scholarly journals Urinary NGAL and RBP Are Biomarkers of Normoalbuminuric Renal Insufficiency in Type 2 Diabetes Mellitus

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Aimei Li ◽  
Bin Yi ◽  
Yan Liu ◽  
Jianwen Wang ◽  
Qing Dai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Insufficiency ◽  
Urinary Ngal ◽  
Independent Risk Factors ◽  
Pai 1 ◽  
E Cadherin

Objectives. As a screening index of diabetic kidney disease (DKD), urinary albumin/creatine ratio (UACR) is commonly used. However, approximately 23.3%-56.6% of DKD patients with estimated glomerular filtration rate eGFR<60 ml/min per 1.73 m2 are normoalbuminuric. Thus, urinary biomarkers of nonalbuminuric renal insufficiency in type 2 diabetes mellitus (T2DM) patients are urgently needed. Methods. This cross-sectional study enrolled 209 T2DM patients with normoalbuminuria whose diabetes duration was more than 5 years. The patients were classified into two groups, NO-CKD (eGFR≥60 ml/min per 1.73 m2, n=165) and NA-DKD (eGFR<60 ml/min per 1.73 m2, n=44). Levels of urinary neutrophil gelatinase-associated lipocalin (NGAL), retinol-binding protein (RBP), plasminogen activator inhibitor-1 (PAI-1), vascular cell adhesion molecule-1 (VCAM-1), and E-cadherin were detected, and their correlations with eGFR, plasma TNF-α, IL-6, endothelin-1 (ET-1), and 8-hydroxydeoxyguanosine (8-OHdG) were assessed. Results. Among patients with renal insufficiency, 26.0% was normoalbuminuric. Compared to the NO-CKD group, the NA-DKD group was older with lower hemoglobin (HB) levels and higher systolic blood pressure (SBP), plasma TNF-α, IL-6, and 8-OHdG levels. Logistic regression analysis suggested that age, TNF-α, and 8-OHdG were independent risk factors for nonalbuminuric renal insufficiency. Compared to the NO-CKD group, the NA-DKD group exhibited significant increases in urinary NGAL and RBP levels but not PAI-1, VCAM-1, and E-cadherin. Urinary NGAL and RBP both correlated negatively with eGFR and positively with plasma IL-6 and 8-OHdG. Multiple linear regression indicated NGAL (β=−0.287, p=0.008) and RBP (β=−44.545, p<0.001) were independently correlated with eGFR. Conclusion. Age, plasma TNF-α, and 8-OHdG are independent risk factors for renal insufficiency in T2DM patients with normoalbuminuria. Urinary NGAL and RBP can serve as noninvasive biomarkers of normoalbuminuric renal insufficiency in T2DM.

scholarly journals Clinical Significance of Hemostatic Parameters in the Prediction for Type 2 Diabetes Mellitus and Diabetic Nephropathy

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Lianlian Pan ◽  
Yali Ye ◽  
Mingyi Wo ◽  
Danni Bao ◽  
Fengjiao Zhu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
High Sensitivity ◽  
Area Under Roc Curve ◽  
Independent Risk Factors ◽  
Low Sensitivity

It would be important to predict type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN). This study was aimed at evaluating the predicting significance of hemostatic parameters for T2DM and DN. Plasma coagulation and hematologic parameters before treatment were measured in 297 T2DM patients. The risk factors and their predicting power were evaluated. T2DM patients without complications exhibited significantly different activated partial thromboplastin time (aPTT), platelet (PLT), and D-dimer (D-D) levels compared with controls (P<0.01). Fibrinogen (FIB), PLT, and D-D increased in DN patients compared with those without complications (P<0.001). Both aPTT and PLT were the independent risk factors for T2DM (OR: 1.320 and 1.211, P<0.01, resp.), and FIB and PLT were the independent risk factors for DN (OR: 1.611 and 1.194, P<0.01, resp.). The area under ROC curve (AUC) of aPTT and PLT was 0.592 and 0.647, respectively, with low sensitivity in predicting T2DM. AUC of FIB was 0.874 with high sensitivity (85%) and specificity (76%) for DN, and that of PLT was 0.564, with sensitivity (60%) and specificity (89%) based on the cutoff values of 3.15 g/L and 245 × 109/L, respectively. This study suggests that hemostatic parameters have a low predicting value for T2DM, whereas fibrinogen is a powerful predictor for DN.

scholarly journals Incidence and prognostic factors for the development of symptomatic and asymptomatic marginal ulcers after Roux-en-Y gastric bypass procedures

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
J Süsstrunk ◽  
L Wartmann ◽  
D Mattiello ◽  
T Köstler ◽  
U Zingg
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Type 2 Diabetes Mellitus ◽  
Median Time ◽  
Upper Endoscopy ◽  
Independent Risk Factors

Abstract Objective Marginal ulcer (MU) is a serious complication after Roux-en-Y gastric bypass (RYGB) procedures. This study reports the incidence, risk factors and treatment outcomes of symptomatic and incidentally, at routine endoscopy diagnosed, MU. Methods All patients undergoing RYGB procedures between 2013 and 2018 at a single center were included. Upper endoscopy was performed in case of symptoms and/or routinely 2 and 5 years postoperatively. Results 568 patients (83.3% female) underwent RYGB procedure with a median age of 40 years and median initial body mass index of 41 kg/m2. Median time to follow-up was 2.99 years. Routine 2- and 5-year upper endoscopy was performed in 256 (55.3%) and 65 (38.0%) eligible patients, respectively. In 86 (15.1%) patients, MU was diagnosed at a median time of 14.2 months (4.58 – 26.2) postoperatively and 24.4% of patients with MU were asymptomatic. 76.7% of MUs were located on the side of the Roux-limb. 88.4% of MUs were treated conservatively; re-operation was necessary in 10 (11.6%) patients. Smoking and type 2 diabetes mellitus were the only independent risk factors for MU development in multivariate analysis with a hazard ratio of 2.65 and 1.18 (HbA1c per unit &gt;6.0), respectively. Conclusion MU is a common complication after gastric bypass surgery with 25% of patients being asymptomatic. Follow-up routine endoscopy is recommended for early MU detection and subsequent accurate therapy, especially in patients with the independent risk factors smoking and type 2 diabetes mellitus.

Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high-grade glioma

2011 ◽  
Vol 106 (2) ◽  
pp. 383-389 ◽  
Author(s):  
Lola B. Chambless ◽  
Scott L. Parker ◽  
Laila Hassam-Malani ◽  
Matthew J. McGirt ◽  
Reid C. Thompson
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
High Grade Glioma ◽  
High Grade ◽  
Poor Outcome ◽  
Independent Risk Factors

scholarly journals Study on the levels of calcitonin gene-related peptide, somatostatin and inflammatory factors in patients with coronary artery  disease complicated with type 2 diabetes mellitus

2020 ◽  
Author(s):  
Chenyang Zhang ◽  
Lifang Ye ◽  
Qinggang Zhang ◽  
Yingxiang Song ◽  
Lihong Wang
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Inflammatory Factors ◽  
Control Group ◽  
Diabetic Patients ◽  
Independent Risk Factors ◽  
Stable Cad

Abstract BackgroundTo evaluate the level and correlation of serum neuropeptide cakiNnin gene-elated peptide (CORP), somatostatin (SS) and inflammatory factors (CRP, TNF-o, MCP-1 and sICAM-1) in patients with coronary atherosclerotic heart disease (CAD) complicated with type 2 diabetes mellitus (DM), to explore the mechanism of diabetic patients prone to complicated CAD.MethodsPatients were divided into three groups according to corcmary angiography results and whether there was a history of type 2 diabetes: control group (no CAD or DM; n 58), CAD group (stable CAD without DM; n 68) and DM+CAD group (stable CAD+DM; n =66). The age, sex ratio and body mass index (BMI) of the three groups were balanced, and the indexes of serum CORP, SS and inflammatory factors (CRP, TNE-a, IL-113, MCP-1 and sICAM-1) were measured by ELASA method. The relationship between serum CORP, SS and inflammatory factors (CRP, TNE-¢,11,-1), MCP-1 and sICAM-1) were analyzed by Spearman correlation analysis, and the risk factors f CAD were analysed by binary logistic regression model.ResultsThere were significant differences between neuropeptides (CORP, SS) and inflammatory factors (CRP, TNT', IL-I, MCP-1 and sICAM-1) in the th©© groups. Compared with the control group and the CAD group, CGRP and SS were decreased (P < 0.05), and inflammatory factors were significantly increased (P < 0.05) in the DMTCAD group. CGRP and SS were negatively correlated with inflammatory factors. Logistic regression model showed that CORP, SS, 11-10 and MCP-1 were independent risk factors for CAD (P <0.05). ConclusionCompared with the control group and the CAD group, patients in the DMTCAD group had less CGRP and SS but more inflammatory factors. Moreover, the inflammabry factors were negatively correlated with neuropeptides, and neuropeptides and some inflammatory factors are independent risk factors for CAD. This suggests that the TRPV1 injury in the sensory nerve endings and the reduction of neuropeptides release in type 2 diabetic patients may increase the risk of CAD. The mechanism may include that these neuropeptides may inhibit the inflammatory response to some extend

scholarly journals Identification of independent risk factors for diabetic neuropathy progression in patients with type 2 diabetes mellitus

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110443
Author(s):  
Linjing Huang ◽  
Ximei Shen ◽  
Lingning Huang ◽  
Sunjie Yan ◽  
Peiwen Wu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Logistic Regression ◽  
Diabetic Nephropathy ◽  
Multivariate Logistic Regression ◽  
History Of ◽  
Independent Risk Factors

Objective To identify independent risk factors for diabetic neuropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods We retrospectively analyzed 376 patients with T2DM at the First Affiliated Hospital of Fujian Medical University, China between January 2013 and October 2016. Multivariate logistic regression was used to explore potential risk factors for progression of DN in patients with T2DM. Effect sizes were estimated using odds ratios (ORs) and 95% confidence intervals (CIs). Results The prevalence of DN in patients with T2DM was 43.1%. Multivariate logistic regression indicated that retinopathy (OR: 2.755, 95% CI: 1.599–4.746); diabetic nephropathy (OR: 2.196, 95% CI: 1.279–3.772); longer duration of T2DM (OR: 1.081, 95% CI: 1.045–1.120); use of insulin (OR: 1.091, 95% CI: 1.018–1.170); longer history of alcohol consumption (OR: 1.034, 95% CI: 1.010–1.059); and higher blood urea nitrogen (OR: 1.081, 95% CI: 1.009–1.159) were associated with increased risk of DN in patients with T2DM. Conclusions Retinopathy, diabetic nephropathy, longer duration of T2DM, use of insulin, longer history of alcohol consumption, and higher blood urea nitrogen were independent risk factors for DN. These findings should be verified in large-scale prospective studies.

scholarly journals Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia and type 2 diabetes mellitus

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Dong Huang ◽  
Dingxiu He ◽  
Linjing Gong ◽  
Wen Wang ◽  
Lei Yang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Community Acquired Pneumonia ◽  
Independent Risk Factors ◽  
Severe Community Acquired Pneumonia

Abstract Background The present study was performed to investigate the impacts of type 2 diabetes mellitus (T2DM) on severe community-acquired pneumonia (SCAP) and to develop a novel prediction model for mortality in SCAP patients with T2DM. Methods This was a retrospective observational study conducted in consecutive adult patients with SCAP admitted to the intensive care unit (ICU) of West China Hospital, Sichuan University, China, between September 2011 and September 2019. The primary outcome was hospital mortality. A propensity score matching (PSM) analysis model with a 1:2 ratio was used for the comparisons of clinical characteristics and outcomes between T2DM and nondiabetic patients. The independent risk factors were identified via univariate and then multivariable logistic regression analysis and were then used to establish a nomogram. Results In total, 1262 SCAP patients with T2DM and 2524 matched patients without T2DM were included after PSM. Patients with T2DM had longer ICU length of stay (LOS) (13 vs. 12 days, P = 0.016) and higher 14-day mortality (15% vs. 10.8%, P < 0.001), 30-day mortality (25.7% vs. 22.7%, P = 0.046), ICU mortality (30.8% vs. 26.5%, P = 0.005), and hospital mortality (35.2% vs. 31.0%, P = 0.009) than those without T2DM. In SCAP patients with T2DM, the independent risk factors for hospital mortality were increased numbers of comorbidities and diabetes-related complications; elevated C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), brain natriuretic peptide (BNP) and blood lactate; as well as decreased blood pressure on admission. The nomogram had a C index of 0.907 (95% CI: 0.888, 0.927) in the training set and 0.873 (95% CI: 0.836, 0.911) in the testing set, which was superior to the pneumonia severity index (PSI, AUC: 0.809, 95% CI: 0.785, 0.833). The calibration curve and decision curve analysis (DCA) also demonstrated its accuracy and applicability. Conclusions SCAP patients with T2DM had worse clinical outcomes than nondiabetic patients. The nomogram has good predictive performance for hospital mortality and might be generally applied after more external validations.

scholarly journals Prevalence and Clinical Significance of Occult Pulmonary Infection in Elderly Patients with Type 2 Diabetes Mellitus

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jian Hua ◽  
Ping Huang ◽  
Honghui Liao ◽  
Xiaobing Lai ◽  
Xiaoyi Zheng
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Elderly Patients ◽  
Pulmonary Infection ◽  
Senile Dementia ◽  
Bed Rest ◽  
Independent Risk Factors

The occult pulmonary infection is the most common complications in elderly patients with type 2 diabetes mellitus (T2DM). Since its etiological characteristics has not been clarified, infection control remains a serious problem for public health. To investigate the prevalence and clinical significance of occult pulmonary infection in elderly T2DM patients, in this study, 573 elderly patients cochallenged with T2DM and community-acquired pulmonary infection from January 2018 to December 2020 were selected in the hospitals and divided into occult pneumonia group (OP, n = 249 ) and nonoccult pneumonia group (NOP, n = 324 ) according to the nature of infection. Clinical medical records were analyzed retrospectively to summarize the infection characteristics of elderly diabetics with occult pneumonia. The prevalence of the cases (278/324, 85.8%) in NOP group was not higher than that in OP group (206/249, 82.7%; P > 0.05 ). Also, there was not significant difference in the distribution of isolated pathogens among the positive patients. The length of hospitalization and mortality of OP patients were significantly higher than those NOP patients. Multivariate logistic regression showed that advanced age, comorbidities, hypothyroidism, senile dementia, and prolonged bed rest were independent risk factors for occult pneumonia in elderly diabetic patients. Therefore, the results demonstrated that the pulmonary infection in elderly patients with diabetes mellitus is often occult. Gram-negative bacteria are the predominant pathogens and cause poor prognosis. Advanced age, comorbidities (senile dementia, hypothyroidism), and prolonged bed rest are the independent risk factors for occult pneumonia.

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