Study on the correlation between PPARγ, Aβ1-42, miR-155 and the occurrence and development of diabetes

The objective of this research was to study the correlation between PPARγ, Aβ1-42, miR-155 and the occurrence and development of diabetes. For this purpose, 52 patients with diabetes who were hospitalized from September 2019 to May 2021 were selected as the research objects. They were grouped according to the severity of the disease, which was pre-diabetes (n=16), mild (n=25), and moderate (n=16). =11), another 20 healthy subjects were taken as the control group, and the levels of PPARγ, Aβ1-42, miR-155 in each group were measured, and the correlation between changes in the levels of various indicators and the occurrence and development of diabetes was explored. Results showed that comparison of age, gender, course of disease, BMI, living habits, comorbidities, and high-density lipoprotein among the groups of diabetic patients (P>0.05); the levels of total cholesterol, triglycerides and low-density cholesterol decreased with the development of diabetes (P<0.05) ); Compared with the healthy group, the levels of PPARγ and miR-155 were significantly reduced, and the levels of Aβ1-42 were significantly increased (P<0.05); compared with the prediabetes, the levels of mild and moderate PPARγ and miR-155 showed a downward trend, and Aβ1 -42 level showed an upward trend (P<0.05); PPARγ and miR-155 levels were negatively correlated with pre-diabetes, mild, and moderate; Aβ1-42 was positively correlated with pre-diabetes, mild, and moderate (P<0.05) ; PPARγ, Aβ1-42, miR-155 levels can effectively predict the occurrence and development of diabetes, and the sensitivity, specificity and accuracy of the detection of diabetes by various indicators, positive predictive value and negative predictive value are significantly higher. It is concluded that PPARγ, Aβ1-42, miR-155 are closely related to the occurrence and development of diabetes, and there are many influencing factors of diabetes. Clinical intervention measures can be taken according to specific conditions.

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Predictive value of stress hyperglycemia ratio for the occurrence of acute kidney injury in acute myocardial infarction patients with diabetes

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01962-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Side Gao ◽

Qingbo Liu ◽

Hui Chen ◽

Mengyue Yu ◽

Hongwei Li

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Acute Kidney Injury ◽

Cardiogenic Shock ◽

Predictive Value ◽

Kidney Injury ◽

Left Ventricular Ejection ◽

Diabetic Patients ◽

Stress Hyperglycemia ◽

Patients With Diabetes

Abstract Background Acute hyperglycemia has been recognized as a robust predictor for occurrence of acute kidney injury (AKI) in nondiabetic patients with acute myocardial infarction (AMI), however, its discriminatory ability for AKI is unclear in diabetic patients after an AMI. Here, we investigated whether stress hyperglycemia ratio (SHR), a novel index with the combined evaluation of acute and chronic glycemic levels, may have a better predictive value of AKI as compared with admission glycemia alone in diabetic patients following AMI. Methods SHR was calculated with admission blood glucose (ABG) divided by the glycated hemoglobin-derived estimated average glucose. A total of 1215 diabetic patients with AMI were enrolled and divided according to SHR tertiles. Baseline characteristics and outcomes were compared. The primary endpoint was AKI and secondary endpoints included all-cause death and cardiogenic shock during hospitalization. The logistic regression analysis was performed to identify potential risk factors. Accuracy was defined with area under the curve (AUC) by a receiver-operating characteristic (ROC) curve analysis. Results In AMI patients with diabetes, the incidence of AKI (4.4%, 7.8%, 13.0%; p < 0.001), all-cause death (2.7%, 3.6%, 6.4%; p = 0.027) and cardiogenic shock (4.9%, 7.6%, 11.6%; p = 0.002) all increased with the rising tertile levels of SHR. After multivariate adjustment, elevated SHR was significantly associated with an increased risk of AKI (odds ratio 3.18, 95% confidence interval: 1.99–5.09, p < 0.001) while ABG was no longer a risk factor of AKI. The SHR was also strongly related to the AKI risk in subgroups of patients. At ROC analysis, SHR accurately predicted AKI in overall (AUC 0.64) and a risk model consisted of SHR, left ventricular ejection fraction, N-terminal B-type natriuretic peptide, and estimated glomerular filtration rate (eGFR) yielded a superior predictive value (AUC 0.83) for AKI. Conclusion The novel index SHR is a better predictor of AKI and in-hospital mortality and morbidity than admission glycemia in AMI patients with diabetes.

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Effects of BMI and LDL-cholesterol change pattern on cardiovascular disease in normal adults and diabetics

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001340 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001340

Author(s):

Tae Mi Youk ◽

Min Jin Kang ◽

Sun Ok Song ◽

Eun-Cheol Park

Keyword(s):

Cardiovascular Disease ◽

Ldl Cholesterol ◽

Density Lipoprotein ◽

Diabetic Control ◽

Individual Variability ◽

Control Group ◽

Simple Method ◽

Change Pattern ◽

Patients With Diabetes ◽

Variability Model

IntroductionTo examine how the risk of cardiovascular disease changes according to degree of change in body mass index (BMI) and low-density lipoprotein (LDL)-cholesterol in patients with diabetes using the health medical examination cohort database of the National Health Insurance Service in Korea. In comparison, the pattern in a non-diabetic control group was also examined.Research design and methodsThe study samples were 13 800 patients with type 2 diabetes and 185 898 non-diabetic controls, and their baseline characteristics and repeatedly measured BMI and LDL-cholesterol until occurrence of cardiovascular disease were collected in longitudinal data. We used the variability model that is joint of mixed effects and regression model, then estimated parameters about variability by Bayesian methods.ResultsThe risk of cardiovascular disease was increased significantly with high average real variability (ARV) of BMI in the patients with diabetes, but the risk of cardiovascular disease was not increased according to degree of ARV in non-diabetic controls. The Bayesian variability model was used to analyze the effects of BMI and LDL-cholesterol change pattern on development of cardiovascular disease in diabetics, showing that variability did not have a statistically significant effect on cardiovascular disease. This shows the danger of the former simple method when interpreting only the mean of the absolute value of the variation.ConclusionsThe approach of simple SD in previous studies for estimation of individual variability does not consider the order of observation. However, the Bayesian method used in this study allows for flexible modeling by superimposing volatility assessments on multistage models.

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The slipping slipper sign: a simple test with high specificity and positive predictive value for peripheral neuropathy among diabetic patients

Clinics and Practice ◽

10.4081/cp.2012.e51 ◽

2012 ◽

Vol 2 (2) ◽

pp. 51 ◽

Cited By ~ 2

Author(s):

Krystal A.T. Gayle ◽

Marshall K. Tulloch-Reid ◽

Rainford J. Wilks ◽

Trevor S. Ferguson

Keyword(s):

Peripheral Neuropathy ◽

Positive Predictive Value ◽

Diabetic Neuropathy ◽

Predictive Value ◽

High Specificity ◽

Diabetic Patients ◽

Simple Test ◽

Diabetes Clinic ◽

Sensitivity Specificity ◽

Single Question

This study evaluated the ability of the slipping slipper sign (defined as unknowingly losing a slipper while walking) to identify diabetic neuropathy in Jamaican patients. A single question was used to ascertain the presence of the slipping slipper sign (SSS) among 69 patients attending a diabetes clinic. Nurses assessed pain, vibration and pressure perception among the same patients in order to detect diabetic neuropathy. The sensitivity, specificity and positive predictive value for the SSS were calculated. Eight participants (men=5, women=3) reported positive SSS. The SSS had a sensitivity of 28.6%, specificity of 100% and positive predictive value (PPV) 100% for neuropathy on at least one of the three tests. These findings indicate that the SSS has high specificity and PPV for diabetic neuropathy but the sensitivity is low. The sign may be a useful adjuvant to conventional methods of screening for severe neuropathy

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Clinical efficacy of oxidative stress correction by actovegin in diabetic polyneuropathy at type 2 diabetic patients with arterial hypertension

Diabetes Mellitus ◽

10.14341/2072-0351-5680 ◽

2010 ◽

Vol 13 (2) ◽

pp. 84-89

Author(s):

Ivan Petrovich Gorshkov ◽

Vladimir Ivanovich Zoloedov ◽

Anna Petrovna Volynkina

Keyword(s):

Oxidative Stress ◽

Arterial Hypertension ◽

Diabetic Polyneuropathy ◽

Oxidative Capacity ◽

Control Group ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Patients With Diabetes ◽

Total Antioxidant

Aim. To study Actovegin efficacy in oxidative stress (OS) correction at diabetic polyneuropathy (DPN) in patients with diabetes mellitus type 2 (DM2)and arterial hypertension (AH).Materials and Methods. 51 patients (24 women and 27 men) aged 53.4?0.7 with the average duration of DM2 5.6?0.2 years, DPN - 4.9?0.2years and AH - 6.0?0.2 years were examined. Daily albuminuria, glomerular filtration rate (GRF) were evaluated, standard methods for diagnosisof DPN were used. 26 patients took Actovegin therapy during 6-8 weeks, the rest 25 patients were in the control group. Parameters of the OS werestudied. Results. The increase of total oxidative capacity, the decrease of total antioxidant capacity and the rise of levels of antibodies to oxidated LDL wererevealed in patients with DM2, DPN and AH. Antioxidant and anti-hypoxic effects of 400 mg/day of Actovegin were established in this group of patients.Conclusions. Actovegin impacts oxidative stress parameters and improves the clinical manifestation of diabetic polyneuropathy.

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Volume rendered 3D OCTA assessment of macular ischemia in patients with type 1 diabetes and without diabetic retinopathy

Scientific Reports ◽

10.1038/s41598-021-99297-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Enrico Borrelli ◽

Domenico Grosso ◽

Mariacristina Parravano ◽

Eliana Costanzo ◽

Maria Brambati ◽

...

Keyword(s):

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Healthy Subjects ◽

Diabetic Group ◽

Control Group ◽

Diabetic Patients ◽

Vascular Volume ◽

Patients With Diabetes ◽

Perfusion Density

AbstractThe aim of this study was to measure macular perfusion in patients with type 1 diabetes and no signs of diabetic retinopathy (DR) using volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). We collected data from 35 patients with diabetes and no DR who had OCTA obtained. An additional control group of 35 eyes from 35 healthy subjects was included for comparison. OCTA volume data were processed with a previously presented algorithm in order to obtain the 3D vascular volume and 3D perfusion density. In order to weigh the contribution of different plexuses’ impairment to volume rendered vascular perfusion, OCTA en face images were binarized in order to obtain two-dimensional (2D) perfusion density metrics. Mean ± SD age was 27.2 ± 10.2 years [range 19–64 years] in the diabetic group and 31.0 ± 11.4 years [range 19–61 years] in the control group (p = 0.145). The 3D vascular volume was 0.27 ± 0.05 mm3 in the diabetic group and 0.29 ± 0.04 mm3 in the control group (p = 0.020). The 3D perfusion density was 9.3 ± 1.6% and 10.3 ± 1.6% in diabetic patients and controls, respectively (p = 0.005). Using a 2D visualization, the perfusion density was lower in diabetic patients, but only at the deep vascular complex (DVC) level (38.9 ± 3.7% in diabetes and 41.0 ± 3.1% in controls, p = 0.001), while no differences were detected at the superficial capillary plexus (SCP) level (34.4 ± 3.1% and 34.3 ± 3.8% in the diabetic and healthy subjects, respectively, p = 0.899). In conclusion, eyes without signs of DR of patients with diabetes have a reduced volume rendered macular perfusion compared to control healthy eyes.

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Clinical Assessment of Three Common Tests for Superior Labral Anterior-Posterior Lesions

The American Journal of Sports Medicine ◽

10.1177/03635465020300061001 ◽

2002 ◽

Vol 30 (6) ◽

pp. 810-815 ◽

Cited By ~ 128

Author(s):

Edward G. McFarland ◽

Tae Kyun Kim ◽

Richard M. Savino

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Shoulder Arthroscopy ◽

Control Group ◽

Type I ◽

Specific Test ◽

Slide Test ◽

Posterior Lesion ◽

Sensitivity Specificity ◽

Anterior Posterior

Background Three tests (active compression, anterior slide, and compression rotation) are commonly used to diagnose superior labral anterior-posterior lesions. Hypothesis We hypothesized that the accuracy, sensitivity, and specificity for these tests was less than that previously reported and that a click in the shoulder during manipulation was not specific for the study lesion. Study Design Case-control study. Methods The three tests were performed on 426 patients who subsequently underwent shoulder arthroscopy. The results of physical examination were compared with the arthroscopic findings and analyzed for sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. Results At arthroscopy, 39 patients had type II to IV lesions (study group); the remaining 387 patients had type I lesion or no lesion (control group). The incidences of positive results were not statistically different between the groups (P > 0.05). Our findings were as follows: most sensitive test, active compression (47%); most specific test, anterior slide (84%); highest positive predictive value, active compression (10%); highest overall accuracy, anterior slide test (77%); lowest overall accuracy, active compression test (54%). The presence of a click and the location of the pain were not reliable diagnostic indicators. Conclusions The results of such tests should be interpreted with caution when considering surgery for a possible superior labral anterior-posterior lesion.

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Association Between 45° Flexion Anteroposterior Elbow Radiographs and Diagnostic Accuracy of Capitellum Osteochondritis Dissecans

The American Journal of Sports Medicine ◽

10.1177/03635465211027178 ◽

2021 ◽

pp. 036354652110271

Author(s):

Michael G. Saper ◽

Viviana Bompadre ◽

Gregory A. Schmale ◽

Sarah Menashe ◽

Monique Burton ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Osteochondritis Dissecans ◽

Predictive Value ◽

Interobserver Reliability ◽

Intraobserver Reliability ◽

Control Group ◽

Level Of Evidence ◽

Level Of Confidence ◽

High Level ◽

Sensitivity Specificity

Background: An anteroposterior (AP) radiograph of the elbow in 45° of flexion has been suggested to increase the diagnostic accuracy of capitellum osteochondritis dissecans (OCD). Purpose: To assess the diagnostic performance, inter- and intraobserver reliability, and confidence level for identifying capitellum OCD using plain radiographs (AP, lateral, and 45° flexion AP). Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: This was a retrospective study of pediatric and adolescent patients with capitellum OCD and a control group. Six independent clinicians who were blinded to the official radiologists’ reports reviewed images on 2 separate occasions, 1 week apart. A 5-point Likert scale was used to assess the clinicians’ level of confidence. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for individual and combinations of radiographic views. Inter- and intraobserver reliability was determined using Cohen kappa (κ) coefficients. Results: A total of 28 elbows (mean age, 12.5 ± 2 years) were included. There were no differences in age ( P = .18), sex ( P = .62), or laterality ( P > .999) between groups. There were marked variations in the diagnostic accuracy between views: sensitivity (AP, 85.1; lateral, 73.2; 45° flexion AP, 91.7), specificity (AP, 89.3; lateral, 91.7; 45° flexion AP, 91.1), PPV (AP, 88.8; lateral, 89.8; 45° flexion AP, 91.1), NPV (AP, 85.7; lateral, 77.4; 45° flexion AP, 91.6), and accuracy (AP, 87.2; lateral, 82.4; 45° flexion AP, 91.4). Standard radiographs (AP and lateral views) failed to diagnose capitellum OCD in 4.8% of cases. The sensitivity of the 3 combined views was 100%. Confidence intervals in the clinicians’ diagnostic assessments were similar for each view (AP, 4.0; lateral, 4.0; and 45° flexion AP, 4.1). Interobserver reliability was substantial for AP and lateral views (κ = 0.65 and κ = 0.60, respectively) but highest for the 45° flexion AP radiographs (κ = 0.72). Intraobserver reliability for the 45° flexion AP view was moderate to almost perfect (κ = 0.45 to 0.93). Conclusion: The 45° flexion AP view can detect capitellum OCD with excellent accuracy, a high level of confidence, and substantial interobserver agreement. When added to standard AP and lateral radiographs, the 45° flexion AP view aids in the identification of capitellum OCD.

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3299Performance of the ESC 0/1h- and 0/3h-algorithm for the early diagnosis of myocardial infarction in patients with diabetes mellitus

European Heart Journal ◽

10.1093/eurheartj/ehz745.0063 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

P M Haller ◽

J T Neumann ◽

N A Soerensen ◽

T S Hartikainen ◽

A Gossling ◽

...

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Predictive Value ◽

Diabetic Patients ◽

Cardiovascular Research ◽

Diagnostic Strategies ◽

Patients With Diabetes ◽

European Society Of Cardiology ◽

Available Information ◽

Rule Out

Abstract Background Patients with diabetes mellitus (DM) may have elevated levels of high-sensitive cardiac troponin (hs-Tn) despite acute myocardial ischemia being present. However, it is unclear whether this constrains diagnostic strategies in patients with suspected acute myocardial infarction (MI). Purpose We aimed to assess the diagnostic performance of the European Society of Cardiology (ESC) 0/1 hour (h) and 0/3h-algorithms comparing patients with and without DM and to derive optimized cut-offs. Methods We prospectively enrolled patients with symptoms suggestive of MI in two large clinical cohorts and measured hs-TnI at admission (baseline) and 1 (cohort A) and 3h (cohort A+B) thereafter. Patients with ST-elevation MI were excluded. Patients were stratified based on a diagnosis of DM at baseline. Final diagnoses were adjudicated independently by two cardiologists using all clinically available information, including hs-TnT, but blinded to hs-TnI values. Our primary outcomes of interest were safety of rule-out (defined by sensitivity and negative predictive value [NPV]), accuracy of rule-in (defined by specificity and positive predictive value [PPV]) and the overall performance (% of patients adjudicated to either rule-out or -in). For optimized cut-offs, a NPV >99.0% and a PPV >75.0% were targeted. Results DM was prevalent in 563 (15.29%) of 3683 included patients. MI was more prevalent among patients with DM (137 [24.3%] vs. 498 [16.0%], p<0.001). Using the ESC 0/1h-algorithm (Figure), rule-out was safe in diabetics (p for sensitivity = 1.00) with higher NPV in non-diabetics (p<0.001), while the proportion of patients ruled-out was smaller in diabetics (22.3% vs. 41.8%). Accuracy of rule-in was significantly lower in diabetics (specificity p=0.0035, PPV p=0.48), with a higher rule-in rate of patients with DM (29.5% vs. 21.8%). Using the ESC 0/3h-algorithm, safety of rule-out was lower in both groups compared to the ESC 0/1h-algorithm, with again higher NPV for non-DM (sensitivity p=0.18, NPV p<0.001) and a higher proportion of non-DM ruled-out (65.9% vs. 75.2%). Accuracy of rule-in was significantly lower for patients with DM (specificity p=0.0094, PPV p=0.87). Cut-off adjustment to yield pre-defined accuracy measures resulted in: 4ng/L at baseline or 6ng/L with a delta of 2ng/l for rule–out and 90ng/L or a delta of 10ng/L for rule-in with the ESC 0/1h algorithm; for the ESC 0/3h-algorithm cut-offs were 5ng/L with a delta of 20% for rule-out and 50ng/L with a delta of 20% for rule-in. Conclusion Application of the ESC 0/1h- and 0/3h-algorithms in diabetic patients provided reduced safety and accuracy for rule-out and rule-in of MI, respectively. Use of alternative cut-offs resulted in improved diagnostic safety and accuracy. Acknowledgement/Funding Abbott Diagnostics, German Center of Cardiovascular Research, German Heart Foundation, Else-Kröhner-Stiftung angegeben

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Prevalence of Elevated Non-HDL Cholesterol among Patients with Diabetes in An Iranian Population

International Journal of Medical Laboratory ◽

10.18502/ijml.v7i2.2909 ◽

2020 ◽

Author(s):

Asma Kheirollahi ◽

Azam Karkhaneh

Keyword(s):

High Density Lipoprotein ◽

Lipid Profile ◽

High Density Lipoprotein Cholesterol ◽

Density Lipoprotein ◽

Hdl Cholesterol ◽

Lipoprotein Cholesterol ◽

Diabetic Patients ◽

Data Set ◽

Patients With Diabetes ◽

Routine Assessment

Background and Aims: Non-high density lipoprotein cholesterol (non- HDL-C), which reflects all cholesterol present in potentially atherogenic lipoprotein particles, might be a useful marker of atherosclerosis in diabetic subjects. In the present study, we evaluated the prevalence of high non-HDL-C in patients with dyslipidemia in diabetic and non-diabetic subjects following LDL-C assessment as the first goal of therapy. Materials and Methods: A data set of 2142 individuals was included in the study. All values of lipid profile were compared between non-diabetic and diabetic groups and the prevalence of dyslipidemia was evaluated in two groups. Results and Conclusions: According to the results, 48% of patients with diabetes achieved combined LDL-C ≤2.5 mmol/L and non-HDL ≤3.3 mmol/L targets, and 58.2% of diabetic patients achieved LDL-C goal while only 50.2% attained non-HDL-C goal. Also, the results indicated that non-HDL-C significantly heightened in patients with diabetes. Therefore, non-HDL-C needs to be calculated as a routine assessment in patients with diabetes.

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Comparison of ox-LDL Levels in Diabetic Patients with Normo-, Micro-, and Macroalbuminuria with Their First Degree Relatives and the Healthy Control Group

International Journal of Endocrinology ◽

10.1155/2012/167154 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Parisa Behzadi ◽

Firouzeh Torabi ◽

Massoud Amini ◽

Ashraf Aminorroaya

Keyword(s):

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Cross Sectional Study ◽

Control Group ◽

Diabetic Patients ◽

Cross Sectional ◽

First Degree Relatives ◽

Significant Difference ◽

Healthy Control ◽

And Control

Oxidized low density lipoprotein (ox-LDL) is a product of oxidative stress. In this cross-sectional study, we compared the ox-LDL concentrations in diabetic patients with normoalbuminuria (n=28), microalbuminuria (n=28), and macroalbuminuria (n=28) with their first degree relatives (n=28) and healthy control people (n=31). They were selected by consecutive patient selection method. The ox-LDL level was assayed using ELISA. We measured blood pressure, lipid profile, fasting plasma glucose (FPG), and HbA1c in all groups. There was no significant difference in ox-LDL concentrations among normoalbuminuric, microalbuminuric, and macroalbuminuric diabetic groups. In diabetic patients with micro- and macroalbuminuria, ox-LDL concentration was higher than their first degree relatives (P=0.04andP=0.03) and control group (P=0.001andP=0.03, resp.). In normoalbuminuric diabetic persons, ox-LDL concentration was just higher than that of healthy people (P=0.02). There was no statistically significant difference in ox-LDL levels between normoalbuminuric diabetic patients and their first degree relatives. In conclusion, the presence and progression of albuminuria in diabetic patients are not related to ox-LDL concentration and genetic predisposition influences the plasma OX-LDL level. Larger sample size is needed to confirm this conclusion in future studies.

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