scholarly journals Associations of markers of arterial stiffness and remodeling with new-onset type 2 diabetes mellitus

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
F Ahmadizar ◽  
K Wang ◽  
F Mattace Raso ◽  
MA Ikram ◽  
M Kavousi

Abstract Funding Acknowledgements Type of funding sources: None. Background. Arterial stiffness/remodeling results in impaired blood flow and, eventually, decreased glucose disposal in peripheral tissues and increased blood glucose. Besides, increased arterial stiffness/remodeling may lead to hypertension, as a potential reciprocal risk factor for type 2 diabetes mellitus (T2D). We, therefore, hypothesized that increased arterial stiffness/remodeling is associated with an increased risk of T2D. Purpose. To study the associations between arterial stiffness/remodeling and incident T2D. Methods. We used the prospective population-based Rotterdam Study. Common carotid arterial properties were ultrasonically determined in plaque-free areas. Aortic stiffness was estimated by carotid-femoral pulse wave velocity (cf_PWV), carotid stiffness was estimated by the carotid distensibility coefficient (carDC). Arterial remodeling was estimated by carotid artery lumen diameter (carDi), carotid intima-media thickness (cIMT), mean circumferential wall stress (CWSmean), and pulsatile circumferential wall stress (CWSpuls). Cox proportional hazard regression analysis was used to estimate the associations between arterial stiffness/remodeling and the risk of incident T2D, adjusted for age, sex, cohort, mean arterial pressure (MAP), antihypertensive medications, heart rate, non- high-density lipoprotein (HDL)-cholesterol, lipid-lowering medications, and smoking. We included interaction terms in the fully adjusted models to study whether any significant associations were modified by sex, age, blood glucose, or MAP. Spearman correlation analyses were applied to examine the correlations between measurements of arterial stiffness/remodeling and glycemic traits. Results. We included 3,055 individuals free of T2D at baseline (mean (SD) age, 67.2 (7.9) years). During a median follow-up of 14.0 years, 395 (12.9%) T2D occurred. After adjustments, higher cf_PWV (hazard ratio (HR),1.18; 95%CI:1.04-1.35), carDi (1.17; 1.04-1.32), cIMT (1.15; 1.01-1.32), and CWSpuls (1.28; 1.12-1.47) were associated with increased risk of incident T2D. After further adjustment for the baseline glucose, the associations attenuated but remained statistically significant. Sex, age, blood glucose, or MAP did not modify the associations between measurements of arterial stiffness/remodeling, and incident T2D. Among the population with prediabetes at baseline (n = 513) compared to the general population, larger cIMT was associated with a greater increase in the risk of T2D. Most measurements of arterial stiffness/remodeling significantly but weakly correlated with baseline glycemic traits, particularly with blood glucose.  Conclusions. Our study suggests that greater arterial stiffness/remodeling is independently associated with an increased risk of T2D development. Blood glucose and hypertension do not seem to play significant roles in these associations. Further studies should disentangle the underlying mechanism that links arterial stiffness/remodeling and T2D.

Author(s):  
Dr. Harish Basera ◽  
Dr. K.C. Pant

Introduction: Thyroid hormone deficiency can lead to adverse health effects even death, if left untreated. It is a pathological condition known as hypothyroidism. Most common symptoms of hypothyroidism in adults are weight gain, fatigue, lethargy, cold intolerance, constipation, and dry skin. These clinical presentations can differ with age and sex, among other factors. Thyroid Stimulating Hormone (TSH), is associated with an increased risk of developing a number of clinical conditions, like cardiovascular diseases, diabetes, lung disease, malignant condition, and psychiatric disorders, both before and after the diagnosis of thyroid dysfunction. Type 2 Diabetes Mellitus (T2DM) is the chronic endocrine disease which is characterized by hyperglycemia resulting in impaired insulin secretion insulin resistance. Material and Methods: This prospective observational study was carried out at OPD of Dept. of Medicine at Govt. Doon Medical College and Hospital. The study period was between jan2019 to August 2019. The anthropometric measurements and demographic characteristics of patients included in the study were recorded. The clinical details and medications are entered into Excel sheet of Microsoft Excel 2013. Biochemical tests were done and reports were entered. Results: Prevalence of hypothyroidism in T2DM is found to be 10.94% in our study. Average BMI was observed to be 28.01 kg/m2 with SD of 3.39 kg/m2. Level of T3 and T4 were observed to be 0.98(0.23) ng/ml and 1.24(0.29) ng/ml respectively. Fasting blood glucose level was 133.05(17.81) mg/dl and post prandial blood glucose level was 201.54(27.33) mg/dl. Among all 112 patients, 71(63.39%) of cases had a family history of diabetes. Conclusion: It is noted that one-tenth of patients with type 2 diabetes mellitus has hypothyroidism. BMI was noted to be more than 28 kg/m2 among all patients. Hypothyroidism may be prevalent in T2DM patients due to duration of diabetes, obesity. To confirm the findings, more studies in this area are required. Keywords: T2DM, Hypothyroidism, TSH, T3, T4.


Cureus ◽  
2021 ◽  
Author(s):  
Yazid A Alghamdi ◽  
Faisal S Al-Shahrani ◽  
Saif S Alanazi ◽  
Fahad A Alshammari ◽  
Abdullah M Alkhudair ◽  
...  

2020 ◽  
Author(s):  
Elina Rautio ◽  
Fredrik Gadler ◽  
Soffia Gudbjörnsdottir ◽  
Stefan Franzén ◽  
Lars Rydén ◽  
...  

<b><i>Objective</i></b><i>: </i>Patients with type 2<i> </i>diabetes mellitus have an increased risk for cardiovascular disease including arrhythmias. The prevalence of bradyarrhythmia and the subsequent need for treatment with pacemakers (PM) is less well explored in a contemporary patient population. The present study explores 1) whether patients with type 2 diabetes mellitus have an increased demand for PM implantation compared with an age- and sex-matched control population without diabetes mellitus; 2) Patient characteristics associated with increased demand of receiving a PM. <p><b><i>Methods</i></b><b>:</b> In this population-matched registry study a total of 416 247 patients with type 2 diabetes mellitus from the Swedish National Diabetes Registry (NDR) and 2 081 235 age and sex-matched controls selected from the general population were included between 1 January 1998 and 31 December 2012 and followed until 31 December 2013. Mean follow-up time was 7 years. Cox’s proportional hazard regression analyses were performed to estimate the demand of PM-treatment and factors identifying patients with such demand.</p> <p><b><i>Results:</i></b> Type 2 diabetes mellitus was associated with increased need of PM-treatment (Hazard ratio (HR) 1.65, 95% CI 1.60-1.69; p<0.0001) which remained (HR 1.56, 95% CI 1.51-1.60; p<0.0001) after adjustments for age, sex, educational level, marital status, country of birth and coronary heart disease. Risk factors for receiving a PM included increasing age, HbA1c, BMI, diabetes duration, blood pressure- and lipid lowering medication.</p> <p><b><i>Conclusion</i></b><i>: </i>The need for PM treatment is higher in patients with type 2 diabetes than in matched population-based controls. Age, diabetes duration and HbA1c seem to be risk factors for PM treatment. </p>


2015 ◽  
Vol 61 (1) ◽  
pp. 46-50
Author(s):  
Zh T Isakova ◽  
E T Talaibekova ◽  
O S Lunegova ◽  
D A Asambarva ◽  
A S Kerimkulova ◽  
...  

A population of ethnic Kyrgyz was examined with a view to elucidating the relationship between the adiponectin G276T gene polymorphic locus and the development of abdominal obesity (AO). The study included 288 subjects at the age between 40 and 70 years. 139 of them (81 women and 58 men) presented with AO while 149 without obesity (62 women and 87 men) constituted the control group. The measured anthropometric parameters included arterial pressure, blood glucose, insulin, and leptin levels, blood lipid composition. Genotypes of adiponectin (AN) G276T gene polymorphism were identified by means of PCR-RFLP analysis. The relationship between the presence of the adiponectin G276T gene polymorphic and the development of abdominal obesity in the women was demonstrated. Specifically, 31% of the women with AO were carriers of T allele compared with 17% in the control group (χ2=7.89; p =0.005). The GT + TT genotype and carriage of T allele were associated with an increased risk of development of abdominal obesity (OR=2.5; 95% CI = 1.25-4.97 for the genotype and OR = 2.2; 95% CI = 1.26-4.000 for the allele). No such relationship was documented among men. The women with AO and GT+TT genotype more frequently than homozygotes presented with type 2 diabetes mellitus (64 and 37% respectively; p=0.017), hypertriglyceridemia (41 and 16.2% respectively; p=0.016), and enhanced blood glucose level (7.74±3.3 and 6.52±1.17; p=0.033). Moreover, their HOMA index was higher than in the homozygotes (3.5±1.7 and 2.63±1.24 respectively; p=0.02). It is concluded that the adiponectin G276T gene polymorphic variant in the women of Kyrgyz ethnicity is associated with abdominal obesity, type 2 diabetes mellitus, hyperglycemia, and hypertriglyceridemia.


2016 ◽  
Vol 4 (4) ◽  
pp. 155-161 ◽  
Author(s):  
Juan José Marín-Peñalver ◽  
Iciar Martín-Timón ◽  
Francisco Javier del Cañizo-Gómez

AbstractBoth hyperglycemia and hypoglycemia in hospitalized patients are associated with adverse outcomes including increased rates of infection, longer hospital length of stay, and even death. Clinical trials in patients with type 2 diabetes mellitus proved that by improving glycemic control, we can reduce all of them. Insulin is the preferred treatment for glycemic control in most cases, but alternative treatment options that can normalize blood glucose levels without hypoglycemia are being sought. Moreover, hospitalized patients are particularly vulnerable to severe, prolonged hypoglycemia since they may be unable to sense or respond to the early warning signs and symptoms of low blood glucose. Finally, nutritional support, corticosteroid therapy, and surgery increase the risk of hyperglycemia that leads to an increased risk of morbidity and mortality. We review the management of type 2 diabetes mellitus patients who are admitted to the general medical wards of the hospital for a procedure of intercurrent illness.


2020 ◽  
Author(s):  
Elina Rautio ◽  
Fredrik Gadler ◽  
Soffia Gudbjörnsdottir ◽  
Stefan Franzén ◽  
Lars Rydén ◽  
...  

<b><i>Objective</i></b><i>: </i>Patients with type 2<i> </i>diabetes mellitus have an increased risk for cardiovascular disease including arrhythmias. The prevalence of bradyarrhythmia and the subsequent need for treatment with pacemakers (PM) is less well explored in a contemporary patient population. The present study explores 1) whether patients with type 2 diabetes mellitus have an increased demand for PM implantation compared with an age- and sex-matched control population without diabetes mellitus; 2) Patient characteristics associated with increased demand of receiving a PM. <p><b><i>Methods</i></b><b>:</b> In this population-matched registry study a total of 416 247 patients with type 2 diabetes mellitus from the Swedish National Diabetes Registry (NDR) and 2 081 235 age and sex-matched controls selected from the general population were included between 1 January 1998 and 31 December 2012 and followed until 31 December 2013. Mean follow-up time was 7 years. Cox’s proportional hazard regression analyses were performed to estimate the demand of PM-treatment and factors identifying patients with such demand.</p> <p><b><i>Results:</i></b> Type 2 diabetes mellitus was associated with increased need of PM-treatment (Hazard ratio (HR) 1.65, 95% CI 1.60-1.69; p<0.0001) which remained (HR 1.56, 95% CI 1.51-1.60; p<0.0001) after adjustments for age, sex, educational level, marital status, country of birth and coronary heart disease. Risk factors for receiving a PM included increasing age, HbA1c, BMI, diabetes duration, blood pressure- and lipid lowering medication.</p> <p><b><i>Conclusion</i></b><i>: </i>The need for PM treatment is higher in patients with type 2 diabetes than in matched population-based controls. Age, diabetes duration and HbA1c seem to be risk factors for PM treatment. </p>


2018 ◽  
Vol 16 (4) ◽  
pp. 368-375 ◽  
Author(s):  
Abdullah Shehab ◽  
Khalid Al-Rasadi ◽  
Mohamed Arafah ◽  
Ali T. Al-Hinai ◽  
Wael Al Mahmeed ◽  
...  

2018 ◽  
Vol 15 (1) ◽  
pp. 31-43 ◽  
Author(s):  
Sayantan Nath ◽  
Sambuddha Das ◽  
Aditi Bhowmik ◽  
Sankar Kumar Ghosh ◽  
Yashmin Choudhury

Background:Studies pertaining to association of GSTM1 and GSTT1 null genotypes with risk of T2DM and its complications were often inconclusive, thus spurring the present study.Methods:Meta-analysis of 25 studies for evaluating the role of GSTM1/GSTT1 null polymorphisms in determining the risk for T2DM and 17 studies for evaluating the role of GSTM1/GSTT1 null polymorphisms in development of T2DM related complications were conducted.Results:Our study revealed an association between GSTM1 and GSTT1 null polymorphism with T2DM (GSTM1; OR=1.37;95% CI =1.10-1.70 and GSTT1; OR=1.29;95% CI =1.04-1.61) with an amplified risk of 2.02 fold for combined GSTM1-GSTT1 null genotypes. Furthermore, the GSTT1 null (OR=1.56;95%CI=1.38-1.77) and combined GSTM1-GSTT1 null genotypes (OR=1.91;95%CI=1.25- 2.94) increased the risk for development of T2DM related complications, but not the GSTM1 null genotype. Stratified analyses based on ethnicity revealed GSTM1 and GSTT1 null genotypes increase the risk for T2DM in both Caucasians and Asians, with Asians showing much higher risk of T2DM complications than Caucasians for the same. </P><P> Discussion: GSTM1, GSTT1 and combined GSTM1-GSTT1 null polymorphism may be associated with increased risk for T2DM; while GSTT1 and combined GSTM1-GSTT1 null polymorphism may increase the risk of subsequent development of T2DM complications with Asian population carrying an amplified risk for the polymorphism.Conclusion:Thus GSTM1 and GSTT1 null genotypes increases the risk for Type 2 diabetes mellitus alone, in combination or with regards to ethnicity.


2020 ◽  
Vol 16 ◽  
Author(s):  
Patricio Lopez-Jaramillo ◽  
Jose Lopez-Lopez ◽  
Daniel Cohen ◽  
Natalia Alarcon-Ariza ◽  
Margarita Mogollon-Zehr

: Hypertension and type 2 diabetes mellitus are two important risk factors that contribute to cardiovascular diseases worldwide. In Latin America hypertension prevalence varies from 30 to 50%. Moreover, the proportion of awareness, treatment and control of hypertension is very low. The prevalence of type 2 diabetes mellitus varies from 8 to 13% and near to 40% are unaware of their condition. In addition, the prevalence of prediabetes varies from 6 to 14% and this condition has been also associated with increased risk of cardiovascular diseases. The principal factors linked to a higher risk of hypertension in Latin America are increased adiposity, low muscle strength, unhealthy diet, low physical activity and low education. Besides being chronic conditions, leading causes of cardiovascular mortality, both hypertension and type 2 diabetes mellitus represent a substantial cost for the weak health systems of Latin American countries. Therefore, is necessary to implement and reinforce public health programs to improve awareness, treatment and control of hypertension and type 2 diabetes mellitus, in order to reach the mandate of the Unit Nations of decrease the premature mortality for CVD.


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