scholarly journals Atherogenic Index in Type 2 Diabetes and Its Relationship with Chronic Microvascular Complications

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Zhen Li ◽  
Qi Huang ◽  
Li Sun ◽  
Tengfei Bao ◽  
Zhe Dai
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
High Risk ◽  
Waist Circumference ◽  
Microvascular Complications ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Atherogenic Index ◽  
Lipid Lowering

Objective. This study was designed to investigate risk factors related to atherogenic index of plasma (AIP), as well as the relationship between AIP and chronic microvascular complications in patients with type 2 diabetes (T2DM). Methods. This study included 2523 patients with T2DM who had not been treated with lipid-lowering drugs and were admitted to the Department of Endocrinology at Zhongnan Hospital, Wuhan University, during the period from January 2015 to February 2018. Anthropometric indicators were measured after overnight fasting. Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) were detected by enzymatic analysis. Standard 75 g oral glucose tolerance testing was performed to measure 0 and 2 hr plasma levels of glucose and insulin. Insulin sensitivity was assessed with HOMA-IR. Results. Increase in AIP was associated with an increased risk for hypertension (P<0.05), HbA1c (P<0.05), HOMA-IR (P<0.05), UA (P<0.05), and decreased eGFR levels (P<0.05). Furthermore, AIP values directly correlated with BMI (r=0.182, P<0.001), waist circumference (r=0.129, P<0.001), blood glucose index (FBG (r=0.153, P<0.001), PPBG (r=0.117, P<0.001), and HbA1c (r=0.074, P<0.001)), insulin resistance (HOMA-IR; r=0.112, P<0.001), and uric acid (UA, r=0.177, P<0.001). Multiple logistic regression analysis showed that waist circumference, HOMA-IR, FBG, systolic blood pressure, and UA were independent risk factors for AIP (all P<0.05). The prevalence of diabetic neuropathy and metabolic syndrome was significantly higher among patients with higher AIP. Conclusion. AIP represents a clinically convenient indicator for the detection of T2DM with high risk of complications and associated diseases and thus is a good predictor and indicator for follow-up monitoring in the treatment of patients with high-risk type 2 diabetes.

scholarly journals Control of Risk Factors for Cardiovascular Disease Among Adults with Previously Diagnosed Type 2 Diabetes Mellitus: A Descriptive Study from a Middle Eastern Arab Population

2012 ◽  
Vol 6 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Jawad A Al-Lawati ◽  
Mohammed N. Barakat ◽  
Ibrahim Al-Zakwani ◽  
Medhat K. Elsayed ◽  
Masoud Al-Maskari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Risk Factor ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Cvd Risk

Background: Despite the high burden of type 2 diabetes mellitus (T2DM) in Oman, there are scarce data from a nationally representative sample on the level of glycaemia and other cardiovascular (CVD) risk factor control. Objective: To estimate the proportion of patients with T2DM at goal for glycaemia and CVD risk factors using the National Diabetes Guidelines (NDG) and the American Diabetes Association (ADA) clinical care guidelines; and to assess the quality of selected services provided to patients with T2DM. Methods: A sample of 2,551 patients (47% men) aged ≥20 years with T2DM treated at primary health care centers was selected. Patient characteristics, medical history and treatment were collected from case notes, Diabetes Registers and computer frameworks including the use of the last 3 laboratory investigations results and blood pressure (BP) readings recorded in 2007. Results: The overall mean age of the cohort was 54±13 years with an average median duration of diabetes of 4 (range 2 to 6) years. Over 80% of patients were overweight or obese (body mass index (BMI) of ≥25 Kg/m2). Sixty-nine percent were on oral anti-diabetic medication, 52% on anti-hypertensives and 40% on lipid lowering drugs. Thirty percent of patients were at goal for glycosylated haemoglobin level (<7%), 26% for BP (systolic/diastolic <130/80 mmHg), 55% for total cholesterol (<5.2 mmol/l), 4.5% for low-density lipoprotein cholesterol (<1.8 mmol/l), 52% for high-density lipoprotein cholesterol (>1 mmol/l for men, >1.3 mmol/l for women), and 61% for triglycerides (<1.7 mmol/l). Over 37% had micro-albuminuria and 5% had diabetic nephropathy. Conclusion: Control of hyperglycaemia and other CVD risk factor appears to be suboptimal in Omani patients with T2DM and need to be addressed in the triad of patient, physician and health system.

Transcription Factor 7-Like-2 (TCF7L2) rs7903146 (C/T) Polymorphism in Patients with Type 2 Diabetes Mellitus

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Arig Aly Seif ◽  
Amira Ibrahim Hamed ◽  
Ahmed Mohamed Bahaaeldin ◽  
Walaa Ahmed Yousry Kabiel ◽  
Mohamed Ahmed Abo El Azm
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Transcription Factor ◽  
High Risk ◽  
Gene Polymorphism ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Tcf7l2 Rs7903146

Abstract Background Type 2 diabetes mellitus (T2DM) is a heterogeneous group of metabolic disorders characterized by the incapability of pancreatic beta cells to increase insulin secretion to compensate for insulin resistance in the peripheral tissues. T2DM is a multi-factorial disease including several environmental factors with the presence of genetic predisposition. The transcription factor 7-like-2 gene (TCF7L2) rs7903146 (C/T) polymorphism is one of the most susceptible genes to T2DM discovered to date, with contribution to the disease through the Wnt/β –catenin signaling pathway affecting pancreatic islet development, expression of several genes involved in insulin granules exocytosis and the incretin glucagon-like peptide 1 (GLP-1) gene. Aim of the Work In this study we aimed to investigate the potential association of the transcription factor 7-like-2 (TCF7L2) rs7903146 (C/T) gene polymorphism in patients with type 2 diabetes mellitus. Patients and Methods The study was a case- control study conducted on 70 T2DM patients recruited from the endocrinology clinic at Ain Shams University Hospitals, and 30 non diabetic healthy controls matched with the patients in age and sex. All subjects underwent full history taking, thorough clinical examination, routine laboratory investigations including haemoglobin A1c (HbA1c), lipid profile; total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) and determination of TCF7L2 gene polymorphism by real-time quantitative polymerase chain reaction (RT-PCR). Results The minor T allele of the rs7903146(C/T) SNP was associated with high risk of development of T2DM with an OR of 1.35 (95% CI: 0.68-2.6), the heterozygous genotype (CT) with an OR 1.16 (95% CI: 0.49-2.7) and the homozygous mutant genotype (TT) with OR of 3.16 (95% CI: 0.15-6.31), however, they were statistically insignificant (p-value &gt;0.05). Conclusion Our study did not confirm the presence of significant association between the TCF7L2 rs7903146(C/T) polymorphism and T2DM, however, it pointed to the possibility of presence of high risk of development of T2DM in patients with TT genotype. Further studies with higher sample size are needed to clarify the association.

The Atherogenic Index of Plasma: A Powerful and Reliable Predictor for Coronary Artery Disease in Patients With Type 2 Diabetes

Angiology ◽  
2021 ◽  
pp. 000331972110121
Author(s):  
Kuo Zhou ◽  
Zheng Qin ◽  
Jinfan Tian ◽  
Kongyong Cui ◽  
Yunfeng Yan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Atherogenic Index ◽  
Atherogenic Index Of Plasma ◽  
Artery Disease ◽  
Cad Risk

We evaluated the predictive power of the atherogenic index of plasma (AIP) for coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). A total of 3278 patients who underwent coronary angiography were consecutively enrolled, including 2052 patients with CAD and 1226 patients with T2DM but without CAD. Patients in the CAD group had higher levels of triglyceride (TG), total cholesterol, low-density lipoprotein cholesterol, AIP and a lower level of high-density lipoprotein cholesterol (HDL-C). In correlation analyses, AIP correlated positively with body mass index, log (homeostasis model assessment of insulin resistance), TG, remnant lipoprotein cholesterol, non–HDL-C, but negatively with age and HDL-C. Multivariate logistic regression analyses demonstrated that AIP was an independent risk factor for CAD in diabetic patients and was validated by multiple models. Furthermore, the ORs for CAD risk were raised with increasing AIP quartiles; ORs of AIP quartiles Q2–Q4 compared with Q1 were 1.56, 1.70, and 2.22, respectively ( Ps < .001), which suggested AIP was the lipid parameter that most strongly associated with incident CAD. In conclusion, AIP is a powerful and reliable biomarker for predicting CAD risk beyond individual lipid profiles in patients with T2DM.

scholarly journals Transcription Factor 7-Like-2 (TCF7L2) rs7903146 (C/T) Polymorphism in Patients with Type 2 Diabetes Mellitus

2020 ◽  
Vol 26 (3) ◽  
pp. 112-118
Author(s):  
Ahmed Mohamed Bahaaeldin ◽  
Arig Aly Seif ◽  
Amira Ibrahim Hamed ◽  
Walaa Ahmed Yousry Kabiel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Transcription Factor ◽  
High Risk ◽  
Gene Polymorphism ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Peripheral Tissues

<b><i>Introduction:</i></b> Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by the incapability of pancreas to increase insulin secretion to compensate for insulin resistance in the peripheral tissues. T2DM is a multifactorial disease including several environmental factors with the presence of genetic predisposition. The transcription factor 7-like-2 gene (<i>TCF7L2</i>) rs7903146 (C/T) polymorphism is one of the most susceptible genes to T2DM discovered to date, with contribution to the disease through the Wnt/β-catenin signaling pathway affecting pancreatic islet development, expression of several genes involved in insulin granules exocytosis, and the incretin glucagon-like peptide 1 (<i>GLP-1</i>) gene. Then, <i>TCF7L2</i> gene seems to affect diabetes susceptibility through B-cell dysfunction that is why we studied its association with T2DM in particular. <b><i>Objectives:</i></b> To investigate the potential association of the transcription factor 7-like-2 (<i>TCF7L2</i>) rs7903146 (C/T) gene polymorphism in patients with T2DM. <b><i>Methods:</i></b> A case-control study conducted on 70 T2DM patients recruited from the endocrinology clinic at Ain Shams University Hospitals, and 30 non-diabetic healthy controls age- and sex-matched with the patients. All subjects underwent full history taking; thorough clinical examination; routine laboratory investigations including hemoglobin A1c, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol; and determination of <i>TCF7L2</i> gene polymorphism by qRT-PCR. <b><i>Results:</i></b> The minor T allele of the rs7903146(C/T) SNP was associated with high risk of development of T2DM with an OR of 1.35 (95% CI: 0.68–2.6) and the heterozygous genotype (CT) with an OR 1.16 (95% CI: 0.49–2.7); however, they were statistically insignificant (<i>p</i> value &#x3e;0.05). <b><i>Conclusion:</i></b> Our study did not confirm the presence of significant association between the <i>TCF7L2</i> rs7903146(C/T) polymorphism and T2DM; however, it pointed out the possibility of presence of high risk of development of T2DM in patients with TT genotype. Further studies with higher sample size are needed to clarify the association.

scholarly journals Prenatal Lead Exposure, Type 2 Diabetes, and Cardiometabolic Risk Factors in Mexican Children at Age 10–18 Years

2019 ◽  
Vol 105 (1) ◽  
pp. 210-218 ◽  
Author(s):  
Yun Liu ◽  
Adrienne S Ettinger ◽  
Martha Téllez-Rojo ◽  
Brisa N Sánchez ◽  
Zhenzhen Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Prenatal Exposure ◽  
Lead Exposure ◽  
Cardiometabolic Risk ◽  
Density Lipoprotein ◽  
Public Hospitals ◽  
Cardiometabolic Risk Factors ◽  
Lipoprotein Cholesterol

Abstract Context Several cross-sectional studies have assessed the association of lead exposure with type 2 diabetes and cardiometabolic risk factors in adults; however, studies of such associations in childhood are rare. Objective We assessed the prospective associations of prenatal exposure to lead with type 2 diabetes and cardiometabolic risk factors in children. Design The Early Life Exposure in Mexico to Environmental Toxicants is a birth cohort study of pregnant women and their offspring. Setting Public hospitals in Mexico City. Patients or Other Participants Women were recruited during pregnancy; their offspring were recruited for a follow-up visit at age 10 to 18 years (n = 369). Main Outcome Measures We measured fasting serum markers of type 2 diabetes and cardiometabolic risk factors in children, including fasting glucose, insulin, and lipids. The index of insulin resistance was calculated. Results The geometric mean of maternal blood lead levels (BLLs) during pregnancy was 4.3 µg/dL (95% confidence interval [CI]): 4.0-4.6 µg/dL) in the entire sample. In boys, those with maternal BLLs ≥ 5 µg/dL (compared with those with BLLs &lt; 5 µg/dL) had significantly lower z scores for total cholesterol (β = -0.41, 95% CI: -0.71, -0.12), high-density lipoprotein cholesterol (β = -0.32, 95% CI: -0.59, -0.05), and low-density lipoprotein cholesterol (β = -0.52, 95% CI: -0.81, -0.22), adjusting for covariates. No associations were detected in girls. Conclusions In our study, we found that higher prenatal exposure to lead was associated with lower levels of cholesterol in children following a sex-specific pattern. Further studies with a larger sample size that examine whether sex is a potential modifier are needed to confirm our findings.

Prevalence of type 2 diabetes and associated risk factors among Saharawi refugees in Algeria

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Henjum ◽  
M K R Kjollesdal ◽  
M O Flaaten ◽  
E Andersen ◽  
V T Hjellset ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
High Risk ◽  
Waist Circumference ◽  
Overweight And Obesity ◽  
Refugee Camps ◽  
High Blood Glucose ◽  
Effective Manner ◽  
Associated Risk Factors

Abstract Background The Saharawi refugees have been living in refugee camps in the Algerian desert since 1975 and are dependent on food aid. A double burden of malnutrition by the coexistence of undernutrition among children and overweight and obesity among adults has been observed in the Saharawi refugee camps. Limited knowledge about the prevalence of type 2 diabetes (T2D) and associated risk factors exists in this population. The aim of this study was, therefore, to address this gap in the literature. Methods A cross-sectional survey was carried out in five Saharawi refugee camps in Algeria in 2014. A total of 180 women and 175 men were included. HbA1c was used to assess the prevalence of T2D and prediabetes. The Finnish Diabetes Risk Score (FINDRISC) was used to estimate the risk of developing T2D. Multiple logistic regressions were performed to assess risk factors associated with T2D and prediabetes. Results Median (min, max) HbA1c among the Saharawi refugees was 35 (4, 135) mmol/mol. The prevalence of T2D and prediabetes was 7% and 10%, respectively. The prevalence of overweight and obesity combined was 45%, and higher in women than in men. According to FINDRISC, 9% of participants had high risk of developing diabetes and 10% had moderate risk. In adjusted models, significant predictors for T2D were age, waist circumference and having a first-degree relative with T2D. Significant predictors for prediabetes were age, body mass index (BMI), waist circumference and a history of high blood glucose. Conclusions We found moderate prevalence of diabetes and prediabetes and a relatively high prevalence of overweight and obesity among the Saharawi refugees, especially the women. Given the fragility of the Saharawi health care system, screening for diabetes should be conducted in a cost-effective manner and high-risk individuals should receive advice about lifestyle changes (e.g. diet and physical activity). Key messages We found moderate prevalence of diabetes and pre-diabetes among the Saharawi refugees, and a high proportion were classified as overweight or obese. In light of this, the rates of T2D are likely to increase in the near future. The Saharawi health authorities should pay attention to the increased risk of diabetes in this vulnerable population.

scholarly journals Efficacy and Safety of Alirocumab 300 mg Every 4 Weeks in Individuals With Type 2 Diabetes on Maximally Tolerated Statin

2019 ◽  
Vol 104 (11) ◽  
pp. 5253-5262 ◽  
Author(s):  
Dirk Müller-Wieland ◽  
Daniel J Rader ◽  
Patrick M Moriarty ◽  
Jean Bergeron ◽  
Gisle Langslet ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dose Adjustment ◽  
Low Density Lipoprotein ◽  
Injection Site Reaction ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Upper Respiratory Tract ◽  
Efficacy And Safety

Abstract Context In the ODYSSEY CHOICE I trial, alirocumab 300 mg every 4 weeks (Q4W) was assessed in patients with hypercholesterolemia. Alirocumab efficacy and safety were evaluated in a patient subgroup with type 2 diabetes mellitus (T2DM) and who were receiving maximally tolerated statins with or without other lipid-lowering therapies. Methods Participants received either alirocumab 300 mg Q4W (n = 458, including 96 with T2DM) or placebo (n = 230, including 50 with T2DM) for 48 weeks, with alirocumab dose adjustment to 150 mg every 2 weeks at Week (W) 12 if W8 low-density lipoprotein cholesterol (LDL-C) levels were ≥70 mg/dL or ≥ 100 mg/dL, depending on cardiovascular risk, or if LDL-C reduction was <30% from baseline. Efficacy end points included percentage change from baseline to W24 for lipids, and time-averaged LDL-C over W21 to W24. Results In individuals with T2DM, LDL-C reductions from baseline to W24 and the average of W21 to W24 were significantly greater with alirocumab (−61.6% and −68.8%, respectively) vs placebo. At W24, alirocumab significantly reduced levels of non–high-density lipoprotein cholesterol (HDL-C) and other lipids. At W24, 85.9% and 12.5% of individuals in the alirocumab and placebo groups, respectively, reached both non–HDL-C <100 mg/dL and LDL-C <70 mg/dL. At W12, In total, 18% of alirocumab-treated participants received dose adjustment. The most common treatment-emergent adverse events were upper respiratory tract infection and injection-site reaction. No clinically significant changes in fasting plasma glucose and glycated hemoglobin were observed. Conclusion In individuals with T2DM, alirocumab 300 mg Q4W was generally well tolerated and efficacious in reducing atherogenic lipoproteins.

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