Abstract MP06: Statins and the Risk of Diabetes Type II in Children Ages 8 to 20 with and without Dyslipidemia

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Nina Joyce ◽  
Justin Zachariah ◽  
Charles Eaton ◽  
Amal trivedi ◽  
Gregory Wellenius
Keyword(s):  
Latency Period ◽  
Type Ii Diabetes Mellitus ◽  
Sensitivity Analyses ◽  
Cumulative Exposure ◽  
Type Ii ◽  
Eligibility Criteria ◽  
Match Rate ◽  
Increased Risk ◽  
Significant Difference ◽  
Statin Use

Introduction: There is increasing evidence of a causal association between statin use and type II diabetes mellitus (T2DM) in adults. However the risk of incident T2DM in children treated with statins is unknown, and a recent study demonstrating a protective effect of familial hypercholesterolemia suggests there may be heterogeneity of effect by the presence of genetic dyslipdemia. We estimated the association between statin use and the risk of T2DM in a commercially insured population ages 8 to 20 from 2004 to 2013 with and without a diagnosis of dyslipidemia. Methods: New users of statins with a minimum 75 percent of days covered (PDC) in the first year of use were matched to up to 10 non-users using year-specific propensity scores within a 0.01 caliper. The outcome was defined as incident T2DM more than 12 months after the match date to address possible confounding by indication and allow for a biologically plausible level of cumulative exposure. Cox proportional hazard models were used to estimate the relative hazards for T2DM among statin users and non-users. Time was defined from the end of the 12 month latency period to either the outcome or censoring. Sensitivity analyses varied the width of this exclusionary window, as well as PDC to test the robustness of our results to study assumptions. Results: There were a total of 13,443,478 patients who met eligibility criteria, 755 (0.1%) of whom were started on statins and met the minimum PDC. Of these, 748 (98%) were matched with no significant difference in the year-specific match rate. Statin use was associated with an increased risk of T2DM in children without dyslipidemia diagnosis (HR 2.75, 95%CI 1.20-6.30, p=0.01), but not in children with a recorded diagnosis of dyslipidemia (HR 1.01, 95%CI 0.59-1.70, p=0.98). The results were robust to variations in the latency period and PDC (figure). Conclusion: Statin use was associated with increased risk of new onset T2DM in children without a dyslipidemia diagnosis, but not in children with a diagnosis of dyslipidemia.

Gastrostomy Tubes Placed in Children With Neurologic Impairment: Associated Morbidity and Mortality

2021 ◽  
pp. 088307382110001
Author(s):  
Jody L. Lin ◽  
Joseph Rigdon ◽  
Keith Van Haren ◽  
MyMy Buu ◽  
Olga Saynina ◽  
...  
Keyword(s):  
Severe Pneumonia ◽  
Sensitivity Analyses ◽  
Tube Placement ◽  
Composite Outcome ◽  
Eligibility Criteria ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Neurologic Impairment ◽  
Increased Risk ◽  
The Impact

Background: Gastrostomy tube (G-tube) placement for children with neurologic impairment with dysphagia has been suggested for pneumonia prevention. However, prior studies demonstrated an association between G-tube placement and increased risk of pneumonia. We evaluate the association between timing of G-tube placement and death or severe pneumonia in children with neurologic impairment. Methods: We included all children enrolled in California Children’s Services between July 1, 2009, and June 30, 2014, with neurologic impairment and 1 pneumonia hospitalization. Prior to analysis, children with new G-tubes and those without were 1:2 propensity score matched on sociodemographics, medical complexity, and severity of index hospitalization. We used a time-varying Cox proportional hazard model for subsequent death or composite outcome of death or severe pneumonia to compare those with new G-tubes vs those without, adjusting for covariates described above. Results: A total of 2490 children met eligibility criteria, of whom 219 (9%) died and 789 (32%) had severe pneumonia. Compared to children without G-tubes, children with new G-tubes had decreased risk of death (hazard ratio [HR] 0.47, 95% confidence interval [CI] 0.39-0.55) but increased risk of the composite outcome (HR 1.21, CI 1.14-1.27). Sensitivity analyses using varied time criteria for definitions of G-tube and outcome found that more recent G-tube placement had greater associated risk reduction for death but increased risk of severe pneumonia. Conclusion: Recent G-tube placement is associated with reduced risk of death but increased risk of severe pneumonia. Decisions to place G-tubes for pulmonary indications in children with neurologic impairment should weigh the impact of severe pneumonia on quality of life.

Retrospective Study on Hospital Admissions due to Pyelonephritis in Type II Diabetic Patients

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Dilraj Dhillon ◽  
Thomas Randall ◽  
David Zezoff ◽  
Mouchumi Bhattacharyya
Keyword(s):  
Retrospective Study ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Type Ii Diabetes Mellitus ◽  
Hospitalized Patients ◽  
Diabetic Patients ◽  
Clean Intermittent Catheterization ◽  
Type Ii ◽  
Indwelling Catheters ◽  
Significant Difference

Background: Pyelonephritis is a urinary tract infection that ascends to involve the kidneys. It can also occur as an infection secondary to bacteremia. Some pathogens that commonly cause pyelonephritis are E. coli, enterobacteriaceae, staphylococci, and pseudomonas. The initial patient presentation usually involves fever, chills, nausea, vomiting, costovertebral angle tenderness, and flank pain. Other cystitis symptoms such as dysuria, increased urinary frequency, malodorous urine, and hematuria may or may not be present. Symptoms of pyelonephritis with bacteriuria are sufficient for the diagnosis of pyelonephritis. Aim: The aim of this study was to investigate a potential link between Type II Diabetes Mellitus and pyelonephritis. Methods: In this retrospective study, hospitalized patients during the study period were reviewed. Variables examined were sex, age, and length of stay. Patients were excluded if they had known urogenital abnormalities, indwelling catheters (Foley, nephrostomy, suprapubic, or who regularly perform clean intermittent catheterization), were pregnant, or were on dialysis. Results: Of 333 patients analyzed, diabetics had a longer length of stay then non-diabetics (4.49 vs 3.67 days respectively; p=0.0041) and females were significantly younger than men in hospitalized patients for pyelonephritis were (50.0 vs 63.5 years; p=<0.0001). Further, it was found that diabetics were significantly older than nondiabetics were (60.4 vs 47.3; p=<0.0001) and more diabetics getting admitted with pyelonephritis were men vs women (59.32% vs 35.27%; p=0.0007). Conclusion: Results of the study were significant in showing that of all pyelonephritis-hospitalized patients on average the length of stay was longer for diabetics and it demonstrated that female patients with pyelonephritis are significantly younger than male patients hospitalized with pyelonephritis. Of note, there was no significant difference in the length of stay for diabetic patients based on their treatment modality (diet controlled vs. oral medications vs. insulin dependent vs. combined). The study also showed that diabetics getting admitted for pyelonephritis are more men and older in age compared to the nondiabetics.

scholarly journals Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus

2019 ◽  
Vol 35 (5) ◽  
Author(s):  
Muhammad Khalid ◽  
Muhammad Kashif Hanif ◽  
Qamar Ul Islam ◽  
Muhammad Asim Mehboob
Keyword(s):  
Endothelial Cell ◽  
Cell Density ◽  
Type Ii Diabetes Mellitus ◽  
Corneal Endothelial Cell ◽  
Endothelial Cell Density ◽  
Diabetic Patients ◽  
Type Ii ◽  
Significant Difference ◽  
Corneal Endothelial Cell Density ◽  
Study Population

Objective: To compare the mean change in Corneal Endothelial cell Density (CED), from baseline (pre-operative value), two months after phacoemulsification cataract surgery between type II diabetic patients and non-diabetic patients. Methods: This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. 80 eyes of 72 type II diabetic patients and 80 eyes of 77 non diabetic controls, having Nuclear Opalescence (NO) grades 2 and 3 on slit lamp examination underwent phacoemulsification surgery. CED was measured in cells/mm2, of concerned eye of each subject preoperatively and 2 months post operatively using specular microscope. The difference in mean CED change between the two groups after surgery was analyzed. Results: Mean age of study population was 61.41± 6.76 years. Out of study population, 92 (57.5%) were males and 68 (42.5%) were females. There was a statistically significant difference between both groups in terms of mean post-operative CED, mean change in CED and mean frequency change in CED (p <0.05). There was no statistically significant difference between both groups in age, gender, laterality of eyes and mean pre-operative CED, (p >0.05). Difference of pre-operative CED from post-operative CED in each group was statistically significant. Conclusion: There is a significant difference between diabetic population and normal population in terms of corneal endothelial loss after uneventful phacoemulsification cataract surgery. doi: https://doi.org/10.12669/pjms.35.5.596 How to cite this:Khalid M, Hanif MK, Qamar ul Islam, Mehboob MA. Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.596 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Elevated serum uric acid and triglycerides level in the patients with Type II Diabetes Mellitus- a Nepalese case control study

2017 ◽  
Vol 2 (2) ◽  
pp. 26-34
Author(s):  
Hridaya Parajuli ◽  
Jyotsna Shakya ◽  
Bashu Dev Pardhe ◽  
Puspa Raj Khanal ◽  
Narayan Prasad Parajuli ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type Ii ◽  
Significant Difference

Background: Hyperuricemia is associated with type 2 diabetes, which is a metabolic disorder of multiple etiologies resulting from defects in insulin action. The present study wascarried out to look for any association between uric acid and Type II Diabetes Mellitus and also status of triacylglycerol level among those patients.Methods: The blood samples were collected 100 diabetic and 100 non-diabetic individuals in the department of biochemistry and then analyzed for estimation of blood glucose, Uric Acid and Triacylglycerol level.Results: The average level of serum uric acid in diabetic patients was higher (5.706±1.617) in comparison to non diabetic subjects (4.322±0.784) with statistically significant difference (p≤0.05). For female the result indicate there was a positive correlation between (FBS and triglycerides) and (triglycerides and uric acids) which was statistically significant (r =-0.465, n = 41, p = 0.002) and(r =-0.370, n = 41, p = 0.017) respectively.Conclusions: This study documents that hyperuricemia is associated with type 2 diabetes mellitus. Furthermore, the serum triacylglycerol and serum uric acid is also found to be associated risk factors for diabetic complications. Hence, timely diagnosis and management of diabetes is vital to control the complications related to diabetes.Ann. Clin. Chem. Lab. Med. 2016:2(1); 26-34

Study of Association between Microalbuminuria and Microvascular Complications in Type II Diabetes Mellitus Patients in RajaRajeswari Medical College and Hospital, Karnataka

2017 ◽  
Vol 3 (1) ◽  
pp. 6-10
Author(s):  
N Bhavya ◽  
V Ajith Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Observational Study ◽  
Type Ii Diabetes ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Duration Of Diabetes ◽  
Medical College ◽  
Increased Risk

ABSTRACT Introduction India is claimed to be the diabetes capital of the world. Many studies had proven that persistent hyperglycemia and associated metabolic syndrome features like hypertension, dyslipidemia, and obesity contribute to the development of vascular complications. The risk of chronic complications increases as a function of the duration of hyperglycemia; they usually become apparent in the second decade of hyperglycemia. Since type II diabetes mellitus (DM) often has a long asymptomatic period of hyperglycemia, many individuals with type II DM have complications at the time of diagnosis. The vascular complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular (coronary artery disease, peripheral arterial disease, cerebro-vascular disease) complications. The present study aims to study the occurrence of microalbuminuria in patients with type II DM and note its association with the duration of diabetes since diagnosis and microvascular complications of DM. Study design Prospective observational study. Materials and methods The study is a clinical, prospective, and observational study of 100 type II diabetics attending the medicine department outpatient/inpatient of RajaRajeswari Medical College & Hospital, Bengaluru, Karnataka, India, who form the subjects for the study conducted from August 2015 to July 2016 (12 months) and who matched the inclusion criteria. Data were collected after obtaining informed/written consent from patient. After detailed history, detailed clinical examination, and general physical and systemic examinations, fundoscopy was carried out and relevant laboratory investigations were done. Results and conclusion The overall occurrence of microalbuminuria was 38%. The occurrence of microalbuminuria showed a direct relationship with increasing age (p = 0.053) and increasing duration of diabetes since diagnosis. A hemoglobin (Hb)A1c value above 7% is associated with 50% or higher incidence of microalbuminuria (p = 0.018). Patients with a body mass index of more than 25kg/m2 have increased risk of developing type II DM and significant increase in microalbuminuria. The incidence of microalbuminuria is significantly associated with How to cite this article Bhavya N, Kumar VA. A Study of Association between Microalbuminuria and Microvascular Complications in Type II Diabetes Mellitus Patients in RajaRajeswari Medical College and Hospital, Karnataka. J Med Sci 2017;3(1):6-10.

scholarly journals Diastolic dysfunction in cases with Type II diabetes mellitus.

2019 ◽  
Vol 26 (12) ◽  
pp. 2040-2043
Author(s):  
Munir Ahmed ◽  
Abdul Hayee ◽  
Shahla Afsheen Memon ◽  
Ismail Salim Memon ◽  
Abdul Qayoom Memon
Keyword(s):  
Diabetes Mellitus ◽  
Diastolic Dysfunction ◽  
Type Ii Diabetes ◽  
Female Gender ◽  
Type Ii Diabetes Mellitus ◽  
P Value ◽  
Type I ◽  
Type Ii ◽  
Cross Sectional ◽  
Significant Difference

Objectives: To determine the frequency of diastolic dysfunction in patients presenting with type II Diabetes Mellitus. Study Design: Cross sectional study. Setting: Sheikh Zayed Hospital, Rahim Yar Khan. Period: From 01-01-2017 to 30-06-2017. Material & Methods: In this study the cases were selected via non probability consecutive sampling of both male and female gender with age more than 40 years having type II DM of at least more than 2 years were included. The cases suffering from type I DM, gestational DM and those with HTN, end stage kidney and liver failure were excluded. Trans thoracic echocardiography was done to label diastolic dysfunction and was labelled as yes when the E/A ratio was <0.8. The data was analysed using chi square test and p value less than 0.05 was taken as significant. Results: In this study, 100 cases of type II DM were included with mean age of 51.31±7.89 years at presentation. There were 61% males and 39% females. Diastolic dysfunction was observed in 53% of the cases. There was no significant difference in terms of gender where it affected 56.41% of females with p= 0.92. Diastolic dysfunction was more in cases that had duration of DM more than 3 years affecting 48 (70.58%) cases with p= 0.001 and it was also significantly high in cases that had BMI more than 30 where it was seen in 40 (70.17%) of cases with p= 0.001. Conclusion: Diastolic dysfunction seen in half of the cases suffering from type II DM and it is significantly high in cases that had duration of DM more than 3 years and BMI more than 30.

scholarly journals Association of Time–Varying Intensity of Ventilation With Mortality in Patients With COVID−19 ARDS: Secondary Analysis of the PRoVENT–COVID Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Michiel T. U. Schuijt ◽  
David M. P. van Meenen ◽  
Ignacio Martin–Loeches ◽  
Guido Mazzinari ◽  
Marcus J. Schultz ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Secondary Analysis ◽  
Fixed Time ◽  
Sensitivity Analyses ◽  
Cumulative Exposure ◽  
Time Varying ◽  
Joint Models ◽  
Clinical Trial Registration ◽  
Increased Risk ◽  
Different Levels

Background: High intensity of ventilation has an association with mortality in patients with acute respiratory failure. It is uncertain whether similar associations exist in patients with acute respiratory distress syndrome (ARDS) patients due to coronavirus disease 2019 (COVID−19). We investigated the association of exposure to different levels of driving pressure (ΔP) and mechanical power (MP) with mortality in these patients.Methods: PRoVENT–COVID is a national, retrospective observational study, performed at 22 ICUs in the Netherlands, including COVID−19 patients under invasive ventilation for ARDS. Dynamic ΔP and MP were calculated at fixed time points during the first 4 calendar days of ventilation. The primary endpoint was 28–day mortality. To assess the effects of time–varying exposure, Bayesian joint models adjusted for confounders were used.Results: Of 1,122 patients included in the PRoVENT–COVID study, 734 were eligible for this analysis. In the first 28 days, 29.2% of patients died. A significant increase in the hazard of death was found to be associated with each increment in ΔP (HR 1.04, 95% CrI 1.01–1.07) and in MP (HR 1.12, 95% CrI 1.01–1.36). In sensitivity analyses, cumulative exposure to higher levels of ΔP or MP resulted in increased risks for 28–day mortality.Conclusion: Cumulative exposure to higher intensities of ventilation in COVID−19 patients with ARDS have an association with increased risk of 28–day mortality. Limiting exposure to high ΔP or MP has the potential to improve survival in these patients.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT04346342.

Fibrinogen Concentrate to Cardiac Surgery Patients with Ongoing Bleeding does not Increase the Risk of Thromboembolic Complications or Death

2020 ◽  
Vol 120 (03) ◽  
pp. 384-391 ◽  
Author(s):  
Katarina Waldén ◽  
Anders Jeppsson ◽  
Salmir Nasic ◽  
Martin Karlsson
Keyword(s):  
Cardiac Surgery ◽  
Cox Regression ◽  
Composite Endpoint ◽  
University Hospital ◽  
Sensitivity Analyses ◽  
Thromboembolic Complications ◽  
Fibrinogen Concentrate ◽  
Increased Risk ◽  
Significant Difference ◽  
Secondary Endpoints

Abstract Background We investigated whether fibrinogen concentrate administration to bleeding patients is associated with an increased risk of thromboembolic complications and death. Methods All consecutive patients who underwent first-time cardiac surgery at Sahlgrenska University Hospital from 2009 to 2014 were included. Patients, who had received fibrinogen concentrate, were compared with those who had not received fibrinogen concentrate. The primary endpoint was a composite of thromboembolic complications and death within 1 year after surgery. Secondary endpoints included the composite and mortality within 30 days and mortality within 1 year after surgery. Multivariable logistic regression and Cox regression models were used to compare the groups. Propensity score (PS)-matched models were used for sensitivity analyses. Results A total of 5,408 patients were included in the present study, of which 564 (10.4%) received fibrinogen concentrate. The composite endpoint occurred in 3.5% of patients at 30 days and 10.5% at 1 year. There was no significant difference between the groups in the composite endpoint at 1 year (adjusted hazard ratio [HR]: 1.11, 95% confidence interval [CI]: 0.84–1.46, p = 0.45) or in the secondary endpoints, that is, mortality at 1 year (adjusted HR: 1.38, 95% CI: 0.93–2.04, p = 0.11), composite at 30 days (adjusted odds ratio [OR]: 1.07, 95% CI: 0.64–1.81, p = 0.79) and mortality at 30 days (adjusted OR: 1.00, 95% CI: 0.51–1.96, p = 0.50). The results of the sensitivity analyses were consistent with those of main analyses. Conclusion Perioperative administration of fibrinogen concentrate to bleeding cardiac surgery patients is not associated with an increased risk of thromboembolic complications or death.

scholarly journals Ten-year single-centre experience with type II endoleaks: Intervention versus observation

2017 ◽  
Vol 22 (4) ◽  
pp. 316-323 ◽  
Author(s):  
Ikram-Ul Haq ◽  
Arun Kelay ◽  
Meryl Davis ◽  
Jocelyn Brookes ◽  
Tara M Mastracci ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Time Frame ◽  
Type Ii ◽  
Risk Of Mortality ◽  
Surveillance Imaging ◽  
Increased Risk ◽  
Significant Difference ◽  
Aneurysm Growth ◽  
Aneurysm Repair

Our objective was to determine the relative merits of intervention or observation of type II endoleaks (T2Ls). A retrospective analysis was performed on 386 infra-renal endovascular aneurysm repair (IR-EVAR) patients from 2006 to 2015. Annual surveillance imaging of patients undergoing EVAR at our centre were analysed, and all endoleaks were subjected to a multidisciplinary team meeting for consideration and treatment. In the 10-year time frame, 386 patients (79.5±8.7 years) underwent an IR-EVAR. Eighty-one patients (21.0%) developed a T2L and intervention was undertaken in 28 (34.6%): 17 (60.7%) were treated via a transarterial approach (TA) and 11 (39.3%) using the translumbar approach (TL). Fifty-three patients (65.4%) with T2Ls were managed conservatively. Patients who received T2L treatment had a greater proportion of recurrent T2Ls than patients who were conservatively managed ( p=0.032). T2Ls associated with aneurysmal growth were more resistant to treatment than those where there was no change or a decrease in aneurysm size during follow-up (0.033). There was no significant difference in the TA and TL approach with respect to endoleak repair success ( p=0.525). Treatment of a T2L did not confer a survival advantage compared to conservative management ( p=0.449) nor did the choice of either the TA or TL approach ( p=0.148). Our study suggests the development of a T2L associated with aneurysm growth may represent an aggressive phenotype that is resistant to treatment. However, this did not lead to an increased risk of mortality over follow-up. Neither a transarterial nor a translumbar approach to treating a T2L conferred superiority.

scholarly journals Association of fetuin-A with dyslipidemia and insulin resistance in type-II Diabetics of Pakistani population

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Fasiha Fatima ◽  
Naveed Ahsan ◽  
Aliya Nasim ◽  
Faiza Alam
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Lipid Profile ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Pakistani Population ◽  
Fetuin A ◽  
Significant Difference ◽  
Type Ii Diabetics

Background & Objective: Fetuin-A, hepatokine is responsible for instigating insulin resistance by inhibiting tyrosine kinase receptors. Our objective was to investigate the relationship of fetuin-A with dyslipidemia and insulin resistance in type-II diabetics of Pakistani population. Methods: In this cross sectional study which was conducted at Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi between October 2013 to March 2014, a total of 330 participants were selected and divided into two groups. Group-A (n = 165) normal healthy individual and Group-B (n = 165) Type-II diabetes mellitus mellitus with no comorbidities. Serum fetuin-A and insulin levels were determined by commercially prepared ELISA kits while fasting blood glucose (FBG) and lipid profile were performed by enzymatic kit method. Employing independent t-test, comparison of groups was done and correlation was achieved by using spearman correlation. Results: The results demonstrate a significant difference in mean values of fetuin-A, lipid profile, glucose, insulin and Homoeostasis Model Assessment of Insulin resistance (HOMA-IR) in type-II diabetics when compared to normal healthy individuals (p<0.01). A positive correlation was found between serum fetuin-A levels and FBG(r= 0.495, p< 0.001), insulin(r= 0.227, p< 0.001), HOMA-IR(r= 0.336, p<0.001, triglycerides(r= 0.197, p< 0.001) and LDL-cholesterol(r= 0.170, p= 0.002), while negative correlation with HDL-cholesterol(r= -0.251, p< 0.001). Conclusion: The study concludes that fetuin-A might be accountable for dyslipidemia and insulin resistance in type-II diabetes mellitus mellitus. So the high levels of Fetuin-A responsible for insulin resistance might alters endothelium and causes inflammation, vasoconstriction and thrombosis and ultimately atherosclerosis. doi: https://doi.org/10.12669/pjms.36.2.1106 How to cite this:Fatima F, Ahsan N, Nasim A, Alam F. Association of fetuin-A with dyslipidemia and insulin resistance in type-II Diabetics of Pakistani population. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1106 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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