scholarly journals An Inconvenient Relationship of Hemoglobin A1c Level with Endothelial Function in Type 2 Diabetes

2020 ◽  
Author(s):  
Takayuki Yamaji ◽  
Takahiro Harada ◽  
Yu Hashimoto ◽  
Yuji Takaeko ◽  
Masato Kajikawa ◽  
...  

Abstract Background Diabetes is associated with endothelial dysfunction. However, there is little information on the relationship between hemoglobin A1c (HbA1c) level and endothelial function. This study evaluated the relationship between HbA1c level and flow-mediated vasodilation (FMD).Methods We measured FMD in 1215 patients with type 2 diabetes including 349 patients not taking antidiabetic drugs and 866 patients taking antidiabetic drugs. The patients were divided into four groups based on HbA1c levels: <48 mmol/mol, 48–52 mmol/mol, 53–63 mmol/mol, and ≥ 64 mmol/mol. (< 6.5%, 6.5–6.9%, 7.0-7.9%, ≥ 8.0%)Results An inverted U-shaped pattern of association between HbA1c level and FMD was observed at the peak of HbA1c of about 53 mmol/mol (7%). FMD was significantly smaller in the HbA1c < 48 mmol/mol (6.5%) group than in the HbA1c 48–52 mmol/mol (6.5–6.9%) group and HbA1c 53–63 mmol/mol (7.0-7.9%) group (p < 0.001 and p < 0.001), and FMD values were similar in the HbA1c < 48 mmol/mol (6.5%) group and HbA1c ≥ 64 mmol/mol (8.0%) group. There were no significant differences in nitroglycerine-induced vasodilation (NID) values among the four groups. After adjustments for confounding factors, FMD was significantly smaller in the HbA1c < 48 mmol/mol (6.5%) group than in the HbA1c 48–52 mmol/mol (6.5–6.9%) and HbA1c 53–63 mmol/mol (7.0-7.9%) group (p = 0.002 and p = 0.04). In patients not taking antidiabetic drugs, FMD was also significantly smaller in the HbA1c < 48 mmol/mol (6.5%) group than in the HbA1c 48–52 mmol/mol (6.5–6.9%) group and HbA1c 53–63 mmol/mol (7.0-7.9%) group (p < 0.001 and p = 0.02), and there were no significant differences in NID values among the four groups.Conclusions These findings suggest that a low HbA1c level of < 48 mmol/mol (6.5%) is associated with endothelial dysfunction. An HbA1c level of 48–52 mmol/mol (6.5–6.9%) may be appropriate for maintenance of endothelial function.

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045415
Author(s):  
Takayuki Yamaji ◽  
Takahiro Harada ◽  
Yu Hashimoto ◽  
Yuji Takaeko ◽  
Masato Kajikawa ◽  
...  

ObjectiveThe aim of this study was to determine the relationship of haemoglobin A1c (HbA1c) level with flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) in patients with type 2 diabetes.DesignCross-sectional study.Setting22 university hospitals and affiliated clinics in Japan.Participants1215 patients with type 2 diabetes including 349 patients not taking antidiabetic drugs.MeasuresWe evaluated FMD and HbA1c level. All patients were divided into four groups based on HbA1c level: <6.5%, 6.5%–6.9%, 7.0%–7.9% and ≥8.0%.ResultsAn inverted U-shaped pattern of association between HbA1c level and FMD was observed at the peak of HbA1c of about 7%. FMD was significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%–6.9% group and HbA1c 7.0%–7.9% group (p<0.001 and p<0.001), and FMD values were similar in the HbA1c <6.5% group and HbA1c ≥8.0% group. There were no significant differences in NID values among the four groups. After adjustments for confounding factors, FMD was significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%–6.9% and HbA1c 7.0%–7.9% group (p=0.002 and p=0.04). In patients not taking antidiabetic drugs, FMD was also significantly smaller in the HbA1c <6.5% group than in the HbA1c 6.5%–6.9% group and HbA1c 7.0%–7.9% group (p<0.001 and p=0.02), and there were no significant differences in NID values among the four groups.ConclusionsThese findings suggest that there is an inverted U-shaped pattern of association between FMD and HbA1c and that a low HbA1c level of <6.5% is associated with endothelial dysfunction.Trial registration numberUMIN000012950, UMIN000012951, UMIN000012952 and UMIN000003409.


2018 ◽  
Vol 132 (23) ◽  
pp. 2509-2518 ◽  
Author(s):  
Gargi Mahapatra ◽  
S. Carrie Smith ◽  
Timothy M. Hughes ◽  
Benjamin Wagner ◽  
Joseph A. Maldjian ◽  
...  

Blood-based bioenergetic profiling has promising applications as a minimally invasive biomarker of systemic bioenergetic capacity. In the present study, we examined peripheral blood mononuclear cell (PBMC) mitochondrial function and brain morphology in a cohort of African Americans with long-standing Type 2 diabetes. Key parameters of PBMC respiration were correlated with white matter, gray matter, and total intracranial volumes. Our analyses indicate that these relationships are primarily driven by the relationship of systemic bioenergetic capacity with total intracranial volume, suggesting that systemic differences in mitochondrial function may play a role in overall brain morphology.


e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Rixi Gahung ◽  
Karel Pandelaki ◽  
Emma Sy. Moeis

Abstract: Diabetes mellitus is still increasing in number in the future. Type 2 diabetes mellitus type 2 (T2DM) often appears in adults and the cause is due to a shortage of the hormone insulin on a relative basis, generally appears slowly and gradually worsens. One of the parameters to control blood sugar level is HbA1c. The high HbA1c increases the risks and complications in T2DM patients. This study aimed to obtain the relationship between HbA1c level and GFR among T2DM patients. This was an analytical study using the patient's medical record data. This study was conducted at the Endocrine Clinic and Heart and Hypertension Clinic with a total samples of 65 patients. The results showed that of the 65 subjects, there were 40 male patients and 25 female patients. The Pearson correlation test showed that the relationship of the HbA1c level and GFR had a p value = 0.05 > 0.462 and the correlation r = 0.093. Conclusion: There was no significant relationship between HbA1c level and GFR in type 2 DM patients. Keywords: HbA1c, GFR, type 2 DM Abtsrak: Diabetes merupakan suatu penyakit tidak menular yang akan terus meningkat jumlahnya di masa datang. Diabetes Melitus tipe 2 (DMT2) sering muncul pada orang dewasa dan penyebabnya oleh karena kekurangan hormon insulin secara relatif , umumnya muncul perlahan dan secara bertahap akan bertambah berat. Salah satu parameter kontrol kadar gula darah ialah HbA1c. Jika HbA1c meningkat terjadi pula peningkatan resiko komplikasi. Penelitian ini bertujuan untuk mengetahui hubungan kadar HbA1c dengan eLFG pada pasien DMT2. Jenis penelitian ini analitik dengan mengevaluasi data rekam medik pasien. Penelitian dilakukan di Poliklinik Endokrin dan Poliklinik Jantung dan Hipertensi dengan jumlah subyek penelitian 65 pasien DMT2. Hasil penelitian ini menunjukkan bahwa dari 65 orang subjek terdapat 40 laki-laki dan 25 perempuan. Untuk mengetahui adanya hubungan kadar HbA1c dengan LFG digunakan analisis bivariat Pearson correlation yang mendapatkan nilai p hitung = 0,462> 0,05 dengan kekuatan korelasi r = 0,093. Simpulan: Tidak terdapat hubungan bermakna antara kadar HbA1c dengan eLFG pada pasien DM tipe 2.Kata kunci: HbA1c, eLFG, DM tipe 2


2021 ◽  
Vol 2 (1) ◽  
pp. 23-28
Author(s):  
Alexander Petra Sihite ◽  
I Gusti Ngurah Pramesemara ◽  
I Wayan Surudarma

Background: Type 2 diabetes mellitus is a metabolic disease that characterized by high blood sugar levels. This condition is often not noticed immediately and usually patient starting to realize it when complications have been occurred. A long-term complication of type 2 DM that occurred in men is erectile dysfunction (ED). ED is a condition when a person is unable to achieve or maintain an erection for sexual intercourse. One factor that influence the occurrence of ED and its severity in type 2 DM patients is the duration of the disease. Objective: The aim of this study was to determine the relationship of type 2 DM duration and the occurrence of ED. Methods: This study is an observational analytic cross-sectional study conducted at the Puskesmas (Public Health Center) Denpasar Barat I. The research data was obtained through medical record data and fill the International Index of Erectile Function (IIEF-5) questionnaire on 36 type 2 DM patients aged around 40-60 years. The statistical analysis used was Fisher's exact test. Results: The results showed that of the 36 samples, 19 (52.8%) samples had type 2 DM <24 months and 17 (47.2%) samples had type 2 DM >24 months. It was found that 5 (13.9%) samples did not experience ED while the rest experienced ED with different severity. There was a significant relationship between the type 2 DM duration and the occurrence of erectile dysfunction at Puskesmas Denpasar Barat I (p = 0.022). Conclusion: Study has found that type 2 DM patients with the longer duration (>24 months)  have a higher occurrence of ED and tended to be more severe compared to those with shorter duration (<24 months). Further studies should be performed with higher number of patients and more controlled risk factor so it will be more accurate in determining the relationship between the duration of type 2 DM and ED.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Ahmad Khusairi Azemi ◽  
Siti Safiah Mokhtar ◽  
Aida Hanum Ghulam Rasool

Diabetes mellitus is associated with endothelial dysfunction; it causes progressive vascular damage resulting from an impaired endothelium-dependent vasorelaxation. In the diabetes state, presence of hyperglycemia and insulin resistance predisposes to endothelial dysfunction. Clinacanthus nutans, widely used as a traditional medicine for diabetes is reported to have hypoglycemic, hypolipidemic, antioxidant, and anti-inflammatory properties. However, the possibility of C. nutans affecting the vascular endothelial function in diabetes remains unclear. This study was aimed at evaluating the effects of C. nutans methanolic leaves extract (CNME) on endothelial function in a type 2 diabetes (T2DM) rat model. Sixty male Sprague-Dawley rats were divided into five groups (n=12 per group): nondiabetic control, nondiabetic treated with four weeks of CNME (500 mg/kg/daily), untreated diabetic rats, diabetic treated with metformin (300 mg/kg/daily), and diabetic treated with CNME (500 mg/kg/daily). T2DM was induced by a single intraperitoneal injection of low-dose streptozotocin (STZ) to rats fed with high-fat diet (HFD). Endothelial-dependent and endothelial-independent relaxations and contractions of the thoracic aorta were determined using the organ bath. Aortic endothelial nitric oxide synthase (eNOS) expression was determined using Western blotting. Endothelial-dependent relaxation was reduced in diabetic rats. Both diabetic groups treated with CNME or metformin significantly improved the impairment in endothelium-dependent vasorelaxation; this was associated with increased expression of aortic eNOS protein. CNME- and metformin-treated groups also reduced aortic endothelium-dependent and aortic endothelium-independent contractions in diabetics. Both of these diabetic-treated groups also reduced blood glucose levels and increased body weight compared to the untreated diabetic group. In conclusion, C. nutans improves endothelial-dependent vasodilatation and reduces endothelial-dependent contraction, thus ameliorating endothelial dysfunction in diabetic rats. This may occur due to its effect on increasing eNOS protein expression.


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