scholarly journals Associations between different bilirubin subtypes and diabetic microvascular complications in middle-aged and elderly individuals

2020 ◽  
Vol 11 ◽  
pp. 204201882093789
Author(s):  
Heng Wan ◽  
Hui Zhu ◽  
Yuying Wang ◽  
Kun Zhang ◽  
Yi Chen ◽  
...  

Aims: Some studies have reported associations between bilirubin and diabetic microvascular complications. However, these studies focused only on total bilirubin (TBIL) without distinguishing different bilirubin subtypes. In this study, we aimed to investigate the associations of TBIL, direct bilirubin (DBIL) and indirect bilirubin (IBIL) levels with albuminuria/creatinine ratio (ACR) and the prevalence of diabetic retinopathy (DR) among diabetic adults. Methods: We analyzed 4368 individuals out of 4813 diabetic participants enrolled from seven communities in 2018 in a cross-sectional study. Participants underwent several checkups, including the measurement of anthropometric parameters, blood pressure, glucose, lipid profile, TBIL, DBIL, IBIL and ACR. DR was detected by high-quality fundus photographs and was remotely read by ophthalmologists. Results: Compared with the first quartile of DBIL, participants in the fourth quartile had a lower prevalence of high ACR (odds ratio (OR) 0.76; 95% confidence interval (CI) 0.59, 0.99) ( p for trend < 0.05). Neither TBIL nor IBIL was associated with the prevalence of high ACR. In DR, higher DBIL and TBIL by one standard deviation was associated with a 19% (OR 0.81; 95% CI 0.69, 0.94) and a 12% (OR 0.88; 95% CI 0.78, 0.99) lower frequency of DR, respectively (both p for trend < 0.05). However, IBIL was not associated with the prevalence of DR. These associations were adjusted for potential confounding factors. Conclusion: DBIL had a stronger association with high ACR and DR than TBIL or IBIL did in diabetic adults. The effect of DBIL on diabetic complications should be noted and investigated in further studies.

2020 ◽  
Vol 7 ◽  
Author(s):  
Nasser Alqahtani ◽  
Eisa Ghazwani ◽  
Awad Alqahtani ◽  
Mohammed Helaly

Background: Vitamin D deficiency is widespread and coexisted with diabetes. However, the relation between Vitamin D level and glycemic control is not yet fully understood. This study examines the correlation between vitamin D level and glycemia indicators and diabetic microvascular complications.Methods: The study is a cross-sectional study, had been done at the outpatient department in Najran university hospital, Saudi Arabia from May 2019 to February 2020. 220 patients recruited by simple random sampling.Results: 60% of diabetes (n-130) had been using oral anti-glycemic medications, though most of them had uncontrolled glycemic status and had got microvascular complications. It is notable that among diabetes having a low vitamin D level; 55.5% had high FBS, 45.6% had high RBS and 65% had high HBA1C. Besides,17% have retinopathy, 16.6% have nephropathy, 26.2% have peripheral neuropathy and 1.9% have a diabetic foot.Conclusion: The clinical and laboratory assessments are essential to control the glycemic state in diabetes. The study noted that an inverse relationship between the level of vitamin D with blood sugar levels and diabetic microvascular complications. To assure the feasibility of the prediction of vitamin D level in assessing the progress of diabetes further studies are needed.


2018 ◽  
Vol 5 (2) ◽  
pp. 271
Author(s):  
Prasanna Venkatesh ◽  
Jayasingh K. ◽  
Srikanth K. ◽  
Siva R. Green

Background: Pre-diabetes is a mounting health problem occurring worldwide. Microvascular complications are prone to occur during this stage. Early diagnosis and treatment delay progression to diabetes mellitus and microvascular complications. Aims and objectives of the study was to determine the prevalence of microalbuminuria, c-peptide and fundal changes in pre-diabetics.Methods: 125 pre-diabetic patients those who visited MGMCRI General Medicine OPD and admitted in wards were taken into the study after fulfilling the inclusion criteria and after obtaining written informed consent. All those study patient’s urine and blood sample were sent for analysis of microalbuminuria and C-peptide respectively. Fundus was examined for retinopathic changes.Results: Among 125 prediabetic participants, prevalence of microalbuminuria was 12.8%, c-peptide levels was elevated in 46.4 %, but none of the study participants had fundal diabetic retinopathy changes.Conclusions: The microvascular complications like microalbuminuria starts in the pre-diabetic stage itself. Prevalence of increased c-peptide levels and microalbuminuria was more in individuals who had both IFG and IGT. Elevated C peptide level and microalbuminuria were found to appear much earlier than retinopathy in prediabetes. Hence its use can enhance for early diagnosis of prediabetes.


2021 ◽  
Author(s):  
Xin Li ◽  
Zi-Wei Yu ◽  
Chang-Wei Yang ◽  
Ming Hao ◽  
Xin-Yuan Gao ◽  
...  

Abstract Background and aims: Obesity often coexists with diabetes has been recognized as a risk factor for diabetic complications. Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes, and the metabolic syndrome (MetS) is one of the most common symptoms of diabetes. The purpose of this study was to explore the relationship between DR and some induces, including NC, CVAI, PWNC and so on; as well as the relationship between DR and MetS.Methods: From 2018 to 2019, a total of 562 diabetics from the Hulan District of Harbin, Heilongjiang, were selected and completed a questionnaire survey. The questionnaire included basic patient information, anthropometric parameters, blood pressure, biochemical parameters and fundus photography results.Results: In both men and women, a one standard deviation (SD) increase in NC、CVAI and PWNC was not associated with the prevalence of DR (P>0.05). However, in both men and women, a one SD increase in NC、CVAI and PWNC was significantly associated with the prevalence of MetS (P<0.05). These association were all adjusted for potential confounding factors. Moreover, DR was not associated with MetS(P>0.05).Conclusions: NC, CVAI and PWNC are associated with the prevalence of MetS. NC in men and CVAI in women had the largest area under the ROC curve compared to the other induces, which may be convenient and valuable anthropometric measurements for early prevention of MetS. However, these induces had no association with DR and there is no relationship between DR and MetS.


Author(s):  
Akram Ghadiri-Anari ◽  
Somayeh Gholami ◽  
Elham Sheyda ◽  
Shadab Kharazmi ◽  
Nasim Namiranian

Abstract- Due to high prevalence of diabetes in our region (16.3%) and no data on the frequency of gastrointestinal (GI) symptoms in this population, we performed a cross-sectional study to evaluate the frequency of GIsymptoms in diabetic patients and its association between microvascular complications (retinopathy and nephropathy) and gastrointestinal symptoms in diabetic subjects.This analytical crosssectional study was conducted from 2014 to 2016 on 233 patients with type 2 diabetes mellitus (T2DM), 3065-year, referred to Yazd diabetic research center. They were selected by convenient sample method. A questionnaire according to Rome III Criteria was used to collect digestive information related to diabetes. Last HbA1c (Since 2-3 months ago) was available in the patient's medical folder. Diabetic nephropathy defines to increased excretion rate of albumin in the urine in the range of above 30 mg/g creatinine. Diabetic retinopathy was examined by an expert ophthalmologist (retinal specialist). For the current study, 233 patients (age 30-65 years with mean age of 57.43±10.49 years, 102 (43.8%) males and 131 (56.2%) females) were included. Among 233 patients, 91 cases (39.1%) had nephropathy,and 111(47.6%) subjects had different degrees of retinopathy. Bloating and early satiety and upper GI symptoms were higher in the subjects with retinopathy than another group. In summary, this study provides evidence that GI symptoms in diabetic subjects are independently linked to diabetic complications, particularly to retinopathy.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2032
Author(s):  
Judit Companys ◽  
Maria José Gosalbes ◽  
Laura Pla-Pagà ◽  
Lorena Calderón-Pérez ◽  
Elisabet Llauradó ◽  
...  

We aimed to differentiate gut microbiota composition of overweight/obese and lean subjects and to determine its association with clinical variables and dietary intake. A cross-sectional study was performed with 96 overweight/obese subjects and 32 lean subjects. Anthropometric parameters were positively associated with Collinsella aerofaciens, Dorea formicigenerans and Dorea longicatena, which had higher abundance the overweight/obese subjects. Moreover, different genera of Lachnospiraceae were negatively associated with body fat, LDL and total cholesterol. Saturated fatty acids (SFAs) were negatively associated with the genus Intestinimonas, a biomarker of the overweight/obese group, whereas SFAs were positively associated with Roseburia, a biomarker for the lean group. In conclusion, Dorea formicigenerans, Dorea longicatena and Collinsella aerofaciens could be considered obesity biomarkers, Lachnospiraceae is associated with lipid cardiovascular risk factors. SFAs exhibited opposite association profiles with butyrate-producing bacteria depending on the BMI. Thus, the relationship between diet and microbiota opens new tools for the management of obesity.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045892
Author(s):  
Solomon Feleke ◽  
Gudina Egata ◽  
Firehiwot Mesfin ◽  
Gizachew Yilak ◽  
Abebaw Molla

ObjectiveThe study aimed to assess the prevalence of stunting, wasting, underweight and associated factors in orphaned children under 5 years old.DesignA cross-sectional study.SettingGambella City, Ethiopia.ParticipantsA sample of 419 under 5 orphaned children included in the study. Eligible households with orphans had selected using a systematic random sampling method. The lottery method was used when more than one eligible study participants live in the household. An OR with 95% CI was performed to measure the strength of association between each dependent variable and independent variables. Variables with p<0.05 were declared statistically significant.Primary outcomeThe main outcome of this study was the prevalence of undernutrition among orphaned under 5 and its associated factors.ResultsPrevalence of stunting, wasting and underweight in orphan children under 5 were 12.2%, 37.8% and 21.7%, respectively. The prevalnce of wasting peaks among age group of 36–47 months (42.5%), whereas underweight peaks in 48–59 months (27.7%). Food insecurity, wealth index, family size, vitamin A supplementation, diarrhoea, fever 2 weeks before the survey, children under 5 and parents’ death were associated with undernutrition.ConclusionThe prevalence of stunting, wasting and underweight among orphan children under 5 was significantly high. Multisectoral collaborative efforts towards access to health services, improving income-generating activities, micronutrient supplementation and social support and protection targeting orphan and vulnerable populations have to be built up.


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