scholarly journals Divergence in Accuracy of Diabetes Screening Methods in Tuberculosis Patients: A Cross- Sectional Study from Brazil and Peru

2021 ◽  
Author(s):  
Thomas A. Carmo ◽  
Catarina D. Fernandes ◽  
José F. Fróes Neto ◽  
Davi Neri Araújo ◽  
Caian L. Vinhaes ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Glycated Hemoglobin ◽  
Characteristic Curve ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Screening Methods ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Tuberculosis Diagnosis ◽  
Total Accuracy

Abstract Background: To evaluate the accuracy of distinct diabetes mellitus (DM) screening methods in persons with active Tuberculosis PWTB.Methods: Levels of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) at the time of tuberculosis diagnosis at the study clinics were assessed from two distinct retrospective cohorts of PWTB from Brazil (n=116) and Peru (n=136) to evaluate accuracy for detecting pre-DM and DM cases. Additionally, we investigated the association of clinical and sociodemographic factors with tuberculosis and pre-DM or DM in each country.Results: When comparing PWTB from Brazil and Peru, Peruvian individuals presented higher FPG levels at baseline (median [IQR] 91 [81–106 vs 95 [88.4–102.1]]; p=0.02), while those from Brazil had significant higher levels of HbA1c (median [IQR] 6.3 [5.7-7.15] vs 5.1 [4.9-5.4]; p<0.01). Additional analysis using the receiver operating characteristic curve revealed that the markers showed distinct accuracy to identify dysglycemia among PWTB in each country. Conclusion: Our findings indicate that there are significant differences in the total accuracy of the glycemic screening methods evaluated between PWTB from two highly endemic countries from South America, highlighting the need to revisit the diagnostic criteria of DM/PDM in individuals with tuberculosis.

scholarly journals MicroRNAs-1299, -126-3p and -30e-3p as Potential Diagnostic Biomarkers for Prediabetes

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 949
Author(s):  
Cecil J. Weale ◽  
Don M. Matshazi ◽  
Saarah F. G. Davids ◽  
Shanel Raghubeer ◽  
Rajiv T. Erasmus ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Predictive Ability ◽  
Roc Curves ◽  
Tolerance Test ◽  
Cross Sectional Study ◽  
Oral Glucose ◽  
Cross Sectional ◽  
Receiver Operating

This cross-sectional study investigated the association of miR-1299, -126-3p and -30e-3p with and their diagnostic capability for dysglycaemia in 1273 (men, n = 345) South Africans, aged >20 years. Glycaemic status was assessed by oral glucose tolerance test (OGTT). Whole blood microRNA (miRNA) expressions were assessed using TaqMan-based reverse transcription quantitative-PCR (RT-qPCR). Receiver operating characteristic (ROC) curves assessed the ability of each miRNA to discriminate dysglycaemia, while multivariable logistic regression analyses linked expression with dysglycaemia. In all, 207 (16.2%) and 94 (7.4%) participants had prediabetes and type 2 diabetes mellitus (T2DM), respectively. All three miRNAs were significantly highly expressed in individuals with prediabetes compared to normotolerant patients, p < 0.001. miR-30e-3p and miR-126-3p were also significantly more expressed in T2DM versus normotolerant patients, p < 0.001. In multivariable logistic regressions, the three miRNAs were consistently and continuously associated with prediabetes, while only miR-126-3p was associated with T2DM. The ROC analysis indicated all three miRNAs had a significant overall predictive ability to diagnose prediabetes, diabetes and the combination of both (dysglycaemia), with the area under the receiver operating characteristic curve (AUC) being significantly higher for miR-126-3p in prediabetes. For prediabetes diagnosis, miR-126-3p (AUC = 0.760) outperformed HbA1c (AUC = 0.695), p = 0.042. These results suggest that miR-1299, -126-3p and -30e-3p are associated with prediabetes, and measuring miR-126-3p could potentially contribute to diabetes risk screening strategies.

scholarly journals Patients with pheochromocytoma exhibit low aldosterone renin ratio

2020 ◽  
Author(s):  
Tomoko Yamada ◽  
Hidenori Fukuoka ◽  
Yusei Hosokawa ◽  
Yukiko Odake ◽  
Kenichi Yoshida ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Adrenal Adenoma ◽  
Characteristic Curve ◽  
Plasma Renin ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Adrenal Tumors ◽  
Cross Sectional ◽  
Plasma Aldosterone Concentration ◽  
Sensitive Marker

Abstract Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA). Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled. Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA. Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC.

scholarly journals Diagnostic Test Efficacy of Meibomian Gland Morphology and Function

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jiaxin Xiao ◽  
Muhammed Yasin Adil ◽  
Jonatan Olafsson ◽  
Xiangjun Chen ◽  
Øygunn A. Utheim ◽  
...  
Keyword(s):  
Dry Eye ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Tear Film ◽  
Cross Sectional Study ◽  
Meibomian Gland ◽  
Clinical Parameters ◽  
Cross Sectional ◽  
And Function ◽  
Breakup Time

AbstractMeibomian gland dysfunction (MGD) is the leading cause of dry eye and proposed treatments are based on disease severity. Our purpose was to establish reliable morphologic measurements of meibomian glands for evaluating MGD severity. This retrospective, cross-sectional study included 100 MGD patients and 20 controls. The patients were classified into dry eye severity level (DESL) 1–4 based on symptoms and clinical parameters including tear-film breakup time, ocular staining and Schirmer I. The gland loss, length, thickness, density and distortion were analyzed. We compared the morphology between patients and controls; examined their correlations to meibum expressibility, quality, and DESL. Relative to controls, the gland thickness, density and distortion were elevated in patients (p < 0.001 for all tests). The area under the receiver operating characteristic curve was 0.98 (95% confidence interval [CI], 0.96–1.0) for gland loss, and 0.96 (CI 0.91–1.0) for gland distortion, with a cutoff value of six distorted glands yielding a sensitivity of 93% and specificity of 97% for MGD diagnosis. The gland distortion was negatively correlated to the meibum expressibility (r = −0.53; p < 0.001) and DESL (r = −0.22, p = 0.018). In conclusion, evaluation of meibomian gland loss and distortion are valuable complementary clinical parameters to assess MGD status.

scholarly journals Anemia in tuberculosis cases: A biomarker of severity?

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245458
Author(s):  
Edson Beyker de Mendonça ◽  
Carolina AranaStanis Schmaltz ◽  
Flavia Marinho Sant’Anna ◽  
Alexandre Gomes Vizzoni ◽  
Daniela Palheiro Mendes-de-Almeida ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Microcytic Anemia ◽  
Normocytic Anemia ◽  
Cross Sectional ◽  
Tuberculosis Patients ◽  
Clinical Forms ◽  
Tuberculosis Diagnosis ◽  
Prevalence Of Anemia

Introduction Anemia is a common condition at tuberculosis diagnosis, and there is evidence that its prevalence is higher in patients with tuberculosis than in those infected with Mycobacterium tuberculosis and healthy controls. Information about anemia during tuberculosis diagnosis is still scarce in the Brazilian population. The aim of this study was to describe the prevalence of anemia in patients with tuberculosis cared for at a referral center and its association with clinical forms of tuberculosis and other characteristics of these patients. Materials and methods This was a retrospective cross-sectional study of tuberculosis patients diagnosed from January 2015 to December 2018 at the Clinical Research Laboratory on Mycobacteria (LAPCLIN-TB) of Evandro Chagas National Institute of Infectious Diseases (INI)/Oswaldo Cruz Foundation (Fiocruz). A database of an ongoing cohort study underway at this service since 2000 provided the baseline information on tuberculosis cases extracted from a visit template. Exploratory and logistic regression analyses were performed to verify associations between anemia and demographic characteristics, socioeconomic status, clinical conditions, and laboratory results. Results Of the 328 cases reviewed, 70 were excluded, with258 retained. The prevalence of anemia was 61.2% (27.5% mild, 27.5% moderate and 6.2% severe). Among patients with anemia, 60.8% had normochromic normocytic anemia, and 27.8% showed hypochromic microcytic anemia. In logistic regression analysis, anemia was associated with a history of weight loss >10%, hospitalizations, coinfection with HIV, increased platelet count and microcytosis. Anemia was more frequent in the most severe clinical forms, such as meningeal and disseminated tuberculosis. Conclusions Anemia was highly prevalent in tuberculosis patients at diagnosis, predominantly as normochromic normocytic anemia and in mild and moderate forms. It was associated with baseline characteristics and conditions indicative of severe disease, suggesting that anemia could be a biomarker of tuberculosis severity.

scholarly journals Glycated Hemoglobin in the Diagnosis of Diabetes Mellitus in a Semi-Urban Brazilian Population

2019 ◽  
Vol 16 (19) ◽  
pp. 3598 ◽  
Author(s):  
Nayla Cristina do Vale Moreira ◽  
Renan M. Montenegro ◽  
Haakon E. Meyer ◽  
Bishwajit Bhowmik ◽  
Ibrahimu Mdala ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Glycated Hemoglobin ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Cross Sectional Study ◽  
Brazilian Population ◽  
Model Assessment ◽  
Cross Sectional ◽  
Sensitive Marker

The study evaluated glycated hemoglobin (HbA1c) as a diagnostic tool for diabetes and pre-diabetes in the Brazilian population. Further, the homeostasis model assessment of insulin resistance (HOMA-IR) was also examined against HbA1c values to identify the most suitable cut-off points for HOMA-IR to predict the risk of diabetes. A cross-sectional study was conducted among 714 randomly selected subjects. HbA1c, fasting, and 2 h plasma glucose values were measured. Insulin resistance estimates were calculated with HOMA-IR. The receiver operating characteristic curve assessed HbA1c performance. The adjusted prevalence rate of diabetes mellitus was 14.7%, and pre-diabetes 14.2%. The optimal HbA1c cut-off value was ≥6.8% for the diagnosis of diabetes, and ≥6.0% for pre-diabetes. The area under the curve using HbA1c was 0.85 (95% CI: 0.80–0.90) for detecting diabetes and 0.61 (95% CI: 0.55–0.67) for pre-diabetes. The optimal HOMA-IR cut-off value was 2.06 for HbA1c at 6.8%. The HbA1c cut-off value of ≥6.8% may be suitable for diagnosing diabetes in the Brazilian population. Our results do not support the use of HbA1c to diagnose pre-diabetes. A HOMA-IR cut-off point of 2.06 was a sensitive marker to assess the risk of diabetes.

scholarly journals BMI, Waist to Height Ratio and Waist Circumference as a screening tool for Hypertension in Hospital out Patients: A Cross-Sectional, Non-inferiority study

2021 ◽  
Author(s):  
Rajan Shrestha ◽  
Sanjib K. Upadhyay ◽  
Bijay Khatri ◽  
Janak R. Bhattarai ◽  
Manish Kayastha ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Characteristic Curve ◽  
Cross Sectional Study ◽  
Outpatient Setting ◽  
Factor Screening ◽  
Cross Sectional ◽  
Obesity And Overweight ◽  
Risk Factor Screening ◽  
Prevalence Of Obesity ◽  
Waist To Height Ratio

Abstract Objective The study aimed to determine the burden of obesity, using three commonly employed metrics in the hospital outpatient setting of a developing country as predictors of hypertension through a non-inferiority study.Design A cross-sectional study design was adopted.Setting This study was conducted in Health Promotion and Risk Factor Screening Service in a tertiary Eye and ENT hospital in a semi-urban area of Nepal.Participants 2,256 randomly selected 40-69 years outpatients.Outcome measures Correlation analysis, the area under the Receiver Operating Characteristic curve, Odds ratios (OR) were calculated between three obesity metrices and hypertension.Results The prevalence of obesity and overweight by BMI was 16.09% and 42.20%, respectively; by WHtR was 32.76%, which is two times higher than obesity measured by BMI. High WC was observed among 66.76% of participants. Female participants had a greater prevalence of high WC (77.46%) than males (53.73%) (p<0.001). Prevalence of hypertension and pre-hypertension was 40.67% and 36.77%, respectively. The areas under the curve were significantly higher than 0.5 for BMI (0.593), WHtR (0.602), and WC (0.610).Conclusion WC correlated well with obesity and hypertension. It also had a higher predicting ability than WHtR and BMI to predict hypertension. WC thus proved to be non-inferior to two other commonly used metrics. It proved superior in detecting obesity in female. This inexpensive and simple non-tension tape measurement may play an important role in the future diagnosis of obesity and the prediction of HTN in resource-constrained settings of developing countries.

scholarly journals Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports

2020 ◽  
Author(s):  
Tomoko Yamada ◽  
Hidenori Fukuoka ◽  
Yusei Hosokawa ◽  
Yukiko Odake ◽  
Kenichi Yoshida ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Adrenal Adenoma ◽  
Characteristic Curve ◽  
Plasma Renin ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Adrenal Tumors ◽  
Cross Sectional ◽  
Plasma Aldosterone Concentration ◽  
Sensitive Marker

Abstract Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC. Trial registrationThis study was not registered because of the retrospective analysis.

scholarly journals Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports

2020 ◽  
Author(s):  
Tomoko Yamada ◽  
Hidenori Fukuoka ◽  
Yusei Hosokawa ◽  
Yukiko Odake ◽  
Kenichi Yoshida ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Adrenal Adenoma ◽  
Characteristic Curve ◽  
Plasma Renin ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Adrenal Tumors ◽  
Cross Sectional ◽  
Plasma Aldosterone Concentration ◽  
Sensitive Marker

Abstract Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA). Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled. Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA. Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC.

scholarly journals Patients with pheochromocytoma exhibit low aldosterone renin ratio-preliminary reports

2020 ◽  
Author(s):  
Tomoko Yamada ◽  
Hidenori Fukuoka ◽  
Yusei Hosokawa ◽  
Yukiko Odake ◽  
Kenichi Yoshida ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Adrenal Adenoma ◽  
Characteristic Curve ◽  
Plasma Renin ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Adrenal Tumors ◽  
Cross Sectional ◽  
Plasma Aldosterone Concentration ◽  
Sensitive Marker

Abstract Background Plasma renin activity (PRA) is generally increased in patients with pheochromocytoma (PCC) due to low circulating plasma volume and activation of β-1 adrenergic receptor signaling. However, there has been no study on the aldosterone renin ratio (ARR) in patients with PCC. To elucidate the issue, this study aimed to determine the PRA, plasma aldosterone concentration (PAC), and ARR in patients with PCC and compare them with those in patients with subclinical Cushing’s syndrome (SCS) and non-functioning adrenal adenoma (NFA).Methods In this retrospective single-center, cross-sectional study, 67 consecutive patients with adrenal tumors (PCC (n =18), SCS (n =18), and NFA (n =31)) diagnosed at Kobe University Hospital between 2008 and 2014 were enrolled.Results PRA was significantly higher in patients with PCC than in those with SCS and NFA (2.1 (1.3~2.8) vs. 0.7 (0.5~1.8) and 0.9 (0.6~1.4) ng/mL/h; p =0.018 and p =0.025). Although PACs were comparable among the three groups, ARR was significantly lower in patients with PCC than in those with SCS and NFA (70.5 (45.5~79.5) vs. 156.0 (92.9~194.5) and 114.9 (90.1~153.4); p =0.001 and p <0.001). Receiver operating characteristic curve analysis demonstrated that, in differentiating PCC from NFA, PRA >1.55 ng/mL/h showed a sensitivity of 70.0% and specificity of 80.6%. Interestingly, ARR <95.4 showed a sensitivity of 83.3% and specificity of 86.7%, which were higher than those in PRA.Conclusions ARR decreased in patients with PCC, which was a more sensitive marker than PRA. Further study is necessary to understand the usefulness of this convenient marker in the detection of PCC. Trial registration This study was not registered because of the retrospective analysis.

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