scholarly journals Hypoglycemia In The Emergency, But What Awaits Us For Cardiac Risks In The Future?

2021 ◽  
Author(s):  
Onur Akhan ◽  
İsa Ardahanlı
Keyword(s):  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Cross Sectional ◽  
Glucose Levels ◽  
Blood Tests ◽  
Flow Mediated Dilatation ◽  
Endothelial Dysfunctions

Introduction: Several homeostatic changes like an increase in sympathoadrenal response and oxidative stress occur in hypoglycemia. As a result of these findings, an increase in inflammation and pre-atherogenic factors is observed and these changes may lead to endothelial dysfunction. Aim: Our study aims to reveal possible cardiac risks (systolic-diastolic functions and endothelial dysfunctions) in patients who have applied to the emergency department with hypoglycemia. Methods: This cross-sectional, case-control study included 46 hypoglycemia patients who admitted to the emergency with symptoms compatible with hypoglycemia and diagnosed with hypoglycemia and 30 healthy volunteers. All patients were evaluated with baseline echocardiography, tissue-doppler imaging(carotid and brachial artery). Also, the fasting blood tests of the patients referred to the internal medicine department were examined. Results: There were no differences between the groups regarding age, weight, body mass index, and systolic blood pressure. Total cholesterol, LDL, HDL, Vitamin B12, TSH, and fasting blood glucose levels were similar in the groups’ blood tests (all p values>0.05). We observed a statistically significant decrease in diastolic dysfunction parameters: E/A and E/e’ ratios (respectively, p=0.020 and 0.026). It was shown that insulin resistance was influential in forming these considerable differences. The patient group observed that the carotid intima-media thickness was more remarkable(p=0.001), and the brachial flow-mediated dilatation value was smaller(p=0.003), giving an idea about endothelial functions.

scholarly journals Association of prehypertension and hyperhomocysteinemia with subclinical atherosclerosis in asymptomatic Chinese: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019829 ◽  
Author(s):  
Bo Liu ◽  
Zhihao Chen ◽  
Xiaoqi Dong ◽  
Guangming Qin
Keyword(s):  
Risk Factor ◽  
Subclinical Atherosclerosis ◽  
Multiple Logistic Regression Analysis ◽  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Control Group ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference

ObjectivesComorbid hypertension and hyperhomocysteinemia is an important risk factor for carotid atherosclerotic plaque formation. We put forward the hypothesis that the subjects with comorbid prehypertension and hyperhomocysteinemia also had an increased risk of subclinical atherosclerosis, using carotid intima–media thickness (CIMT) as the marker of the atherosclerotic process.MethodsA total of 4102 asymptomatic Chinese subjects aged 18–60 years were divided into four groups according to blood pressure (BP) and homocysteine (HCY) level: the control group without prehypertension or hyperhomocysteinemia, isolated prehypertension group, simple hyperhomocysteinemia group and prehypertension with hyperhomocysteinemia group. Serum lipids, fasting blood glucose (FBG), HCY and CIMT were measured.ResultsThere was significant difference in the positive rates of increased CIMT among four groups. Compared with the controls, the subjects in the other three groups had a higher risk of increased CIMT (isolated prehypertension group, OR 2.049, 95% CI 1.525 to 2.754; simple hyperhomocysteinemia group, OR 2.145, 95% CI 1.472 to 3.125; prehypertension and hyperhomocysteinemia group, OR 3.199, 95% CI 2.362 to 4.332). However, by multiple logistic regression analysis, only comorbid prehypertension and hyperhomocysteinemia was independently associated with increased CIMT (OR 1.485, 95% CI 1.047 to 2.108, P<0.05).ConclusionsComorbid prehypertension and hyperhomocysteinemia was an independent risk factor of subclinical atherosclerosis in asymptomatic Chinese, but isolated prehypertension or hyperhomocysteinemia was not. Therefore, combined intervention for prehypertension and hyperhomocysteinemia may contribute to decrease the incident of cardiovascular disease.

scholarly journals SCREENING MARKERS

2016 ◽  
Vol 23 (08) ◽  
pp. 932-938
Author(s):  
Sikandar Hayat Khan ◽  
Syed Aown Raza Bokhari ◽  
Muhammad Shahzad Hanif
Keyword(s):  
Diabetes Mellitus ◽  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Radiology Department ◽  
Cardiovascular Risks ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Experienced Radiologist ◽  
Diagnosed Diabetes

The screening measures to identify various cardiovascular risks relatedto hyperglycemia, hypertension and hypercholesterolemia are involves both anatomicassessments like anthropometric measures or body’s physiological evaluation by performingbiochemical parameters. In this regard “lipid accumulation product” (LAP) has surfaced as amarker to incorporate both these anatomic and physiological considerations. Objectives: 1. Tomeasure the LAP differences between subjects having normal and higher levels of glucose, totalcholesterol, age, carotid intima media thickness and subjects with and without hypertension. 2.To compare BMI and LAP in terms of effectiveness as a screening marker for diagnosis of diabetesmellitus and hypertension through ROC curve calculation. Design: Cross-sectional analysis.Place and duration of study: This study was carried out at the departments of pathology, PNSRAHAT hospital from Jan-2011 to Oct-2011. Subjects and methods: After several exclusionsincluding know diabetics a total of 202 subjects were enrolled to undergo sampling for Fastingblood glucose, and lipids in exact medical fasting status. These subjects were later evaluatedfor their various anthropometric measurements including BMI and WHpR (Wait to hip ratio) asper the WHO protocol. Then the individuals went to radiology department where carotid intimamedia thickness measurements were made by experienced radiologist. LAP (Lipid accumulationproducts) score was calculated as: LAP score (Male) = [WC (cm) - 65] x triglycerides (mmol/L)LAP score (Female) = [WC (cm) – 58] x triglycerides (mmol/L). LAP scores, BMI. WHpR andmean CIMT readings were grouped as per their high or low results. Results: Out of BMI, WHpRand LAP score, only groups based upon LAP score were observed to be significantly differentfor fasting blood glucose, total cholesterol and mean CIMT levels. Hypertensive subjects hadhigher LAP scores and WHpR than non-hypertensive subjects; however, BMI differences werenot considered significant. One way ANOVA shows the LAP scores progressively rising formnormoglycemic subjects {58.38 (95% CI: 51.08-65.67)} to subjects having IFG {70.94(95%CI:60.88-81.00)} to newly diagnosed diabetes mellitus {101.59(95%CI: 78.35-124.83)}.[P=0.001]The AUCs for diagnosing hypertension was higher for LAP scores than for BMI and WHpR[{(LAP score: 0.648 (95% CI: 0.536-0.760), p= 0.027} vs {(WHpR: 0.588 (95% CI: 0.466-0.709),p= 0.191} vs {(BMI: 0.541 (95% CI: 0.412-0.670), p=0.545}]. Similarly, the AUCs for BMI andWHpR were lower than that of LAP score for predicting a diagnosis of diabetes mellitus [{(LAPscore: 0.584 (95% CI: 0.502-0.665), p= 0.047} vs {(BMI: 0.531 (95% CI: 0.448-0.613), p=0.468}vs {WHpR: 0.518 (95% CI: 0.435-0.601), p=0.668}]. Conclusion: LAP scores were higherin subjects with established cardiovascular risks like hyperglycemia, hypercholesterolemia,accelerated atherosclerosis and hypertension that simple anthropometric indices like BMI andWHpR.

Carotid Intimal Thickness and Flow-Mediated Dilatation in Diabetic and Nondiabetic Continuous Ambulatory Peritoneal Dialysis Patients

2009 ◽  
Vol 29 (2_suppl) ◽  
pp. 96-101 ◽  
Author(s):  
Narayan Prasad ◽  
Sudeep Kumar ◽  
Anurag Singh ◽  
Archana Sinha ◽  
Kamal Chawla ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Inorganic Phosphate ◽  
Pearson Correlation ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cross Sectional ◽  
Flow Mediated Dilatation ◽  
Serum Inorganic Phosphate

Objectives We compared carotid intima media thickness (CIMT) and flow-mediated dilatation (FMD) between cases [end-stage renal disease patients (diabetic and nondiabetic) on peritoneal dialysis (PD)] and controls (diabetic and hypertensive patients with normal renal function) with the objective of identifying risk factors predicting atherosclerosis. Methods This cross-sectional study involved 124 subjects (62 cases, 62 controls). In both the case and control populations, we used B-mode ultrasonography to study CIMT and endothelium-dependent FMD, according to American College of Cardiology guidelines on brachial artery measurement. Pearson correlation was used to evaluate the correlation between CIMT and other variables. Results Compared with controls, cases had significantly higher systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol, triglycerides, serum uric acid, inorganic phosphate, C-reactive protein, and parathyroid hormone, and significantly lower hemoglobin, calcium, and high-density lipoprotein. Compared with controls, cases showed significantly greater CIMT (0.60 ± 0.08 mm vs 0.54 ± 0.03 mm, p < 0.001) and significantly lower FMD (0.15 ± 0.08 cm vs 0.21 ± 0.04 cm, p = 0.02). Among cases, patients with diabetes had significantly greater CIMT (0.62 ± 0.08 mm vs 0.58 ± 0.07 mm, p = 0.05) than did patients without diabetes; FMD was similar in diabetic and nondiabetic patients on continuous ambulatory PD (0.16 ± 0.03 cm vs 0.18 ± 0.03 cm, p = 0.20). Conclusions Compared with controls, cases had significantly higher CIMT and lower FMD. Cases with diabetes had significantly higher CIMT than did cases without diabetes, but FMD was similar in diabetic and nondiabetic cases. Serum inorganic phosphate is an independent risk factor for atherosclerosis and was significantly correlated with CIMT. The noninvasive CIMT and FMD tests can be used to monitor atherosclerosis and endothelial dysfunction.

scholarly journals The Relationship between Cardiovascular Risk Scores and Several Markers of Subclinical Atherosclerosis in an Asymptomatic Population

2021 ◽  
Vol 10 (5) ◽  
pp. 955
Author(s):  
Ovidiu Mitu ◽  
Adrian Crisan ◽  
Simon Redwood ◽  
Ioan-Elian Cazacu-Davidescu ◽  
Ivona Mitu ◽  
...  
Keyword(s):  
Risk Score ◽  
Subclinical Atherosclerosis ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Risk Scores ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Single Center Study ◽  
Asymptomatic Individuals

Background: The current cardiovascular disease (CVD) primary prevention guidelines prioritize risk stratification by using clinical risk scores. However, subclinical atherosclerosis may rest long term undetected. This study aimed to evaluate multiple subclinical atherosclerosis parameters in relation to several CV risk scores in asymptomatic individuals. Methods: A cross-sectional, single-center study included 120 asymptomatic CVD subjects. Four CVD risk scores were computed: SCORE, Framingham, QRISK, and PROCAM. Subclinical atherosclerosis has been determined by carotid intima-media thickness (cIMT), pulse wave velocity (PWV), aortic and brachial augmentation indexes (AIXAo, respectively AIXbr), aortic systolic blood pressure (SBPao), and ankle-brachial index (ABI). Results: The mean age was 52.01 ± 10.73 years. For cIMT—SCORE was more sensitive; for PWV—Framingham score was more sensitive; for AIXbr—QRISK and PROCAM were more sensitive while for AIXao—QRISK presented better results. As for SBPao—SCORE presented more sensitive results. However, ABI did not correlate with any CVD risk score. Conclusions: All four CV risk scores are associated with markers of subclinical atherosclerosis in asymptomatic population, except for ABI, with specific particularities for each CVD risk score. Moreover, we propose specific cut-off values of CV risk scores that may indicate the need for subclinical atherosclerosis assessment.

scholarly journals Caesarean delivery is associated with increased blood pressure in young adult offspring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amaraporn Rerkasem ◽  
Sarah E. Maessen ◽  
Antika Wongthanee ◽  
Sakda Pruenglampoo ◽  
Ampica Mangklabruks ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Birth Cohort ◽  
Fasting Blood Glucose ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Adjusted Relative Risk ◽  
Obesity Risk ◽  
Chiang Mai ◽  
Clinical Assessments

AbstractWe examined the associations between caesarean section (CS) delivery and cardiovascular risk factors in young adults in Thailand. Participants were 632 offspring from a birth cohort in Chiang Mai (Northern Thailand), born in 1989–1990 and assessed in 2010 at a mean age of 20.6 years, including 57 individuals (9.0%) born by CS and 575 born vaginally. Clinical assessments included anthropometry, blood pressure (BP), carotid intima-media thickness, and fasting blood glucose, insulin, and lipid profile. Young adults born by CS had systolic BP (SBP) 6.2 mmHg higher (p < 0.001), diastolic BP 3.2 mmHg higher (p = 0.029), and mean arterial pressure (MAP) 4.1 mmHg higher (p = 0.003) than those born vaginally. After covariate adjustments, SBP and MAP remained 4.1 mmHg (p = 0.006) and 2.9 mmHg (p = 0.021) higher, respectively, in the CS group. The prevalence of abnormal SBP (i.e., pre-hypertension or hypertension) in the CS group was 2.5 times that of those born vaginally (25.0% vs 10.3%; p = 0.003), with an adjusted relative risk of abnormal SBP 1.9 times higher (95% CI 1.15, 2.98; p = 0.011). There were no differences in anthropometry (including obesity risk) or other metabolic parameters. In this birth cohort in Thailand, CS delivery was associated with increased blood pressure in young adulthood.

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