The Challenge of Lipid Management in Patients with Diabetes or Other Endocrine Disorders

2010 ◽  
Vol 7 (2) ◽  
pp. 92
Author(s):  
Alberico L Catapano ◽  
Liliana Grigore ◽  
Angela Pirillo ◽  
◽  
◽  
...  
Keyword(s):  
Statin Therapy ◽  
Meta Analysis ◽  
Diabetic Patients ◽  
Endocrine Disorders ◽  
Lipid Management ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Associated Risk Factors

Diabetes increases the risk of developing cardiovascular disease (CVD), and several guidelines suggest that subjects with diabetes are at high risk of developing CVD. The increased risk can be attributed, at least in part, to associated risk factors, including hypertension and dyslipidaemia. The role of statins in primary and secondary prevention of CVD is well established, and the positive effect has been clearly demonstrated also in patients with type 2 diabetes. A number of studies have evaluated the effect of statin therapy on incident CVD and shown that statin therapy produces a great reduction in cardiovascular risk, but a recent meta-analysis revealed a slight increase in the risk of developing diabetes. Such risk is, however, low, especially when compared with the reduction in cardiovascular events and should not interfere with the choice of treating diabetic patients with a cholesterol-lowering therapy.

The GSTM1 and GSTT1 Null Genotypes Increase the Risk for Type 2 Diabetes Mellitus and the Subsequent Development of Diabetic Complications: A Meta-analysis

2018 ◽  
Vol 15 (1) ◽  
pp. 31-43 ◽  
Author(s):  
Sayantan Nath ◽  
Sambuddha Das ◽  
Aditi Bhowmik ◽  
Sankar Kumar Ghosh ◽  
Yashmin Choudhury
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Meta Analysis ◽  
Subsequent Development ◽  
Asian Population ◽  
Gstm1 Null Genotype ◽  
Increased Risk

Background:Studies pertaining to association of GSTM1 and GSTT1 null genotypes with risk of T2DM and its complications were often inconclusive, thus spurring the present study.Methods:Meta-analysis of 25 studies for evaluating the role of GSTM1/GSTT1 null polymorphisms in determining the risk for T2DM and 17 studies for evaluating the role of GSTM1/GSTT1 null polymorphisms in development of T2DM related complications were conducted.Results:Our study revealed an association between GSTM1 and GSTT1 null polymorphism with T2DM (GSTM1; OR=1.37;95% CI =1.10-1.70 and GSTT1; OR=1.29;95% CI =1.04-1.61) with an amplified risk of 2.02 fold for combined GSTM1-GSTT1 null genotypes. Furthermore, the GSTT1 null (OR=1.56;95%CI=1.38-1.77) and combined GSTM1-GSTT1 null genotypes (OR=1.91;95%CI=1.25- 2.94) increased the risk for development of T2DM related complications, but not the GSTM1 null genotype. Stratified analyses based on ethnicity revealed GSTM1 and GSTT1 null genotypes increase the risk for T2DM in both Caucasians and Asians, with Asians showing much higher risk of T2DM complications than Caucasians for the same. </P><P> Discussion: GSTM1, GSTT1 and combined GSTM1-GSTT1 null polymorphism may be associated with increased risk for T2DM; while GSTT1 and combined GSTM1-GSTT1 null polymorphism may increase the risk of subsequent development of T2DM complications with Asian population carrying an amplified risk for the polymorphism.Conclusion:Thus GSTM1 and GSTT1 null genotypes increases the risk for Type 2 diabetes mellitus alone, in combination or with regards to ethnicity.

scholarly journals Role of Aspirin for primary prevention of cardiovascular and all-cause mortality events in diabetes: An updated meta-analysis of randomized controlled trials.

2021 ◽  
Author(s):  
Hua Ma ◽  
QIng Gu ◽  
Huining Niu ◽  
Xiaohua Li ◽  
Rong Wang
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Meta Analysis ◽  
Significant Risk ◽  
Diabetic Patients ◽  
Primary Endpoints ◽  
All Cause Mortality ◽  
Patients With Diabetes ◽  
Rule Out

Background: The use of Aspirin in the primary prevention of cardiovascular disease (CVD) is still a topic of debate, especially in patients with diabetes. The present meta-analysis aims to rule out the efficacy of Aspirin in patients with diabetes and to compare the effectiveness of Aspirin with a placebo (or no treatment) for the primary prevention of CVD and all-cause mortality events in people with diabetes. Materials and Methods: An extensive and systematic search was conducted in Medline (via PubMed), Cinahl (via Ebsco), Scopus, and Web of Sciences from 1988 to December 2020. A detailed literature search was conducted using Aspirin, cardiovascular disease (CVD), diabetes, and efficacy to identify trials of patients with diabetes who received Aspirin for primary prevention of CVD. Demographic details with the primary outcome of events and bleeding outcomes were analyzed. The risk of bias (RoB) in included studies was evaluated using the QUADAS-2 tool. Results: A total of 5 studies out of 13 were included with 23,570 diabetic patients; 11,738 allocated to Aspirin and 11,832 allocated to the placebo group. In patients with diabetes, there was no difference between Aspirin and placebo with respect to the risk of all-cause death with a confidence interval (CI) varying 0.63 to 1.17. In addition, there were no differences in the bleeding outcomes with an odds ratio of 1.4411 (CI 0.47 to 4.34). Conclusion: Aspirin has no significant risk on primary endpoints of cardiovascular events and the bleeding outcomes in diabetic patients compared to placebo. More research on the use of Aspirin alone or in combination with other antiplatelet drugs is required in patients with diabetes to supplement currently available research.

scholarly journals Study on Thyroid Dysfunction in Patients with Type-2 Diabetes

2020 ◽  
Vol 7 (52) ◽  
pp. 3142-3147
Author(s):  
Senthil Chander ◽  
Kalpana Dev Venkatesan ◽  
Christina Mary Paul
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
General Medicine ◽  
Diabetic Patients ◽  
Endocrine Disorders ◽  
Cross Sectional ◽  
Patients With Diabetes

BACKGROUND Diabetes mellitus is one of the leading endocrine disorders worldwide. Thyroid dysfunction is a common endocrine disorder affecting the general population next to diabetes. The objective of this study was to determine the prevalence of thyroid dysfunction among patients with Type 2 diabetes. METHODS This analytical cross sectional study was conducted from June 2019 to Dec 2019. One hundred and fifty type–2 diabetes patients who attended the outpatient clinic of General Medicine Department, ACS Medical College and Hospital were included in the study. A detailed history and examination was done after getting informed consent. Blood samples were collected and sent to the laboratory for the evaluation of thyroid profile. RESULTS Thyroid dysfunction was found in 27 % of the patients with diabetes. Subclinical hypothyroidism was the most common thyroid dysfunction reported (14.7 %) followed by clinical hypothyroidism (10 %), subclinical hyperthyroidism (2 %) and clinical hyperthyroidism (0.6 %). CONCLUSIONS Thyroid dysfunction is common in patients with type-2 diabetes. A substantial proportion of the diabetic patients with thyroid dysfunction have subclinical hypothyroidism. Unidentified thyroid dysfunction could negatively impact diabetes and its complications. Therefore, early and routine screening of thyroid is recommended in all patients with diabetes to reduce the burden of the disease. KEYWORDS Type-2 Diabetes Mellitus, Thyroid Dysfunction, Hypothyroidism

scholarly journals Association of Myocardial Fibrosis Detected by Late Gadolinium-Enhanced MRI with Clinical Outcomes of Patients with Diabetes: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Zhi Yang ◽  
Rong Xu ◽  
Jia-rong Wang ◽  
Hua-yan Xu ◽  
Hang Fu ◽  
...  
Keyword(s):  
Myocardial Fibrosis ◽  
Random Effects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Imaging Biomarker ◽  
Diabetic Patients ◽  
Significant Heterogeneity ◽  
Cardiac Events ◽  
Increased Risk ◽  
Patients With Diabetes

Abstract Background Prior studies demonstrated that myocardial fibrosis assessed by late gadolinium-enhanced (LGE) MRI is associated with an increased risk for major adverse cardiac and cerebrovascular events (MACCE) or major adverse cardiac events (MACE) in patients with diabetes. However, the results of these studies were controversial and limited. Therefore, we performed this meta-analysis assessing the associations of myocardial fibrosis detected by LGE with the risk of MACCE and MACE in patients with diabetes. Methods We selected studies using MEDLINE, EMBASE and Cochrane by Ovid on December 2019. Prospective and retrospective studies that assessed the associations of myocardial fibrosis detected by LGE with the risk of MACCE or MACE in patients with diabetes with a disease duration of at least 12 months. Two independent reviewers performed the data extraction using a standardized form. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated by a random-effects model. Results Eight studies with 1121 patients were included in this meta-analysis, and follow-up of patients ranged from 17 to 70 months. The prevalence of LGE in the total sample was high, occurring in 38.09%. The annualized event rates (AERs) for MACCE was 11.94% in patients with diabetes and LGE. The presence of myocardial fibrosis detected by LGE was associated with an increased risk for MACCE (HR: 2.58; 95%CI 1.42-4.71; P=0.002) and MACE (HR: 5.28; 95%CI 3.20-8.70; P=0.000) in patients with diabetes. In a subgroup meta-analysis, ischemic fibrosis detected by LGE was associated with MACCE/MACE (HR 3.75, 95%CI 2.11-6.69; P=0.000) in patients with diabetes. In diabetic patients with preserved ejection fraction, the association between myocardial fibrosis detected by LGE and MACCE/MACE remained significant (HR: 4.02; 95%CI 2.22-7.25; P=0.000). All of the meta-analyses showed no significant heterogeneity from random effects. Conclusion This study demonstrated that myocardial fibrosis detected by LGE conferred an increase in the risk of MACCE/MACE in patients with diabetes and may be an imaging biomarker for risk stratification.

scholarly journals Long-term glycemic variability and risk of stroke in patients with diabetes: a meta-analysis

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Xiaoli Ren ◽  
Zhiyun Wang ◽  
Congfang Guo
Keyword(s):  
Standard Deviation ◽  
Coefficient Of Variation ◽  
Meta Analysis ◽  
Glycemic Variability ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Follow Up Studies ◽  
Patients With Diabetes

Abstract Objectives Long-term glycemic variability has been related to increased risk of vascular complication in patients with diabetes. However, the association between parameters of long-term glycemic variability and risk of stroke remains not fully determined. We performed a meta-analysis to systematically evaluate the above association. Methods Medline, Embase, and Web of Science databases were searched for longitudinal follow-up studies comparing the incidence of stroke in diabetic patients with higher or lower long-term glycemic variability. A random-effect model incorporating the potential heterogeneity among the included studies were used to pool the results. Results Seven follow-up studies with 725,784 diabetic patients were included, and 98% of them were with type 2 diabetes mellitus (T2DM). The mean follow-up duration was 7.7 years. Pooled results showed that compared to those with lowest category of glycemic variability, diabetic patients with the highest patients had significantly increased risk of stroke, as evidenced by glycemic variability analyzed by fasting plasma glucose coefficient of variation (FPG-CV: risk ratio [RR] = 1.24, 95% confidence interval [CI] 1.11 to 1.39, P < 0.001; I2 = 53%), standard deviation of FPG (FPG-SD: RR = 1.16, 95% CI 1.02 to 1.31, P = 0.02; I2 = 74%), HbA1c coefficient of variation (HbA1c-CV: RR = 1.88, 95% CI 1.61 to 2.19 P < 0.001; I2 = 0%), and standard deviation of HbA1c (HbA1c-SD: RR = 1.73, 95% CI 1.49 to 2.00, P < 0.001; I2 = 0%). Conclusions Long-term glycemic variability is associated with higher risk of stroke in T2DM patients.

scholarly journals The Potential Role of Osteopontin and Furin in Worsening Disease Outcomes in COVID-19 Patients with Pre-Existing Diabetes

Cells ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 2528
Author(s):  
Yvonne Adu-Agyeiwaah ◽  
Maria B. Grant ◽  
Alexander G. Obukhov
Keyword(s):  
Elevated Serum ◽  
Premature Mortality ◽  
Proteolytic Processing ◽  
Diabetic Patients ◽  
Metabolic Dysfunction ◽  
The Novel ◽  
Disease Outcomes ◽  
Increased Risk ◽  
Patients With Diabetes

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the ongoing coronavirus disease 2019 (COVID-19) pandemic, with more than 50 million cases reported globally. Findings have consistently identified an increased severity of SARS-CoV-2 infection in individuals with diabetes. Osteopontin, a cytokine-like matrix-associated phosphoglycoprotein, is elevated in diabetes and drives the expression of furin, a proprotein convertase implicated in the proteolytic processing and activation of several precursors, including chemokines, growth factors, hormones, adhesion molecules, and receptors. Elevated serum furin is a signature of diabetes mellitus progression and is associated with a dysmetabolic phenotype and increased risk of diabetes-linked premature mortality. Additionally, furin plays an important role in enhancing the infectivity of SARS-CoV-2 by promoting its entry and replication in the host cell. Here, we hypothesize that diabetes-induced osteopontin and furin protein upregulation results in worse outcomes in diabetic patients with SARS-CoV-2 infection owing to the roles of these protein in promoting viral infection and increasing metabolic dysfunction. Thus, targeting the osteopontin-furin axis may be a plausible strategy for reducing mortality in SARS-CoV-2 patients with diabetes.

scholarly journals Application of artificial intelligence in prediction of cardiovascular complications in patients with diabetes mellitus type 2: A protocol of systematic review

2021 ◽  
Author(s):  
Hengameh Ferdosian ◽  
◽  
Hadi Zamanian ◽  
Sayed Ali Emami ◽  
Elahe Sedighi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Microvascular Complications ◽  
Cardiovascular Complications ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Review Question

Review question / Objective: The aim of this systematic review is to evaluate AI-based models in identifying predictors of cardiovascular events and risk predtion in patients with diabetes mellitus type2. Condition being studied: T2DM patients have an increased risk of macrovascular and microvascular complications, lead to decreased quality of life and mortality. Considering the significance of cardiovascular complications in these patients, prediction of such events would be important. Different traditional statistical methods(such as regression) and new AI-besed algorithms are used to predict these complications in diabetic patients.

scholarly journals Association between PTX3 and PVT1 genetic polymorphisms and the risk of diabetic kidney disease in type 2 diabetic patients

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Sindhu Varghese ◽  
Gowtham Kumar Subburaj
Keyword(s):  
Kidney Disease ◽  
Genetic Polymorphisms ◽  
Diabetic Kidney Disease ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Diabetic Kidney ◽  
Increased Risk ◽  
Type 2 Diabetic

Abstract Background Very few studies have investigated the role of PTX3 and PVT1 genetic polymorphisms and their association in the progression of diabetic kidney diseases. Diabetic kidney disease (DKD) is a prominent reason of end-stage renal disease and also known to be involved in the high mortality rate of cardiovascular diseases. The current study has examined the role of PTX3 and PVT1 genetic polymorphisms in the development of diabetic kidney disease in type 2 diabetic patients. Results A significant difference between the genotypes and alleles of the rs2305619 polymorphism was observed in the diabetic patients with DKD when compared with the control group. The frequency of GG genotype was observed to be high in diabetic patients with DKD when compared to the other two groups. This specified that diabetic patients with GG genotype are at an increased risk to develop DKD. However, PVT1 (G/A) polymorphism did not show any association in the allele and genotypic frequencies with DKD when compared with T2DM and controls. Conclusion Our results propose a major influence of GG genotype of rs2305619 polymorphism to be significantly linked with an increased risk of DKD in type 2 diabetic patients.

scholarly journals Statins for Primary Prevention of Cardiovascular and Cerebrovascular Events in Diabetic Patients without Established Cardiovascular Diseases: A Meta-Analysis

2011 ◽  
Vol 120 (02) ◽  
pp. 116-120 ◽  
Author(s):  
Y.-H. Chen ◽  
B. Feng ◽  
Z.-W. Chen
Keyword(s):  
Primary Prevention ◽  
Statin Therapy ◽  
Therapy Group ◽  
Coronary Revascularization ◽  
Meta Analysis ◽  
Diabetic Patients ◽  
Cerebrovascular Events ◽  
All Cause Mortality ◽  
Patients With Diabetes ◽  
Control Therapy

AbstractLipid-lowering medications could lead to a significant reduction in major cardiovascular events in patients with diabetes. However, there was still controversy regarding the use of statins in patients with diabetes for primary prevention. The meta-analysis was performed to evaluate the outcomes of statin-therapy in diabetic patients without established cardiovascular diseases.7 randomized controlled trials of statin- vs. control-therapy in patients with diabetes were included. A total number of 12 711 patients were involved. The outcomes of interest were major adverse cardiovascular and cerebrovascular events (MACCE), including myocardial infarction, stroke, all-cause mortality and coronary revascularization.A total of 1 376 MACCE occurred during follow-up, with 9.54% (605 patients) in the statin therapy group and 12.10% (771 patients) in control group. Statin therapy was associated with a significant reduction in the incidence of MACCE (0.79, 95%CI 0.66–0.95; P=0.01). Meanwhile, the risk of stroke and coronary revascularization were reduced 29 and 26% in statin therapy group. However, there was no statistical difference of all-cause mortality between statin- and control-therapy group (3.73 vs. 4.65%, P=0.13).For primary prevention in patients with diabetes without established cardiovascular disease, statin therapy could reduce the cardiovascular and cerebrovascular events, but not all-cause mortality.

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