P6200Effect of LPA gene on CAD risk among diabetic patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Borges ◽  
R Palma Dos Reis ◽  
A Pereira ◽  
F Mendonca ◽  
J Sousa ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
General Population ◽  
Independent Predictor ◽  
Statistical Significance ◽  
Diabetic Patients ◽  
Diabetes Status ◽  
Chi Squared ◽  
Coronary Patients ◽  
Diabetic Population ◽  
Cad Risk

Abstract Introduction Previous research reported that LPA gene is a strong and independent predictor of CAD in non-diabetic patients but not in patients with type 2 diabetes. These results suggest that LPA gene might contribute less to CAD risk in patients with T2DM than in general population. Objective Investigate, in our population, the association between LPA gene CT variant and CAD risk among diabetic patients. Methods 3050 individuals (1619 coronary patients and 1431 controls) were genotyped for LPA rs3798220 TT/CT. Pearson's chi-squared test was applied to evaluate the association between LPA variants and CAD, firstly, in the general population and, secondly, in the group of patients with T2DM (n=735). Multivariate logistic regression was performed with LPA CT variant and 6 traditional risk factors (TRF) (smoking, dyslipidemia, diabetes, hypertension, family history of CAD and physical inactivity) in both general and diabetic population. Results In total population, LPA CT variant was found to be strongly and significantly associated with CAD with an OR of 2.32 (95% CI: 1.56–3.45; p<0.0001). However, this association was less pronounced in the diabetic population with a CAD risk of 1.38 (95% CI: 0.56–3.43) without statistical significance (p=0.485). In the presence of 6 major TRF, multivariate analysis showed that LPA CT remained a strong and independent predictor of CAD risk (OR= 2.34; 95% CI: 1.52–3.62; p<0.0001). In diabetic population, LPA was no longer an independent predictor for CAD by multivariate analysis. Conclusions Our results show that the effect of LPA gene on CAD risk among diabetic patients might be different from that in the general population. Diabetes status is such a strong risk factor that may attenuate the genetic effects of LPA on CAD risk. This may indicate a complex role of Lp (a) and diabetes interaction in cardiometabolic diseases.

scholarly journals Study comparing the clinical profile of patients with stroke in diabetic and non-diabetic patients

2019 ◽  
Vol 6 (5) ◽  
pp. 1397
Author(s):  
G. Sathish Kumar ◽  
S. Rajeswaran ◽  
U. B. Padmanaban
Keyword(s):  
Tamil Nadu ◽  
Statistical Significance ◽  
Clinical Profile ◽  
P Value ◽  
Diabetic Patients ◽  
Chi Square ◽  
Cross Sectional ◽  
Diabetic Population ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Background: A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). Computed tomography (CT) and magnetic resonance imaging (MRI) was done to determine the type of stroke. Diabetes mellitus is a well-recognized risk factor for ischemic stroke. The study was undertaken to assess the clinical characteristics, outcome pattern and to compare the pattern of stroke in diabetics and non-diabetics.Methods: An observational cross-sectional prospective study wherein a hundred stroke patients being admitted to MGMGH, Trichy were sampled and the clinical profile along with outcome is compared in diabetic and non- diabetic populations and the statistical significance of the same.Results: The proportion of patients with poor outcome following stroke was significantly higher in diabetics compared with non-diabetic patients being chi square value was 37.6514 and p value was found to be significantly less than 0.0001.Conclusions: The study resulted the large hemorrhages are twice as much common in the diabetic population compared to the non-diabetic population , the incidence increases with the chronicity of diabetes  and the outcome is superior in the non-diabetics compared to the diabetics admitted in Mahatma Gandhi Memorial Government Hospital, Tiruchirappalli,  Tamil Nadu, India.

scholarly journals Established Tumour Biomarkers Predict Cardiovascular Events and Mortality in the General Population

2021 ◽  
Vol 8 ◽  
Author(s):  
Valentina Bracun ◽  
Navin Suthahar ◽  
Canxia Shi ◽  
Sanne de Wit ◽  
Wouter C. Meijers ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Independent Predictor ◽  
Statistical Significance ◽  
Female Gender ◽  
Male Gender ◽  
Morbidity And Mortality ◽  
All Cause Mortality ◽  
Shared Risk ◽  
Tumour Biomarkers

Introduction: Several lines of evidence reveal that cardiovascular disease (CVD) and cancer share similar common pathological milieus. The prevalence of the two diseases is growing as the population ages and the burden of shared risk factors increases. In this respect, we hypothesise that tumour biomarkers can be potential predictors of CVD outcomes in the general population.Methods: We measured six tumour biomarkers (AFP, CA125, CA15-3, CA19-9, CEA and CYFRA 21-1) and determined their predictive value for CVD in the Prevention of Renal and Vascular End-stage Disease (PREVEND) study. A total of 8,592 subjects were enrolled in the study.Results: The levels of CEA significantly predicted CV morbidity and mortality, with hazard ratios (HRs) of HR 1.28 (95% CI 1.08–1.53), respectively. Two biomarkers (CA15-3 and CEA) showed statistical significance in predicting all-cause mortality, with HRs 1.58 (95% CI 1.18–2.12) and HR 1.60 (95% CI 1.30–1.96), when adjusted for shared risk factors and prevalent CVD. Furthermore, biomarkers seem to be sex specific. CYFRA 21-1 presented as an independent predictor of CV morbidity and mortality in female, but not in male gender, with HR 1.82 (95% CI 1.40–2.35). When it comes to all-cause mortality, both CYFRA and CEA show statistical significance in male gender, with HR 1.64 (95% CI 1.28–3.12) and HR 1.55 (95% CI 1.18–2.02), while only CEA showed statistical significance in female gender, with HR 1.64 (95% CI 1.20–2.24). Lastly, CA15-3 and CEA strongly predicted CV mortality with HR 3.01 (95% CI 1.70–5.32) and HR 1.82 (95% CI 1.30–2.56). On another hand, CA 15-3 also presented as an independent predictor of heart failure (HF) with HR 1.67 (95% CI 1.15–2.42).Conclusion: Several tumour biomarkers demonstrated independent prognostic value for CV events and all-cause mortality in a large cohort from the general population. These findings support the notion that CVD and cancer are associated with similar pathological milieus.

scholarly journals Prediction Model for Severe Community-acquired Pneumonia Development among Patients with Diabetes Mellitus

2021 ◽  
Author(s):  
Ruoming Tan ◽  
Tingting Pan ◽  
Yuzhen Qiu ◽  
Jiahui Wang ◽  
Xiaoling Qi ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prediction Model ◽  
Statistical Significance ◽  
Predictive Biomarkers ◽  
Absolute Lymphocyte Count ◽  
Community Acquired Pneumonia ◽  
Diabetic Patients ◽  
Validation Group ◽  
Tertiary Teaching ◽  
Severe Community Acquired Pneumonia

Introduction: Diabetes is an independent risk factor for the development of severe community-acquired pneumonia (CAP) and associated with pneumonia-related hospitalization as well as mortality. Here, we assessed several selected biomarkers to determine their predictive value for progression to severe CAP among diabetic patients. Research design and methods: A retrospective cohort study of diabetic patients with CAP was conducted at a tertiary teaching hospital. The prediction model group (N=100) comprised patients registered between January 2015 to December 2016. Multivariate analysis was performed to identify predictive biomarkers from this cohort. The validation group (N=108) comprised the patients between January 2017 to February 2019. Predictive performance was assessed in the validation group. Results: A total of 208 diabetic inpatients with CAP were recruited. Further multivariate analysis showed that C-reactive protein (CRP), absolute lymphocyte count (ALC), immunoglobulin (IgM), and HbA1C at admission were independently associated with progression to severe CAP in diabetic patients during hospitalization. The prediction model =0.0179555*CRP+1.975918* HbA1C-2.879364* ALC -0.026255* IgM -8.220555. The area under ROC (AUROC) curve in the validation group was 0.851 (0.781-0.921) with statistical significance (P<.05). Conclusions: In diabetic patients with CAP, a combination of CRP, ALC, IgM, and HbA1C at admission could be used to predict the progression to severe CAP.

Reliability of a Single β-Thromboglobulin Measurement in a Diabetic Population : Importance of PGE1 in Anticoagulant Mixture

1987 ◽  
Vol 57 (02) ◽  
pp. 201-204 ◽  
Author(s):  
P Y Scarabin ◽  
L Strain ◽  
C A Ludlam ◽  
J Jones ◽  
E M Kohner
Keyword(s):  
In Vitro Release ◽  
Mean Value ◽  
Reliable Estimate ◽  
Diabetic Patients ◽  
Single Measurement ◽  
Diabetic Population ◽  
The Difference ◽  
Vitro Release

SummaryDuring the collection of samples for plasma β-thromboglobulin (β-TG) determination, it is well established that artificially high values can be observed due to in-vitro release. To estimate the reliability of a single β-TG measurement, blood samples were collected simultaneously from both arms on two separate occasions in 56 diabetic patients selected for a clinical trial. From each arm, blood was taken into two tubes containing an anticoagulant mixture with (tube A) and without (tube B) PGE!. The overall mean value of B-TG in tube B was 1.14 times higher than in tube A (p <0.01). The markedly large between-arms variation accounted for the most part of within-subject variation in both tubes and was significantly greater in tube B than in tube A. Based on the difference between B-TG values from both arms, the number of subjects with artifically high B-TG values was significantly higher in tube B than in tube A on each occasion (overall rate: 28% and 14% respectively). Estimate of between-occasions variation showed that B-TG levels were relatively stable for each subject between two occasions in each tube. It is concluded that the use of PGEi decreases falsely high B-TG levels, but a single measurement of B-TG does not provide a reliable estimate of the true B-TG value in vivo.

scholarly journals Parathyroid hormone Gene and Genes Involved in the Maintenance of Vitamin D Levels Association with Mandibular Retrognathism

2021 ◽  
Vol 11 (5) ◽  
pp. 369
Author(s):  
Erika Calvano Küchler ◽  
Caio Luiz Bitencourt Reis ◽  
Guido Marañón-Vásquez ◽  
Paulo Nelson-Filho ◽  
Mírian Aiko Nakane Matsumoto ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Interaction Model ◽  
Distribution Analysis ◽  
Nucleotide Polymorphisms ◽  
Allele Distribution ◽  
Vitamin D Levels ◽  
Lateral Cephalograms ◽  
Genes Encoding ◽  
Chi Squared ◽  
Mandibular Retrognathism

In this study we evaluated whether single nucleotide polymorphisms (SNPs) in the genes encoding PTH, VDR, CYP24A1, and CYP27B1 were associated with mandibular retrognathism (MR). Samples from biologically-unrelated Brazilian patients receiving orthodontic treatment were included in this study. Pre-orthodontic lateral cephalograms were used to determine the phenotype. Patients with a retrognathic mandible were selected as cases and those with an orthognathic mandible were selected as controls. Genomic DNA was used for genotyping analysis of SNPs in PTH (rs694, rs6256, and rs307247), VDR (rs7975232), CYP24A1 (rs464653), and CYP27B1 (rs927650). Chi-squared or Fisher’s tests were used to compare genotype and allele distribution among groups. Haplotype analysis was performed for the SNPs in PTH. The established alpha was p < 0.05. Multifactor dimensionality reduction (MDR) was used to identify SNP–SNP interactions. A total of 48 (22 males and 26 females) MR and 43 (17 males and 26 females) controls were included. The linear mandibular and the angular measurements were statistically different between MR and controls (p < 0.05). In the genotype and allele distribution analysis, the SNPs rs694, rs307247, and rs464653 were associated with MR (p < 0.05). MDR analyses predicted the best interaction model for MR was rs694–rs927650, followed by rs307247–rs464653–rs927650. Some haplotypes in the PTH gene presented statistical significance. Our results suggest that SNPs in PTH, VDR, CYP24A1, and CYP27B1 genes are associated with the presence of mandibular retrognathism.

scholarly journals Ischemic and bleeding risk stratification in diabetic patients after acute coronary syndrome based on insulin requirement

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Cavallari ◽  
E Sagazio ◽  
E Antonucci ◽  
P Calabro' ◽  
F Gragnano ◽  
...  
Keyword(s):  
Insulin Therapy ◽  
Antiplatelet Therapy ◽  
Clinical Benefit ◽  
Dual Antiplatelet Therapy ◽  
Bleeding Risk ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Diabetes Status ◽  
Increased Risk ◽  
Net Clinical Benefit

Abstract Background Diabetes is a known risk factor for a first or recurrent cardiovascular event, however, its association with an increased risk of bleeding is controversial. To date, no study has explored the prognostic weight of insulin therapy in the setting of ACS. Purpose To investigate the differential role of insulin versus no insulin therapy on ischemic and bleeding risks in patients with diabetes and ACS. Methods START-ANTIPLATELET is a prospective, real-world multicenter registry including consecutive patients admitted for ACS. For the purpose of this analysis, patients were stratified according to diabetes status and insulin therapy. We compared 1-year rates of major adverse cardiovascular events, a composite of cardiovascular death, myocardial infarction and stroke, and of any bleeding, according to diabetes status (no diabetes, diabetes not on insulin therapy, diabetes on insulin therapy). In addition, we evaluated the net clinical benefit of dual antiplatelet therapy with the newer P2Y12 inhibitors (ticagrelor or prasugrel) vs dual antiplatelet therapy with clopidogrel according to diabetes status. Results In an overall population of 907 patients, 198 had diabetes, 10.6% of whom were on insulin. From non-diabetic patients to diabetic patients not on insulin and diabetic patients on insulin there was a stepwise decrease of MACE-free survival (log-rank p 0.039) with incidence of events at 1 year being 3.8%, 6.8% (adjusted p vs no diabetes 0.49) and 12.5% (adjusted p vs no diabetes 0.047), respectively (Figure, panel A). The rates of any bleeding were higher in patients on insulin (20.8% vs 8.8% in those without diabetes and 5.8% in diabetic patients not receiving insulin; log-rank p 0.028; Figure, panel B). Multivariable analysis demonstrated an almost 5-fold increase of any bleeding in diabetic patients with vs without insulin (OR 4.98, 95% CI 1.46–16.92; p=0.010). In the overall population, the incidence of the net composite endpoint including MACE or major bleeding with the use of ticagrelor/prasugrel on top of aspirin was significantly lower compared to use of clopidogrel (4.7% vs 8.4%; OR 0.54, 95% CI 0.30–0.94, p=0.031). This net clinical benefit in patients receiving a newer P2Y12 inhibitor was regardless of the diabetes status (p for interaction 0.48). Conclusions In this cohort of ACS patients, the presence of diabetes stratified by insulin therapy was associated with a graded increase in the 1-year rates of MACE. Conversely, insulin therapy significantly contributed to the overall increase of bleeding risk in diabetes. Funding Acknowledgement Type of funding source: None

Combination of AST to ALT and neutrophils to lymphocytes ratios as predictors of locally advanced disease in patients with bladder cancer subjected to radical cystectomy: Results from a single-institutional series

2021 ◽  
pp. 039156032110351
Author(s):  
Alessandro Uleri ◽  
Rodolfo Hurle ◽  
Roberto Contieri ◽  
Pietro Diana ◽  
Nicolòmaria Buffi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Advanced Disease ◽  
Independent Predictor ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Small Sample ◽  
Locally Advanced Disease ◽  
Increased Risk

Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease. Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). Methods: We retrospectively analyzed clinical and pathological data of 139 consecutive patients who underwent RC at our institution. Logistic regression models (LRMs) were fitted to test the above-mentioned outcomes. Results: A total of 139 consecutive patients underwent RC at our institution. Eighty-six (61.9%) patients had a locally-advanced disease. NLR (2.53 and 3.07; p = 0.005) and DRR (1 and 1.17; p = 0.01) were significantly higher in patients with locally-advanced disease as compared to organ-confined disease. In multivariable LRMs, an increasing DRR was an independent predictor of locally-advanced disease (OR = 3.91; 95% CI: 1.282–11.916; p = 0.017). Similarly, an increasing NLR was independently related to presence of locally-advanced disease (OR = 1.28; 95% CI: 1.027–1.591; p = 0.028). In univariate LRMs, patients with DRR > 1.21 had a higher risk of locally advanced disease (OR = 2.83; 95% CI: 1.312–6.128; p = 0.008). Similarly, in patients with NLR > 3.47 there was an increased risk of locally advanced disease (OR = 3.02; 95% CI: 1.374–6.651; p = 0.006). In multivariable LRMs, a DRR > 1.21 was an independent predictor of locally advanced disease (OR = 2.66; 95% CI: 1.12–6.35; p = 0.027). Similarly, an NLR > 3.47 was independently related to presence of locally advanced disease (OR = 2.24; 95% CI: 0.95–5.25; p = 0.065). No other covariates such as gender, BMI, neoadjuvant chemotherapy or diabetes reached statistical significance. The AUC of the multivariate LRM to assess the risk of locally advanced disease was 0.707 (95% CI: 0.623–0.795). Limitations include the retrospective nature of the study and the relatively small sample size.

scholarly journals Insulin Resistance as a Predictor of Cardiovascular Disease in Patients on peritoneal dialysis

2013 ◽  
Vol 33 (4) ◽  
pp. 411-418 ◽  
Author(s):  
Yun Li ◽  
Lihua Zhang ◽  
Yong Gu ◽  
Chuanming Hao ◽  
Tongying Zhu
Keyword(s):  
Insulin Resistance ◽  
Peritoneal Dialysis ◽  
Independent Predictor ◽  
Hazard Ratio ◽  
Diabetic Patients ◽  
Model Assessment ◽  
Mortality Hazard ◽  
Cv Disease ◽  
The Impact ◽  
Mortality Hazard Ratio

BackgroundInsulin resistance is associated with multiple risk factors for cardiovascular (CV) disease in the general population. Patients on peritoneal dialysis (PD) are more likely to develop insulin resistance. However, no evaluation of the impact of insulin resistance on CV disease morbidity or mortality in patients on PD has been performed.MethodsOur prospective cohort study included all non-diabetic patients on PD at our center ( n = 66). Insulin resistance was evaluated at baseline by the homeostasis model assessment method (HOMA-IR) using fasting glucose and insulin levels. The cohort was followed for up to 58 months (median: 41.3 months; interquartile range: 34.3 months). A multivariate Cox model was used to analyze the impact of insulin resistance on CV disease mortality.ResultsFourteen CV events occurred in the higher HOMA-IR group [IR-H (HOMA-IR values in the range 2.85 – 19.5), n = 33], but only one event occurred in the lower HOMA-IR group (IR-L (HOMA-IR values in the range 0.83 – 2.71), n = 33) during the follow-up period. Level of HOMA-IR was a significant predictor of CV events [risk ratio: 17.7; 95% confidence interval (CI): 2.10 to 149.5; p = 0.008]. In the IR-H group, 10 patients died (8 CV events), but in the IR-L group, only 4 patients died (1 CV event). Patients in the IR-H group experienced significantly higher CV mortality (hazard ratio: 9.02; 95% CI: 1.13 to 72.2; p = 0.04). Even after adjustments for age, systolic blood pressure, body mass index, C-reactive protein, triglycerides, resistin, and leptin, HOMA-IR remained an independent predictor of CV mortality (hazard ratio: 14.8; 95% CI: 1.22 to 179.1; p = 0.03).ConclusionsInsulin resistance assessed using HOMA-IR was an independent predictor of CV morbidity and mortality in a cohort of nondiabetic patients on PD. Insulin resistance is a modifiable risk factor; the reduction of insulin resistance may reduce CV risk and improve survival in this group of patients.

scholarly journals Calcium Channel Autoantibodies Predicted Sudden Cardiac Death and All-Cause Mortality in Patients with Ischemic and Nonischemic Chronic Heart Failure

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Haiyun Yu ◽  
Juanhui Pei ◽  
Xiaoyan Liu ◽  
Jingzhou Chen ◽  
Xian Li ◽  
...  
Keyword(s):  
Heart Failure ◽  
Multivariate Analysis ◽  
Sudden Cardiac Death ◽  
Chronic Heart Failure ◽  
Cardiac Death ◽  
Independent Predictor ◽  
All Cause Mortality ◽  
Patient Prognosis ◽  
The Relationship

The purpose of this study was to evaluate whether CC-AAbs levels could predict prognosis in CHF patients. A total of 2096 patients with CHF (841 DCM patients and 1255 ICM patients) and 834 control subjects were recruited. CC-AAbs were detected and the relationship between CC-AAbs and patient prognosis was analyzed. During a median follow-up time of 52 months, there were 578 deaths. Of these, sudden cardiac death (SCD) occurred in 102 cases of DCM and 121 cases of ICM. The presence of CC-AAbs in patients was significantly higher than that of controls (bothP<0.001). Multivariate analysis revealed that positive CC-AAbs could predict SCD (HR 3.191, 95% CI 1.598–6.369 for DCM; HR 2.805, 95% CI 1.488–5.288 for ICM) and all-cause mortality (HR 1.733, 95% CI 1.042–2.883 for DCM; HR 2.219, 95% CI 1.461–3.371 for ICM) in CHF patients. A significant association between CC-AAbs and non-SCD (NSCD) was found in ICM patients (HR = 1.887, 95% CI 1.081–3.293). Our results demonstrated that the presence of CC-AAbs was higher in CHF patients versus controls and corresponds to a higher incidence of all-cause death and SCD. Positive CC-AAbs may serve as an independent predictor for SCD and all-cause death in these patients.

Adjuvant Supplementation with L-Carnitine in Diabetic Population and its effects on Lipid Parameters

2021 ◽  
Vol 15 (8) ◽  
pp. 2017-2019
Author(s):  
Rao Salman Aziz ◽  
Usman Saeed ◽  
Nasim Aslam Ghumman ◽  
Muhammad Arshad ◽  
Asif Sohail ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Triglyceride Level ◽  
Clinical Care ◽  
Diabetic Patients ◽  
Healthy Population ◽  
Patients With Diabetes ◽  
Diabetic Population ◽  
Large Discount ◽  
The Impact ◽  
Lipid Parameters

Background: Diabetes is a complicated disease requires continuous clinical care, to govern blood sugar. Aim: To decides the impact of management of L carentin to diabetics at the lipid profile. Methods: This study turned into performed on 120 diabetic Patients had been decided on from endocrinology and diabetes, inside decided on standards. The Patients distributed into three Strata (1st Strata of healthy population and two Strata of patients with diabetes who were on metformin and glibenclamide, one Strata took a L carnitine in a dose of 1000 mg TDS and a Strata dealing with a placebo for a period of ninety days). Results: It is observed those who are on Lcarnitine, confirmed a large discount (p <0.05) with inside the triglyceride level, at the same time as no large adjustments had been located withinside the level of cholesterol and HDL and LDL. Conclusion: These study outcomes that management of L carentin improved profile of lipid in type-2diabetic Patients. Keyword: Dyslipidemia, Diabetes mellitus (DM), l-carnitine (LC).

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