scholarly journals Clinical and genetic risk factors for new-onset diabetes mellitus after transplantation (NODAT) in major transplant centres in Malaysia

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Rhanye Mac Guad ◽  
Andrew W. Taylor-Robinson ◽  
Yuan Seng Wu ◽  
Siew Hua Gan ◽  
Nur Lisa Zaharan ◽  
...  

Abstract Background New-onset diabetes after transplantation (NODAT) is associated with reduced patient and graft survival. This study examined the clinical and selected genetic factors associated with NODAT among renal-transplanted Malaysian patients. Methods This study included 168 non-diabetic patients (58% males, 69% of Chinese ethnicity) who received renal transplantation between 1st January 1994 to 31st December 2014, and were followed up in two major renal transplant centres in Malaysia. Fasting blood glucose levels were used to diagnose NODAT in patients who received renal transplantation within 1 year. Two single nucleotide polymorphisms (SNPs), namely; rs1494558 (interleukin-7 receptor, IL-7R) and rs2232365 (mannose-binding leptin-2, MBL2) were selected and genotyped using Sequenom MassArray platform. Cox proportional hazard regression analyses were used to examine the risk of developing NODAT according to the different demographics and clinical covariates, utilizing four time-points (one-month, three-months, six-months, one-year) post-transplant. Results Seventeen per cent of patients (n = 29, 55% males, 69% Chinese) were found to have developed NODAT within one-year of renal transplantation based on their fasting blood glucose levels. NODAT patients had renal transplantation at an older age compared to non-NODAT (39.3 ± 13.4 vs 33.9 ± 11.8 years, p = 0.03). In multivariate analysis, renal-transplanted patients who received a higher daily dose of cyclosporine (mg) were associated with increased risk of NODAT (Hazard ratio (HR) =1.01 per mg increase in dose, 95% confidence interval (CI) 1.00–1.01, p = 0.002). Other demographic (gender, ethnicities, age at transplant) and clinical factors (primary kidney disease, type of donor, place of transplant, type of calcineurin inhibitors, duration of dialysis pre-transplant, BMI, creatinine levels, and daily doses of tacrolimus and prednisolone) were not found to be significantly associated with risk of NODAT. GA genotype of rs1494558 (HR = 3.15 95% CI 1.26, 7.86) and AG genotype of rs2232365 (HR = 2.57 95% CI 1.07, 6.18) were associated with increased risk of NODAT as compared to AA genotypes. Conclusion The daily dose of cyclosporine and SNPs of IL-7R (rs1494558) and MBL2 (rs2232365) genes are significantly associated with the development of NODAT in the Malaysian renal transplant population.

2019 ◽  
Vol 6 (3) ◽  
pp. 706
Author(s):  
K. N. S. V. Chalapathi Rao ◽  
Ashok Vankayala ◽  
Suresh Babu Sayana ◽  
D. S. S. K. Raju

Background: Several observational studies, well controlled randomized trials and meta-analyses reported that patients treated with statins has high risk of new onset diabetes mellitus (NODM), but the exact incidence and mechanism is still unclear and controversy. The present study was planned to find out the incidence of prediabetes and NODM and possible mechanism of action.Methods: This was a prospective, cross‑sectional study carried out at the Department of General Medicine for a period of one and half year between August 2017 and February 2019. Normoglycemic patients whose fasting blood glucose levels below 100 mg/dL and at least one year of treatment with statins were recruited in the study. Glycaemic status, development of prediabetes and NODM and insulin resistance were the primary outcomes whereas lipid profile, adverse drug effects of statins were secondary outcomes. Collected data was analysed by suitable statistical methods.Results: A total of 146 patients were recruited and 120 completed the entire study. Mean fasting blood glucose levels before initiation of statin therapy was 89.45±10.21. After one year of statin therapy, patients were separated as prediabetics and new onset diabetics and there mean fasting blood glucose levels were 116.24±12.86 (n=10) and 152.44±20.12 (n=12) respectively. A total of 12 (10.0%) patients were developed NODM and 10 (8.2%) patients developed prediabetes at the end of statin therapy. Atorvastatin 40mg was most frequency prescribed statin followed by Atorvastatin 20mg. A total of 70 (58.3%) study participants developed mild to moderate drug related adverse effects (ADRs), statin‑induced myalgia (55.7%) was the most common ADR.Conclusions: Patients treatment with statins had developed prediabetes and NODM. Atorvastatin 40mg and greater dose significantly induced NODM. Fasting blood glucose levels should be measured periodically with prescription contains higher doses of statins.


2012 ◽  
Vol 19 (06) ◽  
pp. 786-788
Author(s):  
KIRAN BUTT ◽  
FARAH DEEBA ◽  
HAVAIDA ATTIQUE

Objective: The objective of the present study was to determine the changes in the glucose level and lipid profile in patients withpolycystic ovarian syndrome (PCOS). Study Design: Descriptive study. Place and Duration of the study: This study was conducted atInstitute of Molecular Biology and Biotechnology, The University of Lahore from June 2009 to June 2010. Patients and Methods: Total 50patients with PCOS were included and 50 age-matched control subjects were also selected for comparison. Their glucose levels and lipidprofile were assessed using commercial kits. The data thus obtained was subjected to statistical analysis. Results: Significant differences(P<0.05) in fasting blood glucose level and individual parameters of lipid profile were observed in women with PCOS. A higher prevalence ofhypertriglyceridemia, hypercholesterolemia, higher LDL, lower HDL and higher fasting blood glucose levels was explored in PCOS womenthan controls. Conclusions: Abnormal glucose level and lipid profile in PCOS women showed that these women are at an increased risk ofdeveloping diabetes and subsequently cardiovascular diseases.


2015 ◽  
Vol 7 (1) ◽  
pp. 30-33
Author(s):  
Shivali Kapoor ◽  
Manjit Kaur ◽  
Amrit Pal Singh Rana ◽  
A Suryanarayan

Background: Platelets with altered morphology or large size are more thrombogenic and are likely to be associated with increased risk of vascular disease. Platelet parameters especially high mean platelet volume (MPV) has been reported in diabetic patients as major contributing factor. The aim of the present study was to find correlation between fasting blood glucose value and hematological variables (PC and MPV), not only in diabetics, but also in the normoglycemic subjects and patients with impaired fasting blood glucose levels.Materials and Methods: In the present study 3471 subjects were analyzed retrospectively and categorized into three groups based on the fasting blood glucose levels as Group I - normoglycemics (FBG ? 109 mg/dl, n = 1158), Group II- impaired fasting blood glucose (FBG ? 126 mg/dl, n = 1158) and Group III – Diabetics (FBG ? 127 mg/dl, n = 1155).Results: We found progressive increase in value of MPV with the increasing FBG levels, in the following order: G1 (8.44 ± 0.842 fl), G2 (8.98 ± 0.898 fl), G3 (9.31 ± 0.967 fl). The platelet count however, did not show much statistical significance with rising glucose levels.Conclusions: MPV increased proportionally with increasing plasma glucose levels. Although the variation between the normoglycemics and impaired fasting group was not very significant, the parameters still showed progressive increase with rising sugar levels significant in diabetic group.Asian Journal of Medical Sciences Vol.7(1) 2015 30-33


2020 ◽  
pp. 44-47
Author(s):  
Farheen Fatima ◽  
D. Joya Rani ◽  
B. Chandini Rani

Stress refers to processes involving perception, appraisal and response to noxious events or stimuli. While acute stress can activate adaptive responses, chronic stresses are detrimental to health by altering various physiological parameters1. One such change involves blood glucose levels. This study was done to detect any alterations in blood glucose levels on exposure to chronic mental stress. Mental stress was assessed using the Stress scale of the DASS – 42 questionnaire. Correlation between stress perception and altered blood glucose levels was seen. Reasons for this change range from effects of stress hormones on carbohydrate & lipid metabolism to changes in brain which promote stress eating. There is increased risk for obesity, Diabetes Mellitus and Metabolic syndrome in future. Interventions to reduce this risk include lifestyle modifications which include caloric restriction, increasing physical activity and getting involved in customised activities which reduce stress.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jing Liu ◽  
Nan N. Cheng ◽  
Zi Y. Zhou ◽  
Yue Zhang ◽  
Jie Yang ◽  
...  

Abstract Background The purpose of this study was to examine the correlation between fasting blood glucose and new-onset hypertension and examine any synergistically effect modification with multiple risk factors. Methods We conducted post-hoc analyses of repeated-measures data in the original Dongzhi osteoporosis cohort study. In total, 3985 participants without hypertension aged 25–64 years were included in the current analyses. Generalized estimating equation models were used to assess the relationship between fasting blood glucose and risk of new-onset hypertension after adjusting for pertinent covariates and autocorrelations among siblings. Results 393 men (19.4%) and 398 women (20.3%) without hypertension at the baseline developed hypertension by the end of the study period. Compared to lower baseline fasting blood glucose levels (Q1–Q3: < 5.74 mmol/L; clinical cut points: < 5.6 mmol/L), higher baseline fasting blood glucose levels (Q4: ≥ 5.74 mmol/L; clinical cut points: ≥ 5.6 mmol/L and < 7.0 mmol/L) increased the risk of new-onset hypertension significantly [(OR: 1.54, 95% CI 1.19–1.98, P < 0.001); (OR: 1.38, 95% CI 1.09–1.75, P = 0.008)] in women. Additionally, a stronger significant association was found in women with elevated fasting blood glucose on risk of new-onset of hypertension with higher total cholesterol (≥ 5.2 mmol/L) [(OR: 2.76; 95% CI: (1.54, 4.96), P < 0.001)]. However, no association was found between fasting blood glucose and risk of new-onset hypertension in men. Conclusions High fasting blood glucose may be significantly associated with risk of new-onset hypertension in Chinese women, especially in women with higher total cholesterol. Further randomized studies are needed to confirm our findings.


2021 ◽  
Vol 4 (1) ◽  
pp. 51-60
Author(s):  
Sunita Karki ◽  
Anjan Rai ◽  
Manish Pradhan

Introduction Acrochordons or skin tags are common benign cutaneous tumors that occur especially over the neck and major flexures. A possible association between diabetes mellitus and dyslipidemia is observed in numerous past studies with varying results. We aim to find out the association of diabetes mellitus with acrochordons Methods: One hundred patients were enrolled in our study. Among them, 50 (27 males and 23 females) with skin tags were selected as cases and 50 with other dermatologic diseases after matching age and gender were taken as controls. Blood glucose levels including both fasting and postprandial glucose levels were determined for both cases and controls and compared. Results: There was a higher frequency of Diabetes Mellitus and impaired glucose tolerance in patients with skin tags in comparison to controls (p<0.001). Moreover, there were higher odds of acquiring skin tags in patient with abnormal blood glucose levels. Conclusions: There is an increased risk of developing DM in patients with skin tags. It is highly recommended that suspicion for Diabetes Mellitus is to be done in patients with skin tags for early screening and diagnosis of Diabetes.


2021 ◽  
Vol 17 (4) ◽  
pp. 157
Author(s):  
Ni Ketut Sutiari ◽  
Ali Khomsan ◽  
Hadi Riyadi ◽  
Faisal Anwar ◽  
Desak Putu Yuli Kurniati ◽  
...  

Health status and micronutrient intake among vegetarian and non-vegetarian in BaliBackground: Several studies have reported that vegetarian diets have health benefits for those adopting the diets.Objective: This study aimed to compare anemia status and micronutrient intake between vegetarians and non-vegetarians in Bali.Methods: This cross-sectional study was conducted in Bali. A total of 240 samples consisting of 160 vegetarians and 80 non-vegetarians were randomly selected. Hemoglobin (Hb) and fasting blood sugar levels were measured using the cyanmethemoglobin method and enzymatic colorimetric, respectively. Meanwhile, the data on micronutrient intakes were collected by interviews using the semi-quantitative food frequency questionnaire (SQFFQ). The data were analyzed using descriptive statistics, and the Mann-Whitney test was performed to analyze the differences.Results: The study’s results showed that the mean Hb levels in the vegetarian group were significantly lower than non-vegetarians (p=0.002; p<0.05), and the anemia status in vegetarian women were higher (22.5%) than non-vegetarian women (2.5%). The mean fasting blood glucose level in non-vegetarians was significantly higher than in the vegetarian group (p=0.000; p<0.05). There were no differences in zinc (Zn) intake between vegetarians and non-vegetarians, but there were significant differences (p<0.05) in vitamin C, vitamin D, vitamin B12, folic acid, magnesium (Mg), calcium (Ca), and iron (Fe) intakes.Conclusions: There were differences in anemia status and fasting blood glucose levels between vegetarians and non-vegetarians. The fasting blood glucose levels of non-vegetarians were higher than vegetarians, and there were differences in the intake of certain micronutrients between vegetarians and non-vegetarians.


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