scholarly journals Association between microvascular complications and glycated hemoglobin in patients with diabetes

2020 ◽  
Vol 73 (9-10) ◽  
pp. 277-283
Author(s):  
Biljana Lakic ◽  
Verica Petrovic ◽  
Kosana Stanetic ◽  
Suzana Savic
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Confidence Interval ◽  
Diabetic Neuropathy ◽  
Creatinine Clearance ◽  
Diastolic Blood Pressure ◽  
Odds Ratio ◽  
Glycated Hemoglobin ◽  
Microvascular Complications ◽  
Patients With Diabetes

Introduction. The aim of this study was to determine the prevalence of microvascular complications in type 1 and type 2 diabetes mellitus patients in relation to glycated hemoglobin. Material and Methods. This cross-sectional study analyzed the prevalence of microvascular complications in patients with diabetes mellitus registered at the Primary Health Center Banja Luka. Demographic data, duration of diabetes, blood pressure, glycated hemoglobin, dyslipidemia, type of therapy, presence of retinopathy, neuropathy and nephropathy were analyzed. Data collection was done from December 2017 to November 2018. Results. The study included 228 patients, 132 (57.9%) men and 96 (42.1%) women. The most common microvascular complication was diabetic neuropathy (24.2%). The mean glycated hemoglobin level in patients with diabetic complications was 7.75 ? 1.66%. Although all participants with complications had unregulated diabetes mellitus (glycated hemoglobin > 7%), a statistically significant difference was found in regard to microalbuminuria (> 30 mg/24 h) and/or proteinuria (> 0.15 g/24 h) and/or decreased creatinine clearance (< 1.5 ml/sec) and their mean glycated hemoglobin (p = 0.025), while for other complications (neuropathy and retinopathy) the same was not confirmed. Multivariate logistic regression analysis confirmed that microalbuminuria and/or proteinuria and/or decreased creatinine clearance (odds ratio = 2.174; 95% confidence interval: 1.040 - 4.543; p = 0.039) as well as elevated diastolic blood pressure (odds ratio = 1.09; 95% confidence interval: 1.024 - 1.162; p = 0.007) were factors associated with glycated hemoglobin > 7%. Conclusion. The most common microvascular complication in patients with both types of diabetes mellitus is diabetic neuropathy with a prevalence of 24.2%. The presence of microalbuminuria and/or proteinuria and/ or decreased creatinine clearance were associated with glycated hemoglobin > 7% and elevated diastolic blood pressure.

scholarly journals Relationship between Dietary n-6 Fatty Acid Intake and Hypertension: Effect of Glycated Hemoglobin Levels

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1825 ◽  
Author(s):  
Haruki Nakamura ◽  
Akinori Hara ◽  
Hiromasa Tsujiguchi ◽  
Thao Thi Thu Nguyen ◽  
Yasuhiro Kambayashi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Fatty Acids ◽  
Fatty Acid ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Glycated Hemoglobin ◽  
Cross Sectional Study ◽  
Fatty Acid Intake ◽  
Cross Sectional ◽  
Acid Intake

The relationship between dietary n-6 fatty acids and hypertension is not clear. The metabolic products of n-6 fatty acids include those that control blood pressure, such as prostaglandin and thromboxane, and that differ depending on the extent of glucose tolerance. This cross-sectional study investigated the association of dietary n-6 fatty acid intake on hypertension, and the effects of glycated hemoglobin (HbA1c) value in 633 Japanese subjects aged 40 years and older. Dietary intake was measured using a validated brief self-administered diet history questionnaire. We defined hypertension as the use of antihypertensive medication or a blood pressure of 140/90 mmHg. The prevalence of hypertension was 55.3%. A high n-6 fatty acids intake inversely correlated with hypertension in subjects with HbA1c values less than 6.5% (odds ratio, 0.857; 95% confidence interval, 0.744 to 0.987). On the contrary, in subjects with an HbA1c value of 6.5% or higher, the n-6 fatty acids intake was significantly associated with hypertension (odds ratio, 3.618; 95% confidence interval, 1.019 to 12.84). Regular dietary n-6 fatty acid intake may contribute to the prevention and treatment of hypertension in a healthy general population. By contrast, in subjects with diabetes, regular n-6 fatty acids intake may increase the risk of hypertension.

scholarly journals Blood Pressure Association with Sodium Intake from Snacks Among Undergraduates of Afe Babalola University, Nigeria

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 152-152
Author(s):  
Kayode Ajayi ◽  
Ibidayo Alebiosu
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Body Mass ◽  
Odds Ratio ◽  
Sodium Intake ◽  
Metabolic Equivalent ◽  
The Mean

Abstract Objectives The aim of the study was to assess the association between blood pressure (BP) values and sodium intake from snacks. Methods The mean weekly consumption of snacks was evaluated in 1500 randomly selected undergraduate aged 16–24 years by a food frequency questionnaire. Participants were divided into quartiles of systolic blood pressure and diastolic blood pressure. The mean weekly exercise level was calculated as the product of duration and frequency of each activity (in hours/week), weighted by an estimate of the metabolic equivalent of the activity (MET) and summed for the activities performed. The whole cohort was divided into tertiles of exercise and the individuals were classified as; sedentary, moderately active and active. The cut of points in the whole cohort were respectively; ≤10, 11–29, ≥30 MET h/week. Exercise levels were therefore expressed as MET h/week. Results The mean age, metabolic equivalent of activity (METs), body mass index (BMI) and mean sodium intake from snacks per day were; 20.10 ± 1.44 years, 25.51 ± 10.03 METs h/week, 24.86 ± 4.80 kg/m2 and 1.5 g/day respectively. Systolic blood pressure (SBP) ranges between 104.43 ± 4.89 mmHg and 137.27 ± 16.71 mmHg while the diastolic blood pressure (DBP) ranges from 71.24 ± 7.83–83.11 ± 12.03 mmHg. The SBP and DBP significantly increased from the lower to the higher tertile of sodium from snacks and with increasing frequency of salty snacks consumption (P &lt; 0.001). In the multiple logistic regression model, being in the highest SBP quartile (≥115 mmHg) was significantly associated with consumption of sodium from snacks (odds ratio (OR) = 1.46; 95% confidence interval (CI) 1.13–1.82; P = 0.001), age, gender and body mass index. Also, being in the highest DBP quartile (≥70 mmHg) was significantly associated with consumption of sodium from snacks (odds ratio (OR) = 2.84; 95% confidence interval (CI) 1.41–5.69; P = 0.003), age, body mass index, but not with gender. Conclusions The study has shown that a strong association exists between sodium intake from snack, daily frequency of consumption of salty snacks and blood pressure. Public education and social marketing are needed to motivate the undergraduate to choose healthier snacks with lower sodium content. Funding Sources The study did not receive any funding from any source.

scholarly journals Did blood transfusion increase mortality in patients with diabetes undergoing isolated coronary artery bypass graft surgery? A propensity score-matched analysis of 816 patients

2020 ◽  
Vol 28 (4) ◽  
pp. 586-592
Author(s):  
Muharrem Koçyiğit
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery ◽  
Blood Transfusion ◽  
Confidence Interval ◽  
Coronary Artery Bypass ◽  
Odds Ratio ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Patients With Diabetes ◽  
Pump Coronary Artery Bypass

Background: The aim of this study was to compare clinical outcomes of blood transfusion in patients with diabetes mellitus undergoing isolated on-pump coronary artery bypass grafting. Methods: The medical records of a total of 1,912 patients (1,300 males, 612 females; mean age 60.7±10.0) with diabetes who underwent isolated on-pump coronary artery bypass grafting between January 1999 and June 2019 were retrospectively analyzed. The patients were divided into two groups as patients with and without blood transfusions. The mortality rates were compared between the two groups. Results: The mortality rate was 14 times higher in the patients receiving blood transfusion (odds ratio: 14.80; 95% confidence interval 5.05 to 43.34; p<0.001). However, in the multivariate logistic regression analysis, there were no statistically significant difference in mortality between the patient groups, when diabetes mellitus was a covariate factor (Odds ratio: 8.34; 95% confidence interval 3.94 to 17.66 vs. odds ratio 8.36; 95% confidence interval 3.95 to 17.70). Conclusion: The propensity score-matched analysis of patients with diabetes showed that clinical outcomes were more severely affected by blood transfusion.

scholarly journals Nephrolithiasis in Cushing’s Disease: Prevalence, Etiopathogenesis, and Modification after Disease Cure

2003 ◽  
Vol 88 (5) ◽  
pp. 2076-2080 ◽  
Author(s):  
Antongiulio Faggiano ◽  
Rosario Pivonello ◽  
Daniela Melis ◽  
Mariagiovanna Filippella ◽  
Carolina Di Somma ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Uric Acid ◽  
Confidence Interval ◽  
Arterial Hypertension ◽  
Odds Ratio ◽  
Urinary Creatinine ◽  
Systemic Arterial Hypertension ◽  
Prevalence Of Obesity ◽  
Urinary Citrate

The pathogenesis of nephrolithiasis in Cushing’s syndrome is still not completely clarified. The current study aimed at investigating prevalence of nephrolithiasis and role of different lithogenic factors in Cushing’s disease (CD). Forty-six CD patients (24 with active and 22 with cured disease) and 46 sex- and age-matched controls entered the study. Body mass index, blood pressure, fasting glucose and insulin, serum and urinary creatinine, urea, uric acid, electrolytes, and cystine, urinary volume, pH, oxalate, and citrate levels, and renal ultrasonography (US) were performed in all patients and controls. Nephrolithiasis was found in 50% of active patients, 27.3% of cured patients, and 6.5% of controls (P &lt; 0.001). Compared with controls, patients with active disease had a significantly increased prevalence of obesity, arterial hypertension, diabetes mellitus, hypercalciuria, hypocitraturia, and hyperuricosuria, significantly higher levels of serum and urinary cystine, urinary creatinine, urea, uric acid, potassium, calcium, phosphorus, and oxalate, significantly lower levels of urinary citrate levels. Compared with controls, patients cured from CD had a significantly increased prevalence of obesity, systemic arterial hypertension, and diabetes mellitus, whereas urinary citrate was significantly decreased. At multivariate analysis, a significantly increased risk to develop kidney stones was independently associated with urinary excretion of uric acid (odds ratio = 1.6, confidence interval = 1.0–2.5) and systemic arterial blood pressure (odds ratio = 2.6, confidence interval = 1.1–6.6). In conclusion, patients with active CD have an increased prevalence of nephrolithiasis compared with general population, which decreases but not disappears in patients successfully cured from the disease. This complication is likely caused by the synergic effect of different hypercortisolism-dependent metabolic and hemodynamic abnormalities, among which systemic arterial hypertension and excessive urinary uric acid excretion seem to play a pivotal role.

scholarly journals Diabetes mellitus is associated with worse baseline and less post-treatment recovery of arterial stiffness in patients with primary aldosteronism

2022 ◽  
Vol 13 ◽  
pp. 204062232110667
Author(s):  
Cheng-Hsuan Tsai ◽  
Xue-Ming Wu ◽  
Che-Wei Liao ◽  
Zheng-Wei Chen ◽  
Chien-Ting Pan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Propensity Score ◽  
Arterial Stiffness ◽  
Diastolic Blood Pressure ◽  
Propensity Score Matching ◽  
Primary Aldosteronism ◽  
Specific Treatment ◽  
Post Treatment ◽  
Patients With Diabetes

Background: Aldosterone excess in primary aldosteronism (PA) has been linked to insulin resistance, and diabetes mellitus has been associated with increased arterial stiffness and worse cardiovascular outcomes. However, the impact of diabetes on baseline and post-treatment arterial stiffness in patients with PA is unknown. Methods: This study prospectively enrolled 1071 PA patients, of whom 177 had diabetes and 894 did not. Clinical, biochemical, and brachial-ankle pulse wave velocity (baPWV) data were analyzed at baseline and 1 year after PA-specific treatment. After propensity score matching of age, sex, body mass index, systolic and diastolic blood pressure, hypertension duration, and number of antihypertensive medications, 144 patients with diabetes and 320 without diabetes were included for further analysis. Results: After propensity score matching, the baseline characteristics were balanced between the diabetes and nondiabetes groups except for fasting glucose, HbA1c, and lipid profiles. The patients with diabetes had significantly worse baseline baPWV compared with those without diabetes. After multivariable linear regression, the presence of diabetes mellitus remained a significant predictor of worse baseline mean baPWV (β: 46.3, 95% confidence interval: 2.9–89.7, p = 0.037). After 1 year of PA-specific treatment, only the nondiabetes group had significant recovery of mean baPWV (1661.8 ± 332.3 to 1565.0 ± 329.2 cm/s, p < 0.001; Δ = −96.8 ± 254.6 cm/s). In contrast, the diabetes group had less improvement (1771.2 ± 353.8 cm/s to 1742.0 ± 377.2 cm/s, p = 0.259; Δ = −29.2 ± 263.2 cm/s) even though the systolic and diastolic blood pressure significantly improved in both groups. Conclusion: The presence of diabetes mellitus in PA patients was associated with worse baseline and less post-treatment recovery of arterial stiffness.

scholarly journals Cardiometabolic Differences in Children Born After in Vitro Fertilization: Follow-Up Study

2008 ◽  
Vol 93 (5) ◽  
pp. 1682-1688 ◽  
Author(s):  
Manon Ceelen ◽  
Mirjam M. van Weissenbruch ◽  
Jan P. W. Vermeiden ◽  
Flora E. van Leeuwen ◽  
Henriette A. Delemarre-van de Waal
Keyword(s):  
Blood Pressure ◽  
In Vitro Fertilization ◽  
Confidence Interval ◽  
Diastolic Blood Pressure ◽  
Odds Ratio ◽  
Fasting Glucose ◽  
Vitro Fertilization ◽  
Follow Up Study

Abstract Context: Increasing evidence suggests that adverse conditions during early prenatal life are associated with cardiometabolic dysfunction in postnatal life. In vitro fertilization (IVF) conception may be an early prenatal life event with long-term health consequences. Objective: Our objective was to investigate several cardiometabolic measures in 8- to 18-yr-old IVF singletons and spontaneously conceived controls born from subfertile parents. Design and Setting: This follow-up study was conducted at the VU University medical center, Amsterdam, The Netherlands. Participants: Blood pressure was examined in 225 IVF-conceived children and 225 age- and gender-matched spontaneously conceived control children. Several indicators of insulin resistance were studied in a pubertal subpopulation (131 IVF children and 131 controls). Main Outcome Measures: Blood pressure, fasting glucose, and fasting insulin were determined. Results: Systolic and diastolic blood pressure levels were higher in IVF children than controls (109 ± 11 vs. 105 ± 10 mm Hg, P &lt; 0.001; and 61 ± 7 vs. 59 ± 7 mm Hg, P &lt; 0.001, respectively). Children born after IVF were also more likely to be in the highest systolic and diastolic blood pressure quartiles (odds ratio = 2.1, 95% confidence interval 1.4, 3.3; odds ratio = 1.9, 95% confidence interval 1.2, 3.0, respectively). Furthermore, higher fasting glucose levels were observed in pubertal IVF children (5.0 ± 0.4 vs. 4.8 ± 0.4 mmol/liter in controls; P = 0.005). Blood pressure and fasting glucose differences could not be explained by current body size, birth weight, and other early life factors or by parental characteristics, including subfertility cause. Conclusions: These findings highlight the importance of continued cardiometabolic monitoring of IVF-conceived children and might contribute to current knowledge about periconceptional influences and their consequences in later life.

scholarly journals Association between Blood Pressure and Serum Thyroid-Stimulating Hormone Concentration within the Reference Range: A Population-Based Study

2007 ◽  
Vol 92 (3) ◽  
pp. 841-845 ◽  
Author(s):  
Bjørn O. Åsvold ◽  
Trine Bjøro ◽  
Tom I. L. Nilsen ◽  
Lars J. Vatten
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Outcome Measures ◽  
Odds Ratio ◽  
Reference Range ◽  
Positive Association ◽  
Population Based ◽  
Thyroid Stimulating Hormone ◽  
Cross Sectional ◽  
Population Based Study

Abstract Context: The association between thyroid function and blood pressure is insufficiently studied. Objective: The objective of the investigation was to study the association between TSH within the reference range and blood pressure. Design and Setting: This was a cross-sectional, population-based study. Subjects: A total of 30,728 individuals without previously known thyroid disease were studied. Main Outcome Measures: The main outcome measures were mean systolic and diastolic blood pressure and pulse pressure and odds ratio for hypertension (&gt;140/90 mm Hg or current or previous use of antihypertensive medication), according to categories of TSH. Results: Within the reference range of TSH (0.50–3.5 mU/liter), there was a linear increase in blood pressure with increasing TSH. The average increase in systolic blood pressure was 2.0 mm Hg [95% confidence interval (CI) 1.4–2.6 mm Hg] per milliunit per liter increase in TSH among men, and 1.8 mm Hg (95% CI 1.4–2.3 mm Hg) in women. The corresponding increase in diastolic blood pressure was 1.6 mm Hg (95% CI 1.2–2.0 mm Hg) in men and 1.1 mm Hg (95% CI 0.8–1.3 mm Hg) in women. Comparing TSH of 3.0–3.5 mU/liter (upper part of the reference) with TSH of 0.50–0.99 mU/liter (lower part of the reference), the odds ratio for hypertension was 1.98 (95% CI 1.56–2.53) in men and 1.23 (95% CI 1.04–1.46) in women. Conclusion: Within the reference range of TSH, we found a linear positive association between TSH and systolic and diastolic blood pressure that may have long-term implications for cardiovascular health.

scholarly journals Glycated Hemoglobin (HbA1c) as a Biomarker for Diabetic Foot Peripheral Neuropathy

Diseases ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Giulia Casadei ◽  
Marta Filippini ◽  
Lorenzo Brognara
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Neuropathy ◽  
Diabetic Foot ◽  
Glycated Hemoglobin ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Glycemic Variability ◽  
Future Research ◽  
Patients With Diabetes ◽  
Axonal Dysfunction ◽  
Biomarker Research

Background: Diabetic peripheral neuropathy (DPN) is known to predict foot ulceration, lower-extremity amputation and mortality. Patients with diabetes mellitus have a predisposition toward developing chronic inflammatory demyelinating polyneuropathy, and this may also facilitate the formation of diabetic foot and cutaneous impairment, which are considered one of the most serious impairments of diabetes mellitus, with a prevalence of 4–10% in this population. Biomarkers research provides opportunities for the early diagnosis of these complications for specific treatments useful to prevent amputation and, therefore, physical inability and mental disturbance. The recent literature has suggested that glycemic levels may be a novel factor in the pathogenesis of diabetic foot complications and is an important mediator of axonal dysfunction. The aim of this systematic literary review is to determine whether hemoglobin A1c (HbA1c) is a positive predictor for diabetic foot peripheral neuropathy and its complications, such as foot cutaneous impairments. There is a lack of consensus regarding the effect of glycemic variability on diabetic foot peripheral neuropathy, unlike other complications such as retinopathy, nephropathy or micro/macrovascular pathology. Methods: Relevant articles were searched in the Medline database using PubMed and Scopus and relevant keywords. The primary search terms used were “glycated hemoglobin” OR “HbA1c” AND “diabetic neuropathies” AND “Foot”. Results: A number of articles (336) were initially identified while searching the scientific literature regarding this topic, and 32 articles were selected and included in this review. Conclusions: This review highlights the role of HbA1c in diabetic foot peripheral neuropathy. Biomarkers play an important role in the decision-making process, and HbA1c levels are extensively used for diabetic foot clinical outcomes and settings, but biomarker research in diabetic foot peripheral neuropathy is in its infancy and will require careful attention to a number of factors and associations, since the consequences of DPN also include neurological alterations. HbA1c is an accurate and easy-to-administer test and can be an effective biomarker in establishing the diagnosis of diabetes, but future research should focus on standardizing the HbA1c level and selecting which DPN value and its correlated complications, such as foot cutaneous impairments, are the most informative.

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