scholarly journals Association between central non-dipping pattern and platelets morphology in adults with type 1 diabetes without cardiovascular disease: a cross-sectional study

Author(s):  
Michal Kulecki ◽  
Dariusz Naskret ◽  
Mikolaj Kaminski ◽  
Dominika Kasprzak ◽  
Pawel Lachowski ◽  
...  

Abstract BackgroundPeople with type 1 diabetes mellitus (T1DM) have higher cardiovascular risk (CVR) compared to those from the general population. One of the markers of elevated CVR is a non-dipping pattern. Mean platelet volume (MPV) and platelet distribution width (PDW) are related to platelets' activation. Aortic systolic blood pressure (SBP Ao) has a better predictive value for cardiovascular disease than brachial systolic blood pressure (SBP Br). Hypertensives with non-dipping pattern have higher MPV than dippers. However, this relationship was never investigated among people with T1DM. This study aimed to investigate the association between central dipping pattern and platelets morphology in subjects with T1DM.MethodsWe measured SBPAo and SBPBr with a validated non-invasive brachial oscillometric device - Arteriograph 24 (TensioMed Ltd., Budapest, Hungary) - during twenty-four-hour analysis in T1DM subjects without diagnosed hypertension. The non-dipping pattern was defined as a nocturnal SBP Ao fall of less than 10%. We collected medical history, anthropometrical features, and laboratory results. The group was divided based on the dipping pattern for dippers and non-dippers. ResultsFrom total 62 subjects (32 males) aged 30.1 (25.7-37) years with T1DM duration 15.0 (9.0-20) years, 36 were non-dippers based on SBP Ao. Non-dipper group had significantly higher MPV (10.4 [10-10.7] fl vs 10.9 [10.3-11.5] fl; p = 0.03) and PDW (12.3 [11.7-12.8] fl vs 13.95 [11.7-15.1] fl; p=0.02) than dipper group. The groups did not differ in classic risk factors. Multivariate logistic regression revealed that MPV (OR: 3.74; 95% CI =1.48-9.45; p = 0.005) and daily insulin intake (OR: 445.11; 95% CI = 4.25 - 46597.42; p = 0.01) were independently positively associated with non-dipping pattern based on SBP Ao. PDW was also independently positively related to central non-dipping pattern (OR: 1.91; 95% CI = 1.22 - 3.00; p = 0.005).ConclusionsT1DM subjects with central non-dipping pattern have higher values of MPV and PDW than dippers. MPV and PDW are independently positively associated with SBP Ao non-dipping pattern among people with T1DM.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michal Kulecki ◽  
Dariusz Naskret ◽  
Mikolaj Kaminski ◽  
Dominika Kasprzak ◽  
Pawel Lachowski ◽  
...  

AbstractThe non-dipping pattern is nighttime systolic blood pressure (SBP) fall of less than 10%. Several studies showed that the non-dipping pattern, increased mean platelet volume (MPV), and platelet distribution width (PDW) are associated with elevated cardiovascular risk. Hypertensives with the non-dipping pattern have higher MPV than the dippers but this relationship was never investigated among people with type 1 diabetes mellitus (T1DM). This study aimed to investigate the association between the central dipping pattern and platelet morphology in T1DM subjects. We measured the central and brachial blood pressure with a validated non-invasive brachial oscillometric device—Arteriograph 24—during twenty-four-hour analysis in T1DM subjects without diagnosed hypertension. The group was divided based on the central dipping pattern for the dippers and the non-dippers. From a total of 62 subjects (32 males) aged 30.1 (25.7–37) years with T1DM duration 15.0 (9.0–20) years, 36 were non-dippers. The non-dipper group had significantly higher MPV (MPV (10.8 [10.3–11.5] vs 10.4 [10.0–10.7] fl; p = 0.041) and PDW (13.2 [11.7–14.9] vs 12.3 [11.7–12.8] fl; p = 0.029) than dipper group. Multivariable logistic regression revealed that MPV (OR 3.74; 95% CI 1.48–9.45; p = 0.005) and PDW (OR 1.91; 95% CI 1.22–3.00; p = 0.005) were positively associated with central non-dipping pattern adjusting for age, sex, smoking status, daily insulin intake, and height. MPV and PDW are positively associated with the central non-dipping pattern among people with T1DM.


2022 ◽  
Author(s):  
Roberta Maria Duailibe Ferreira Reis Reis ◽  
Dayse Aparecida Silva ◽  
Maria da Glória Tavares ◽  
Gilvan Cortês Nascimento ◽  
Sabrina da Silva Pereira Damianse ◽  
...  

Abstract BackgroundPatients with type 1 diabetes (T1D) have a higher risk of developing cardiovascular disease (CVD), which is a major cause of death in this population. The objective of this study was to investigate early markers of CVD associated with clinical data and autosomal ancestry in T1D patients from an admixed Brazilian population. MethodsA cross-sectional study was conducted with 99 T1D patients. The early markers of CVD included the ankle-brachial index (ABI), coronary artery calcium score (CACS), and carotid Doppler sonography. Demographic, clinical, and serum data were collected. A panel of autosomal informational insertion/deletion ancestry markers was used to estimate the individual proportions of European, African, and Amerindian ancestry.ResultsThe study sample had a mean age of 27.6 years and 14.4 years of duration of T1D. The prevalence of alterations in early CVD markers was: ABI (< 0,9) 19.6%, CACS (> 0 +) 4.1%, and carotid Doppler 5.0%. There was significant agreement between CACS and carotid Doppler, and these were correlated with traditional risk factors for CVD. There was a predominance of European ancestry (47.3%), followed by African (28%) and Ameridian (24.7%). There were no association between early CVD markers and autosomal ancestry proportions.ConclusionThe ABI was useful in the early identification of CVD in asymptomatic young patients with T1D and with a short duration of disease, and showed agreement with the carotid Doppler. Although CACS and carotid Doppler are non-invasive tests, carotid Doppler is more cost-effective, and both have limitations in screening for CVD in young patients with a short duration of T1D. We did not find a statistically significant relationship between autosomal ancestry proportions and early CVD markers in an admixed Brazilian population.


Joints ◽  
2017 ◽  
Vol 05 (03) ◽  
pp. 143-146 ◽  
Author(s):  
Carlo Doria ◽  
Giulia Mosele ◽  
Francesca Badessi ◽  
Leonardo Puddu ◽  
Gianfilippo Caggiari

Purpose To evaluate the prevalence of adhesive capsulitis (AC) of the shoulder in patients with type 1 diabetes mellitus (T1DM) in Sardinia. Methods In this cross-sectional study, we evaluated 943 patients with T1DM attending the division of Endocrinology and Metabolism at the University Hospital in Sassari, Italy. The criteria for diagnosing AC were: pain for at least 1 month, inability to lie on the affected shoulder, and restricted active and passive shoulder joint movements in at least three planes. Age, gender, duration of DM, blood pressure, and presence of neuropathy and retinopathy were noted. Metabolic control of DM was evaluated with glycosylated hemoglobin A1c (GHbA1c) blood concentrations. Results AC was diagnosed in 331 patients (prevalence: 35.1%). Age, duration of DM, high blood pressure levels, and the presence of neuropathy and retinopathy were significantly associated with AC. No significant association was observed between gender and AC. There was no significant difference in mean levels of GHbA1c in T1DM patients with or without AC. Conclusion This study shows that AC of the shoulder is a common disorder in patients with T1DM in Sardinia. It is significantly associated with age, duration of DM, and related complications. Level of Evidence Level IV, observational cross-sectional study.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hema Viswambharan ◽  
Chew Weng Cheng ◽  
Kirti Kain

AbstractIncreased brachial systolic blood-pressure (BP) predicts diabetes (T2DM) but is not fully effective. Value of absolute ankle systolic BP for T2DM compared to brachial systolic BP is not known. Our objectives were to assess independent relationships of ankle-systolic BP with T2DM and cardiovascular disease in Europeans and south Asians. Cross-sectional studies of anonymised data from registered adults (n = 1087) at inner city deprived primary care practices. Study includes 63.85% ethnic minority. Systolic BP of the left and right-brachial, posterior-tibial and dorsalis-pedis-arteries measured using a Doppler probe. Regression models’ factors were age, sex, ethnicity, body mass index (BMI) and waist height ratio (WHtR). Both brachial and ankle systolic-BP increase with diabetes in Europeans and south Asians. We demonstrated that there was a significant positive independent association of ankle BP with diabetes, regardless of age and sex compared to Brachial. There was stronger negative association of ankle blood pressure with cardiovascular disease, after adjustment for BMI, WHtR and ethnicity. Additionally, we found that ankle BP were significantly associated with cardiovascular disease in south Asians more than the Europeans; right posterior tibial. Ankle systolic BPs are superior to brachial BPs to identify risks of Type 2DM and cardiovascular diseases for enhanced patient care.


2021 ◽  
Author(s):  
Paul Minh Huy Tran ◽  
Eileen Kim ◽  
Lynn Kim Hoang Tran ◽  
bin Satter Khaled ◽  
Wenbo Zhi ◽  
...  

AbstractDevelopment of complications in type-1 diabetes patients can be reduced by modifying risk factors. We used a cross-sectional cohort of 1646 patients diagnosed with type 1 diabetes (T1D) to develop a clinical risk score for diabetic peripheral neuropathy (DPN), autonomic neuropathy (AN), retinopathy (DR), and nephropathy (DN). Of these patients, 199 (12.1%) had DPN, 63 (3.8%) had AN, 244 (14.9%) had DR, and 88 (5.4%) had DN. We selected five variables to include in each of the four microvascular complications risk models: age, age of T1D diagnosis, duration of T1D, and average systolic blood pressure and HbA1C over the last three clinic visits. These variables were selected for their strong evidence of association with diabetic complications in the literature and because they are modifiable risk factors. We found the optimism-corrected R2 and Harrell’s C statistic were 0.39 and 0.87 for DPN, 0.24 and 0.86 for AN, 0.49 and 0.91 for DR, and 0.22 and 0.83 for DN respectively.This tool (https://ptran25.shinyapps.io/Diabetic_Peripheral_Neuropathy_Risk) was built to help inform patients of their current risk of microvascular complications and to motivate patients to control their HbA1c and systolic blood pressure in order to reduce their risk of these complications.


Author(s):  
Paul Minh Huy Tran ◽  
Eileen Kim ◽  
Lynn Kim Hoang Tran ◽  
Bin Satter Khaled ◽  
Diane Hopkins ◽  
...  

Development of complications in type 1 diabetes patients can be reduced by modifying risk factors. We used a cross-sectional cohort of 1646 patients diagnosed with type 1 diabetes (T1D) to develop a clinical risk score for diabetic peripheral neuropathy (DPN), autonomic neuropathy (AN), retinopathy (DR), and nephropathy (DN). Of these patients, 199 (12.1%) had DPN, 63 (3.8%) had AN, 244 (14.9%) had DR, and 88 (5.4%) had DN. We selected five variables to include in each of the four microvascular complications risk models: age, age of T1D diagnosis, duration of T1D, and average systolic blood pressure and HbA1C over the last three clinic visits. These variables were selected for their strong evidence of association with diabetic complications in the literature and because they are modifiable risk factors. We found the optimism-corrected R2 and Harrell’s C statistic were 0.39 and 0.87 for DPN, 0.24 and 0.86 for AN, 0.49 and 0.91 for DR, and 0.22 and 0.83 for DN, respectively. This tool was built to help inform patients of their current risk of microvascular complications and to motivate patients to control their HbA1c and systolic blood pressure in order to reduce their risk of these complications.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Eva Olga Melin ◽  
Jonatan Dereke ◽  
Magnus Hillman

Abstract Background Type 1 diabetes (T1D) is a major risk factor for cardiovascular disease (CVD). Matrix metalloproteinase-14 (MMP-14) is involved in the development of atherosclerosis and CVD. The main aim was to explore the associations between MMP-14 and selected inflammatory and metabolic variables, CVD, depression, physical activity, smoking and medication in patients with T1D. The secondary aim was to explore associations with CVD. Methods Cross-sectional design. The participants were consecutively recruited from one specialist diabetes out-patient clinic. Depression was assessed by a self-report instrument. Blood samples, anthropometrics and blood pressure were collected, supplemented with data from electronic health records. High MMP-14 was defined as  ≥  5.81 ng/mL. Non-parametric tests, Chi2 tests and multiple logistic regression analyses were performed. Results Two hundred and sixty-eighth T1D patients aged 18–59 years participated (men 58%, high MMP-14 25%, CVD 3%). Sixty-seven patients with high MMP-14, compared to 201 patients with lower MMP-14, had higher prevalence of CVD (8% versus 1%, p  =  0.012), and had higher levels of galectin-3 (p  <  0.001) and MMP-2 (p  =  0.018). Seven patients with CVD, compared to 261 without, were older (p  =  0.003), had longer diabetes duration (p  =  0.027), and had higher prevalence of high MMP-14 (71% versus 24%, p  =  0.012), abdominal obesity (p  =  0.014), depression (p  =  0.022), usage of antidepressants (p  =  0.008), antihypertensive drugs (p  =  0.037) and statins (p  =  0.049). Galectin-3 (per ng/mL) [adjusted odds ratio (AOR) 2.19, p  <  0.001], CVD (AOR 8.1, p  =  0.027), and MMP-2 (per ng/mL) (AOR 1.01, p  =  0.044) were associated with high MMP-14. Depression (AOR 17.4, p  =  0.006), abdominal obesity (15.8, p  =  0.006), high MMP-14 (AOR 14.2, p  =  0.008), and diabetes duration (AOR 1.10, p  =  0.012) were associated with CVD. Conclusions The main findings of this study were that galecin-3, MMP-2, and CVD were independently associated with high levels of MMP-14 in T1D patients. The association between MMP-14 and galectin-3 is a new finding. No traditional risk factors for CVD were associated with MMP-14. Depression, abdominal obesity and MMP-14 were independently associated with CVD.


2015 ◽  
Vol 7 (S1) ◽  
Author(s):  
Patrícia Ramos Guzatti ◽  
Amely PS Balthazar ◽  
Maria Heloisa Busi da Silva Canalli ◽  
Thais Fagnani Machado

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eva O. Melin ◽  
Jonatan Dereke ◽  
Magnus Hillman

Abstract Background Low levels of the soluble tumour necrosis factor-like weak inducer of apoptosis (sTWEAK) and depression are linked to cardiovascular disease. Galectin-3, inadequate glycemic control and low high-density lipoprotein (HDL)-cholesterol levels were previously linked to depression in these patients with type 1 diabetes mellitus (T1DM). The main aim was to explore whether sTWEAK was associated with depression. A secondary aim was to explore diabetes related variables associated with low sTWEAK. Methods Cross-sectional design. T1DM patients (n = 283, men 56%, age18–59 years) were consecutively recruited from one specialist diabetes clinic. Depression was defined as Hospital Anxiety and Depression Scale-Depression sub scale ≥8 points. Blood samples, anthropometrics and blood pressure were collected, supplemented with data from electronic health records. Enzyme linked immunosorbent assays were used to measure sTWEAK and galectin-3. Low sTWEAK was defined as < 7.2 ng/ml and high galectin-3 as ≥2.6 ng/ml. Multiple logistic regression analyses were performed, calibrated and validated for goodness of fit. We adjusted for age, sex, diabetes duration, galectin-3, metabolic variables, serum-creatinine, smoking, physical inactivity, medication, and cardiovascular complications. Results For 29 depressed versus 254 non-depressed patients the prevalence rates were for low sTWEAK: 93 and 68% (p = 0.003) and for high galectin-3: 34 and 13% (p = 0.005) respectively. HDL-cholesterol levels were lower for the depressed (p = 0.015). Patients with low sTWEAK versus high sTWEAK had lower usage of continuous subcutaneous insulin infusion (CSII) (6% versus 17%, p = 0.005). Low sTWEAK (adjusted odds ratio (AOR) 9.0, p = 0.006), high galectin-3 (AOR 6.3, p = 0.001), HDL-cholesterol (per mmol/l) (AOR 0.1, p = 0.006), use of antidepressants (AOR 8.4, p < 0.001), and age (per year) (AOR 1.05, p = 0.027) were associated with depression. CSII (AOR 0.3, p = 0.003) and depression (AOR 7.1, p = 0.009) were associated with low sTWEAK. Conclusions Lower levels of sTWEAK and HDL-cholesterol and higher levels of galectin-3 were independently associated with depression in T1DM. These factors might all contribute to the increased risk for cardiovascular disease and mortality previously demonstrated in patients with depression. CSII (inversely) and depression were independently associated with low sTWEAK levels.


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