scholarly journals A study of the influence of lipid profile in diabetic patients on the incidence of cerebrovascular events

2019 ◽  
Vol 6 (3) ◽  
pp. 816
Author(s):  
Taha Mahboob Ali Khalid ◽  
Rahul Gandhi G.

Background: The relationship between elevated serum lipids and atherosclerosis is well established. Recent studies have demonstrated not only that the serum lipid concentration but also the distribution of TG and cholesterol within major lipoprotein classes are of importance for the development of atherosclerosis. Elevated plasma concentrations of LDL and decreased HDL are associated with increased risk of atherosclerosis. To study the influence of lipid profile in diabetic patients on the incidence of cerebrovascular events.Methods: The study was based on 60 patients meeting the inclusion criteria from those who were admitted at Shadan Institute of Medical Sciences, Hyderabad, India from Feb 2013-May 2014. Detailed history was taken and thorough physical examination done pertaining to the involved condition. Patients who were conscious, slow progression of neurological deficit, rapid onset of lateralizing signs with variable blood pressure were considered to be suffering from infarction.Results: The mean values of lipid profile were significantly different among the gender. There were more females with medium and high TC values as compared to females and this difference was found to be significant. Though the number of females with high HDL values was more than males, the difference was not found to be significant. The number of females with high LDL values was far more than males and this difference was found to be significant. Though the number of females was more with high TG values, the difference was not found to be significant.Conclusions: In conclusion, our study gives evidence that poor glycemic control is a strong risk factor for stroke in patients with NIDDM.

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19519-e19519
Author(s):  
O. Yellin ◽  
J. Crowley ◽  
R. A. Swift ◽  
A. Makary ◽  
D. S. Gravenor ◽  
...  

e19519 Background: Although the overall survival of MM patients has improved with new treatment options, few studies have evaluated prognostic factors since these new therapies have become available. Monthly ZOL has been incorporated into many of these regimens to reduce skeletal complications. Side effects from ZOL have been reported but their frequency and outcomes have not been well-defined. This retrospective study aimed to identify key baseline and on-treatment prognostic factors among MM patients treated with ZOL. Methods: Three hundred patient charts were consecutively reviewed. Data was collected from the date of MM diagnosis to the date of chart review. Patient chart inclusion criteria required a diagnosis of MM and having received at least one dose of ZOL. Results: The median survival of among patients in this study was 131 months. Significant early risk factors for overall survival included skeletal-related events (SRE), increased serum creatinine, elevated serum calcium, and ISS Stage II or III at diagnosis. Fourteen patients (4.7%) developed osteonecrosis of the jaw (ONJ) after 9–96 months of ZOL treatment. Notably, there was a trend toward an increased risk of ONJ among diabetic patients. Thirteen patients with ONJ remain alive and currently are in remission or with stable disease. One patient with ONJ died while in remission from a myocardial infarction. Among the patients with a follow up of 4–49 months from the diagnosis of ONJ, 2 showed some worsening of this complication, 5 remained stable, while 7 improved or resolved. Patients with ONJ showed an improved overall survival using both landmark and time-dependent analysis. In addition, the overall skeletal morbidity rate (SMR; SREs/year) was 0.16. Notably, patients who developed ONJ had a lower SMR than among patients who did not develop ONJ. Conclusions: These results suggest that skeletal complications are an important prognostic factor for MM. Although ONJ occurs in MM patients, most patients show improvement with proper management and this complication appears to be associated with a reduced risk of SREs and improved overall survival. [Table: see text]


Author(s):  
M. Abdul Majid ◽  
M. Abdul Bashet ◽  
M. Estiar Rahman ◽  
M. Sabrina Moonajilin ◽  
M. Ruhul Furkan Siddique

Background: The diabetic patients are at increased risk to develop lipid abnormalities (hyperlipidemia). Diabetic patients who have lipid abnormalities are more prone to develop cardiovascular diseases. The aim of the current study was to estimate lipid profiles of patients with type-2 diabetes mellitus at Savar area, Dhaka, Bangladesh.Methods: This was a multidisciplinary study conducted between January to April, 2017. A total of 105 known cases of type-2 diabetic patients were investigated. Demographic characteristics and clinical data situation of the patients were taken by interview questionnaire. About 5 ml of fasting venous blood sample was collected from each subject for biochemical analysis. Data obtained were analyzed using Statistical Package of Social Sciences (SPSS-IBM) version 22.Results: Out of 105 patients, 64.8% patients were male and 35.2% were female. The mean±SD for age of patients was 47.67±5.9. The pattern of lipid abnormalities estimated was high serum triglycerides (TGs) in 58.1% patients, high serum total cholesterol (TC) in 61.9%, low high-density lipoprotein cholesterol (HDL-C) in 44.8%, high low-density lipoprotein (LDL-C) in 53.3%. Among all the variables only HDL levels was found significantly associated with age group (p=0.043). Study also revealed that, among all the variables only LDL-C level was found significantly associated with education (p=0.028) and TC level was associated with gender (p=0.003).Conclusions: Hyperlipidemia is a common complication of diabetes mellitus. Therefore maintaining good lipid profile can prevent development and progression of related complications among patient with diabetes mellitus.


Author(s):  
Juhi Aggarwal ◽  
Niharika Singh ◽  
Mayur Kumar

Background: Metabolic syndrome is a progressive disorder which includes a wide array of disorders i.e. central obesity, hypertension, dyslipidemia, hyperglycemia, and insulin resistance. In patients with metabolic syndrome there is an increased risk of mortality due to coronary heart disease, stroke, vascular dysfunction etc. Obesity is one of the most crucial epidemics of modern times and hormone leptin plays an important role in regulation of body weight and energy balance.Methods: A total of 355 individuals were selected from the OPD, Department of general medicine at ESIC hospital, Okhla and it comprised of 196 males and 159 females suffering from type 2 diabetes mellitus with metabolic syndrome. The data was collected over a year i.e. June 2018 to July 2019. After baseline clinical and anthropometric evaluation, Fasting Blood Sugar (FBS), Post Prandial Blood Sugar (PPBS), lipid profile, Insulin (fasting), and leptin levels of the patients were analyzed.Results: Blood sugar fasting, blood sugar post prandial, lipid profile, leptin and insulin levels were increased significantly in female patients as compared to male patients with type 2 diabetic patients and metabolic syndrome.Conclusions: Based on the study results, it was found that leptin correlate significantly with metabolic syndrome and could be used as a biomarker for the early detection of the disease.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Job A. J. Verdonschot ◽  
João Pedro Ferreira ◽  
Pierpaolo Pellicori ◽  
Hans-Peter Brunner-La Rocca ◽  
Andrew L. Clark ◽  
...  

Abstract Background Patients with diabetes mellitus (DM) are at increased risk of developing heart failure (HF). The “Heart OMics in AGEing” (HOMAGE) trial suggested that spironolactone had beneficial effect on fibrosis and cardiac remodelling in an at risk population, potentially slowing the progression towards HF. We compared the proteomic profile of patients with and without diabetes among patients at risk for HF in the HOMAGE trial. Methods Protein biomarkers (n = 276) from the Olink®Proseek-Multiplex cardiovascular and inflammation panels were measured in plasma collected at baseline and 9 months (or last visit) from HOMAGE trial participants including 217 patients with, and 310 without, diabetes. Results Twenty-one biomarkers were increased and five decreased in patients with diabetes compared to non-diabetics at baseline. The markers clustered mainly within inflammatory and proteolytic pathways, with granulin as the key-hub, as revealed by knowledge-induced network and subsequent gene enrichment analysis. Treatment with spironolactone in diabetic patients did not lead to large changes in biomarkers. The effects of spironolactone on NTproBNP, fibrosis biomarkers and echocardiographic measures of diastolic function were similar in patients with and without diabetes (all interaction analyses p > 0.05). Conclusions Amongst patients at risk for HF, those with diabetes have higher plasma concentrations of proteins involved in inflammation and proteolysis. Diabetes does not influence the effects of spironolactone on the proteomic profile, and spironolactone produced anti-fibrotic, anti-remodelling, blood pressure and natriuretic peptide lowering effects regardless of diabetes status.  Trial registration NCT02556450.


Author(s):  
LUKONG HUBERT SHALANYUY ◽  
SAMJE MOSES

Objective: Diabetes mellitus has become a clinical condition of public health importance, especially in developing countries due to its high mortality and morbidity. The aim of this study was to measure and compare the lipid and serum trace mineral profile among type 2 diabetics and hypertensive diabetics with controls. Methods: This cross-sectional study was carried out at the Regional Hospital, Bamenda, involving 50 diabetic normotensives, 50 hypertensive diabetics, and 50 normal recruited subjects. Serum levels of lipids and minerals were determined using standard methods. Results: Of the four trace elements assessed, except for copper (Cu) whose mean values in diabetics were abnormally increased (p=0.01), zinc (Zn), magnesium (Mg), and chromium (Cr) showed significantly decreased mean values in diabetics compared to the controls (p<0.05). The mean levels of these trace elements were also significantly reduced in hypertensive diabetic patients (p<0.05). In diabetics, there was no significant difference in the lipid levels. However, only total cholesterol (TC) and low-density lipoprotein mean values were significantly higher in hypertensive diabetic patients compared to the normal controls. There was also a positive significant correlation between the body mass index and Cr (r=+0.3, p=0.045) in diabetics. Conclusion: This study saw statistically significant differences in the serum lipid and trace element levels between diabetics, hypertensive diabetics, and controls: With diabetic and diabetic hypertensive patients having higher serum Cu levels and decreased serum Mg, Zn, and Cr levels compared to the normal controls. The lipid profile levels in diabetics and hypertensive diabetics were not significant differences within the study groups for all lipid profile estimations except for TC and LDL which were significantly higher only in hypertensive diabetic patients.


Cells ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 2528
Author(s):  
Yvonne Adu-Agyeiwaah ◽  
Maria B. Grant ◽  
Alexander G. Obukhov

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.


2017 ◽  
Vol 5 (2) ◽  
pp. 131-136 ◽  
Author(s):  
Soha M. Abd El Dayem ◽  
Mona Abd El Kader ◽  
Soheir Ibrahim ◽  
Enas Mokhtar ◽  
Eman Abd El Megeed

AIM: To evaluate leptin and lipid profile in overweight patients with type 1 diabetes.PATIENTS AND METHODS: The study included 50 overweight patients with type 1 diabetes and 50 age and sex matched healthy controls. Blood samples were taken for evaluation of glycosylated haemoglobin, lipid profile and leptin. Also, urine samples were taken for evaluation of albumin/creatinine ratio.RESULTS: Leptin level was significantly lower in overweight with type 1 diabetes and showed a significant positive correlation with hip circumference and body mass index and negative correlation with glycosylated haemoglobin (HbA1c). Leptin level was significantly lower in overweight diabetic patients with HbA1c > 7.5 %. The best cut-off point between overweight diabetic group and control group regarding leptin levels was found at 16.9 (ng/ml) with a sensitivity of 68% and specificity of 56%, area under the curve 0.623.CONCLUSION: Leptin levels were found to be low in overweight patients with type 1 diabetes and showed correlation with the body mass index and hip circumference. LDL was significantly higher while HDL was significantly lower in the diabetic, overweight group indicating increased risk of cardiovascular disease. Leptin level in overweight diabetic patients might be related to the metabolic control.


Author(s):  
Mohammed Sassi ◽  

Background: Dyslipidemia is one of the most common metabolic syndrome among diabetic patients due to several factors include insulin insufficiency, resistance, and central obesity. Furthermore both vitamin D deficiency and diabetes are most public health worldwide problems. Therefore the aim of the present work to study the dyslipidemia and vitamin D status in diabetes patients and also to study the relation between vitamin D status and lipid profile in diabetic patients. Methods: A Cross sectional study conducted on randomly selected diabetic patients whether have vitamin D deficiency with dyslipidemia, vitamin D deficiency with no dyslipidemia or dyslipidemia with no vitamin D deficiency. A total sample 165 patients enrolled in the study with serum lipid profile, vitamin D and glycemic control measured at beginning and end of the study. The data analysis was done through Chi-square or T test at α< 0.05. Result: The data collected on 165 patients revealed that, patients aged 41-60 years were most common, and female gender was twice as male. This study include both types of diabetes with vitamin D deficiency and dyslipidemia or vitamin D deficiency with no dyslipidemia or dyslipidemia with not vitamin D deficiency as control. Therefore, the result of this work confirmed that vitamin D deficiency significant implicated in elevated serum levels of TG, TC, LDL, VLDL, FPG and HbA1C (P< 0.05). However, vitamin D deficiency has linked to slight increased serum HDL levels. In compared to man, vitamin D deficiency linked significantly to dyslipidemia and abnormal high levels blood glucose and HbA1C par in women. Conclusion: The present study revealed that, vitamin D deficiency associated negatively with serum levels of TC, TG, VLDL, LDL, FPG and HbA1C whereas the deficiency of vitamin D linked to elevated HDL levels. In gender distribution lower vitamin D values associated with elevated serum FPG, HbA1C, lipid profile with exception HDL in women. The data of this study suggested that, diabetic patients with dyslipidemia may improve their lipid profile and glucose hemostasis through vitamin D supplementation


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Roland-Richard Macharzina ◽  
Julia Helm ◽  
Alexa Böhrsch ◽  
Anna Grabs ◽  
Roman Sztajcel ◽  
...  

Background: Risk of stroke was associated with ultrasonographic heterogeneity and echolucency of internal carotid artery stenosis (ICAS). We intended to evaluate the prediction for cerebrovascular events in asymptomatic ICAS with a recently established plaque heterogeneity index (HI) determined with three-dimensional ultrasonography (3D-US) using the Gray Scale Median (GSM) in comparison to the GSM of single 2D gray scale sections alone. We hypothesized that an association between HI and ipsilateral neurologic events exists. Patients and Methods: In 245 patients informed consent was given after pre-screening examinations and gray scale 2D- and 3D-US was performed at 10 MHz to receive longitudinal sections through ICAS in a prospective fashion. Stenoses were graded according to NASCET criteria by duplex ultrasonography. In addition a majority received a baseline computer tomography (CT) angiography of ICAS to confirm stenosis grades in combination with a cerebral CT scan. HI was determined in a blinded fashion using the GSM of three parallel 3D-rendered longitudinal slices through the plaque by calculating the difference between the maximum and the minimum GSM divided by the mean. Neurologic assessment was scheduled every 6 months. The composite endpoint transient ischemic attack, stroke and amaurosis fugax ipsilateral to the ICAS was evaluated by a neurologist and cerebral CT or magnetic resonance scans were used to confirm diagnosis. Results: 3D-US was performed in 160 asymptomatic ICAS at good quality to detemine GSM of whole plaque sections. Most of the ICAS ranged 40 - 60%. Patients with a heterogenous plaque, having a HI higher than the median, had a more than 4-fold increased risk (p < 0.05) of suffering an ipsilateral neurologic event. The Kaplan-Meier analysis also demonstrated that patients with a heterogenous plaque suffer more neurologic events (Log-rank p = 0.02). We did not find a significant association of the combined neurologic events and the GSM measured with 2D-US but there was a trend towards a lowered mean GSM in the symptomatic patients measured with 3D-US. Conclusion: The HI of ICAS was predictive for cerebrovascular events. The HI is probably a better predictor for cerebral events than GSM alone.


Blood ◽  
1997 ◽  
Vol 89 (8) ◽  
pp. 3055-3060 ◽  
Author(s):  
J.T. Slattery ◽  
R.A. Clift ◽  
C.D. Buckner ◽  
J. Radich ◽  
B. Storer ◽  
...  

Abstract The influence of busulfan (BU) plasma concentration on outcome of transplantation from HLA identical family members for the treatment of chronic myelogenous leukemia (CML) was examined in 45 patients transplanted in chronic phase (CP) (n = 39) or accelerated phase (AP) (n = 6). All patients received the same regimen of BU, 16 mg/kg orally and cyclophosphamide (CY), 120 mg/kg intravenously. Plasma concentrations of BU at steady state (CSSBU) during the dosing interval were measured for each patient. The mean CSSBU was 917 ng/mL (range, 642 to 1,749; median, 917; standard deviation, 213). Of patients with CSSBU below the median, seven (five of 18 in CP and two of four in AP) developed persistent cytogenetic relapse and three of these patients died. There were no relapses in patients with CSSBU above the median. The difference in the cumulative incidence of relapse between the two groups was statistically significant (P = .0003). CSSBU was the only statistically significant determinant of relapse in univariable or multivariable analysis. The 3-year survival estimates were 0.82 and 0.64 for patients with CSSBU above and below the median (P = .33). There was no statistically significant association of CSSBU with survival or nonrelapse mortality, although the power to detect a difference in survival between 0.82 and 0.64 was only 0.24, similarly CSSBU above the median was not associated with an increased risk of severe regimen-related toxicity. We conclude that low BU plasma levels are associated with an increased risk of relapse.


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