Haplotypen, also die „genetische" Suszeptibilit{\"a}t Autoantik{\"o}rper zu entwickeln, untersucht. W{\"a}hrend bei FAMI-Patienten die Entwicklung von β1-AAk keinen Einfluss auf den Verlauf der LV-Pumpfunktion zu haben scheint, wird diese bei AMitis-Patienten durch hochaffine β1-AAk im Verlauf stark beeintr{\"a}chtigt. Bei FAMI-Patienten konnte nach einer gr{\"o}ßeren Herzsch{\"a}digung (CK-Werte >1000 U/l) eine schlechtere Pumpfunktion im Vergleich zu kleineren Myokardinfarkten (CK-Werte <1000 U/l) nachgewiesen werden, unabh{\"a}ngig von β1-AAk-Status. F{\"u}r die Prognose und die Erholung der LV-Pumpfunktion scheint bei FAMI-Patienten folglich die Infarktgr{\"o}ße, aber nicht die Entwicklung von β1-AAk wichtig zu sein. Hinsichtlich der unterschiedlichen Zytokinprofile bei FAMI- und AMitis-Patienten, die hochaffine β1-AAk entwickeln, scheinen bestimmte Zytokine die Induktion einer kardialen Autoimmunit{\"a}t zu beg{\"u}nstigen, w{\"a}hrend andere Zytokine wohl eher protektive immunologische Reaktionen in Gang setzen: Die proinflammatorischen Zytokine IL-1β, IL-2, IL-7, IL-12, IL-17, GM-CSF, MIP-1α und IFN-γ waren bei β1-AAk-positiven AMitis-Patienten statistisch signifikant erh{\"o}ht. Protektive Effekte k{\"o}nnten dagegen von den antiinflammatorischen Zytokinen IL-1RA, IL-10 und IL-13 ausgehen, deren Serumspiegel bei FAMI- gegen{\"u}ber AMitis-Patienten im Vergleich erh{\"o}ht waren. Beim direkten Vergleich von AMitis-Patienten mit hochaffinen β1-AAk und solchen ohne β1-AAk, zeigten sich bei Patienten mit hochaffinen β1-AAk h{\"o}here Konzentrationen an IL-1β, IL-2, IL-6, IL-7, IL-12, IL-17, GM-CSF, MIP-1α und TNF-α. Bei Patienten ohne Autoantik{\"o}rper waren demgegen{\"u}ber die Spiegel von IL-1RA, IL-10 und IL-13 erh{\"o}ht, was zu einer besseren Erholung der LV-Pumpfunktion f{\"u}hrte. Nach genetischer Typisierung der CTLA-4-Haplotypen (Polymorphismen SNP +49G/A und SNP CT60A/G) fand sich bei Patienten mit dem Allel G/G ein h{\"o}heres Risiko β1-AAk zu entwickeln, w{\"a}hrend das Allel A/A jeweils mit einem geringeren Risiko kardiale Autoantik{\"o}rper zu entwickeln assoziiert war und somit protektiv gegen Autoimmunph{\"a}nomene wirken k{\"o}nnte.}, subject = {Immunreaktion}, language = {de} } @article{VetrivelZhangEngeletal.2021, author = {Vetrivel, Sharmilee and Zhang, Ru and Engel, Mareen and Altieri, Barbara and Braun, Leah and Osswald, Andrea and Bidlingmaier, Martin and Fassnacht, Martin and Beuschlein, Felix and Reincke, Martin and Chen, Alon and Sbiera, Silviu and Riester, Anna}, title = {Circulating microRNA Expression in Cushing's Syndrome}, series = {Frontiers in Endocrinology}, volume = {12}, journal = {Frontiers in Endocrinology}, issn = {1664-2392}, doi = {10.3389/fendo.2021.620012}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229761}, year = {2021}, abstract = {Context Cushing's syndrome (CS) is a rare disease of endogenous hypercortisolism associated with high morbidity and mortality. Diagnosis and classification of CS is still challenging. Objective Circulating microRNAs (miRNAs) are minimally invasive diagnostic markers. Our aim was to characterize the circulating miRNA profiles of CS patients and to identify distinct profiles between the two major CS subtypes. Methods We included three groups of patients from the German Cushing's registry: ACTH-independent CS (Cortisol-Producing-Adenoma; CPA), ACTH-dependent pituitary CS (Cushing's Disease; CD), and patients in whom CS had been ruled out (controls). Profiling of miRNAs was performed by next-generation-sequencing (NGS) in serum samples of 15 CS patients (each before and after curative surgery) and 10 controls. Significant miRNAs were first validated by qPCR in the discovery cohort and then in an independent validation cohort of 20 CS patients and 11 controls. Results NGS identified 411 circulating miRNAs. Differential expression of 14 miRNAs were found in the pre- and postoperative groups. qPCR in the discovery cohort validated 5 of the significant miRNAs from the preoperative group analyses. Only, miR-182-5p was found to be significantly upregulated in the CD group of the validation cohort. Comparing all CS samples as a group with the controls did not reveal any significant differences in expression. Outcome In conclusion, our study identified miR-182-5p as a possible biomarker for CD, which has to be validated in a prospective cohort. Furthermore, our results suggest that presence or absence of ACTH might be at least as relevant for miRNA expression as hypercortisolism itself.}, language = {en} } @article{TraubHusseiniWeber2021, author = {Traub, Jan and Husseini, Leila and Weber, Martin S.}, title = {B cells and antibodies as targets of therapeutic intervention in neuromyelitis optica spectrum disorders}, series = {Pharmaceuticals}, volume = {14}, journal = {Pharmaceuticals}, number = {1}, issn = {1424-8247}, doi = {10.3390/ph14010037}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-222957}, year = {2021}, abstract = {The first description of neuromyelitis optica by Eug{\`e}ne Devic and Fernand Gault dates back to the 19th century, but only the discovery of aquaporin-4 autoantibodies in a major subset of affected patients in 2004 led to a fundamentally revised disease concept: Neuromyelits optica spectrum disorders (NMOSD) are now considered autoantibody-mediated autoimmune diseases, bringing the pivotal pathogenetic role of B cells and plasma cells into focus. Not long ago, there was no approved medication for this deleterious disease and off-label therapies were the only treatment options for affected patients. Within the last years, there has been a tremendous development of novel therapies with diverse treatment strategies: immunosuppression, B cell depletion, complement factor antagonism and interleukin-6 receptor blockage were shown to be effective and promising therapeutic interventions. This has led to the long-expected official approval of eculizumab in 2019 and inebilizumab in 2020. In this article, we review current pathogenetic concepts in NMOSD with a focus on the role of B cells and autoantibodies as major contributors to the propagation of these diseases. Lastly, by highlighting promising experimental and future treatment options, we aim to round up the current state of knowledge on the therapeutic arsenal in NMOSD.}, language = {en} } @phdthesis{Simon2021, author = {Simon, Rosa-Sophie}, title = {Hypoglyk{\"a}mische Episoden bei h{\"a}modialysepflichtigen Patienten mit Typ-2-Diabetes-mellitus - Ein Vergleich von Therapieans{\"a}tzen}, doi = {10.25972/OPUS-24874}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-248741}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2021}, abstract = {Im Rahmen der EFSD Studie erfolgt die Aufzeichnung von Blutzuckerdaten und Interpretation. Dabei erfolgte die Unterteilung in vier Therapiegruppen: Patienten mit reiner Insulintherapie, mit OAD-Therapie, mit einer Kombination aus Insulin und OAD-Therapie sowie mit einer di{\"a}tetischen Therapie. Unterschieden wurde innerhalb der Therapiegruppen zwischen Dialysezeiten und dialysefreier Zeit. Die definierten Hypoglyk{\"a}mieintervalle (Hypoglyk{\"a}mie 51 bis 70 mg/dl, schwere Hypoglyk{\"a}mie ≤ 50 mg/dl) wurden in den verschiedenen Gruppen und Zeiten ausgewertet. Insgesamt kam es w{\"a}hrend der Gesamtaufzeichnungszeit zu einem prozentual geringen zeitlichen Auftreten von Hypoglyk{\"a}mien sowohl w{\"a}hrend der Dialysezeit als auch w{\"a}hrend der dialysefreien Zeit. Die Therapiegruppen unterschieden sich deutlich in ihrer Gruppengr{\"o}ße. Durch die entsprechenden Vorerkrankungen besteht bereits ein deutlich erh{\"o}htes Hypoglyk{\"a}mierisiko und damit erh{\"o}htes Mortalit{\"a}tsrisiko bei der untersuchten Patientenkohorte. Im Vergleich aller vier unterschiedenen Therapiegruppen ergab sich keine statistische Signifikanz bez{\"u}glich eines erh{\"o}hten Hypoglyk{\"a}mierisikos bei einer Therapiegruppe. Weder zeigte sich eine Signifikanz w{\"a}hrend der Dialyse noch in der dialysefreien Zeit. Auch in der Auswertung der HbA1c-Werte besteht eine breite Verteilung, sodass keine zuverl{\"a}ssige Aussage {\"u}ber eine Hypoglyk{\"a}mieneigung abgeleitet werden kann.}, subject = {Diabetes mellitus Typ 2}, language = {de} }