Author: "Thozhukat, Sathyapalan" - Searchworks@Jio Institute Digital Library Search Results

579 results on '"Thozhukat, Sathyapalan"'

1. Molecular Aspects of Cardiovascular Risk Factors

Author: Shang-Zhong Xu and Thozhukat Sathyapalan
Subjects: n/a, Microbiology, QR1-502
Abstract: Cardiovascular diseases (CVDs) are the leading cause of death [...]
Published: 2024
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2. Effects of Iranian herbal Zofa® syrup for the management of clinical symptoms in patients with COVID-19: A randomized clinical trial

Author: Ali Ghazvini, Amir Vahedian-azimi, Morteza Abdoli, Farshid Rahimibashar, Yunes Panahi, Thozhukat Sathyapalan, and Amirhossein Sahebkar
Subjects: coronavirus disease 2019, herbal medicine, respiratory infection, symptoms, iran, Therapeutics. Pharmacology, RM1-950
Abstract: Objective: The objective of this study was to determine the role of Iranian herbal Zofa® syrup in improving the clinical symptoms of patients with COVID-19.Materials and Methods: This randomized clinical trial was conducted on 105 patients with COVID-19. Patients were randomly assigned to the intervention (n=35) group (received 10 ml of Zofa® syrup every 8 hours/seven days plus standard treatment) or the control (n=70) group (received only standard treatment). Assessments were performed before and after treatment.Results: The groups were comparable regarding age (p=0.980), gender (p=0.584), comorbidities (p=0.318), or drug history (p=0.771). There was no difference between patients' recovery status at the time of discharge (p=0.327) or two weeks post-discharge (p=0.165) in the intervention and control groups. No patient was hospitalized to the intensive care unit (ICU) for supplemental oxygen therapy and no patient died in the intervention group. However, in the control group, three (4.5%) patients were transferred to the ICU, and two (3.03%) patients died.Conclusion: Considering the better recovery status of the patients at the time of discharge and the absence of patient deaths in the intervention group, more additional studies are needed to confirm these findings and elucidate the role of Zofa® in COVID-19.
Published: 2023
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3. Association of Vitamin D with Perfluorinated Alkyl Acids in Women with and without Non-Obese Polycystic Ovary Syndrome

Author: Alexandra E. Butler, Thozhukat Sathyapalan, Priya Das, Edwina Brennan, and Stephen L. Atkin
Subjects: endocrine disrupting chemicals, PFAAs, perfluorinated alkyl acids, PFOA, PFOS, PFNA, Biology (General), QH301-705.5
Abstract: Background. Perfluorinated alkyl acids (PFAAs) are persistent organic pollutants affected by BMI and ethnicity, with contradictory reports of association with vitamin D deficiency. Methods. Twenty-nine Caucasian women with non-obese polycystic ovary syndrome (PCOS) and age- and BMI-matched Caucasian control women (n = 30) were recruited. Paired serum samples were analyzed for PFAAs (n = 13) using high-performance liquid chromatography–tandem mass spectrometry. Tandem mass spectrometry determined levels of 25(OH)D3 and the active 1,25(OH)2D3. Results. Women with and without PCOS did not differ in age, weight, insulin resistance, or systemic inflammation (C-reactive protein did not differ), but the free androgen index was increased. Four PFAAs were detected in all serum samples: perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS). Serum PFOS was higher in PCOS versus controls (geometric mean [GM] 3.9 vs. 3.1 ng/mL, p < 0.05). Linear regression modeling showed that elevated PFHxS had higher odds of a lower 25(OH)D3 (OR: 2.919, 95% CI 0.82–5.75, p = 0.04). Vitamin D did not differ between cohorts and did not correlate with any PFAAs, either alone or when the groups were combined. When vitamin D was stratified into sufficiency (>20 ng/mL) and deficiency (3 or the active 1,25(OH)2D3 in this Caucasian population, nor do they appear to be associated with vitamin D deficiency, suggesting that future studies must account for these factors in the analysis.
Published: 2024
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4. Effect of Hypoglycemia and Rebound Hyperglycemia on Proteomic Cardiovascular Risk Biomarkers

Author: Manjula Nandakumar, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: type 2 diabetes, hypoglycemia, glucose variability, cardiovascular markers, Biology (General), QH301-705.5
Abstract: Introduction: Hypoglycemia has been associated with cardiovascular events, and glucose variability has been suggested to be associated with increased cardiovascular risk. Therefore, in this study, we examined the effect on proteomic cardiovascular risk protein markers of (i) mild iatrogenic hypoglycemia and (ii) severe iatrogenic hypoglycemia followed by rebound hyperglycemia. Methods: Two iatrogenic hypoglycemia studies were compared; firstly, mild hypoglycemia in 18 subjects (10 type 2 diabetes (T2D), 8 controls; blood glucose to 2.8 mmoL/L (50 mg/dL) for 1 h), and secondly, severe hypoglycemia in 46 subjects (23 T2D, 23 controls; blood glucose to Results: Baseline to euglycemia showed no change in any of the proteins measured in the T2D cohort. With severe hypoglycemia, the study controls showed an increase in Angiopoietin 1 (ANGPT1) (p < 0.01) and Dickkopf-1 (DKK1) (p < 0.01), but no changes were seen with mild hypoglycemia. In both the mild and severe hypoglycemia studies, at the point of hypoglycemia, T2D subjects showed suppression of Brother of CDO (BOC) (p < 0.01). At 1 h post-hypoglycemia, the changes in ANGPT1, DKK1, and BOC had resolved, with no additional protein biomarker changes despite rebound hyperglycemia from 1.8 ± 0.1 to 12.2 ± 2.0 mmol/L. Conclusions: Proteomic biomarkers of cardiovascular disease showed changes at hypoglycemia that resolved within 1 h following the hypoglycemic event and with no changes following hyperglycemia rebound, suggesting that any cardiovascular risk increase is due to the hypoglycemia and not due to glucose fluctuation per se.
Published: 2024
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5. Neuroprotective effects of trehalose following middle cerebral artery occlusion in rats

Author: Fatemeh Forouzanfar, Alireza Hoseini, Thozhukat Sathyapalan, and Amirhossein Sahebkar
Subjects: Trehalose, Stroke, Cerebral ischemia, Middle cerebral artery occlusion, MCAO, Occlusion, Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
Abstract: Background: Ischemic stroke remains one of the leading causes of mortality and disability in the population. Middle cerebral artery occlusion (MCAO) followed by reperfusion is widely accepted to mimic stroke in basic medical research. Trehalose is a non-reducing disaccharide compound found naturally in most organisms such as bacteria, yeasts, invertebrates and even in plants except for vertebrates. Its protective role has been shown in various neurological disorders. In the current study, the MCAO model was used to investigate the therapeutic efficacy of trehalose. Methods: In this experimental study, 32 Male Wistar rats were subjected to MCAO following 24 h of reperfusion. Wistar rats were randomly divided into four groups: Sham-operated control group (Sham), middle cerebral artery occlusion (MCAO) group, trehalose (50 and 100 mg/kg) treatment + MCAO groups. Trehalose was intraperitoneally injected 3- and 6 h post-ischemia. After 24 h of reperfusion and evaluation of the intensity of neurological dysfunction via a modified Rogers scale, the brains were removed and the volume of ischemia was stained using 2,3,5-triphenyl tetrazolium chloride. Results: Compared with the control group, trehalose administration with dosages of 50 and 100 mg/kg significantly decreased the modified Rogers score (p
Published: 2023
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6. Association of C-reactive protein with histological, elastographic, and sonographic indices of non-alcoholic fatty liver disease in individuals with severe obesity

Author: Tannaz Jamialahmadi, Simona Bo, Mitra Abbasifard, Thozhukat Sathyapalan, Ali Jangjoo, Seyed Adel Moallem, Wael Almahmeed, Sorour Ashari, Thomas P. Johnston, and Amirhossein Sahebkar
Subjects: Fatty liver, Steatohepatitis, Liver fibrosis, Biopsy, Elastography, Nutritional diseases. Deficiency diseases, RC620-627, Public aspects of medicine, RA1-1270
Abstract: Keypoints Obesity and NAFLD/NASH are commonly accompanied by inflammation. We tested if serum hs-CRP is associated with indices of NAFLD/NASH and liver fibrosis in morbidly obese patients. hs-CRP was significantly associated with any degree of histologically diagnosed liver damage.
Published: 2023
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7. Exploration of the correlation of serum polychlorinated biphenyl levels with luteal phase hormonal parameters and infertility in women with or without polycystic ovary syndrome

Author: Alexandra E. Butler, Edwina Brennan, Daniel S. Drage, Thozhukat Sathyapalan, and Stephen L. Atkin
Subjects: polychlorinated biphenyls, organic pollutants, pcos, infertility, in vitro fertilization, reproductive health, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: IntroductionPolychlorinated biphenyls (PCBs) are organic lipophilic pollutants that accumulate in the body. Previous research has linked PCBs with menstrual function; therefore, this study was undertaken to investigate the correlation of PCBs with luteal phase hormonal parameters of menstrual function at day 21 in a group of non-obese women prior to in vitro fertilization (IVF).MethodsFifty-eight non-obese Caucasian women from a UK academic center, 29 with polycystic ovary syndrome (PCOS) and 29 without, were recruited. PCOS women all had anovulatory infertility. Non-PCOS women: five with unexplained infertility, the remainder with male factor infertility (n=14) or tubal problems (n=10). Blood was withdrawn at day 21 of the menstrual cycle for non-PCOS women, at the time of mock embryo transfer. PCBs were measured using high resolution gas chromatography.ResultsOnly PCB118, PCB153, PCB138 and PCB180 were detected in all samples, and levels did not differ between PCOS and non-PCOS subjects. In non-PCOS subjects, PCB153, PCB138 and PCB180 inversely correlated with estradiol (p
Published: 2023
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8. Serum polychlorinated biphenyl levels and circulating miRNAs in non-obese women with and without polycystic ovary syndrome

Author: Edwina Brennan, Alexandra E. Butler, Daniel S. Drage, Thozhukat Sathyapalan, and Stephen L. Atkin
Subjects: microRNA (miRNA), polychlorinated biphenyls (PCBs), polycystic ovary syndrome (PCOS), endocrine disruptors, organic pollutants, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: IntroductionPolychlorinated biphenyls (PCBs), organic lipophilic pollutants that accumulate through diet and increase with age, have been associated with polycystic ovary syndrome (PCOS) and shown to affect microRNA (miRNA) expression. This work aimed to determine if PCBs were associated with circulating miRNAs and whether there were any correlations with serum PCB/miRNA levels and hormonal changes.Methods29 non-obese PCOS and 29 healthy control women, with similar age and body mass index (BMI), had their serum miRNAs measured together with 7 indicator PCBs (PCB28, PCB52, PCB101, PCB118, PCB138, PCB153, PCB180) using high resolution gas chromatography coupled with high resolution mass spectrometry.ResultsIn the combined study cohort, four miRNAs (hsa-miR-139-5p, hsa-miR-424-5p, hsa-miR-195-5p, hsa-miR-335-5p) correlated with PCBs, but none correlated with metabolic parameters. hsa-miR-335-5p correlated with FSH. When stratified, 25 miRNAs correlated with PCBs in controls compared to only one (hsa-miR-193a-5p) in PCOS; none of these miRNAs correlated with the metabolic parameters of BMI, insulin resistance, or inflammation (C-reactive protein, CRP). However, of these 25 miRNAs in controls, hsa-miR-26a-5p, hsa-miR-193a-5p, hsa-miR-2110 and hsa-miR-195-5p positively correlated with luteinizing hormone (LH), hsa-miR-99b-5p and hsa-miR-146b-5p correlated with estradiol, hsa-miR-193a-5p correlated with progesterone, hsa-miR-195-5p correlated with follicle stimulating hormone (FSH), and hsa-miR-139-5p and hsa-miR-146b-5p negatively correlated with anti-müllerian hormone (AMH) (all p
Published: 2023
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9. The severity and duration of Hypoglycemia affect platelet-derived protein responses in Caucasians

Author: Abu Saleh Md Moin, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Type 2 diabetes, Hypoglycemia, Platelet-associated proteins, Inflammation, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Objective Severe hypoglycemia is associated with increased cardiovascular death risk, and platelet responses to hypoglycemia (hypo) have been described. However, the impact of deep transient hypo (deep-hypo) versus prolonged milder hypo (mild-hypo) on platelet response is unclear. Research Design and methods Two hypo studies were compared; firstly, mild-hypo in 18-subjects (10 type-2-diabetes (T2D), 8 controls), blood glucose to 2.8mmoL/L (50 mg/dL) for 1-hour; secondly deep-hypo in 46-subjects (23 T2D, 23 controls), blood glucose to
Published: 2022
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10. High density lipoprotein-associated proteins in non-obese women with and without polycystic ovary syndrome

Author: Alexandra E. Butler, Abu Saleh Md Moin, Željko Reiner, Thozhukat Sathyapalan, Tannaz Jamialahmadi, Amirhossein Sahebkar, and Stephen L. Atkin
Subjects: polycystic ovary syndrome, lipids, HDL, LDL, dyslipidemia, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: IntroductionDyslipidemia frequently occurs in women with polycystic ovary syndrome (PCOS), but it is unclear whether dyslipidemia is due to obesity and insulin resistance (IR) or is inherent to PCOS. To address this, proteomic analysis of proteins important in lipid metabolism, particularly for high-density lipoprotein cholesterol (HDL-C), was performed in non-obese, non-insulin resistant PCOS women compared to matched controls.MethodsWeight and aged-matched non-obese subjects with PCOS (n=24) and without IR were compared with control women (n=24). 19 proteins were measured by Somalogic proteomic analysis: alpha-1-antichymotrypsin, alpha-1-antitrypsin, apolipoproteins A-1, B, D, E, E2, E3, E4, L1, M, clusterin, complement C3, hemopexin, heparin cofactor-II (HCFII), kininogen-1, serum amyloid A-1, amyloid beta A-4 and paraoxonase-1.ResultsWomen with PCOS had a higher free androgen index (FAI) (p0.05). The triglyceride:HDL-cholesterol ratio was elevated (p=0.03) in PCOS. Alpha-1-antitrypsin levels were lower (p0.05). However, in PCOS, alpha-1-antichymotrypsin correlated negatively with BMI (r=-0.40, p
Published: 2023
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11. Hypoglycemia-induced changes in complement pathways in type 2 diabetes

Author: Abu Saleh Md Moin, Manjula Nandakumar, Ilhame Diboun, Ahmed Al-Qaissi, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Hypoglycemia, Type 2 diabetes, Complement proteins, Proteomics, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background and aims: An association between hypoglycaemia and adverse cardiovascular events has been suggested from longitudinal and retrospective cohort studies. The complement pathway proteins in hypoglycemia are not well studied. Here, we hypothesized that these circulating proteins would be elevated in response to hypoglycemia in type 2 diabetes (T2D) through the inflammatory response. Methods: A prospective, parallel study in T2D (n = 23) and controls (n = 23). Subjects underwent insulin-induced hypoglycemia with blood sampling at baseline, hypoglycemia and post-hypoglycemia; SOMAscan proteomic analysis of complement pathway-related proteins, cytokines and inflammatory proteins was undertaken. Results: At baseline: Complement C2 (p
Published: 2021
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12. Classical and alternate complement factor overexpression in non-obese weight matched women with polycystic ovary syndrome does not correlate with vitamin D

Author: Abu Saleh Md Moin, Thozhukat Sathyapalan, Alexandra E. Butler, and Stephen L. Atkin
Subjects: polycystic ovary syndrome, complement factors, C3, C4, vitamin D, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: IntroductionWomen with polycystic ovary syndrome (PCOS) exhibit complement factor expression changes that may be obesity-driven rather than an intrinsic facet of PCOS; furthermore, complement changes have been associated with vitamin D deficiency, a common feature of PCOS. Therefore, complement pathway proteins and vitamin D levels may be linked in PCOS.MethodsWe measured plasma levels of complement pathway proteins by Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement for the classical (C4, C4a, and C4b) and alternative pathways (C3, C3b, iC3b, properdin, and factors B, D, and H) in weight and age-matched non-obese non-insulin resistant women with PCOS (n = 24) and control women (n = 24). Proteins that differed between groups were correlated with 25-hydroxyvitamin D3 (25(OH)D3) and 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), measured by isotope-dilution liquid chromatography tandem mass spectrometry.ResultsWomen with PCOS had a higher free androgen index and anti-Mullerian hormone, though insulin resistance was comparable to controls; likewise, C-reactive protein, a marker of inflammation, was comparable between cohorts. In the alternative complement pathway, C3, iC3b, and properdin were increased in PCOS (p
Published: 2022
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13. Complement Dysregulation in Obese Versus Nonobese Polycystic Ovary Syndrome Patients

Author: Alexandra E. Butler, Abu Saleh Md Moin, Thozhukat Sathyapalan, and Stephen L. Atkin
Subjects: polycystic ovary syndrome, complement factors, factor H, C3, properdin, factor B, Cytology, QH573-671
Abstract: Introduction: Upregulation of complement system factors are reported to be increased in polycystic ovary syndrome (PCOS) and may be due to obesity and insulin resistance rather than inherently due to PCOS. We directly compared complement factors from an obese, insulin-resistant PCOS population to a nonobese, non-insulin-resistant PCOS population in a proteomic analysis to investigate this. Methods: Plasma was collected from 234 women (137 with PCOS and 97 controls) from a biobank cohort and compared to a nonobese, non-insulin-resistant population (24 with PCOS and 24 controls). Slow off-rate modified aptamer (SOMA) scan plasma protein measurement was undertaken for the following complement system proteins: C1q, C1r, C2, C3, C3a, iC3b, C3b, C3d, C3adesArg, C4, C4a, C4b, C5, C5a, C5b-6 complex, C8, properdin, factor B, factor D, factor H, factor I, Mannose-binding protein C (MBL), complement decay-accelerating factor (DAF) and complement factor H-related protein 5 (CFHR5). Results: The alternative pathway of the complement system was overexpressed in both obese and nonobese PCOS, with increased C3 (p < 0.05) and properdin (p < 0.01); additionally, factor B increased in obese PCOS (p < 0.01). For inhibitors of this pathway, factor I was increased (p < 0.01) in both slim and obese PCOS, with an increase in CFHR5 and factor H in obese PCOS (p < 0.01). Complement factors iC3b, C3d and C5a, associated with an enhanced B cell response and inflammatory cytokine release, were increased in both slim and obese PCOS (p < 0.05). C3a and its product, C3adesArg, were both significantly elevated in nonobese PCOS (p < 0.05) but not in nonobese PCOS. There was no association with insulin resistance. BMI correlated positively in both groups with factor B, factor H and C5a. Additionally, in obese PCOS, BMI correlated with C3d, factor D, factor I, CFHR5 and C5a (p < 0.05), and in nonobese PCOS, BMI correlated with properdin, iC3b, C3, C3adesArg, C3a, C4, C5, C5a and C1q. In obese controls, BMI correlated with C3, C3desArg, C3a, C3d, C4, factor I, factor B, C5a and C5, whilst in nonobese controls, BMI only correlated negatively with C1q. Comparison of nonobese and obese PCOS showed that properdin, C3b, iC3b, C4A, factor D, factor H and MBL differed. Conclusion: The upregulation of the alternative complement pathway was seen in nonobese PCOS and was further exacerbated in obese PCOS, indicating that this is an inherent feature of the pathophysiology of PCOS that is worsened by obesity and is reflected in the differences between the nonobese and obese PCOS phenotypes. However, the increase in the complement proteins associated with activation was counterbalanced by upregulation of complement inhibitors; this was evident in both PCOS groups, suggesting that insults, such as a cardiovascular event or infection, that cause activation of complement pathways may be amplified in PCOS.
Published: 2023
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14. Impact of severe hypoglycemia on the heat shock and related protein response

Author: Alexander S. Atkin, Abu Saleh Md Moin, Manjula Nandakumar, Ahmed Al-Qaissi, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Medicine, Science
Abstract: Abstract Heat shock proteins contribute to diabetes-induced complications and are affected by glycemic control. Our hypothesis was that hypoglycemia-induced heat shock and related protein changes would be amplified in type 2 diabetes (T2D). This prospective, case–control study enrolled 23 T2D patients and 23 control subjects who underwent hyperinsulinemic-induced hypoglycemia (≤ 2.0 mmol/L (36 mg/dl)) with blood sampling at baseline, at hypoglycemia and after a 24-h post-hypoglycemia follow-up period. Proteomic analysis of heat shock-related and pro-inflammatory proteins was performed. At baseline, MAPKAPK5 (p = 0.02) and UBE2G2 (p = 0.003) were elevated and STUB1 decreased (p = 0.007) in T2D. At hypoglycemia: PPP3CA (p
Published: 2021
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15. Impact of metformin on the clinical and metabolic parameters of women with polycystic ovary syndrome: a systematic review and meta-analysis of randomised controlled trials

Author: Mohammed Altigani Abdalla, Najeeb Shah, Harshal Deshmukh, Amirhossein Sahebkar, Linda Östlundh, Rami H. Al-Rifai, Stephen L. Atkin, and Thozhukat Sathyapalan
Subjects: Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Context: Polycystic ovary syndrome (PCOS) is one of the commonest endocrine disorders affecting women of reproductive age, and metformin is a widely used medication in managing this condition. Aim: To review the available literature comprehensively on the therapeutic impact of metformin on the clinical and metabolic parameters of women with PCOS. Data source: We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library and the Web of Science and selected sources for grey literature from their inception to April 2020. An updated search in PubMed was performed in June 2022. Data synthesis: Two reviewers selected eligible studies and extracted data, and the review is reported following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: In 24 eligible randomised controlled trials (RCTs) involving 564 participants who received metformin therapy, metformin was associated with significant reduction in body weight by 3.13 kg (95% CI: −5.33, −0.93), body mass index (BMI) by 0.82 kg/m² (95% CI: −1.22, −0.41), fasting blood glucose [standardised mean difference (SMD): −0.23; 95% CI: −0.40, −0.06], low-density lipoprotein cholesterol (LDL-C) (SMD: −0.41; 95% CI: −0.85, 0.03), total testosterone (SMD: −0.33; 95% CI: −0.49, −0.17), androstenedione (SMD: −0.45; 95% CI: −0.70, −0.20), 17-hydroxyprogesterone (17-OHP) (SMD: −0.58; 95% CI: −1.16, 0.00) and increase the likelihood of clinical pregnancy rate [odds ratio (OR): 3.00; 95% CI: 1.95, 4.59] compared with placebo. Conclusion: In women with PCOS, metformin use has shown a positive impact in reducing body weight, BMI, total testosterone, androstenedione, 17-OHP, LDL-C, fasting blood glucose and increasing the likelihood of pregnancy in women with PCOS.
Published: 2022
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16. MiRNA and associated inflammatory changes from baseline to hypoglycemia in type 2 diabetes

Author: Manjunath Ramanjaneya, Ruth Priyanka, Milin Bensila, Jayakumar Jerobin, Krunal Pawar, Thozhukat Sathyapalan, Abdul Badi Abou-Samra, Najeeb M. Halabi, Abu Saleh Md Moin, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Type 2 diabetes, hypoglycemia, miRNA, metabolic pathways, proteomics, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: ObjectiveHypoglycemia in type 2 diabetes (T2D) increases morbidity and mortality but the underlying physiological response is still not fully understood, though physiological changes are still apparent 24 hours after the event. Small noncoding microRNA (miRNA) have multiple downstream biological effects that may respond rapidly to stress. We hypothesized that hypoglycemia would induce rapid miRNA changes; therefore, this pilot exploratory study was undertaken.MethodsA pilot prospective, parallel study in T2D (n=23) and controls (n=23). Insulin-induced hypoglycemia (2mmol/l: 36mg/dl) was induced and blood sampling performed at baseline and hypoglycemia. Initial profiling of miRNA was undertaken on pooled samples identified 96 miRNA that were differentially regulated, followed by validation on a custom designed 112 miRNA panel.ResultsNine miRNAs differed from baseline to hypoglycemia in control subjects; eight were upregulated: miR-1303, miR-let-7e-5p, miR-1267, miR-30a-5p, miR-571, miR-661, miR-770-5p, miR-892b and one was downregulated: miR-652-3p. None of the miRNAs differed from baseline in T2D subjects.ConclusionA rapid miRNA response reflecting protective pathways was seen in control subjects that appeared to be lost in T2D, suggesting that mitigating responses to hypoglycemia with blunting of the counter-regulatory response in T2D occurs even in patients with short duration of disease.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT03102801?term=NCT03102801&draw=2&rank=1, identifier NCT03102801.
Published: 2022
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17. Vitamin D association with coagulation factors in polycystic ovary syndrome is dependent upon body mass index

Author: Abu Saleh Md Moin, Thozhukat Sathyapalan, Alexandra E. Butler, and Stephen L. Atkin
Subjects: Polycystic ovary syndrome, Vitamin D, Obesity, Fibrinogen, Coagulation, Medicine
Published: 2021
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18. Roux-en-Y gastric bypass-induced bacterial perturbation contributes to altered host-bacterial co-metabolic phenotype

Author: Jia V. Li, Hutan Ashrafian, Magali Sarafian, Daniel Homola, Laura Rushton, Grace Barker, Paula Momo Cabrera, Matthew R. Lewis, Ara Darzi, Edward Lin, Nana Adwoa Gletsu-Miller, Stephen L. Atkin, Thozhukat Sathyapalan, Nigel J. Gooderham, Jeremy K. Nicholson, Julian R. Marchesi, Thanos Athanasiou, and Elaine Holmes
Subjects: Bariatric surgery, Bile acids, Host-microbial metabolism, Metabolic profiling, Microbiome, Microbial ecology, QR100-130
Abstract: Abstract Background Bariatric surgery, used to achieve effective weight loss in individuals with severe obesity, modifies the gut microbiota and systemic metabolism in both humans and animal models. The aim of the current study was to understand better the metabolic functions of the altered gut microbiome by conducting deep phenotyping of bariatric surgery patients and bacterial culturing to investigate causality of the metabolic observations. Methods Three bariatric cohorts (n = 84, n = 14 and n = 9) with patients who had undergone Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) or laparoscopic gastric banding (LGB), respectively, were enrolled. Metabolic and 16S rRNA bacterial profiles were compared between pre- and post-surgery. Faeces from RYGB patients and bacterial isolates were cultured to experimentally associate the observed metabolic changes in biofluids with the altered gut microbiome. Results Compared to SG and LGB, RYGB induced the greatest weight loss and most profound metabolic and bacterial changes. RYGB patients showed increased aromatic amino acids-based host-bacterial co-metabolism, resulting in increased urinary excretion of 4-hydroxyphenylacetate, phenylacetylglutamine, 4-cresyl sulphate and indoxyl sulphate, and increased faecal excretion of tyramine and phenylacetate. Bacterial degradation of choline was increased as evidenced by altered urinary trimethylamine-N-oxide and dimethylamine excretion and faecal concentrations of dimethylamine. RYGB patients’ bacteria had a greater capacity to produce tyramine from tyrosine, phenylalanine to phenylacetate and tryptophan to indole and tryptamine, compared to the microbiota from non-surgery, normal weight individuals. 3-Hydroxydicarboxylic acid metabolism and urinary excretion of primary bile acids, serum BCAAs and dimethyl sulfone were also perturbed following bariatric surgery. Conclusion Altered bacterial composition and metabolism contribute to metabolic observations in biofluids of patients following RYGB surgery. The impact of these changes on the functional clinical outcomes requires further investigation. Video abstract
Published: 2021
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19. Oxidative Stress Markers and Heat Shock Proteins in Non-Obese Women with Polycystic Ovary Syndrome Are Not Elevated and Show No Correlation with Vitamin D

Author: Manjula Nandakumar, Thozhukat Sathyapalan, Alexandra E. Butler, and Stephen L. Atkin
Subjects: polycystic ovary syndrome, oxidative stress, heat shock proteins, vitamin D3, Biology (General), QH301-705.5
Abstract: Introduction. Oxidative stress (OS) is recognized in the pathophysiology of polycystic ovary syndrome (PCOS). OS results in intracellular reactive oxygen species generation, causing oxidative protein damage that is protected by heat shock proteins (HSPs). Vitamin D is thought to reduce and protect against OS; therefore, OS, HSP, and vitamin D levels may be associated with PCOS. However, their expression in PCOS without underlying inflammation is unknown. Methods. In this exploratory study, the plasma levels of 7 OS proteins and 10 HSPs that are affected by the OS process were measured using Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurements in non-obese, non-insulin resistant women with PCOS (n = 24) without systemic inflammation and control (n = 24) women; the cohorts were matched for weight and age. The OS proteins and HSPs were correlated with 25-hydroxy vitamin D3 (25(OH)D3) and the active form, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), as measured by isotope-dilution liquid chromatography tandem mass spectrometry. Results. The PCOS women versus the controls had comparable insulin resistance and systemic inflammation (C-reactive protein 2.0 mg/L vs. 2.3 mg/L, p > 0.05), but higher free androgen index and anti-mullerian hormone levels. Among the OS proteins, only esterase D (ESD; p < 0.01) was elevated in PCOS and the HSPs did not differ between the PCOS and control women. There was no correlation of 25(OH)D3 or 1,25(OH)2D3 with any of the proteins. Conclusions. In a PCOS population that was non-obese and without insulin resistance and systemic inflammation, only ESD was elevated in PCOS, whilst the other OS proteins and HSPs were not elevated. Further, none of the OS proteins or HSPs were correlated with either 25(OH)D3 or 1,25(OH)2D3 in either cohort of women or when both cohorts were combined, indicating that the OS and HSP responses were largely absent and not affected by vitamin D in a non-obese PCOS population.
Published: 2023
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20. Association between Organochlorine Pesticides and Vitamin D in Female Subjects

Author: Edwina Brennan, Alexandra E. Butler, Manjula Nandakumar, Daniel S. Drage, Thozhukat Sathyapalan, and Stephen L. Atkin
Subjects: Organochlorine pesticides (OCPs), organic pollutants, vitamin D, cholecalciferol, Biology (General), QH301-705.5
Abstract: In human population studies, organochlorine pesticides (OCPs) have been linked to vitamin D deficiency. Therefore, this study examined the association between OCPs, vitamin D3 (cholecalciferol, 25(OH)D3), and the active metabolite 1,25-dihydrovitamin D3 (1,25(OH)2D3) in a cohort of non-obese women. The serum samples of 58 female participants (age—31.9 ± 4.6 years; body mass index (BMI)—25.7 ± 3.7 kg/m2) were screened for 10 indicator OCPs. 25(OH)D3 and 1,25(OH)2D3 levels were determined via isotope dilution liquid chromatography tandem mass spectrometry. In this cohort, the 25(OH)D3 and 1,25(OH)2D3 levels were 22.9 ± 11.2 ng/mL and 0.05 ± 0.02 ng/mL, respectively, with 28 participants classified as 25(OH)D3-deficient (3. p,p′-dichlorodiphenyldichloroethylene (DDE) and ƩOCPs correlated positively with 1,25(OH)2D3, with the latter being negatively correlated with estimated glomerular filtration rate (eGFR). In women with sufficient 25(OH)D3 levels, p,p′-dichlorodiphenyltrichloroethan (DDT) was positively correlated with 1,25(OH)2D3, whilst in the deficient group, hexachlorobenzene (HCB) and p,p′-(DDE) were positively correlated with 1,25(OH)2D3, β-Hexachlorocyclohexane (HCH) was positively correlated with 25(OH)D3, and none of the OCPs were associated with measures of renal function. Overall, OCPs and ƩOCPs were not associated with 25(OH)D3, suggesting that they are unrelated to vitamin D deficiency, but p,p′-DDE and ƩOCPs correlated positively with active 1,25(OH)2D3, while ƩOCPs correlated negatively with eGFR, suggesting a possible renal effect. Analysis of vitamin D deficiency revealed an association between β-HCH and 25(OH)D3, and between HCB and p,p′-DDE and 1,25(OH)2D3, suggesting that OCP effects may be enhanced in cases of vitamin D deficiency.
Published: 2023
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21. Regulation of circulating CTRP-2/CTRP-9 and GDF-8/GDF-15 by intralipids and insulin in healthy control and polycystic ovary syndrome women following chronic exercise training

Author: Jayakumar Jerobin, Manjunath Ramanjaneya, Ilham Bettahi, Raihanath Parammal, Kodappully Sivaraman Siveen, Meis Alkasem, Myint Aye, Thozhukat Sathyapalan, Monica Skarulis, Stephen L. Atkin, and Abdul Badi Abou-Samra
Subjects: C1Q/TNF related proteins, Growth differentiation factors, Lipid, Insulin, Insulin resistance, Euglycemic clamp, Nutritional diseases. Deficiency diseases, RC620-627
Abstract: Abstract Background Polycystic ovary syndrome (PCOS) is associated with obesity, diabetes, and insulin resistance. The circulating C1Q/TNF-related proteins (CTRP-2, CTRP-9) and growth differentiation factors (GDF-8, GDF-15) contribute to glucose and lipid homeostasis. The effects of intralipids and insulin infusion on CTRP-2, CTRP-9, GDF-8 and GDF-15 in PCOS and control subjects before and after chronic exercise training were examined. Methods Ten PCOS and nine healthy subjects were studied at baseline status and after moderate-intensity chronic exercise training (1 h exercise, 3 times per week, 8 weeks). All participants were infused with 1.5 mL/min of saline or intralipids (20%) for 5 h, and during the last 2 h of saline or intralipids infusion hyperinsulinemic-euglycemic clamp (HIEC) was performed. CTRP-2, CTRP-9, GDF-8 and GDF-15 levels were measured at 0, 3 and 5 h. Results Intralipids dramatically increased CTRP-2 levels in PCOS (P = 0.02) and control (P = 0.004) subjects, which was not affected by insulin infusion or by exercise. Intralipids alone had no effects on CTRP-9, GDF-8, or GDF-15. Insulin increased the levels of GDF-15 in control subjects (P = 0.05) during the saline study and in PCOS subjects (P = 0.04) during the intralipid infusion. Insulin suppressed CTRP9 levels during the intralipid study in both PCOS (P = 0.04) and control (P = 0.01) subjects. Exercise significantly reduced fasting GDF-8 levels in PCOS (P = 0.03) and control (P = 0.04) subjects; however, intralipids infusion after chronic exercise training increased GDF-8 levels in both PCOS (P = 0.003) and control (P = 0.05) subjects and insulin infusion during intralipid infusion reduced the rise of GDF-8 levels. Conclusion This study showed that exogenous lipids modulate CTRP-2, which might have a physiological role in lipid metabolism. Since chronic exercise training reduced fasting GDF-8 levels; GDF-8 might have a role in humoral adaptation to exercise. GDF-15 and CTRP-9 levels are responsive to insulin, and thus they may play a role in insulin responses.
Published: 2021
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22. Metabolic consequences of obesity on the hypercoagulable state of polycystic ovary syndrome

Author: Abu Saleh Md Moin, Thozhukat Sathyapalan, Ilhame Diboun, Mohamed A. Elrayess, Alexandra E. Butler, and Stephen L. Atkin
Subjects: Medicine, Science
Abstract: Abstract Polycystic ovary syndrome (PCOS) women have a hypercoagulable state; however, whether this is intrinsically due to PCOS or, alternatively, a consequence of its metabolic complications is unclear. We determined plasma coagulation pathway protein levels in PCOS (n = 146) and control (n = 97) women recruited to a PCOS biobank. Circulating levels of a panel of 18 clotting pathway proteins were determined by Slow Off-rate Modified Aptamer-scan plasma protein measurement. Cohorts were age matched, though PCOS had elevated body mass index (p
Published: 2021
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23. Identification of macrophage activation-related biomarkers in obese type 2 diabetes that may be indicative of enhanced respiratory risk in COVID-19

Author: Abu Saleh Md Moin, Thozhukat Sathyapalan, Ilhame Diboun, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Medicine, Science
Abstract: Abstract Hyperactivation of the immune system through obesity and diabetes may enhance infection severity complicated by Acute Respiratory Distress Syndrome (ARDS). The objective was to determine the circulatory biomarkers for macrophage activation at baseline and after serum glucose normalization in obese type 2 diabetes (OT2D) subjects. A case-controlled interventional pilot study in OT2D (n = 23) and control subjects (n = 23). OT2D subjects underwent hyperinsulinemic clamp to normalize serum glucose. Plasma macrophage-related proteins were determined using Slow Off-rate Modified Aptamer-scan plasma protein measurement at baseline (control and OT2D subjects) and after 1-h of insulin clamp (OT2D subjects only). Basal M1 macrophage activation was characterized by elevated levels of M1 macrophage-specific surface proteins, CD80 and CD38, and cytokines or chemokines (CXCL1, CXCL5, RANTES) released by activated M1 macrophages. Two potent M1 macrophage activation markers, CXCL9 and CXCL10, were decreased in OT2D. Activated M2 macrophages were characterized by elevated levels of plasma CD163, TFGβ-1, MMP7 and MMP9 in OT2D. Conventional mediators of both M1 and M2 macrophage activation markers (IFN-γ, IL-4, IL-13) were not altered. No changes were observed in plasma levels of M1/M2 macrophage activation markers in OT2D in response to acute normalization of glycemia. In the basal state, macrophage activation markers are elevated, and these reflect the expression of circulatory cytokines, chemokines, growth factors and matrix metalloproteinases in obese individuals with type 2 diabetes, that were not changed by glucose normalisation. These differences could potentially predispose diabetic individuals to increased infection severity complicated by ARDS. Clinical trial reg. no: NCT03102801; registration date April 6, 2017.
Published: 2021
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24. Biomarkers of COVID-19 severity may not serve patients with polycystic ovary syndrome

Author: Abu Saleh Md Moin, Manjula Nandakumar, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Biomarkers, Polycystic ovary syndrome, COVID-19, SARS-CoV-2, Platelet degranulation, Coagulation factors, Medicine
Published: 2021
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25. Angiopoietin-1: an early biomarker of diabetic nephropathy?

Author: Alexandra E. Butler, Ahmed Al-Qaissi, Thozhukat Sathyapalan, and Stephen L. Atkin
Subjects: Type 2 diabetes, Diabetic kidney disease, Biomarkers, Proteomics, Medicine
Published: 2021
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26. COVID-19 biomarkers for severity mapped to polycystic ovary syndrome

Author: Abu Saleh Md Moin, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Medicine
Published: 2020
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27. The effects of empagliflozin vs metformin on endothelial microparticles in overweight/obese women with polycystic ovary syndrome

Author: Zeeshan Javed, Maria Papageorgiou, Leigh A Madden, Alan S Rigby, Eric S Kilpatrick, Stephen L Atkin, and Thozhukat Sathyapalan
Subjects: endothelial microparticles, polycystic ovary syndrome, sglt2 inhibitors, empagliflozin, metformin, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Context: Endothelial microparticles (EMPs) are novel, surrogate biomarkers of endothelial function and have been shown to be elevated in women with polycystic ovary syndrome (PCOS). It remains poorly understood how pharmacological options for managing PCOS affect EMP levels. Objective: To characterise and compare the effects of empagliflozin vs metf ormin on the circulating levels of EMPs in overweight/obese women with PCOS. Methods: This was a randomised, comparative, 12-week single-centre trial conducted at the Academic Diabetes, Endocrinology and Metabolism Research Centre, Hull, UK. This analysis includes data from 39 overweight/obese women with PCOS who completed the study and were randomised to empagliflozin (15 mg/day) (n = 19) or metformin (1500 mg/day) (n = 20). Blood samples were collected at baseline and 12 weeks after treatment and analysed for specific surface proteins (ICAM-1, VCAM-1, PECA M-1, E-selectin and endoglin) expressed by circulating EMPs using flow cytometry. Results: In the empagliflozin group, ICAM-1 (P = 0.006), E-selectin (P = 0.016) and VCAM-1 (P = 0.001) EMPs increased significantly following 12 weeks of treatment, but no changes were seen in PECAM-1 (P = 0.93) or endoglin (P = 0.13) EMPs. In the metformin group, VCAM-1 EMPs (P < 0.001) increased significantly after 12 weeks of treatment, w hereas all other EMPs remained unchanged. When data were expressed as percentage change from baseline in each group, no significant differences were seen between groups for any biomarker (P-values from 0.22 to 0.80). Conclusions: Short-term administration of empagliflozin and metformin in ove rweight/ obese women with PCOS appear to increase EMPs expressed by endothelial cells during their activation.
Published: 2020
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28. Real-world use of once-weekly semaglutide in patients with type 2 diabetes: pooled analysis of data from four SURE studies by baseline characteristic subgroups

Author: Thozhukat Sathyapalan, Andrei-Mircea Catarig, Patrick Holmes, Jean-François Yale, Ulrik Bodholdt, Sergiu Catrina, Alice Clark, Neda Rajamand Ekberg, Umut Erhan, Søren Tang Knudsen, Joanne Liutkus, Bernd Schultes, and Gottfried Rudofsky
Subjects: Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Published: 2022
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29. Corrigendum: Association of microRNAs With Embryo Development and Fertilization in Women Undergoing Subfertility Treatments: A Pilot Study

Author: Alexandra E. Butler, Thomas Keith Cunningham, Vimal Ramachandran, Ilhame Diboun, Anna Halama, Thozhukat Sathyapalan, S. Hani Najafi-Shoushtari, and Stephen L. Atkin
Subjects: microRNA, IVF, fertilization rate, embryo, infertility, Reproduction, QH471-489, Medicine (General), R5-920
Published: 2022
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30. Effect of Moderate Aerobic Exercise on Complement Activation Pathways in Polycystic Ovary Syndrome Women

Author: Manjunath Ramanjaneya, Ibrahem Abdalhakam, Ilham Bettahi, Milin Bensila, Jayakumar Jerobin, Myint Myint Aye, Meis Alkasem, Thozhukat Sathyapalan, Stephen Lawrence Atkin, and Abdul-Badi Abou-Samra
Subjects: PCOS, T2D, complement-related proteins, M value, VO2max, exercise, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: BackgroundThe complement system is pivotal in host defense mechanisms, protecting against pathogenic infection by regulating inflammation and cell immunity. Complement-related protein activation occurs through three distinct pathways: classical, alternative, and lectin-dependent pathways, which are regulated by cascades of multiple proteins. Complement activation is recognized in polycystic ovary syndrome (PCOS) to be associated with obesity and insulin sensitivity. Exercise reduces insulin resistance and may help reduce obesity, and therefore, this study was undertaken to determine the effect of exercise on the activation of complement-related proteins in PCOS and control women.Subjects and MeasurementsIn this study, 10 controls and 11 PCOS subjects who were age- and weight-matched underwent an 8-week supervised exercise program at 60% maximal oxygen consumption. Weight was unchanged though insulin sensitivity was increased in PCOS subjects and controls. Fasting baseline and post-exercise samples were collected and 14 complement-related proteins belonging to classical, alternative, and lectin-dependent pathways were measured.ResultsBaseline levels of complement C4b and complement C3b/iC3b were higher in PCOS (P < 0.05) compared with controls. Exercise reduced complement C1q (P < 0.05), C3 (P < 0.001), C4 (P < 0.01), factor B (P < 0.01), factor H (P < 0.01), and properdin (P < 0.05) in controls, but not in PCOS women.ConclusionExercise induced complement changes in controls that were not seen in PCOS subjects, suggesting that these pathways remain dysregulated even in the presence of improved insulin sensitivity and not improved by moderate aerobic exercise.Clinical Trial RegistrationISRCTN registry, ISRCTN42448814.
Published: 2022
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31. HDL-Associated Proteins in Subjects with Polycystic Ovary Syndrome: A Proteomic Study

Author: Alexandra E. Butler, Abu Saleh Md Moin, Željko Reiner, Thozhukat Sathyapalan, Tannaz Jamialahmadi, Amirhossein Sahebkar, and Stephen L. Atkin
Subjects: HDL, lipoprotein, obesity, PCOS, proteomics, slow off-rate modified aptamer, Cytology, QH573-671
Abstract: Introduction. Serum lipoproteins, with the exception of high-density lipoprotein cholesterol (HDL-C), are increased in polycystic ovary syndrome (PCOS) and their levels may reflect the associated obesity and insulin resistance, but the nature of this association is not fully explained. Therefore, proteomic analysis of key proteins in lipoprotein metabolism was performed. Methods. In this cohort study, plasma was collected from 234 women (137 with PCOS and 97 controls without PCOS). Somalogic proteomic analysis was undertaken for the following 19 proteins involved in lipoprotein, and particularly HDL, metabolism: alpha-1-antichymotrypsin; alpha-1-antitrypsin; apolipoproteins A-1, B, D, E, E2, E3, E4, L1, and M; clusterin; complement C3; hemopexin; heparin cofactor II; kininogen-1; serum amyloid A-1; amyloid beta A-4; and paraoxonase-1. Results. The levels of apolipoprotein E were higher in PCOS (p = 0.012). However, the other isoforms of ApoE, ApoE2, E3, and E4, did not differ when compared with controls. ApoM was lower in PCOS (p = 0.000002). Complement C3 was higher in PCOS (p = 0.037), as was heparin cofactor II (HCFII) (p = 0.0004). The levels of the other proteins associated with lipoprotein metabolism did not differ between PCOS and controls. Conclusions. These data contribute to the concern of the deleterious dyslipidemia found in PCOS, with the novel combination reported here of higher levels of ApoE, C3 and HCFII together with lower ApoM. The dysregulation of these proteins could circumvent the protective effect of HDL-C and contribute to a more atherogenic profile that may increase cardiovascular risk.
Published: 2023
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32. A Comprehensive Review of the Development of Carbohydrate Macromolecules and Copper Oxide Nanocomposite Films in Food Nanopackaging

Author: Mohammad Mesgari, Amir Hossein Aalami, Thozhukat Sathyapalan, and Amirhossein Sahebkar
Subjects: Biotechnology, TP248.13-248.65, Inorganic chemistry, QD146-197
Abstract: Background. Food nanopackaging helps maintain food quality against physical, chemical, and storage instability factors. Copper oxide nanoparticles (CuONPs) can improve biopolymers’ mechanical features and barrier properties. This will lead to antimicrobial and antioxidant activities in food packaging to extend the shelf life. Scope and Approach. Edible coatings based on carbohydrate biopolymers have improved the quality of packaging. Several studies have addressed the role of carbohydrate biopolymers and incorporated nanoparticles to enhance food packets’ quality as active nanopackaging. Combined with nanoparticles, these biopolymers create film coatings with an excellent barrier property against transmissions of gases such as O2 and CO2. Key Findings and Conclusions. This review describes the CuO-biopolymer composites, including chitosan, agar, cellulose, carboxymethylcellulose, cellulose nanowhiskers, carrageenan, alginate, starch, and polylactic acid, as food packaging films. Here, we reviewed different fabrication techniques of CuO biocomposites and the impact of CuONPs on the physical, mechanical, barrier, thermal stability, antioxidant, and antimicrobial properties of carbohydrate-based films.
Published: 2022
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33. Impacts of Sodium/Glucose Cotransporter-2 Inhibitors on Circulating Uric Acid Concentrations: A Systematic Review and Meta-Analysis

Author: Abolfazl Akbari, Mahdi Rafiee, Thozhukat Sathyapalan, and Amirhossein Sahebkar
Subjects: Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Background. Several trials have assessed the antihyperglycemic effects of sodium/glucose cotransporter-2 inhibitors (SGLT2i) in patients with type 2 diabetes mellitus (T2DM). We conducted a quantitative analysis to assess the impact of SGLT2is on serum uric acid (SUA) in patients with T2DM. Methods. Placebo-controlled trials published before 13 August 2021 were identified by searching PubMed, Embase, Web of Science, and Scopus. The intervention group received SGLT2i as monotherapy or add-on treatment, and the control group received a placebo that was replaced with SGLT2i. Clinical trials providing changes in SUA were included. The mean change of SUA, glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body weight were calculated (PROSPERO CRD42021287019). Results. After screening of 1172 papers, 59 papers were included in the systematic review. A total of 55 trials (122 groups) of 7 types of SGLT2i on patients with T2DM were eligible for meta-analysis. All SGLT2is significantly decreased SUA levels compared with the placebo groups: empagliflozin mean difference MD=−40.98 μmol/L, 95% CI [-47.63, -34.32], dapagliflozin MD=−35.17 μmol/L, 95% CI [-39.68, -30.66], canagliflozin MD=−36.27 μmol/L, 95% CI [−41.62, −30.93], luseogliflozin MD=−24.269 μmol/L, 95% CI [-33.31, -15.22], tofogliflozin MD=−19.47 μmol/L, 95% CI [−27.40, −11.55], and ipragliflozin MD=−18.85 μmol/L, 95% CI [−27.20, −10.49]. SGLT2i also decreased FPG, body weight, and HbA1c levels. SUA reduction persisted during long-term treatment with SGLT2i (except for empagliflozin), while the SUA reduction was affected by the duration of diabetes. Conclusions. SGLT2i can be a valid therapeutic strategy for patients with T2DM and comorbid hyperuricemia. Besides reducing FPG, body weight, and HbA1c, SGLT2i can significantly decrease SUA levels compared to placebo (Total MD=−34.07 μmol/L, 95% CI [-37.00, -31.14]).
Published: 2022
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34. The Predictive Role of Parathyroid Hormone for Nonalcoholic Fatty Liver Disease following Bariatric Surgery

Author: Tannaz Jamialahmadi, Mohsen Nematy, Mohammed Abdalla, Ali Jangjoo, Ladan Goshayeshi, Matthew Kroh, Seyed Adel Moallem, Mitra Abbasifard, Thozhukat Sathyapalan, and Amirhossein Sahebkar
Subjects: Nutritional diseases. Deficiency diseases, RC620-627
Abstract: Background. Morbid obesity is frequently complicated by chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), and fibrosis. Parathyroid hormone (PTH) is found to be elevated in morbid obesity due to the defective hepatic metabolism of vitamin D. Bariatric surgery is performed to help patients with BMI>40 kg/m2 to effectively lose weight, particularly in patients with obesity who are afflicted with complications such as NAFLD/NASH. Objective. This study aimed to evaluate the PTH level as a predictor of hepatic function in individuals with morbid obesity who have undergone bariatric surgery. Methods. Ninety subjects with morbid obesity referred for Roux en-Y gastric bypass surgery were recruited. After IRB approval, demographic profiles, anthropometric factors, liver biopsy, and laboratory tests were obtained. The two-dimensional shear wave elastography (2D-SWE) technique was applied to assess hepatic stiffness. Results. A significant reduction occurred six months after bariatric surgery in the anthropometric indices p
Published: 2022
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35. Potential Biomarkers to Predict Acute Ischemic Stroke in Type 2 Diabetes

Author: Abu Saleh Md Moin, Manjula Nandakumar, Ahmed Al-Qaissi, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: type 2 diabetes, endothelial proteins, biomarkers, ischemic stroke, predictive biomarkers, Biology (General), QH301-705.5
Abstract: Background and Purpose: Patients with type 2 diabetes (T2D) have increased risk of cardiovascular disease (CVD), encompassing myocardial infarction, stroke, and peripheral vascular disease. We hypothesized that those biomarkers indicative of acute ischemic stroke (AIS) seen in large vessel occlusion (LVO) may also be elevated in T2D and further enhanced by stress conditions; therefore, these proteins represent potentially predictive biomarkers for those T2D patients at high risk of AIS.Methods: We performed an exploratory proteomic analysis in control subjects (n = 23) versus those with type 2 diabetes (T2D) (n = 23) who underwent a hyperinsulinemic clamp study to transient severe hypoglycemia [blood glucose
Published: 2021
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36. Glucose excursions in type 2 diabetes modulate amyloid-related proteins associated with dementia

Author: Abu Saleh Md Moin, Ahmed Al-Qaissi, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Type 2 diabetes, Glucose variability, Amyloid-associated proteins, Alzheimer’s disease, Medicine
Published: 2021
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37. Renal Effects of Empagliflozin in Patients with Type 2 Diabetes Mellitus

Author: Habib, Yaribeygi, Mina, Maleki, Thozhukat, Sathyapalan, Tannaz, Jamialahmadi, and Amirhossein, Sahebkar
Subjects: Pharmacology, Drug Discovery, Organic Chemistry, Molecular Medicine, Biochemistry
Abstract: Abstract: Type 2 diabetes mellitus (T2DM) is one of the main causes of mortality and morbidity worldwide. It leads to various long-term complications such as diabetic nephropathy. Diabetes nephropathy is the leading cause of renal failure in patients with chronic kidney diseases undergoing hemodialysis. Hence preventing the development and progression of diabetic nephropathy is one of the main goals in the management of patients with type 2 diabetes. Sodium-glucose cotransporter 2 inhibitors of empagliflozin is a potent anti-hyperglycemic agents. In addition, it has been shown to have some pharmacologic potentials to provide renoprotective effects in patients with T2DM. In the current study, we review the available clinical data on the potential renoprotective effects of this drug from a mechanistic and molecular viewpoint.
Published: 2023
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38. Association of microRNAs With Embryo Development and Fertilization in Women Undergoing Subfertility Treatments: A Pilot Study

Author: Alexandra E. Butler, Thomas Keith Cunningham, Vimal Ramachandran, Ilhame Diboun, Anna Halama, Thozhukat Sathyapalan, S. Hani Najafi-Shoushtari, and Stephen L. Atkin
Subjects: microRNA, IVF, fertilization rate, embryo, infertility, Reproduction, QH471-489, Medicine (General), R5-920
Abstract: Objective: Small non-coding RNAs, known as microRNAs (miRNAs), have emerging regulatory functions within the ovary that have been related to fertility. This study was undertaken to determine if circulating miRNAs reflect the changes associated with the parameters of embryo development and fertilization.Methods: In this cross-sectional pilot study. Plasma miRNAs were collected from 48 sequentially presenting women in the follicular phase prior to commencing in vitro fertilization (IVF). Circulating miRNAs were measured using locked nucleic acid (LNA)-based quantitative PCR (qPCR), while an updated miRNA data set was used to determine their level of expression.Results: Body mass index and weight were associated with the miRNAs let7b-3p and miR-375, respectively (p < 0.05), with the same relationship being found between endometrium thickness at oocyte retrieval and miR-885-5p and miR-34a-5p (p < 0.05). In contrast, miR-1260a was found to be inversely associated with anti-Mullerian hormone (AMH; p = 0.007), while miR-365a-3p, miR122-5p, and miR-34a-5p correlated with embryo fertilization rates (p < 0.05). However, when omitting cases of male infertility (n = 15), miR122-5p remained significant (p < 0.05), while miR-365a-3p and miR-34a-5p no longer differed; interestingly, however, miR1260a and mir93.3p became significant (p = 0.0087/0.02, respectively). Furthermore, age was negatively associated with miR-335-3p, miR-28-5p, miR-155-5p, miR-501-3p, and miR-497-5p (p < 0.05). Live birth rate was negatively associated with miR-335-3p, miR-100-5p, miR-497-5p, let-7d, and miR-574-3p (p < 0.05), but these were not significant when age was accounted for.However, with the exclusion of male factor infertility, all those miRNAs were no longer significant, though miR.150.5p emerged as significant (p = 0.042). A beta-regression model identified miR-1260a, miR-486-5p, and miR-132-3p (p < 0.03, p = 0.0003, p < 0.00001, respectively) as the most predictive for fertilization rate. Notably, changes in detectable miRNAs were not linked to cleavage rate, top quality embryos (G3D3), and blastocyst or antral follicle count. An ingenuity pathway analysis showed that miRNAs associated with age were also associated with the variables found in reproductive system diseases.Conclusion: Plasma miRNAs prior to the IVF cycle were associated with differing demographic and IVF parameters, including age, and may be predictive biomarkers of fertilization rate.
Published: 2021
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39. Therapeutics for type-2 diabetes mellitus: a glance at the recent inclusions and novel agents under development for use in clinical practice

Author: Najeeb Shah, Mohammed Altigani Abdalla, Harshal Deshmukh, and Thozhukat Sathyapalan
Subjects: Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Diabetes mellitus (DM) is a chronic, progressive, and multifaceted illness resulting in significant physical and psychological detriment to patients. As of 2019, 463 million people are estimated to be living with DM worldwide, out of which 90% have type-2 diabetes mellitus (T2DM). Over the years, significant progress has been made in identifying the risk factors for developing T2DM, understanding its pathophysiology and uncovering various metabolic pathways implicated in the disease process. This has culminated in the implementation of robust prevention programmes and the development of effective pharmacological agents, which have had a favourable impact on the management of T2DM in recent times. Despite these advances, the incidence and prevalence of T2DM continue to rise. Continuing research in improving efficacy, potency, delivery and reducing the adverse effect profile of currently available formulations is required to keep pace with this growing health challenge. Moreover, new metabolic pathways need to be targeted to produce novel pharmacotherapy to restore glucose homeostasis and address metabolic sequelae in patients with T2DM. We searched PubMed, MEDLINE, and Google Scholar databases for recently included agents and novel medication under development for treatment of T2DM. We discuss the pathophysiology of T2DM and review how the emerging anti-diabetic agents target the metabolic pathways involved. We also look at some of the limiting factors to developing new medication and the introduction of unique methods, including facilitating drug delivery to bypass some of these obstacles. However, despite the advances in the therapeutic options for the treatment of T2DM in recent years, the industry still lacks a curative agent.
Published: 2021
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40. Treatment of genitourinary syndrome of menopause: the potential effects of intravaginal ultralow-concentration oestriol and intravaginal dehydroepiandrosterone on quality of life and sexual function

Author: Valentina Lucia La Rosa, Michał Ciebiera, Li-Te Lin, Shangrong Fan, Salvatore Butticè, Thozhukat Sathyapalan, Robert Jędra, Patricia Lordelo, and Alessandro Favilli
Subjects: genitourinary syndrome of menopause, local therapy, oestriol, dehydroepiandrosterone, quality of life, sexuality, Medicine
Abstract: The climacteric is considered a natural phase in a woman’s aging process and is defined as the period starting from the decline in ovarian activity until after the end of ovarian function. Genitourinary syndrome of menopause (GSM) is commonly observed in menopausal women and is characterised by a collection of symptoms resulting from changes to the internal and external genitalia as well as the lower urinary tract. Several studies have demonstrated the close association between sexual dysfunction and symptoms related to GSM. Many medications, at different doses, have been studied over the years for the treatment of the symptoms of GSM. More specifically, ultralow-dose intravaginal oestriol and intravaginal dehydroepiandrosterone (DHEA) are reported to improve symptoms, signs, and quality of life of women with GSM, and they are safe owing to their specific local effect. While the dosage and the administration of intravaginal DHEA are well defined, the literature on intravaginal oestriol is less uniform: different doses and times of administration are proposed with different possible combinations with other non-pharmacological therapies, although a more standardised treatment may be necessary. The aim of this review is to summarise the available data about the effects of ultralow-concentration oestriol and intravaginal DHEA on the menopause-related symptoms, quality of life, and sexual function of women affected by GSM.
Published: 2019
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41. Muscle mass measures and incident osteoporosis in a large cohort of postmenopausal women

Author: Maria Papageorgiou, Thozhukat Sathyapalan, and Rudolph Schutte
Subjects: Muscle mass measures, Osteoporosis, Postmenopausal women, Skeletal muscle mass, Appendicular skeletal muscle mass, Diseases of the musculoskeletal system, RC925-935, Human anatomy, QM1-695
Abstract: Abstract Background Despite several muscle mass measures being used in the current definitions of sarcopenia, their usefulness is uncertain because of limited data on their association with health outcomes. The aim of the study was to compare the performance of different muscle mass measures for predicting incident osteoporosis in postmenopausal women. Methods This study included data from 149 166 participants (aged 60.3 ± 5.5 years) as part of the UK Biobank cohort. Body composition was assessed using bioelectrical impedance. The muscle mass measures included were total body skeletal muscle mass (SMM) and appendicular SMM (aSMM) divided by height squared (ht2), derived residuals, SMM, SMM adjusted for body mass (SMM/bm × 100), and aSMM normalized for body mass index (aSMM/BMI). Diagnoses of the events were confirmed by primary care physicians and coded according to the World Health Organization's International Classification of Diseases 10th Revision (ICD‐10: M80‐M82). Results Over a median follow‐up of 6.75 (5th to 95th percentile interval, 1.53 to 8.37) years, 394 newly diagnosed cases of osteoporosis occurred, with 40 (10.2%) cases being associated with a pathological fracture. SMM/ht2, aSMM/ht2 residual, and SMM were lower in postmenopausal women with osteoporosis compared with women without (all P
Published: 2019
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42. Clinical use of ketamine in psychiatric disorders

Author: Sina Dehestani, Amir Houshang Mohammadpour, Seyed Alireza Sadjadi, Thozhukat Sathyapalan, and Amirhossein Sahebkar
Subjects: Psychiatry and Mental health, Arts and Humanities (miscellaneous), Applied Psychology
Published: 2023
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43. Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY)

Author: Obbina Abani, Ali Abbas, Fatima Abbas, Joshua Abbas, Kasim Abbas, Mustafa Abbas, Sadia Abbasi, Hakam Abbass, Alfie Abbott, Alison Abbott, Nabeel Abdallah, Ammar Abdelaziz, Ashraf Abdelaziz, Mohamed Abdelfattah, Bushra Abdelqader, Audrey Abdul, Basir Abdul, Siddiqui Abdul, Althaf Abdul Rasheed, Ajibode Abdulakeem, Rezan Abdul-Kadir, Abdullah Abdullah, Abdulfatahi Abdulmumeen, Rasheed Abdul-Raheem, Niyaz Abdulshukkoor, Kula Abdusamad, Yazeed Abed El Khaleq, Mai Abedalla, Abeer Abeer Ul Amna, Lynn Abel, Katrina Abernethy, Movin Abeywickrema, Chandra Abhinaya, Affyarsyah Abidin, Adebanke Aboaba, Abigail Aboagye-Odei, Christopher Aboah, Heba Aboelela, Hani Abo-Leyah, Karim Abouelela, Ahmed Abou-Haggar, Mahmoud Abouibrahim, Ahmed Abousamra, Mona Abouzaid, Miriam Abraham, Tizzy Abraham, Abraheem Abraheem, Judith Abrams, Rebecca Abrams, Hyacinth-John Abu, Ahmed Abu-Arafeh, Syed M Abubacker, Akata Abung, Yousuf Abusamra, Yaa Aceampong, Amaka Achara, Devikumar Acharya, Faustina Acheampong, Prince Acheampong, Sarah Acheampong, Janet Acheson, Shiella Achieng, Andres Acosta, Rebecca Acquah, Catherine Acton, Jacqueline Adabie-Ankrah, Paul Adair, Fiona Adam, Matthew Adam, Huzaifa Adamali, Marta Adamczyk, Carol Adams, Charlotte Adams, Daniel Adams, Kate Adams, Laura Adams, Nikkita Adams, Richard Adams, Tim Adams, Laura Adamu-Ikeme, Krishma Adatia, Kirsty Adcock, Lawrence Addai-Boampong, Afua Addo, Oluwatobi Adeagbo, Ade Adebiyi, Ogunlana Adedeji, Yewande Adegeye, Ken Adegoke, Vicki Adell, Sherna Adenwalla, Femi W Adeoye, Oluwasegun A Adesemoye, Emmanuel O Adewunmi, Adedamola Adeyanju, Joyce Adeyemi, Tenifayo Adeyemo, Binay Adhikari, Shanti A Adhikari, Rina Adhikary, Adhikarla Aditya, Patience Adjepong, Gabrielle Adkins, Adnan Adnan, Marguerite Adriaanse, John Aeron-Thomas, Debbie Affleck, Carmel Afnan, Muhammad Afridi, Patricia Afrim, Felicia Akua Afriyie, Zainab A Aftab, Meenakshi Agarwal, Rachel Agbeko, Chris Agbo, Sunil Aggarwal, Arameh Aghababaie, Laura Aguilar Jimenez, Jacqueline Afrakomah Agyekum, Kwame Agyen, Shafana Ahamed Sadiq, Mohamed H Ahammed Nazeer, Mohammad Ahmad, Syed Ahmad, Afshan Ahmed, Ashar Ahmed, Asim Ahmed, Basheer A R Ahmed, Bilal Ahmed, Forizuddin Ahmed, Hamze Ahmed, Hanad Ahmed, Irshad Ahmed, Khaled Ahmed, Khalil Ahmed, Liban Ahmed, Mahin Ahmed, Maria C Ahmed, Muhammad S Ahmed, Naseer Ahmed, Nausheen Ahmed, Osama Ahmed, Rajia A Ahmed, Rawya Ahmed, Rizwan Ahmed, Saif Ahmed, Sammiya Ahmed, Sana G Ahmed, Syed Ahmed, Syed H Ahmed, Roa Ahmed Ali, Bilal Ahmed Mohamud, Sana Ahmed, Sana Ahmer, Augustine Ahonia, Christine Aiken, Dhiraj Ail, Mark Ainsworth, Myriam Aissa, Lindianne Aitken, Bini Ajay, Abdulakeem Ajibode, Ayesha Ajmi, Nasim Akhtar, Nauman Akhtar, Suha Akili, Bolutito Akinbiyi, Oludoyinsola Akindolie, Yinka Akinfenwa, Olugbenga Akinkugbe, Ibrahim Akinpelu, Mohammad Akram, Olugbenro Aktinade, Uzayr Akudi, Ahmad S A R Al Aaraj, Asma Al Balushi, Majd Al Dakhola, Aladdin Al Swaifi, Eslam Al-Abadi, Adegoke Alabi, Narendra Aladangady, Mohamed Alafifi, Ayaz Alam, Sajid Alam, Abbas Al-Asadi, Kyriaki Alatzoglou, Paul Albert, Albertus Albertus, Lorraine Albon, Angela Alcala, Gemma Alcorn, Stephen Alcorn, Aggie Aldana, David Alderdice, Abdullah Aldesouki, Rayan Aldouri, Jonathan Aldridge, Nicolas Aldridge, Ram Maya Ale, Ana Alegria, Alison Alexander, Courtney Alexander, John Alexander, Peter D G Alexander, Julyan Al-fori, Laith Alghazawi, Osama Alhabsha, Bahij Al-Hakim, Rafil Alhameed, Mohammed Al-Hayali, Shams Al-Hity, Ali Ali, Amanda Ali, Asad Ali, Fawzia R Ali, Jawad Ali, Mariam Ali, Mohamed Ali, Mohammad Ali, Muhammad S Ali, Nayab Ali, Oudai Ali, Ramla Ali, Sakina Ali, Syed Ali, Emilio Aliberti, Jade Alin, Abid Alina, Analyn Alipustain, Bachti Alisjahbana, Fine Aliyuda, Katrin Alizadeh, Maithem Al-Jibury, Saba Al-Juboori, Majid Al-Khalil, Abdullah Alkhudhayri, Moutaz Alkhusheh, Fiona Allan, Nataliya Allan, Alison Allanson, Robert Allcock, Eireann Allen, Jade Allen, Kerry Allen, Louise Allen, Poppy Allen, Rebecca Allen, Sam Allen, Sharon Allen, Simon Allen, Tania Allen, Abiola Alli, Kathryn Allison, Bethan Allman, Helen K Allsop, Lynne Allsop, David Allsup, Amal F T Almahroos, Hassan Al-Moasseb, Magda Al-Obaidi, Lina Alomari, Akram Al-Rabahi, Bahar Al-Ramadhani, Zayneb Al-Saadi, Riyam Al-Sammarraie, Inji Alshaer, Rustam Al-Shahi Salman, Warkaq Al-Shamkhani, Fadia Alsheikh, Bashar Al-Sheklly, Sara Altaf, Amanda Alty, Mary Alvarez, Maria Alvarez Corral, Edward Alveyn, Maysaa Alzetani, Susan Amamou, Noor Amar, Sakkarai Ambalavanan, Robert Ambrogetti, Chris Ambrose, Amir Ameen, Amel Amelia Ganefianty, Katharine Ames, Maria R Amezaga, Allison Amin, Amina Amin, Kanish Amin, Syed Amin, Tara Amin, Badshah Amit, Amjad Amjad, Neelma Amjad, James Amoah-Dankwa, Victoria Amosun, Muhammad Amsal, Khaled Amsha, John Amuasi, Noelia Amutio Martin, Pugh Amy, Ann Anada, Atul Anand, Samantha Anandappa, Satya D Anantapatnaikuni, Ellen Anderson, Julie Anderson, Laura Anderson, Marina Anderson, Michelle 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Heike Arndt, Clare Arnison-Newgass, David Arnold, Rachael Arnold, Andrew Arnott, Dhawal Arora, Kavan Arora, Pardeep Arora, Rishi Arora, Arslam Arter, Armena Arumaithurai, Ayush Arya, Rita Arya, Diptesh Aryal, Denisa Asandei, Adeeba Asghar, Malik Asghar, Arif Ashab, Catherine Ashbrook-Raby, Helen Ashby, Jan Ashcroft, John Ashcroft, Samuel Ashcroft, Georgia Asher, Zakariya Ashfak, Ayesha Ashfaq, Abdul Ashish, Dawn Ashley, Sally Ashman-Flavell, Sundar Ashok, Abd-El-Aziz Ashour, Muhammad Z Ashraf, Saima Ashraf, Mohammad B Ashraq, Deborah Ashton, Susan Ashton, Andrew Ashworth, Fiona J Ashworth, Rebecca Ashworth, Arshia Aslam, I Aslam, Suhail Aslam, Laura Aslett, Harshini Asogan, Atif Asrar, Omar Assaf, Raine Astin-Chamberlain, Deborah Athorne, Billie Atkins, Christopher Atkins, Stacey Atkins, John Atkinson, Vicki Atkinson, Abolaji Atomode, Brygitta Atraskiewicz, Abdul A Attia, Eva Attubato, Marie Attwood, Paula Aubrey, Zoltan Auer, Avinash Aujayeb, Aye Chan Thar Aung, Hnin Aung, Hnin Wint 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Patrick Easton, Ruth Eatough, Oluwadamilola Ebigbola, Martin Ebon, Alison Eccles, Sinan Eccles, Chloe Eddings, Michael Eddleston, Maureen Edgar, Katharine Edgerley, Nicholas Edmond, Mary Edmondson, Tracy Edmunds, Abby Edwards, Alexandra Edwards, Catherine Edwards, Joy Edwards, Kennedy Edwards, Mandy Edwards, Martin Edwards, Sophie Edwards, Jenny Eedle, Aline Eggink, Dawn Egginton, Sam Eggleston, Loveth Ehiorobo, Sarah Eisen, Ugochukwu Ekeowa, Mohamed Ekoi, Ayomide Ekunola, Soha El Behery, Nagla Elashhar, Lisa Elawamy, Mohamed Elbeshy, Kate El-Bouzidi, Jennifer Elder, Mohammed El-Din, Emma Eldridge, Diana Eleanor, Uchenna Elenwa, Ibrahim Eletu, Eman Elfar, Mayy Magdy Elgamal, Amr Elgohary, Mohamed A A Elhadi, Stellios Elia, Jennifer Elias, Tania Elias, Nadia Elkaram, Andrew V Elkins, Julie Ellam, Nikki Ellard, Laura N Ellerton, Lucy Elliot, Amy Elliott, Fiona Elliott, Kerry Elliott, Scott Elliott, Sian Elliott, Annie Ellis, Christine Ellis, Kaytie Ellis, Leila Ellis, Rupert Ellis, Tak-Yan Ellis, Yvette Ellis, Alison C Ellwood, Rahma Elmahdi, Einas Elmahi, Hannah-May Elmasry, Mohammed El-Naggar, Najla Elndari, Omer Elneima, Mohamed Elokl, Ahmed Elradi, Mohamed Elsaadany, Mohammed A S A Elsayed, Sally El-Sayeh, Hana El-Sbahi, Mohammad Elsebaei, Tarek Elsefi, Karim El-Shakankery, Alguili Elsheikh, Hosni El-Taweel, Sarah Elyoussfi, Jonathan Emberey, Jonathan R Emberson, John Emberton, Anna Emery, Julian Emmanuel, Ingrid Emmerson, Michael Emms, Florence Emond, Marieke Emonts, Nicu Enachi, Dickson Enenche, Angila Engden, Katy English, Emma Entwistle, Hene Enyi, Marios Erotocritou, Peter Eskander, Hanif Esmail, Fatheha Essa, Brynach Evans, Chris Evans, Debra Evans, E Evans, Emrys Evans, Gail Evans, Gareth Evans, Isabel Evans, Jack Evans, Jacqueline Evans, Jennifer Evans, John Evans, Jolanta Evans, Lisa Evans, Lynn Evans, Mim Evans, Morgan Evans, Ranoromanana Evans, Sharon Evans, Sian Evans, Teriann Evans, Tomos Evans, Caroline Everden, Serenydd Everden, Lynette Every, Hayley Evison, Lynsey Evison, Chiamaka Ezenduka, Jacqueline Faccenda, Leila Fahel, Youstina Fahmay, Ian Fairbairn, Sara Fairbairn, Terry Fairbairn, Andy Fairclough, Louise Fairlie, Mark Fairweather, Anne Fajardo, Naomi Falcone, Euan Falconer, John Fallon, Andrea Fallow, David Faluyi, Victoria Fancois, Ayaan Farah, Muna Farah, Qayyum Farah, Nowin Z Fard, Leila Fares, Amr Farg, Adam Farmer, Katie Farmer, Toni Farmery, Samantha Farnworth, Faiyaz Farook, Hadia Farooq, Sidrah Farooq, Fiona Farquhar, Holly Farr, Aaron Farrell, Barbara Farrell, Fayed Farrukh, James Farthing, Syeda Farzana, Rahmatu Fasina, Azam Fatemi, Mina Fatemi, Suman Fathima, Nibah Fatimah, Maria Faulkner, Saul N Faust, Clair Favager, Joe Fawke, Sinmidele Fawohunre, Abul Fazal, Aisthath Fazleen, Simon Fearby, Connie Fearnley, Alex Feben, Federico Fedel, Daria Fedorova, Christopher Fegan, Mae Felongo, Lynsey Felton, Tim Felton, Kate Fenlon, Andrea Fenn, Ruth Fennelly, Isabelle Fenner, Ciara Fenton, Melisa Fenton, Gloria 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Flanagan, Charles Flanders, Nikolaos Flaris, Gail Fleming, Julie Fleming, Lucy Fleming, Paul Fleming, William Flesher, Alison Fletcher, Anna Fletcher, Jonathan Fletcher, Lucy Fletcher, Simon Fletcher, Sophie Fletcher, Fiona Flett, Karen Flewitt, Sarah Flockhart, Christopher Flood, Ian Floodgate, Jonathan Flor, Vincent Florence, Mary Flowerdew, Sharon Floyd, Margaret J Flynn, Rachel Flynn, Claire Foden, Adama Fofana, Georgina Fogarty, Paul Foley, Linda Folkes, Tracey Fong, Daniela M Font, Aiwyne Foo, Jane Foo, Andrew Foot, Helen R Foot, Jayne Foot, Jane Forbes, Amber Ford, Jamie Ford, Imogen Fordham, Jennifer Foreman, Matthew Forester, Mohammad Forkan, Caroline Fornolles, Adam Forrest, Ellie Forsey, Miranda Forsey, Thomas Forshall, Elliot Forster, Abigail Forsyth, Julian Forton, Conrad Foster, Emily Foster, Joseph Foster, Rachel A Foster, Tracy Foster, Angela Foulds, Ian Foulds, Folakemi Fowe, Natasha Fowkes, Emily Fowler, Robert Fowler, Stephen Fowler, Amy Fox, Claire Fox, Heather Fox, Jonathan Fox, Laura Fox, Lauren Fox, Natalie Fox, Olivia Fox, Simon Fox, Sarah-Jane Foxton, Eva Fraile, Rebecca Frake, Alex Francioni, Olesya Francis, Rebecca Francis, Sarah Francis, Theodora Francis-Bacon, Helen Frankland, Jessica Franklin, Siobhan Franklin, Catherine Fraser, Andi Fratila, Sharon Frayling, Martyn Fredlund, Anna Freeman, Carol Freeman, Elaine Freeman, Hannah Freeman, Nicola Freeman, Clare Freer, Eleanor French, Thomas French, Karen Freshwater, Matthew Frise, Renate Fromson, Adam Frosh, John Frost, Victoria Frost, Oliver Froud, Rachel Frowd, Arun Fryatt, Andrzej Frygier, Bridget Fuller, Liz Fuller, Lucy Fuller, Tracy Fuller, Duncan Fullerton, Carrie Fung, Gayle Fung, Sarah Funnell, John Furness, Andrew Fyfe, Nytianandan G, Elizabeth Gabbitas, Claire Gabriel, Zoë Gabriel, Hadiza Gachi, Sophie Gaffarena, Sarah Gage, Joshua Gahir, Sarveen Gajebasia, Katarzyna Gajewska-Knapik, Babita Gajmer, Zacharoula Galani, Christopher Gale, Hugo Gale, Linda Gale, Rebecca Gale, Swetha Gali, Bernadette Gallagher, Jude Gallagher, Rosie Gallagher, William Gallagher, Feroze Gallam, Joanne Galliford, Catherine Galloway, Chris Galloway, Emma Galloway, Jacqui Galloway, James Galloway, Anna Galvin, Victoria Galvis, Gareth Gamble, Laura Gamble, Liz Gamble, Brian Gammon, Chien N Gan, Muhammad B Ganaie, Jaikumar Ganapathi, Ramesh Ganapathy, Kaminiben Gandhi, Sarah Gandhi, Usha Ganesh, Thenugan Ganeshanathan, Saibal Ganguly, Abrar Gani, Pauline Ganley, Ukraina Garcia, Emma-James Garden, Antoni D Gardener, Emma Gardiner, Michael Gardiner, Phil Gardiner, Siobhan Gardiner, Caroline Gardiner-Hill, Jonathan Gardner, Louis Gardner, Mark Garfield, Atul Garg, Isha Garg, Nathan Garlick, Daniel Garner, Justin Garner, Lucie Garner, Zoe Garner, Rosaline Garr, Kathryn A Garrero, Manisha Gartaula, Florence Garty, Rachel Gascoyne, Hyeriju Gashau, Aoife Gatenby, Erin Gaughan, Alok Gaurav, Mariana Gavrila, Jane Gaylard, Sophie Gayle, Catherine Geddie, Ian Gedge, Sarah Gee, Fartuun Geele, Kalaichelvi Geerthan, Minnie Gellamucho, Karzan Gelly, Leila Gelmon, Sandra Gelves-Zapata, Gemma Genato, Neal Gent, Susan Gent, Natalie Geoghegan, Aparna George, Bini George, Sam George, Susan George, Tina George, Valerie P George, Simon Georges, Domonique Georgiou, Peter Gerard, Leigh Gerdes, Louise Germain, Helen Gerrish, Abel Getachew, Louise Gethin, Siobhan Gettings, Hisham Ghanayem, Bijan Ghavami Kia, Shaista Ghazal, Anca Gherman, Alison Ghosh, Dipansu Ghosh, Justin Ghosh, Subhamay Ghosh, Sarra Giannopoulou, Malick Gibani, Chris Gibb, Ben Gibbison, Kerry Gibbons, Alex Gibson, Bethan Gibson, Jamie Gibson, Kimberley Gibson, Kirsty Gibson, Sian Gibson, Mary Gigi, Cat Gilbert, Jeanette Gilbert, Kayleigh Gilbert, Benjamin Giles, James Gilham, Mandy Gill, Lynne Gill, Paul Gillen, Annelies Gillesen, Katherine Gillespie, Elizabeth Gillham, Andrew Gillian, Deborah Gilliland, Robert Gillott, Danielle Gilmour, Kate Gilmour, Lesley Gilmour, Louis Ginn, Franciscus Ginting, Theodora Giokanini-Royal, Anna Gipson, Barbie Giri, Joanna Girling, Rhian Gisby, Angelena Gkioni, Aikaterini Gkoritsa, Effrossyni Gkrania-Klotsas, Amy Gladwell, James Glanville, Jessica Glasgow, Susannah Glasgow, Jon Glass, Lynn Glass, Sharon Glaysher, Lisa Gledhill, Eleanor Glenday, Ana Glennon, Jodie Glossop, John Glover, Kyle Glover, Michelle Glover, Jan Glover Bengtsson, Deborah Glowski, Sharon Glynn, Chevanthy Gnanalingam, Julie Goddard, Wendy Goddard, Emily Godden, Jo Godden, Sarah Godlee, Emma Godson, Gillian Godwin, Sukanya Gogoi, Aiky Goh, Manjinder Gohel, Rebeca Goiriz, Sriya Gokaraju, Raphael Goldacre, Arthur Goldsmith, Portia Goldsmith, Darren Gomersall, Lucia Gomez, Raquel Gomez-Marcos, Ali Gondal, Celia Gonzalez, Jack Goodall, Vicky Goodall, Bob Goodenough, Anna Goodfellow, Laura Goodfellow, James Goodlife, Camelia Goodwin, Elizabeth Goodwin, Jayne Goodwin, Paula Goodyear, Rajiv Gooentilleke, Michelle Goonasekara, Sheila Gooseman, Shameer Gopal, Chris Gordon, Sally Gordon, Robin 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Christopher A Green, David Green, Frederick Green, Joel Green, Marie Green, Nicola Green, Stacey Green, Diarra Greene, Philippa Greenfield, Alan Greenhalgh, Daniel Greenwood, Sandra Greer, James Gregory, Jane Gregory, Katie Gregory, Tamsin Gregory, Jill Greig, Julia Greig, Rebecca Grenfell, Teena Grenier, Jack Grenville, Jo Gresty, Susan Grevatt, Glaxy Grey, Samuel Gribben, Andrew Gribbin, Amy Gribble, Natasha Grieg, Douglas Grieve, Ben Griffin, Denise Griffin, Mel Griffin, Sian Griffith, Andrew Griffiths, Daniel Griffiths, David Griffiths, Donna Griffiths, Isabel Griffiths, Mark Griffiths, Nicola Griffiths, Oliver Griffiths, Sandra Griffiths, Sarah Griffiths, Scott Griffiths, Yvonne Griffiths, Sofia Grigoriadou, Steph Grigsby, Paul Grist, Evelina Grobovaite, Dorothy Grogono, Clarissa Grondin, Rachel Groome, Pauline Grose, Liliana Grosu, Jenny Grounds, Margaret Grout, Helen Grover, Jayne Groves, Neil Grubb, Julie Grundy, Francesca Guarino, Sharada Gudur, Jacinta Guerin, Sharazeq 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Hale, Jennie Hale, Carmel Halevy, Paul Halford, William Halford, Alaina Halim, Alistair Hall, Anthony Hall, Claire Hall, Elizabeth Hall, Fiona Hall, Helen Hall, Jennifer Hall, Kathryn Hall, Laura Hall, Jan Hallas, Kyle Hallas, Charles Hallett, Jackie Halliday, Akmal Hallman, Heather Halls, Maryam Hamdollah-Zadeh, Ifedadepo A Hamed-Adekale, Bilal Hameed, Mohammed Hameed, Raph L Hamers, Imran Hamid, Mohamad Hamie, Raymond Hamill, Bethany Hamilton, Fergus Hamilton, Gus Hamilton, Leigh Hamilton, Melanie Hamilton, Nicola Hamilton, Sara Hamilton, Ruth Hamlin, Eleanor Hamlyn, Beatrice Hammans, Shirley Hammersley, Kate Hammerton, Bev Hammond, Emily Hammond, Leah Hammond, Sally Hammond, Fiona Hammonds, Ibrahim Hamoodi, Karen Hampshire, James A Hampson, Jude Hampson, Lucy Hampson, Lisa Hamzah, Jenny Han, Ozan Hanci, Sadiyah Hand, Lala Handayani, Jasmine Handford, Soran Handrean, Nina K Handzewniak, Sarah Haney, Vu Thi Kim Hang, Sheharyar Hanif, E Hanison, Esther Hanison, Jennifer Hannah, Amy Hannington, Merhej Hannun, Aidan Hanrath, Helena Hanratty, Daniel Hansen, Anita Hanson, Ashley Hanson, Helen Hanson, Jane Hanson, Kathryn Hanson, Steve Hanson, Ala Haqiqi, Monjurul Haque, Henry Harcourt, Lesley Harden, Zoe Harding, Simon Hardman, Marc Hardwick, Gareth Hardy, Joanna Hardy, Yasmine Hardy, Kumar Haresh, Rachel Harford, Beverley Hargadon, James Hargraves, Carolyn Hargreaves, Alice Harin, Mohammed Haris, Edward Harlock, Paula Harman, Tracy Harman, Mark Harmer, Muhammad A Haroon, Charlie Harper, Heather Harper, James Harper, Peter Harper, Rosemary Harper, Sarah Harrhy, Kate Harrington, Sian Harrington, Yasmin Harrington-Davies, Jade Harris, Jess Harris, John Harris, Laura Harris, Marie-Clare Harris, Nichola Harris, Sophie Harris, David Harrison, Laura Harrison, Melanie Harrison, Olakunbi A Harrison, Rachael Harrison, Rowan Harrison, Susie Harrison, Thomas Harrison, Wendy Harrison, Elizabeth Harrod, Ciaran Hart, Dominic Hart, Jessica Hartley, Lisa Hartley, Rosemary Hartley, Ruth Hartley, Tom Hartley, William Hartrey, Phillipa Hartridge, Stuart Hartshorn, Alice Harvey, Angela Harvey, Anna Harvey, Max Harvey, Catherine Harwood, Helen Harwood, Zoe Harzeli, Brigitte Haselden, Kazi Hashem, Mohammed Hashimm, Tadaaki Hashimoto, Imranullah Hashmi, Jack Haslam, Zena Haslam, Grace Hasnip, Adil Hassan, Ali Hassan, Amro Hassan, Awab Hassan, Zeinab Hassan, Sapna Hassasing, Jane Hassell, Philip Hassell, Alex Hastings, Bethany Hastings, Janice Hastings, Sarah Hathaway-Lees, Jonathan Hatton, Jennifer Hau, May Havinden-Williams, Stefan Havlik, Daniel B Hawcutt, Kadean Hawes, Liz Hawes, Nicola Hawes, Lydia Hawker, Annie Hawkins, Joe Hawkins, Nancy Hawkins, W John Hawkins, Dan Hawley, Ed Hawley-Jones, Edward Haworth, Alasdair W Hay, Cathy Hay, Amna Hayat, Jamal Hayat, Mohamed-Riyal Hayathu, Anne Hayes, Jonas Hayes, Kate Hayes, Melony Hayes, Fiona Hayes, Patrick Hayle, Chloe Haylett, Antara Hayman, Melanie Hayman, Matthew Haynes, Richard Haynes, Rachel Hayre, Carole Hays, Sarah Haysom, James Hayward, Patrick Haywood, Hazel Haywood Hasford, Tracy Hazelton, Phoebe Hazenberg, Zhengmai He, Elizabeth Headon, Carrie Heal, Brendan Healy, Jessica L Healy, Amy Hearn, David Heasman, Angela Heath, Debbie Heath, Rowan Heath, Diane Heaton, Adam Heavens, Kerry Hebbron, Catherine Heckman, Gemma Hector, Sadie Heddon, Andy Hedges, Katrine Hedges, Cheryl Heeley, Elaine Heeney, Richard Heinink, Rajdeep Heire, Ingvild Helgesen, Joanne Hemingway, Ulla Hemmila, Beth Hemmings, Scott Hemphill, Deborah Hemsley, Abigail Henderson, Eilidh Henderson, Jennifer Henderson, Steven Henderson, Joanne Henry, Karol Henry, Lavinia Henry, Margo Henry, Natalie Henry, David Henshall, Gillian Herdman, Rosaleen Herdman-Grant, Morag Herkes, Lucas E Hermans, Fe Marie Hernandez, Emma Heron, Lisa Heron, William Herrington, Emilia Heselden, Peta Heslop, Tracey Heslop, Simon Hester, Emily Hetherington, Joseph Hetherington, Chamila Hettiarachchi, Pramodh Hettiarachchi, Hayley Hewer, John Hewertson, Anna Hewetson, Sue Hewins, Nicola Hewitson, Claire Hewitt, Davina Hewitt, Richard Hewitt, Samuel Hey, Robert S Heyderman, Mathis Heydtmann, Joseph Heys, Jonathan Heywood, Meg Hibbert, John Hickey, Naomi Hickey, Peter Hickey, Nicky Hickman, Alex Hicks, Jenny Hicks, Scott R Hicks, Phan Thi Thu Hien, Daniel Higbee, Lucy Higgins, Andrew Higham, Martin Highcock, Judith Highgate, Mondy Hikmat, Amanda Hill, Helen Hill, Joanne Hill, Lisa Hill, Lucy Hill, Phoebe Hill, Uta Hill, Annette Hilldrith, Catherine Hillman-Cooper, Jon Hilton, Zoe Hilton, Sarah Hinch, Andrew Hindle, Esther Hindley, Alice Hindmarsh, Paul Hine, Kim Hinshaw, Clare Hird, Claire Hirst, Lindsay Hirst, Jemma Hives, Htet M Hlaing, Benson Ho, David K K Ho, Rosemary Ho, Michaela Hoare, David Hobden, Gill Hobden, Maria Hobrok, Simon Hobson, Christopher Hodge, Simon Hodge, Lesley Hodgen, George Hodgetts, Holly Hodgkins, Sally Hodgkinson, David Hodgson, Helen Hodgson, Luke Hodgson, Sheila Hodgson, Gemma Hodkinson, Kenneth Hodson, Mike Hodson, Alison Hogan, Matthew Hogben, Lucy Hogg, Lee Hoggett, Abigail Holborow, Catherine Holbrook, Rebecca Holbrook, Catherine Holden, Jill Holden, Melinda Holden, Sophie Holden, Thomas Holder, Niels Holdhof, Hannah Holdsworth, Lisa Holland, Maureen Holland, Nicky Holland, Poppy Holland, Susan Holland, Marie L Hollands, Elizabeth Holliday, Kyra Holliday, Mark Holliday, Nina Holling, Laszlo Hollos, Nora Hollos, Leah Holloway, Simon Holloway, Max Hollowday, Marcus Hollyer, Amy Holman, Ann Holmes, Megan Holmes, Raphael Holmes, Rebecca Holmes, Kelly Holroyd, Beth Holroyd-Hind, Lyndsey Holt, Siobhan Holt, Susie Holt, Alexandra Holyome, Marie Home, Renate Homewood, Kate Hong, Louise Hoole, Clare Hooper, Samantha Hope, Susan Hope, Bridget Hopkins, Peter W Horby, Stephanie Horler, Anil Hormis, Daniel Hornan, Nicola Hornby, Thomas Horne, Zoey Horne, Rebecca Horner, Caroline Horrobin, Latoya Horsford, Megan Horsford, Mark Horsford, Valana Horsham, Alexander Horsley, Ashley Horsley, Elizabeth Horsley, Sarah Horton, Jane Hosea, Toby Hoskins, Muhammad S Hossain, Rashed Hossain, Maxine Hough, Sarah Hough, Catherine Houghton, Kathryn Houghton, Rebecca Houlihan, Kay Housely, Hamish Houston, Roseanna Hovvels, Lee How, Laura Howaniec, Joanne Howard, Kate Howard, Laura Howard, Linda Howard, Lucy Howard, Megan Howard, Sarah Howard, Stuart Howard, Richard Howard-Griffin, Louise Howard-Sandy, Serena Howe, Alice Howell, Mark Howells, Lyn Howie, Kerry Howlett, Sophie Howlett, Ruth Howman, Josh Hrycaiczuk, Hein Htet, Naing Z Htoon, Su Htwe, Ying Hu, Chiang O H Huah, Sylvia Huang, Kelly Hubbard, Abby Huckle, Shahzya Huda, Alison Hudak, Lisa Hudig, Heather Hudson, Suzanne Hudson, Oli Hudson, Alison Hufton, Connor Huggins, Alistair Hughes, Caitlin Hughes, Emma Hughes, Gareth Hughes, Heather Hughes, Luke Hughes, Martin Hughes, Rachel Hughes, Rebecca Hughes, Samantha Hughes, Stephen Hughes, Vikki Hughes, Wesley Hughes, Lukas Huhn, Ching Hui, Ruth Hulbert, Diana Hull, Grace Hull, Robert Hull, Amanda Hulme, Peter Hulme, Wendy Hulse, George Hulston, Ryan Hum, Megan Hume, Charlotte Humphrey, Alasdair Humphries, Amy Humphries, Joanne Humphries, Charlotte Hunt, Fiona Hunt, Jane Hunt, Jonquil Hunt, Kristen Hunt, Luke Hunt, Molly Hunt, Sophie Hunt, Alexandra Hunter, Catherine Hunter, Ewan Hunter, Karl Hunter, Neil Hunter, Ross Hunter, Sophie Hunter, George Huntington, Fuad Huq, Elizabeth Hurditch, Judith Hurdman, Cian Hurley, Katrina Hurley, Mohammed A Husain, Syeda Y Husaini, Coralie Huson, Afreen Hussain, Chreif Hussain, Ibraar Hussain, Ifza Hussain, Mohammad Hussain, Mohammed Hussain, Muhammad Hussain, Reda Hussain, Rizwana Hussain, Samia Hussain, Sanniah Hussain, Yasmin Hussain, Mohammed Hussam El-Din, Samahir F E M Hussein, Ziad Hussein, Rebecca Hussey, Adiel Haqiq Hussien, Anja Hutchinson, Camille Hutchinson, Dorothy Hutchinson, Elizabeth Hutchinson, John Hutchinson, Claire Hutsby, Paula Hutton, Nguyen Quang Huy, Thuong Huyen, Tran Bang Huyen, Nguyen Thi Huyen Thuong, Hieu Huynh, Daniella Hydes, Jamie Hyde-Wyatt, Niamh Hynes, Megan Hyslop, Angeliki Iakovou, Katherine Ibison, Mazen Ibraheim, Abdalla Ibrahim, Ahmed Ibrahim, Asil Ibrahim, Javed Ibrahim, Mamoun Ibrahim, Mohamed Ibrahim, Wadah Ibrahim, Becky Icke, Adetokunbo Idowu Idowu, Muhammad Idrees, Nauman Idrees, Hina Iftikhar, Mawara Iftikhar, Chukwuemeka Igwe, Ogechukwu Igwe, Mohammad Ijaz, Amaju Ikomi, Clare Iles, Stamatina Iliodromiti, Mary Ilsley, Lorna Ilves, Fatima Mariam Ilyas, La'ali Imam-Gutierrez, Mohamed Iman, Christopher Imray, Haider Imtiaz, Jack Ingham, Jo Ingham, Julie Ingham, Rory Ingham, Tejas Ingle, Jennifer Inglis, Samantha Inglis-Hawkes, Anne Ingram, Luke Ingram, Tanya Ingram, Nicholas Innes, Peter Inns, Vithusha Inpadhas, Ken Inweregbu, Andreea A Ionescu, Ana Ionita, Ilian Petkov Iordanov, Anil Ipe, Javaid Iqbal, Madiha Iqbal, Mishal Iqbal, Mohammed Iqbal, Faisal Iqbal Sait, Iziegbe Irabor, Jane Ireland, Jamie Irisari, Robert Irons, Mohannad Irshad, Muhammad S Irshad, Janice Irvine, Val Irvine, Robert Irving, Mina Ishak, Erica Isherwood, George Isitt, Aminul Islam, MD Tariqul Islam, Samsul Islam, Abdurrahman Islim, Ali Ismail, Omar Ismail, Caroline Ison, M'hamedi Israa, Sharon Isralls, Herny Istiqomah, Monica Ivan, Chineze Ivenso, Nicholas Ivin, Ashleigh Ivy, Sophie Iwanikiw, Karen Ixer, Menaka Iyer, Mia Iyer, Kashif Jabbar, Calum Jack, Joanne Jackman, Sophie Jackman, Amanda Jackson, Ben Jackson, Beth Jackson, Ella Jackson, Helen Jackson, Lauren Jackson, Melanie Jackson, Nicola Jackson, Shane Jackson, Yvonne Jackson, John Jacob, Patricia Jacob, Reni Jacob, Nicola Jacques, Anisa Jafar, Daniel Jafferji, Ali Jaffery, Chandrashekar Jagadish, Vijay Jagannathan, Abubacarr Jagne, Mandeep Jagpal, Neemisha Jain, Seema Jain, Susan Jain, Swati Jain, Sanjay Jaiswal, Danyal Jajbhay, Thomas Jaki, Bintou Jallow, Yusuf Jaly, Rose Jama, Ashraf Jamal, Sabine Jamal, Zeba Jamal, Yasmin Jameel, Albie James, Christie James, Claire James, Kate James, Lee James, Linda James, Lorraine James, Mark James, Monica James, Nicholas James, Olivia James, Patricia James, Rebecca James, Ruth James, Sharon James, Somerset James, Tracy James, Jack Jameson, Louise Jamieson, Aaron Jamison, Phoebe Jane, Karen Janes, Azara Janmohamed, Deepa Japp, Peter Jaques, Victor Jardim, Catherine Jardine, Claire Jarman, Emma Jarnell, Ellie Jarvie, Claire Jarvis, Rosina Jarvis, Patrycja Jastrzebska, Hafsa Javed, Aristotle Javier, Mays Jawad, Lona Jawaheer, Anu Jayachandran, D Jayachandran, Anita Jayadev, Angelina Jayakumar, Deepak Jayaram, Ravi Jayaram, Geeshath Jayasekera, Thilina Jayatilleke, Abi Jayebalan, Jane Jeater, Saman Jeddi, Vandana Jeebun, Mohammad S Jeelani, Katie Jeffery, Helen Jeffrey, Rachel Jeffrey, Nathan Jeffreys, Benjamin Jeffs, Carol Jeffs, Jegan P Jeganathan Ponraj, Debbie Jegede, Taylor Jemima, Ifan Jenkin, Alison Jenkins, Christopher Jenkins, David Jenkins, Elinor Jenkins, Ian Jenkins, Paula Jenkins, Sarah Jenkins, Sian Jenkins, Stephen Jenkins, Felicia Jennings, Jacqui Jennings, Louise Jennings, Virginia Jennings, Ellen Jerome, Douglas Jerry, Greame Jervis, Ellen Jessup-Dunton, Jorge A Jesus Silva, Champa Jetha, Kishan Jethwa, Roshan Kumar Jha, Shaman Jhanji, Khoo Jian, Zhixin Jiao, Laura Jimenez, Ana Jimenez Gil, Jithin Jith, Teishel Joefield, Navraj Johal, Simran Johal, Karine Johannessen, Aisyah Johari, Annie John, Anu John, Maya John, Navin John, Emma Johns, Margaret Johns, Antoinette Johnson, Emma Johnson, Gillian Johnson, Kathryn Johnson, Katie Johnson, Luke Johnson, Mark Johnson, Nelsonseelan Johnson, Oliver Johnson, Rachel Johnson, Brogan Johnston, Claire Johnston, Janet Johnston, Susan Johnston, Victoria Johnston, Dawn Johnstone, Ed Johnstone, Janet Johnstone, Manohar Joishy, Adam Jones, Alistair Jones, Amy Jones, Angela Jones, Annabel Jones, Ben Jones, Bryony Jones, Carys Jones, Ceri Jones, Charlotte Jones, Christine E Jones, Debra Jones, Emily Jones, Gareth Jones, Geraldine Jones, Jac Jones, James Jones, Jonathon Jones, Julie Jones, Kate E Jones, Kimberly Jones, Laura Jones, Laura M Jones, Louise Jones, Mathew Jones, Nancy Jones, Nicola Jones, Olivia Jones, Paul Jones, Philip H Jones, Rhianna Jones, Ruth E Jones, Samantha Jones, Sophie Jones, Stefanie Jones, Steve Jones, Susan Jones, Taya Jones, Thomas Jones, Tim Jones, Tracey Jones, Ramya Jonnalagadda, Rebecca Jordache, Michele Jordan, Sarah Jordan, Abi Jose, Litty Jose, Louise Jose, Sanal Jose, Anna Joseph, Gigee Joseph, P Aiden Joseph, Rosane Joseph, Sibet Joseph, Dhaara Joshi, Mehul Joshi, Pratichi Joshi, Tushar Joshi, Benz Josiah, Lijo Joy, Tiffany Joyce, Hong Ju, Adriel Ju Wen Kwek, Andrew Judd, Edward Jude, Parminder Judge, Jessica Juhl, Sirisha Jujjavarapu, Mark Juniper, Edmund Juszczak, Deepthi Jyothish, Kasamu Kabiru Dawa, Mark Kacar, Nikhil Kadam, Nicole Kader, Ajai Kailey, Matthew Kain, Gail Kakoullis, Azad Kala Bhushan, Richard J K Kalayi, Roobala Kaliannan Periyasami, Efthymia Kallistrou, Thomas Kalmus Eliasz, Seika Kalsoom, Elisa Kam, John Kamara, Ajay Kamath, Prakash Kamath, Ravindra Kamath, Siddharth A Kamerkar, Nick Kametas, Musaiwale Kamfose, Charlotte Kamundi, Dharmesh Kanabar, Leia Kane, Osei Kankam, Thogulava Kannan, Abhinav Kant, Vikas Kapil, Ritoo Kapoor, Sonal Kapoor, S Kaprapina, Sourjya Kar, Janaka Kara, Elshad Karbasi, Shivaali Karelia, Rona Kark, Abhilasha Karkey, Aruna Karki, Soheilali Karmali, Viji Karunanithi, Nicholas Karunaratne, Natashja Kasianczuk, Anbhu Kasiappan Balasubramanian, Vidya Kasipandian, Rizwan Kassam, Janarth Kathirgamachelvam, Mpumelelo Kati, Victoria Katsande, Kulbinder Kaul, Daljit Kaur, Dervinder Kaur, Jasmin Kaur, Jaspreet Kaur, Simran Kaur, Zunaira Kausar, Lisa Kavanagh, susan Kavanagh, Mohammad A Al Kawser, Andrea Kay, Julie Kay, Robert Kay, Sarah Kay, Jossy N Kayappurathu, Srijana Kayastha, Callum Kaye, Ahemd Kazeem, Pooja KC, Min Ke, Timothy Keady, Rachel Kearns, Nichola Kearsley, Joanne Keating, John Keating, Liza Keating, Elizabeth Keddie-Gray, Breffni Keegan, Rachel 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Malik A Khan, Marria Khan, Mehrunnisha Khan, Mohammad Khan, Myra Khan, Nayeem Khan, Nuzhath Khan, Omar Khan, Rabia Khan, Rahila Khan, Shabana Khan, Shahul Khan, Shoaib Khan, Tasaduksultan Khan, Waleed Khan, Waseem Khan, Zuhair Khan, Mohammad S Khan Tharin, Usman F Khatana, Januka Khatri, Jibran Khatri, Jyoti Khatri, Hafiza Khatun, Taslima Khatun, Mena Kheia, Jacyntha Khera, Htet Htet Ei Khin, Najaf Khoja, Kiran Khokhar, Minh Quang Khong, Joshua Khoo, Chloe Khurana, Joyce Kibaru, Faith Kibutu, Andrew Kidd, Michelle Kidd, Joe Kidney, Shane Kidney, Will Kieffer, James Kilbane, Caroline Kilby, Eileen Killen, Beverley Kilner, Susan Kilroy, Bomee Kim, Jee W Kim, Minhee Kim, Aly Kimber, Sarah Kimber, Andy King, Barbara King, Hayley King, Jennifer King, Jenny King, Kirsten King, Matthew King, Rachel King, Sarah King, Victoria King, Emily King-Oakley, Laura Kingsmore, Deborah J Kinnear, Fiona Kinney, Sidra Kiran, Alison Kirby, Adam Kirk, Jeremy Kirk, Jill Kirk, Jodie Kirk, Amy Kirkby, Emily 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Raghu Krishnamurthy, Vinodh Krishnamurthy, Manju Krishnan, Hari Krishnan, Nagaratna Krishnapalli, Suzanne Krizak, Stephen Krueper, Sean Krupej, James Krzowski, Ria Kubaisi, Agnieszka Kubisz-Pudelko, Shavita Kuckreja, Soren Kudsk-Iversen, Aurimas Kudzinskas, Chirag Kukadiya, Nainesha Kulkarni, Susantika Kumala Dewi, Marian Kuma-Mintah, Aditi Kumar, Ayesha Kumar, Mayur Kumar, Ramesh Kumar, Ravi Kumar, Rita Kumar, Rupa Kumar, Satish Kumar, Vikas Kumar, Vimal Kumar, Arun Kundu, Heinke Kunst, Shaibya Singh Kunwar, Klaudia Kupiec, Amit Kurani, Mohammed Kurdy, Kevin Kuriakose, Rincy Kurian, Vimal Kurmars, Cameron Kuronen-Stewart, Ranganai S Kusangaya, Vlad Kushakovsky, Anna Kutera, Apexa Kuverji, Amma Kyei-Mensah, Henriette Kyepa, Thyra Kyere-Diabour, Moe Kyi, Nyan M Kyi, Laura Kyle, Karali-Tsilimpari Kyriaki, Julius Labao, Louise Lacey, Nikki Lack, Maria Lacson, Zahra Ladan, Emma Ladlow, Heather Lafferty, Alice Lagnado, Shondipon Laha, Sushil Lahane, Clement Lai, James Lai, Paula Laidler, Robert Laing, Inez Laing-Faiers, Emily Laity, Katharine Lake, Nicki Lakeman, David Lalloo, Fiona Lalloo, Alison Lam, Classy Lam, Fiona Lamb, Lucy Lamb, Thomas Lamb, Oscar Lambert, Pauline Lambert, Claudia Lameirinhas, Mohammed K G Lami, Holly Lamont, Michal Lamparski, Djillali Lamrani, Christine Lanaghan, Ivone Lancona-Malcolm, Geraldine Landers, Martin J Landray, Matthew Lane, Nicholas Lane, Alidih Lang, Stephen Lang, Daniel Langer, Margaret Langley, Charles Langoya, Emma Langridge, Emily Langthorne, Helen Langton, Beatriz Lara, Taiya Large, Lawrencia Naadu Lartey, Samuel Lassa, Anna Last, Scott Latham, Victoria Latham, Afzal Latheef, Larissa Latif, Nang Latt, Carmen Lau, Dawn Lau, Eva Lau, Gonzalez G Laura, Myra Laurenson, Eloise Lavington, Hou Law, Jessica Law, June Law, Kar Y Law, Penny Law, Richard Law, Laura Lawless, Chris Lawrence, Emma Lawrence, Geoffrey Lawrence, Holly M Lawrence, Neil Lawrence, Ryan Lawrie, Louise Lawson, Natalie Lawson, Rod Lawson, Michael Lay, Stephen Laybourne, Christine Laycock, Reina Layug, Maria Lazo, Thi Thao Le, Vietland Le, Amelia Lea, William Lea, Louisa E Leach, Ian Leadbitter, Thomas Leahy, Richard Lean, Lorna Leandro, Darren Leaning, Ruth Leary, Sandra Leason, Marie A Ledingham, Caroline Lee, Emma Lee, Hannah Lee, Irish Lee, Joshua Lee, Judith Lee, Sam Lee, Shannon Lee, Shi Han Lee, Simon Lee, Sindy Lee, Stephanie Lee, Tracey Lee, Xiang Lee, Robyn Lee, Diana Lees, Jennifer Lees, Helen Legge, Julian Leggett, Katie Leigh-Ellis, David Leitch, Nicky Leitch, Eleni Lekoudis, Petula Lemessy, Nicholas Lemoine, Rebecca Lenagh, Katy Leng, Katrina Lennon, Liz Lennon, Beth Leonard, Kelly Leonard, Wen Leong, Nicky Leopold, Oskar Lepiarczyk, Isla Leslie, Eva Noviani Lestari, Eleni Lester, Emma Levell, Chris Levett, Anastasia Levynska, Alice Lewin, Alison Lewis, Christopher Lewis, David Lewis, Dee Lewis, Heather Lewis, Joanne Lewis, Joseph Lewis, Kathryn Lewis, Keir Lewis, Leon Lewis, Mandy Lewis, Marissa Lewis, Nicolas Lewis, Robert 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Steven Marshall, Jennifer Marshall, Emmeline Martin, Gaynor Martin, Hayley Martin, Hope Martin, Jane Martin, Karen Martin, Kate Martin, Laila Martin, Martha Martin, Michael Martin, Noelia Martin, Tim Martin, Winston Martin, Sarah Martin, Tim Martindale, Marcus Martineau, Lauren Martinez, Jose C Martinez Garrido, Juan Martin-Lazaro, Vijay K Maruthamuthu, Bukhari Marwan, Gemma Maryan, Roman Mary-Genetu, Sam Maryosh, Vidan Masani, Allison Mascagni, Diego Maseda, Zandile Maseko, Sheila Mashate, Yasaman Mashhoudi, Al Mashta, Izhaq Masih, Sanna Masih, Nicholas Maskell, Perry Maskell, Prabina Maskey, Matthew Masoli, Julia Mason, Rebecca Mason, Richard Mason, Ruth Mason, Claire Mason, Mohammad Masood, Mohammad T Masood, Syed S M E Masood, Thalia Massa, Ian Massey, Joseph Masters, Aaqib Masud, Lear Matapure, Cristina Matei, Ropafadzo Matewe, Esther Matey, Manraj Matharu, Stephy Mathen, Alex Mather, Nicole Mather, Jonathan Mathers, Joanna Matheson, Amal Mathew, Anna Mathew, Bijoy Mathew, Moncy 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McFlynn, Erin McGarry, Lorcan McGarvey, Alex McGeachan, Frederick McGee, Laura McGenily, Clodagh McGettigan, Michael McGettrick, Christopher McGhee, Fiona McGill, Sarah McGinnity, Neil McGlinchey, Phil McGlone, Deborah McGlynn, Claire McGoldrick, Clare McGoldrick, Elizabeth McGough, Christopher McGovern, Roisin McGovern, Angela McGowan, Anne McGown, Brendan McGrath, Amanda McGregor, Annemarie McGregor, Michael P McGuigan, Heather McGuinness, Sean McGuire, Tara McHugh, Caroline McInnes, Neil McInnes, Jerome McIntosh, Karen McIntyre, Mhairi McIntyre, Lorna McKay, Conor P McKeag, Jacqueline McKeane, Madeleine McKee, Joseph McKeever, Judith McKenna, Shirley McKenna, Mary McKenzie, Donogh McKeogh, Caroline McKerr, Anthony M McKie, Hayley Mckie, Laura Mckie, Gerard McKnight, Heather McLachlan, Andrew McLaren, Barbara McLaren, Nicola McLarty, Danielle Mclaughlan, Maria McLaughlin, James McLay, Mary McLeish, Tina McLennan, Stewart McLure, Anne Marie McMahon, Genevieve McMahon, Mike McMahon, 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G Pratiwi, Anezka Pratley, Steven Pratt, Chrisan Bimo Prayuda, David Preiss, Claire Prendergast, Lynn Prentice, Peter Prentice, Verity Prescott, Laura Presland, Catharine Prest, Stephen Preston, Martha Pretorius, Natalie Prevatt, Sandra Prew, Ashley Price, Carly Price, Claire Price, David Price, Elizabeth Price, Katie Price, Laura J Price, Nathan Price, Vivien Price, Rachael Price-Eland, Anne Priest, Jimena Prieto, Lorraine Primrose, Clare Prince, John Prince, Judith Prince, Laura Prince, Shirley Pringle, Melissa Prior-Ong, Veronika Pristopan, Kelly Pritchard, Lucy Pritchard, Simon Pritchard, Verma Priyash, Andrew Procter, Clare Proctor, Mike Protopapas, Rebecca Proudfoot, Benjamin Prudon, David Pryor, Solomon Pudi, Angela Puffett, Joanne Pugh, Lawrence Pugh, Mark T Pugh, Nichola Pugh, Richard Pugh, Veronika Puisa, Eni Puji Lestari, Safa Puliyakkadi, Jennifer Pullen, Kirandip Punia, Saleel Punnilath Abdulsamad, Laura Purandare, Daniel Purchase, Corrina Purdue, Rachel Purdy, Bally Purewal, Rebecca Purnell, Molly Pursell, Gregory Purssord, Rory Purves, Sarah Purvis, Khairunnisa Puspatriani, Daniel Putensen, Bhamini Puvaneswaran, Alex Puxty, Kathryn Puxty, Zoe Puyrigaud, Eleanor Pyart, Emily Pye, Michael Pynn, Tariq Qadeer, Mohammad Qayum, Corrine Quah, Sheena Quaid, Nathaniel Quail, Charlotte Quamina, Nguyen Ngo Quang, Georgia Quartermaine, Tara Quasim, Alice Quayle, Eleanor Quek, Siobhan Quenby, Xinyi Qui, Vanessa Quick, Julie Quigley, Juan-Carlos Quijano-Campos, Jhanielle Quindoyos, Andrew Quinn, James Quinn, Tom Quinn, Quratulain Quratulain, Danya Qureshi, Ehsaan Qureshi, Hasanain Qureshi, Iram Qureshi, Khadija Qureshi, Nawaz Qureshi, Qurratulain Qurratulain, Saad Qutab, Muhammad S Rabbani, Simon Rabinowicz, Madalina Raceala, Alan Rachid, Brian Eka Rachman, Raissa Rachman, Laura Rad, Jane Radford, Liz Radford, Jayachandran Radhakrishnan, Hannah Rafferty, Muhammad Y Rafiq, Shabana Rafiq, Cecillia Rafique, Jethin Rafique, Muhammad Rafique, Ravi Ragatha, Aiswarya Raghunathan, Abigail Raguro, Shankho D Raha, Sana Rahama, Mutia Rahardjani, Karen Rahilly, Faisal Rahim, Abdul H Rahimi, Haseena R Rahimi, Muhammad Rahman, Salim Ur Rahman, Sohail Rahmany, Prajan Rai, Sabi Rai, Supriya Rai, Lenka Raisova, Ajay Raithatha, Arjun Raj, Anithya Rajagopal, Pradeep Rajagopalan, Nithy Rajaiah, Kanendran Rajalingam, Arvind Rajasekaran, Aylur Rajasri, Bibek Rajbhandari, Sagar Rajbhandari, Thurkka Rajeswaran, Jyothi Rajeswary, Jeyanthy Rajkanna, Indhuja Rajkumar, Gayathri Rajmohan, Ruth Rallan, Katherine Ralston, Maximilian Ralston, Matsa Ram, Balaji Ramabhadran, Fathima Ramali, Mohamed Ramali, Athimalaipet Ramanan, Shashikira Ramanna, Maheshi Ramasamy, Irfah Rambe, Aradhana Ramchandani, Dhanishta Ramdin, Jozel Ramirez, Mylah Ramirez, Geshwin Ramnarain, Amrita Ramnarine, Lidia Ramos, Tommy Rampling, Shanthi Ramraj, Janine Ramsay, Alex Ramshaw, Aleem Rana, Ghulam F Rana, Naeem Rana, Rehman Rana, Abby Rand, James Rand, Harpal Randheva, Poonam Ranga, Manmeet Rangar, Harini Rangarajan, Sameer Ranjan, Hannah Rank, Poormina Ranka, Rajesh Rankhelawon, Alastair Rankin, Anita Rao, Sandhya Rao, Sanjay Rao, Deepak Rao, Althaf A Rasheed, Khalid Rashid, Madeleine Rason, Valentina Raspa, Somil Rastogi, Fazila Rasul, Simbisai Ratcliff, Sam Ratcliffe, Sophy Ratcliffe, Priti Rath, Sanjeev Rath, Mohmad I Rather, Krishnaraj Rathod, Selina Rathore, Aravinden Ratnakumar, Jonathan Ratoff, Deepa Rattehalli, Davide Ravaccia, Malvi Raval, Phil Ravencroft, Jason Raw, Rachael Raw, Manisha Rawal, Sulaiman A Rawashdeh, Hywel Rawlins, Gautam Ray, Adam Raymond-White, Dana Raynard, Helen Rayner, Nicola Rayner, Amy Raynsford, Salman Razvi, Zarine Razvi, Kerry Read, Sarah Read, Michael Reay, Anne Reddington, Ajay Reddy, Anvesh Reddy, Harsha Reddy, Heidi Redfearn, Aine Redfern-Walsh, Ianto Redknap, Nell Redman, Alex Redome, Joan Redome, Anna Reed, John Reed, Andrew Rees, Caitlin Rees, Helen Rees, James Rees, Martyn Rees, Sarah Rees, Stephanie Rees, Tabitha Rees, Elinor Rees-Jones, Fiona Regan, Karen Regan, Martin Regan, Susan Regan, Kanchan Rege, Amuda Regmi, Ahmed Rehan, A Rehman, Hafiz Rehman, Shoib Rehman, Zainab Rehman, Ada Reid, Andrew Reid, Jennifer Reid, Jeremy Reid, Sharon Reid, Mkyla Reilly, Sharon Reilly, Christina Reith, Arisa Reka, Alda Remegoso, Dinakaran Rengan, Louise Renouf, Stephen Renshaw, Remya Renu Vattekkat, Henrik Reschreiter, Mark Revels, Adam Revill, Glynis Rewitzky, Severine Rey, Charles Reynard, Dominic Reynish, Heather Reynolds, Peter Reynolds, Piero Reynolds, Jonathan Rhodes, Naghma Riaz, Patricia Ribeiro, Emily Rice, Matthew Rice, Natalie Rice, Mel Rich, Alex Richards, Alison Richards, Liz Richards, Suzanne Richards, Celia Richardson, Emma Richardson, Fiona Richardson, Jamie Richardson, Julie Richardson, Madeleine Richardson, Neil Richardson, Nicky Richardson, Joanne Riches, Katie Riches, Leah Richmond, Ruth Richmond, William Ricketts, Hannah Rickman, Anna Riddell, Stephanie Ridgway, Mohamed Ridha, Carrie Ridley, Paul Ridley, Gudrun Rieck, Linsey Rigby, Myckala Rigby, Daniel Rigler, Samita Rijal, Nur Rika, Hannah Riley, Matthew Riley, Phil Riley, Atika Rimainar, Zwesty V P Rimba, Dominic Rimmer, Winarni Rina, Robert Rintoul, Andrew Riordan, David Ripley, Naomi Rippon, Chloe Rishton, Michael Riste, David Ritchie, Jane Ritchie, Andy Ritchings, Pilar Rivera Ortega, Vanessa Rivers, Batool Rizvi, Syed A S Rizvi, Syed H M Rizvi, James Robb, Edel Robbins, Charles Roberts, Gareth Roberts, Ian Roberts, Jane Roberts, Jean Roberts, Karen Roberts, Mark Roberts, Nicky Roberts, Philip Roberts, Rebecca Roberts, Victoria Roberts, Calum Robertson, James Robertson, Jamie Robertson, Kirsten Robertson, Nichola Robertson, Stuart Robertson, Mhairi Robertson, Nicole Robin, Caroline Robinson, Emma Robinson, Gisela Robinson, Hannah Robinson, Jane Robinson, Jemima Robinson, Kate Robinson, Liz Robinson, Matthew Robinson, Nicky Robinson, Richard Robinson, Ryan Robinson, Sandra Robinson, Alexandra Robinson, Steve Robson, Anna Rocca, Lisa Roche, Samantha Roche, Natalie Rodden, Alistair Roddick, Elin Roddy, Jack Roddy, Marion Roderick, Alison Rodger, Faye Rodger, Megan Rodger, Michael Rodger, Alicia Rodgers, Deirdre Rodgers, Natasha Rodgers, Penny Rodgers, Rocio Rodriguez-Belmonte, Nicholas Roe, Charles Roehr, Gill Rogers, Jason Rogers, Joanne Rogers, John Rogers, Leigh Rogers, Lindsay Rogers, Michaela Rogers, Paula Rogers, Susan Rogers, Thomas Rogers, Jana Rojkova, Kshetra Kumari Roka, Sakib Rokadiya, Lee Rollins, Jennifer Rollo, Catherine Rolls, Alexander Rond-Alliston, Claire Rook, Kevin Rooney, Lynsey Rooney, Lace P Rosaroso, Emily J Rosby, Abigail Rose, Alastair Rose, Annie Rose, Steve Rose, Zoe Rose, Josephine Rosier, Anna Roskilly, Gavin A Ross, Isobel Ross, Jack Ross, Jennifer Rossdale, Andrew Ross-Parker, Anthony Rostron, Alfian Nur Rosyid, Alex Rothman, Joanne Rothwell, Lindsay Roughley, Catherine A Rourke, Kathryn Rowan, Neil Rowan, Stephen Rowan, Anna Rowe, Nicola Rowe, Louise Rowe-Leete, Benjamin Rowlands, Elen Rowlands, Megan Rowley, Subarna Roy, Matthew Roycroft, Anna Roynon-Reed, Ann R Royson, Sam Rozewicz, Anna Rudenko, Senthan Rudrakumar, Banu Rudran, Shannon Ruff, Prita Rughani, Rory Rule, Sharon Rundell, Eve Rushforth, Jeremy Rushmer, Darren Rusk, Peter Russell, Richard Russell, Cristina Russo, Marieke Rutgers, Krzysztof Rutkowski, Aidan Ryan, Brendan Ryan, Kathryn Ryan, Lucy Ryan, Matthew Ryan, Pat Ryan, Phil Ryan, Declan Ryan-Wakeling, Elena Rybka, Maggie Ryder, Sophie Ryder, M Saad, Gwendolyn Saalmink, Javeson Sabale, Suganya Sabaretnam, Noman Sadiq, Emma Sadler, Ashiq Saffy, Beth Sage, Harkiran Sagoo, Sobia Sagrir, Rajnish Saha, Sian Saha, Nikhil Sahdev, Sarvjit Sahedra, Jagdeep Sahota, Nooria Said, Shalini Saini, Bryony Saint, Anam Sajid, Sreekanth Sakthi, Hikari Sakuri, Murthy Saladi, Abdul Salam, Armorel Salberg, Erika Salciute, Gina Saleeb, Mumtaz Saleh, Hizni Salih, Laylan Salih, Duha Salim, Sarah Salisbury, SiteEneye Saliu, Rustam Salman, Jenny Salmon, Rebecca Salmon, Dario Salutous, Mfon Sam, Sally Sam, Tinashe Samakomva, Razan Saman, Sakeena Samar, Selva Saminathan, Renaldo Samlal, Emily Sammons, David Sammut, Mark Sammut, Saud Sammut, Thomas Sammut, Sunitha Sampath, Claire Sampson, Julia Sampson, Aashna Samson, Anda Samson, Johnson Samuel, Merna Samuel, Reena Samuel, Thomas D L Samuel, Younan Samuel, Kevin Samuels, Theo Samuels, Joanna Samways, Manjula Samyraju, Ilves Sana, Veronica Sanchez, Amada Sanchez Gonzalez, Alina Sanda-Gomez, Peter Sandercock, Jack Sanders, Amy Sanderson, Tom Sanderson, Kuljinder Sandhu, Loveleen Sandhu, Sam Sandow, Victoria Sandrey, Sarah Sands, Langizya Sanga, Harwinder Sangha, Jasmine Sanghera, Mirriam Sangombe, Mathew Sanju, Lakshmi Sankaran, Filipa Santos, Catarina Santos Ferreira De Almeida, Rojy Santosh, Jayanta Sanyal, Aureo F Sanz-Cepero, Yunima Sapkota, Dan Saragih, Dinesh Saralaya, Anggita Saraswati, Arun Saraswatula, Pira Saravanamuthu, Joshua Sarella, Avishay Sarfatti, Rebecca Sargent, Beatrix Sari, Diah Sari, Khatija Sarkar, Rahuldeb Sarkar, Sruthi Sarma, Paulo Sarmiento, Zainab Sarwar, Thea Sass, Krishna Satchithananthasivam, Sonia Sathe, Sobitha Sathianandan, Abilash Sathyanarayanan, Lavanya S J P Sathyanarayanan, Thozhukat Sathyapalan, Prakash Satodia, Vera Saulite, Andrew Saunders, Rachel Saunders, Samantha Saunders, Anne Saunderson, Heather Savill, Karishma Savlani, Gauri Saxena, Matthew Saxton, Amrinder Sayan, Ian Sayers, Diane Scaletta, Deborah Scanlon, Jeremy Scanlon, Lyndsay Scarratt, Sean Scattergood, Alvin Schadenberg, Jenna Schafers, Wendy Schneblen, Ella Schofield, Rebecca Schofield, Samuel Schofield, David Scholes, Karen Scholes, Alex Schoolmeesters, Natasha Schumacher, Nicola Schunke, Martin Schuster Bruce, Karin Schwarz, Antonia Scobie, Thomas Scoones, Tim Scorrer, Alex Scott, Alistair Scott, Anne Scott, Catherine Scott, Christine Scott, Emily Scott, Kathyn Scott, Leanne Scott, Martha Scott, Stephen Scott, Timothy Scott, Zoe Scott, Sarah Scourfield, Wendy Scrase, Nicholas A Scriven, Angela Scullion, Therese Scullion, Emily Seager, Cathy Seagrave, Rebecca Seaman, Eleanor Sear, Isabella Seaton, Annette Seatter, Anna Seckington, Joanna Sedano, Gabrielle Seddon, Gemma Sedgwick, Yee Yong See, Muhammad A Seelarbokus, Christopher Sefton, Matias Segovia, Fatima Seidu, Gillian Sekadde, Faye Selby, Georgina Selby, Claire Sellar, Rachael Sellars, Katharine Sellers, Joseph Selley, Victoria Sellick, Gobika Selvadurai, Brintha Selvarajah, Haresh Selvaskandan, Subothini S Selvendran, Jeyakumar Selwyn, Alison Semmens, Gary Semple, Michael Sen, Nandini Sen, Seema Sen, Aditya Sengupta, Niladri Sengupta, Susana Senra, HoJan Senya, Teona Serafimova, Elisa Sernicola, Dheeraj Sethi, Shivam Sethi, Niranjan Setty, Abigail Seward, Teswaree Sewdin, Terri-Ann Sewell, Jack Seymour, Katherine Seymour, Hussam Shabbir, Fiona Shackley, Tariq Shafi, Faiza Shafique, Aashni Shah, Ahmar Shah, Anand Shah, Bhavni Shah, Hussun-Ara Shah, Momin Shah, Neil Shah, Pallav Shah, Priyank Shah, Qasim Shah, Rupal Shah, Sarfaraz H Shah, Snehal Shah, Suraj Shah, Syed Shah, Wajid Shah, Saarma Shahad, Sousan Shahi, Sipan Shahnazari, Najam Shahzad, Muhammad Shahzeb, Aisha Shaibu, Zara Shaida, Amina Y Shaikh, Maliha Shaikh, Rajit Shail, Mariya Shaji, Muhammad Shakeel, Roshni Shakya, Korah Shalan, Nadia Shamim, Ummulbaneen Shamji, Anindya Shams, Kazi Shams, Rasha Shamsah, Thomas Shanahan, Hamed Sharaf, Asir Sharif, Ajay Sharma, Ash Sharma, Bhawna Sharma, Mona Sharma, Ojasvi Sharma, Poonam Sharma, Rajeev Sharma, Sagar Sharma, Sanjeev Sharma, Sarkhara Sharma, Seema D Sharma, Shriv Sharma, Sonal Sharma, Alexander Sharp, Charles Sharp, Gemma Sharp, Kerry Sharp, Louise M Sharp, Paula Sharratt, Phoebe Sharratt, Katherine Sharrocks, Serene Shashaa, Alexandra Shaw, Christopher Shaw, Daisy Shaw, David Shaw, Deborah Shaw, Joanne Shaw, Jonathon Shaw, Lisa Shaw, Michele Shaw, Tomos G Shaw, Anna Shawcross, James Shawcross, Jill Shawe, Lou Shayler, Sophy Shedwell, Jonathan Sheffield, Zak Shehata, Arshiya Sheik, Asif Sheikh, Noorann Sheikh, Benjamin Shelley, Sarah Shelton, Anil Shenoy, Julie Shenton, Sarah Shephardson, Amy Shepherd, Kate Shepherd, Lorna Shepherd, Scott Shepherd, Gareth Sheppard, Rhian Sheppeard, Helen Sheridan, Ray Sheridan, Samuel Sherridan, Leanne Sherris, Susanna Sherwin, Shaad Shibly, Fathimath F Shiham, Cassandra Shilladay, Ben Shillitoe, Delane Shingadia, Chiaki Shioi, Anand Shirgaonkar, Kim Shirley, Helen Shirt, Adebusola Shonubi, Jane Shoote, Ruth Shorrocks, Rob Shortman, Rohan Shotton, Sarah Shotton, Charmaine Shovelton, Ervin Shpuza, Anil Shrestha, Apurba Shrestha, Nora Shrestha, Reema Shrestha, Suchita Shrestha, Karen Shuker, Jonathan Shurlock, Jack Shurmer, Erfanur R Shuvo, Gilbert Siame, Loria Siamia, Moses Siaw-Frimpong, Seshnag Siddavaram, Nasir Siddique, Shahla Siddique, Sohail Siddique, Elaine Siddle, Emma Sidebotham, Jo Sidebottom, Roy Sievers, Katie Siggens, Nyma Sikondari, Ilman Silanas, Sofia V Silva, Claudia Silva Moniz, Malcolm Sim, Theresa Simangan, Vimbai Simbi, Robert Sime, George Simmons, Oliver Simmons, Richard Simms, Laura Simon, Merritt Simon, Natalie Simon, Samantha Simpkins, Angela Simpson, Anna Simpson, Danny Simpson, Georgina Simpson, Joanne Simpson, Kerry Simpson, Maria Simpson, Phillip Simpson, Thomas Simpson, Kathryn Simpson, Simon Sinclair, Cindy Sing, Ankita Singh, Claire Singh, Davinder Singh, Jayaprakash Singh, Jyoti Singh, Lokeshwar Singh, Manjeet Singh, Nadira Singh, Pankaj Singh, Prabhsimran Singh, Salil Singh, Saurabh Singh, Shivani Singh, Sumi Singh, Parag Singhal, Bryan Singizi, Vicky Singler, Manas Sinha, Punam Sinha, Sharad Sinha, Utkarsh Sinha, Guy Sisson, Sarah Sithiravel, Karthikadevi Sivakumar, Shanmugasundaram Sivakumar, Darsh Sivakumran, Sivanthi Sivanadarajah, Pasupathy-Rajah Sivasothy, Asok Skaria, Nicole Skehan, Robert Skelly, Orlagh Skelton, Imogen Skene, Denise Skinner, Tabitha Skinner, Victoria Skinner, Agnieszka Skorko, Iwona Skorupinska, Mariola Skorupinska, Amy Slack, Katie Slack, Heather Slade, Mark Slade, Lynda Slater, Nicola Slawson, Rachel Slingsby, Andrew Sloan, Brendan Sloan, Derek Sloan, Geraldine Sloane, Malgorzata Slowinska, Benjamin Small, Ellen Small, Samuel Small, Adam Smallridge, Dawn Smalls, Karen Denise Smallshaw, Andy Smallwood, Brittany Smart, Lynne Smart, Justyna Smeaton, Carien Smit, Aileen Smith, Alex Smith, Amanda Smith, Amy Smith, Andrew Smith, Catherine Smith, Chris Smith, Christopher Smith, Coral Smith, Debra Smith, Dominic Smith, Eleanor Smith, Harriet Smith, Hazel Smith, Helen Smith, Jacky Smith, Jessica Smith, Kate Smith, Kerry Smith, Lara Smith, Linda Smith, Lisa Smith, Loren Smith, Maria Smith, Mark Smith, Martha A Smith, Mel Smith, Nicholas Smith, Oliver Smith, Philippa Smith, Rachel Smith, Rebecca Smith, Rheanna Smith, Richard Smith, Sally Smith, Samantha Smith, Stacey Smith, Stephanie Smith, Susan Smith, Tracy Smith, Victoria Smith, Imogen Smith, John Smith, Sue Smolen, Sara Smuts, Naoise Smyth, Annette Snell, David 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Katelyn Stewart, Keely Stewart, Kristina Stewart, McKenna Stewart, Melissa Stewart, Rachel Stewart, Richard Stewart, Jo Stickley, Gemma Stiller, Sarah Stirrup, Sarah Stock, Alexander Stockdale, Danielle Stocker, Lynne Stockham, Paul Stockton, Emma Stoddard, Kevin Stoffberg, Chelsea Stokes, Chris Stokes, Ben Stone, Roisin Stone, Sarah Stone, Emma-Jane Stoner, Imogen Storey, Kim Storton, Frederick Stourton, Angela Strachan, Catherine Strait, Emma Stratton, Jane Stratton, Sam Straw, Dieter Streit, Emma Stride, Sally Stringer, Sophia Strong-Sheldrake, Siske Struik, Carmel Stuart, Anna Stubbs, Harrison Stubbs, Ann Sturdy, Sharon Sturney, Matt Stuttard, Cristina Suarez, Karuna Subba, Christian P Subbe, Keerth Subramaniam, Manjula Subramanian, Vaidyanathan Subramanian, Venkatram Subramanian, Chinari Subudhi, Rebecca Suckling, Srivatsan Sudershan, Peter Sugden, Putri A Suherman, Rudresh Sukla, Anila Sukumaran, Ezoubi Suleiman, Ali Suliman, Fatimah Suliman, Sugrah Sultan, Uun Sumardi, Samyukta Sundar, Radha Sundaram, Reka Sundhar, Edmond Sung, Nadia Sunni, Jay Suntharalingam, Amitava Sur, Dharmic Suresh, Nayanika Suresh, Shilpa Suresh, Michael Surtees, C Susan, Danielle Suter, Rohan Suthar, Helen Sutherland, Rachel Sutherland, Rebecca Sutherland, Sara-Beth Sutherland, Dovile Sutinyte, Deborah Sutton, Sam Sutton, Siobhan Sutton, Mihaela Sutu, Marie-Louise Svensson, Sima Svirpliene, Andrew Swain, Rose Swain, Thomas Swaine, Christopher Swales, Carla Swanson-Low, Tirion Swart, Stephen Sweetman, Ealish Swift, Paul Swift, Pauline Swift, Rachael Swift, Rachel Swingler, Sophie Swinhoe, Katarzyna Swist-Szulik, Luke Swithenbank, Omair Syed, Catriona Sykes, Daisy Sykes, Eliot Sykes, Luke Sylvester, Declan Symington, Dominic Symon, Andrew Syndercombe, Zoe Syrimi, Jen Syson, Gemma Szabo, Denise Szabó, Tamas Szakmany, Nina Szarazova, Megan Szekely, Adele Szekeres, Matthew Szeto, Kinga Szymiczek, Maria Tadros, Amr Tageldin, Lucy Tague, Hasan Tahir, Muhammad Tahir, Michael Tai, Jennifer 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Elizabeth Wasson, Hazel J Watchorn, Holly Waterfall, Abby Waters, Donald Waters, Mark Waterstone, Abigail Watkin, Catherine Watkins, Catrin Watkins, Eleanor Watkins, Karen Watkins, Lynn Watkins, Abigail Watson, Adam J R Watson, Ekaterina Watson, Eleanor Watson, Felicity Watson, J G R Watson, Louisa Watson, Paul Watson, Rebecca Watson, Robert Watson, Kathleen Watson, Malcolm Watters, Donna Watterson, Khairiah Wattimena, Daniel Watts, John Watts, Merlin Watts, Victoria Waugh, Emma Wayman, Matthew Wayman, Akhlaq Wazir, Mark Weatherhead, Nick Weatherly, Chloe Webb, Claire Webb, Hayley Webb, Kathryn Webb, Kylie Webb, Stephen Webb, Cheryl Websdale, Deborah Webster, Ian Webster, Jemma Webster, Tim Webster, Jordan Wedlin, Ling Wee, Rebecca Weerakoon, Thanuja Weerasinghe, Janaka Weeratunga, Maria Weetman, Shuying Wei, Immo Weichert, Emma Welch, Hugh Welch, James Welch, Leanne Welch, Steven Welch, Benjamin Welham, Samantha Weller, Lucy Wellings, Brian Wells, Susan Wellstead, Berni Welsh, Richard Welsh, Ingeborg Welters, Rachael Welton, Victoria Wenn, Lauren Wentworth, Joan Wesonga, Kate Wesseldine, Joe West, Magdelena West, Raha West, Ruth West, Sophie West, Luke Western, Ruth Westhead, Heather Weston, Alice Westwood, Kelly Westwood, Sharon Westwood, Bill Wetherill, Sharon Wheaver, Helen Wheeler, Ben Whelan, Matthew Whelband, Amanda Whileman, Alison Whitcher, Andrew White, Ayesha White, Benjamin White, Catherine White, Christopher White, Duncan White, James White, Jonathan White, Katie White, Marie White, Nick White, Nikki White, Sarah White, Sonia White, Tracey White, Catherine Whitehead, Kelly Whitehorn, Anne Whitehouse, Claire Whitehouse, Tony Whitehouse, Julia Whiteley, Louiza Whiteley, Sophie Whiteley, Rachael Whitham, Gabriel Whitlingum, David Whitmore, Elizabeth Whittaker, Lindsay Whittam, Ashley Whittington, Helen Whittle, Robert Whittle, Eunice Wiafe, Lou Wiblin, Olivia Wickens, John Widdrington, Jason Wieboldt, Hannah Wieringa, Cornelia Wiesender, Laura Wiffen, Andrew Wight, Ashleigh Wignall, Christopher Wignall, Annamaria Wilce, Danielle Wilcock, Emma Wilcock, Louise Wilcox, Ben Wild, Laura Wild, Stephen Wild, Michael Wilde, Laura Wilding, Peter Wilding, Tracey Wildsmith, Joe Wileman, Joy Wiles, Kate Wiles, Elva Wilhelmsen, Thomas Wiliams, Janet Wilkie, David Wilkin, Hannah Wilkins, Joy Wilkins, Suzanne Wilkins, Iain Wilkinson, Lesley Wilkinson, Nicola Wilkinson, Sophia Wilkinson, Susan Wilkinson, Tim Wilkinson, Sylvia Willetts, Aimee Williams, Alexandra Williams, Alison Williams, Angharad Williams, Anna Williams, Ava Williams, Carl Williams, Caroline V Williams, Claire Williams, Dewi Williams, Eleri Williams, Gail Williams, Gemma Williams, Gina Williams, Hannah Williams, Heledd Williams, James Williams, Jennie Williams, Jill Williams, John Williams, Joseph Williams, Karen Williams, Kathryn Williams, Mandy Williams, Marie Williams, Mark Williams, Matthew Williams, Patricia Williams, Penny Williams, Rachel Williams, Robin Williams, Rupert Williams, Samson Williams, Sarah Williams, Sophie Williams, Steffan Williams, Tamanna Williams, Tania Williams, Annie Williamson, Cath Williamson, Catherine Williamson, Dawn Williamson, James D Williamson, Jodie Williamson, Rachel Williamson, Helen Williamson, Elaine Willis, Elizabeth Willis, Emily Willis, Heather Willis, Herika Willis, Joanna Willis, Louise Wills, Lucy Willsher, Catherine Willshire, Francesca Willson, Jayne Willson, Alison Wilson, Andrea Wilson, Anna Wilson, Antoinette Wilson, Billy Wilson, David Wilson, Imogen Wilson, James Wilson, Karen Wilson, Kate Wilson, Kristy-Ann Wilson, Lucinda Wilson, Mark Wilson, Stephen Wilson, Toni Wilson, John Wilson, Khin Lei Yee Win, Marlar Win, Than Win, Tin Tin Win, Wut Yee Win Win, Lucinda Winckworth, Laura Winder, Piers Winder, Stuart Winearl, Helen Winmill, Simon Winn, Carmen Winpenny, Helen Winslow, Helen Winter, Jonathan Winter, Barbara Winter-Goodwin, Joseph Winterton, Hannah Winwood, Jack Wischhusen, Stephen Wisdom, Matthew Wise, Martin Wiselka, Rebecca Wiseman, Sophie Wiseman, Steven Wishart, Tabitha WIshlade, Eric Witele, Nicholas Withers, Janet Wittes, Donna Wixted, Therese Wodehouse, Will Wolf, Nicola Wolff, Kirsten Wolffsohn, Rebecca Wolf-Roberts, Elena Wolodimeroff, Adam Wolstencroft, Alan Wong, Charlotte Wong, Chi-Hung Wong, Chi-Man Wong, Edwin Wong, Jessica S Y Wong, Kit Y Wong, Mei Yin Wong, Nick Wong, Sam Wong, Ting Wong, Aaron B Wongkyezeng, Amanda Wood, Caroline Wood, Dianne Wood, Fiona Wood, Gordon Wood, Hannah Wood, Jennifer Wood, Joe Wood, Lisa Wood, Louise Wood, Madeleine Wood, Stephen Wood, Tracy Wood, Katharine Woodall, Rebecca Woodfield, Christopher Woodford, Elizabeth Woodford, Jill Woodford, Louise Woodhead, Timothy Woodhead, Philip Woodland, Marc Woodman, Myles Woodman, Stephen Woodmansey, Charlotte Woods, Jane Woods, Katherine Woods, Sarah Woods, Zoe Woodward, Megan Woolcock, Gemma Wooldridge, Rebecca Woolf, Chris Woollard, Christopher Woollard, Louisa Woollen, Emma Woolley, Jade Woolley, Daniel Woosey, Dan Wootton, Joanne Wootton, Daniel Worley, Stephy Worton, Jonathan Wraight, Maria Wray, Kim Wren, Lynn Wren, Caroline Wrey Brown, Catherine Wright, Demi Wright, Francesca Wright, Holly Wright, Imogen Wright, Lianne Wright, Rachel Wright, Sarah Wright, Stephanie Wright, Tim Wright, Caroline Wroe, Hannah Wroe, Henry Wu, Peishan Wu, Pensee Wu, Jonathan Wubetu, Fitria Wulandari, Retno Wulandari, Subie Wurie, Craig Wyatt, Frederick Wyn-Griffiths, Inez Wynter, Bindhu Xavier, Arnold Xhikola, Bingru E Xia, Zhongyang Xia, Effua Yacoba, Santosh Yadav, Masseh Yakubi, May Yan, Yuuki Yanagisawa, Freda Yang, Yingjia Yang, Michael Yanney, Woei Lin Yap, Nabil Yaqoob, Salima Yasmin, Bryan Yates, David Yates, Edward Yates, Helen Yates, Thomas Yates, Mark Yates, Jessica Ye, Charlotte Yearwood Martin, Khin Yein, Fiona Yelnoorkar, Lam Minh Yen, Alastair Yeoh, Chun Yu Yeung, Peter Yew, Durgesh Yewatkar, Laura Ylquimiche Melly, Inez Ynter, H Yong, Jemma Yorke, Jasmine Youens, Abdel Younes Ibrahim, Eoin Young, Gail Young, Louise Young, Asfand Yousafzar, Sajeda Youssouf, Ahmed Yousuf, Hartantri Yovita, Chrissie Yu, Jack S J Yuan, Nindya Yufaniaputri, Bernard Yung, Daniel Yusef, Said Yusef, Intekhab Yusuf, Anna-Sophia Zafar, Silvia Zagalo, Su Zaher, Aqsa Zahoor, Mahrukh Zainab, Thornton Zak, Kareem Zaki, Nabhan Zakir, Kasia Zalewska, Ane Zamalloa, Mohsin Zaman, Shakir Zaman, Julie Zamikula, Louise Zammit, Marie Zammit-Mangion, Marcelina Zawadzka, Mohammed Zayed, Esther Zebracki, Daniel Zehnder, Lisa Zeidan, Darius Zeinali, Jing Zhang, Xiaobei Zhao, Dongling Zheng, Doreen Zhu, Madiha Zia, Omar Zibdeh, Rabia Zill-E-Huma, Ei Thankt Zin, Eva Zincone, Garikai Zindoga, Eleanor Zinkin, Vivian Zinyemba, Christos Zipitis, Letizia Zitter, Arkadiusz Zmierczak, Garazi Zubikarai, Azam Zubir, Naz Zuhra, Rasha Zulaikha, Sabrina Zulfikar, Carol Zullo, Ana Zuriaga-Alvaro, University of St Andrews. Infection and Global Health Division, University of St Andrews. School of Medicine, and Group, RECOVERY Collaborative
Subjects: Adult, Male, Hypoxia/etiology, SARS-CoV-2, COVID-19, 3rd-DAS, General Medicine, Adrenal Cortex Hormones/therapeutic use, AC, Dexamethasone/therapeutic use, Hospitals, Oxygen, Treatment Outcome, SDG 3 - Good Health and Well-being, MCP, Humans, Female
Abstract: Background Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation). We evaluated the use of a higher dose of corticosteroids in this patient group. Methods This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting adult patients with clinical evidence of hypoxia (ie, receiving oxygen or with oxygen saturation Findings Between May 25, 2021, and May 13, 2022, 1272 patients with COVID-19 and hypoxia receiving no oxygen (eight [1%]) or simple oxygen only (1264 [99%]) were randomly allocated to receive usual care plus higher dose corticosteroids (659 patients) versus usual care alone (613 patients, of whom 87% received low-dose corticosteroids during the follow-up period). Of those randomly assigned, 745 (59%) were in Asia, 512 (40%) in the UK, and 15 (1%) in Africa. 248 (19%) had diabetes and 769 (60%) were male. Overall, 123 (19%) of 659 patients allocated to higher dose corticosteroids versus 75 (12%) of 613 patients allocated to usual care died within 28 days (rate ratio 1·59 [95% CI 1·20–2·10]; p=0·0012). There was also an excess of pneumonia reported to be due to non-COVID infection (64 cases [10%] vs 37 cases [6%]; absolute difference 3·7% [95% CI 0·7–6·6]) and an increase in hyperglycaemia requiring increased insulin dose (142 [22%] vs 87 [14%]; absolute difference 7·4% [95% CI 3·2–11·5]). Interpretation In patients hospitalised for COVID-19 with clinical hypoxia who required either no oxygen or simple oxygen only, higher dose corticosteroids significantly increased the risk of death compared with usual care, which included low-dose corticosteroids. The RECOVERY trial continues to assess the effects of higher dose corticosteroids in patients hospitalised with COVID-19 who require non-invasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation. Funding UK Research and Innovation (Medical Research Council), National Institute of Health and Care Research, and Wellcome Trust.
Published: 2023
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44. Soluble Neuropilin-1 Response to Hypoglycemia in Type 2 Diabetes: Increased Risk or Protection in SARS-CoV-2 Infection?

Author: Abu Saleh Md Moin, Ahmed Al-Qaissi, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: Neuropilin-1, type 2 diabetes, COVID-19, SARS-CoV-2, ACE inhibitors, ADAM9, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: IntroductionNeuropilin-1(NRP1) is a cofactor that enhances SARS-CoV-2 coronavirus cell infectivity when co-expressed with angiotensin-converting enzyme 2(ACE2). The Renin-Angiotensin System (RAS) is activated in type 2 diabetes (T2D); therefore, the aim of this study was to determine if hypoglycaemia-induced stress in T2D would potentiate serum NRP1(sNRP1) levels, reflecting an increased risk for SARS-CoV-2 infection.MethodsA case-control study of aged-matched T2D (n = 23) and control (n = 23) subjects who underwent a hyperinsulinemic clamp over 1-hour to hypoglycemia(
Published: 2021
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45. Type 2 Diabetes Coagulopathy Proteins May Conflict With Biomarkers Reflective of COVID-19 Severity

Author: Abu Saleh Md Moin, Ahmed Al-Qaissi, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: type 2 diabetes, hypoglycemia, COVID-19, biomarkers, proteomics, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: ObjectiveDetailed proteomic analysis in a cohort of patients with differing severity of COVID-19 disease identified biomarkers within the complement and coagulation cascades as biomarkers for disease severity has been reported; however, it is unclear if these proteins differ sufficiently from other conditions to be considered as biomarkers.MethodsA prospective, parallel study in T2D (n = 23) and controls (n = 23). A hyperinsulinemic clamp was performed and normoglycemia induced in T2D [4.5 ± 0.07 mmol/L (81 ± 1.2 mg/dl)] for 1-h, following which blood glucose was decreased to ≤2.0 mmol/L (36 mg/dl). Proteomic analysis for the complement and coagulation cascades were measured using Slow Off-rate Modified Aptamer (SOMA)-scan.ResultsThirty-four proteins were measured. At baseline, 4 of 18 were found to differ in T2D versus controls for platelet degranulation [Neutrophil-activating peptide-2 (p = 0.014), Thrombospondin-1 (p = 0.012), Platelet factor-4 (p = 0.007), and Kininogen-1 (p = 0.05)], whilst 3 of 16 proteins differed for complement and coagulation cascades [Coagulation factor IX (p < 0.05), Kininogen-1 (p = 0.05), and Heparin cofactor-2 (p = 0.007)]; STRING analysis demonstrated the close relationship of these proteins to one another. Induced euglycemia in T2D showed no protein changes versus baseline. At hypoglycemia, however, four proteins changed in controls from baseline [Thrombospondin-1 (p < 0.014), platelet factor-4 (p < 0.01), Platelet basic protein (p < 0.008), and Vitamin K-dependent protein-C (p < 0.00003)], and one protein changed in T2D [Vitamin K-dependent protein-C, (p < 0.0002)].ConclusionSeven of 34 proteins suggested to be biomarkers of COVID-19 severity within the platelet degranulation and complement and coagulation cascades differed in T2D versus controls, with further changes occurring at hypoglycemia, suggesting that validation of these biomarkers is critical. It is unclear if these protein changes in T2D may predict worse COVID-19 disease for these patients.Clinical Trial Registrationhttps://clinicaltrials.gov/, identifier NCT03102801.
Published: 2021
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46. The Effect of Free Androgen Index on the Quality of Life of Women With Polycystic Ovary Syndrome: A Cross-Sectional Study

Author: Mohammed Altigani Abdalla, Harshal Deshmukh, Irfaan Mohammed, Stephen Atkin, Marie Reid, and Thozhukat Sathyapalan
Subjects: polycystic ovary syndrome - quality of life - modified PCOS questionnaire - anti-Mullerian hormone - free androgen index, PCOS, psychology, quality of life, reproductive endocrine, Physiology, QP1-981
Abstract: Purpose: Free androgen index (FAI) and anti-Mullerian hormone (AMH) are independently associated with polycystic ovary syndrome (PCOS). This study aimed to describe the relationship between these two markers and health-related quality of life (HR-QoL) in women with PCOS.Methods: This cross-sectional study consisted of 81 women in the Hull PCOS biobank, who fulfilled the Rotterdam consensus criteria for the diagnosis of PCOS. The primary outcome was to measure the various domains of the QoL in the modified polycystic ovary syndrome questionnaire (MPCOSQ).Results: Mean age of the study participants was 28 ± 6.0 years, mean body mass index (BMI) 33.5 ± 7.8 kg/m2, mean FAI (6 ± 5.5), free testosterone (2.99 ± 0.75) and mean AMH (3.5 ± 0.8 units). In linear regression analysis, the FAI was associated with overall mean MPCOSQ score (Beta = 0.53, P-value = 0.0002), and with depression (Beta = 0.45, P-value = 0.01), hirsutism (Beta = 0.99, P-value = 0.0002) and menstrual irregularity (Beta = 0.31, P-value = 0.04). However, with adjustment for age and BMI, FAI was only associated with the hirsutism domain (Beta = 0.94, P-value = 0.001) of the MPCOSQ. FAI was also associated with the weight domain (Beta = 0.63 P-value = 0.005) of MPCOSQ. However, AMH was not associated with the overall mean MPCOSQ score or with any of its domains.Conclusion: FAI but not AMH was associated with QoL in women with PCOS, and this effect was mediated by BMI.
Published: 2021
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47. Plasma heat shock protein response to euglycemia in type 2 diabetes

Author: Stephen L Atkin, Thozhukat Sathyapalan, Alexandra E Butler, Abu Saleh Md Moin, Alexander S Atkin, and Ahmed Al-Qaissi
Subjects: Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Introduction Glucose variability is associated with mortality and macrovascular diabetes complications. The mechanisms through which glucose variability mediates tissue damage are not well understood, although cellular oxidative stress is likely involved. As heat shock proteins (HSPs) play a role in the pathogenesis of type 2 diabetes (T2D) complications and are rapidly responsive, we hypothesized that HSP-related proteins (HSPRPs) would differ in diabetes and may respond to glucose normalization.Research design and methods A prospective, parallel study in T2D (n=23) and controls (n=23) was undertaken. T2D subjects underwent insulin-induced blood glucose normalization from baseline 7.6±0.4 mmol/L (136.8±7.2 mg/dL) to 4.5±0.07 mmol/L (81±1.2 mg/dL) for 1 hour. Control subjects were maintained at 4.9±0.1 mmol/L (88.2±1.8 mg/dL). Slow Off-rate Modified Aptamer-scan plasma protein measurement determined a panel of HSPRPs.Results At baseline, E3-ubiquitin-protein ligase (carboxyl-terminus of Hsc70 interacting protein (CHIP) or HSPABP2) was lower (p=0.03) and ubiquitin-conjugating enzyme E2G2 higher (p=0.003) in T2D versus controls. Following glucose normalization, DnaJ homolog subfamily B member 1 (DNAJB1 or HSP40) was reduced (p=0.02) in T2D, with HSP beta-1 (HSPB1) and HSP-70-1A (HSP70-1A) (p=0.07 and p=0.09, respectively) also approaching significance relative to T2D baseline levels.Conclusions Key HSPRPs involved in critical protein interactions, CHIP and UBE2G2, were altered in diabetes at baseline. DNAJB1 fell in response to euglycemia, suggesting that HSPs are reacting to basal stress that could be mitigated by tight glucose control with reduction of glucose variability.
Published: 2021
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48. Amyloid-related protein changes associated with dementia differ according to severity of hypoglycemia

Author: Stephen L Atkin, Thozhukat Sathyapalan, Alexandra E Butler, Abu Saleh Md Moin, Ahmed Al-Qaissi, Hassan Kahal, and Nitya Kumar
Subjects: Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Introduction Hypoglycemia in type 2 diabetes (T2D) may increase risk for Alzheimer’s disease (AD), but no data on changes in AD-related proteins with differing degrees of hypoglycemia exist. We hypothesized that milder prolonged hypoglycemia would cause greater AD-related protein changes versus severe transient hypoglycemia.Research design and methods Two prospective case-control induced hypoglycemia studies were compared: study 1, hypoglycemic clamp to 2.8 mmol/L (50 mg/dL) for 1 hour in 17 subjects (T2D (n=10), controls (n=7)); study 2, hypoglycemic clamp to 2.0 mmol/L (36 mg/dL) undertaken transiently and reversed in 46 subjects (T2D (n=23), controls (n=23)). Blood sampling at baseline, hypoglycemia and 24-hour post-hypoglycemia, with proteomic analysis of amyloid-related proteins performed.Results In control subjects, the percentage change from baseline to hypoglycemia differed between study 1 and study 2 for 5 of 11 proteins in the AD-related panel: serum amyloid A1 (SAA1) (p=0.009), pappalysin (PAPPA) (p=0.002), apolipoprotein E2 (p=0.02), apolipoprotein E3 (p=0.03) and apolipoprotein E4 (p=0.02). In controls, the percentage change from baseline to 24 hours differed between studies for two proteins: SAA1 (p=0.003) and PAPPA (p=0.004); however, after Bonferroni correction only SAA1 and PAPPA remain significant. In T2D, there were no differential protein changes between the studies.Conclusions The differential changes in AD-related proteins were seen only in control subjects in response to iatrogenic induction of hypoglycemic insults of differing length and severity and may reflect a protective response that was absent in subjects with T2D. Milder prolonged hypoglycemia caused greater AD-related protein changes than severe acute hypoglycemia in control subjects.Trial registration numbers NCT02205996, NCT03102801.
Published: 2021
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49. Mapping of type 2 diabetes proteins to COVID-19 biomarkers: A proteomic analysis

Author: Abu Saleh Md Moin, Ahmed Al-Qaissi, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: biomarkers, type 2 diabetes, COVID-19, SARS-CoV-2, Physiology, QP1-981, Biochemistry, QD415-436
Published: 2021
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50. Platelet Protein-Related Abnormalities in Response to Acute Hypoglycemia in Type 2 Diabetes

Author: Abu Saleh Md Moin, Ahmed Al-Qaissi, Thozhukat Sathyapalan, Stephen L. Atkin, and Alexandra E. Butler
Subjects: type 2 diabetes, obesity, platelet, COVID-19, SARS-CoV-2, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: IntroductionPatients with severe COVID-19 infections have coagulation abnormalities indicative of a hypercoagulable state, with thromboembolic complications and increased mortality. Platelets are recognized as mediators of inflammation, releasing proinflammatory and prothrombotic factors, and are hyperactivated in COVID-19 infected patients. Activated platelets have also been reported in type 2 diabetes (T2D) patients, putting these patients at higher risk for thromboembolic complications of COVID-19 infection.MethodsA case-control study of T2D (n=33) and control subjects (n=30) who underwent a hyperinsulinemic clamp to induce normoglycemia in T2D subjects: T2D: baseline glucose 7.5 ± 0.3mmol/l (135.1 ± 5.4mg/dl), reduced to 4.5 ± 0.07mmol/l (81 ± 1.2mg/dl) with 1-hour clamp; Controls: maintained at 5.1 ± 0.1mmol/l (91.9 ± 1.8mg/dl). Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement was used to determine a panel of platelet proteins.ResultsProthrombotic platelet proteins were elevated in T2D versus controls: platelet factor 4 (PF4, p
Published: 2021
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