scholarly journals The prediction and assessment of cardiovascular and renal disease in type 2 diabetes. A current review

2013 ◽  
Vol 20 (4) ◽  
pp. 427-434
Author(s):  
Loredana Mădălina Popa ◽  
Amorin Remus Popa ◽  
Gabriela Florina Dale ◽  
Mircea Ioachim Popescu
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Risk Stratification ◽  
Prediction Models ◽  
Cost Effective ◽  
Risk Scores ◽  
Risk Patients ◽  
Novel Biomarkers ◽  
Current Guidelines

Abstract According to the current guidelines all type 2 diabetes (T2DM) subjects are at high cardiovascular (CV) risk. Scientists are researching the issue of further risk stratification among already high-risk patients, improved cost-effective risk stratification tools being under development. The assessment of the CV risk with the help of prediction models developed for the general population is considered to be not accurately enough for high risk individuals, therefore the current interest for identifying novel biomarkers and the development of specifically designed risk-scores for individuals with diabetes.

A serum resistin and multi-cytokine inflammatory pathway is linked with and helps predict all-cause death in diabetes

2021 ◽  
Author(s):  
Maria Giovanna Scarale ◽  
Alessandra Antonucci ◽  
Marina Cardellini ◽  
Massimiliano Copetti ◽  
Lucia Salvemini ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Prediction Models ◽  
Total Mortality ◽  
Heart Association ◽  
Plaque Instability ◽  
Prediction Of Mortality ◽  
All Cause Mortality ◽  
Risk Patients

Abstract Context Type 2 diabetes shows high mortality rate, partly mediated by atherosclerotic plaque instability. Discovering novel biomarkers may help identify high-risk patients to expose to more aggressive and specific managements. We recently described a serum REsistin and multiMulti-cytokine inflammAatory Pathway (REMAP), including resistin, IL-1β, IL-6, IL-8 and TNF-α) which associates with cardiovascular disease. Objective We investigated whether REMAP associates with and improves the prediction of mortality in type 2 diabetes. Design A REMAP score was investigated in three cohorts comprising 1,528 patients with T2D (409 incident deaths) and in 59 patients who underwent carotid endoarterectomy (CEA; 24 deaths). Plaques were classified as unstable/stable according to the modified American Heart Association atherosclerosis classification. Results REMAP was associated to all-cause mortality in each cohort and in all 1,528 individuals (fully-adjusted HR for one SD increase =1.34, p<0.001). In CEA patients, REMAP was associated with mortality (HR =1.64, p = 0.04) and a modest change was observed when plaque stability was taken into account [HR =1.58; P = 0.07]. REMAP improved discrimination and reclassification measures of both ENFORCE and RECODe, well-established prediction models of mortality in type 2 diabetes (P<0.05-<0.001). Conclusions REMAP is independently associated with and improves predict all-cause mortality in type 2 diabetes; it can therefore be used to identify high-risk individuals to be targeted with more aggressive managements. Whether REMAP can also identify those patients who are more responsive to IL-6 and IL-1β monoclonal antibodies which reduce cardiovascular burden and total mortality is an intriguing possibility to be tested.

Identification of a spliceosome-associated fingerprint with potential to predict development of type 2 diabetes in high-risk patients

2016 ◽  
Author(s):  
Raul M. Luque ◽  
Manuel D. Gahete ◽  
Mercedes del Rio-Moreno ◽  
Sergio Pedraza-Arevalo ◽  
Antonio Camargo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
High Risk Patients ◽  
Risk Patients

2-OR: Impact of N Terminal Pro B-Type Natriuretic Peptide and High Sensitivity Cardiac Troponin on the Prediction of Death and Cardiovascular Events in High-Risk Patients with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 2-OR
Author(s):  
MARCUS V.B. MALACHIAS ◽  
PARDEEP JHUND ◽  
BRIAN CLAGGETT ◽  
MAGNUS O. WIJKMAN ◽  
RHONDA BENTLEY-LEWIS ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Cardiovascular Events ◽  
High Sensitivity ◽  
High Risk Patients ◽  
Risk Patients

Safety and Tolerability of Pioglitazone in High-Risk Patients with Type 2 Diabetes

Drug Safety ◽  
2009 ◽  
Vol 32 (3) ◽  
pp. 187-202 ◽  
Author(s):  
John Dormandy ◽  
Mondira Bhattacharya ◽  
Anne-Ruth van Troostenburg de Bruyn
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
High Risk Patients ◽  
Risk Patients

Cardiovascular risk assessment and association with novel biomarkers in patients with Type 2 diabetes mellitus

2021 ◽  
Author(s):  
Ane KM Néri ◽  
Geraldo B da S Junior ◽  
Gdayllon C Meneses ◽  
Alice MC Martins ◽  
Elizabeth De F Daher ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Risk Scores ◽  
Cross Sectional ◽  
Novel Biomarkers ◽  
Independent Association ◽  
Kidney Injury Molecule 1

Aim: To investigate the association between cardiovascular risk and biomarkers in patients with Type 2 diabetes (T2DM). Methods: Cross-sectional study, with evaluation of traditional and new biomarkers (serum FGF-23, Syndecan-1 – Sdc-1 and vascular cell adhesion molecule-1 – VCAM-1 and urinary VEGF and kidney injury molecule-1 – KIM-1) and risk scores (Framingham-FRS and UK Prospective Diabetes Study – UKPDS). Results: 128 diabetics were included, with predominance of high risk by FRS and low risk by UKPDS. There was an independent association of VCAM-1 and VEGF with higher risk by FRS-lipids and UKPDS. Conclusion: There was an independent association of VCAM-1 and VEGF with higher cardiovascular risk, showing a subclinical endothelial dysfunction in T2DM. The inclusion of novel biomarkers to risk scores may increase accuracy when assessing cardiovascular risk of diabetic individuals.

Comorbidities and Diabetes Type 2

2021 ◽  
pp. 46-61
Author(s):  
Chinedu I. Ossai ◽  
Nilmini Wickramasinghe ◽  
Steven Goldberg
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Logit Model ◽  
Diabetes Type 2 ◽  
Cost Effective ◽  
Diabetes Type ◽  
High Quality ◽  
Chi Square ◽  
Very High

The prevalence of diabetes type 2 among the population and the increasing rate of new diagnoses as well as other co-morbidities make it imperative that we develop a richer understanding of type 2 diabetes. An Australian survey of diabetes type 2 people for different co-morbidities was carried out to obtain information about the possible connections of the co-morbidities with type 2 diabetes. The analysis is done with the logit model and Pearson's chi-square and the results indicate that gender, age of the patients, and the duration of the diabetes type 2 diagnosis play a significant role in the exposure of individuals to different comorbidities. The influence of the duration of diagnosis and age of the patients is limited in comparison to the gender, which has females at a very high risk of developing the studied co-morbidities compared to males. The findings can improve diabetes type 2 management to boost high quality, proactive, and cost-effective caregiving for the patients.

scholarly journals Prognostic irrelevance of plaque vulnerability following plaque sealing in high-risk patients with type 2 diabetes: an optical coherence tomography study

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Rosalia Dettori ◽  
Andrea Milzi ◽  
Kathrin Burgmaier ◽  
Mohammad Almalla ◽  
Martin Hellmich ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Optical Coherence Tomography ◽  
High Risk ◽  
Clinical Parameters ◽  
Optical Coherence ◽  
Plaque Vulnerability ◽  
High Risk Patients ◽  
Risk Patients

Abstract Background Type 2 diabetes mellitus (T2DM) is associated with an increased cardiovascular risk related at least in part to a more vulnerable plaque phenotype. However, patients with T2DM exhibit also an increased risk following percutaneous coronary intervention (PCI). It is unknown if plaque vulnerability of a treated lesion influences cardiovascular outcomes in patients with T2DM. In this study, we aimed to assess the association of plaque morphology as determined by optical coherence tomography (OCT) with cardiovascular outcome following PCI in high-risk patients with T2DM. Methods 81 patients with T2DM and OCT-guided PCI were recruited. Pre-interventional OCT and systematic follow-up of median 66.0 (IQR = 8.0) months were performed. Results During follow-up, 24 patients (29.6%) died. The clinical parameters age (HR 1.16 per year, 95% CI 1.07–1.26, p < 0.001), diabetic polyneuropathy (HR 3.58, 95% CI 1.44–8.93, p = 0.006) and insulin therapy (HR 3.25, 95% CI 1.21–8.70, p = 0.019) predicted mortality in T2DM patients independently. Among OCT parameters only calcium-volume-index (HR 1.71 per 1000°*mm, 95% CI 1.21–2.41, p = 0.002) and lesion length (HR 1.93 per 10 mm, 95% CI 1.02–3.67, p = 0.044) as parameters describing atherosclerosis extent were significant independent predictors of mortality. However, classical features of plaque vulnerability, such as thickness of the fibrous cap, the extent of the necrotic lipid core and the presence of macrophages had no significant predictive value (all p = ns). Conclusion Clinical parameters including those describing diabetes severity as well as OCT-parameters characterizing atherosclerotic extent but not classical features of plaque vulnerability predict mortality in T2DM patients following PCI. These data suggest that PCI may provide effective plaque sealing resulting in limited importance of local target lesion vulnerability for future cardiovascular events in high-risk patients with T2DM.

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