Dynamics of Carbohydrate Metabolism Indices during the Treatment of Pulmonary Tuberculosis Patients with the Use оf Pathogenetic Therapy

2019 ◽  
pp. 21-25
Author(s):  
O.M. Shvets ◽  
O.S. Shevchenko
Keyword(s):  
Insulin Resistance ◽  
Pulmonary Tuberculosis ◽  
Data Processing ◽  
Carbohydrate Metabolism ◽  
Resistance Index ◽  
Tuberculosis Patients ◽  
Insulin Resistance Index ◽  
Pathogenetic Therapy ◽  
Group 2 ◽  
Group 1

Objective. To assess the dynamics of carbohydrate metabolism indices during the treatment of pulmonary tuberculosis patients with the use of pathogenetic therapy Materials and methods. We examined 40 patients with newly diagnosed destructive pulmonary tuberculosis with bilateral infiltrative changes and massive mycobacteria excretion. Exclusion criteria were: HIV infection/AIDS, diabetes mellitus, chronic hepatitis, extrapulmonary tuberculosis and pulmonary tuberculosis without destruction and without bacterial excretion. Standardized four-component anti-TB treatment regimen was prescribed to all patients. The subjects were randomly distributed between two groups of 20 people. The treatment regimen for patients of group 2 was supplemented with a 10-day course of intravenous infusion of xylitol with a volume of 400 ml once a day. An oral glucose tolerance test (OGTT) was performed, fasting insulin levels were determined, the insulin resistance index (HOMA-IR) and body mass index (BMI) were calculated, and clinical manifestations of intoxication were evaluated. For statistical data processing, the Statistica for Windows version 13.2 generalpurpose data processing software package was used. Results and discussion. At the beginning of treatment, patients of both groups had complaints typical for intoxication syndrome and signs of carbohydrate metabolism disorders in the form of the development of insulin resistance. The median value of the HOMA-IR index in group 1 was 3.03, and in group 2 it was 3.36. During the treatment, in group 2, whose patients received xylitol, a decrease in the average term of relief of intoxication symptoms was observed compared with group 1 (7±2 days vs 11±3 days) (p<0.05). In group 2 the median of insulin level decreased at a statistically significant level (p<0.05) (from 16.5 mcU/mL to 11.4 mcU/mL), and the insulin resistance index HOMA-IR decreased from 3.36 to 2.0, which allows us to suppose the positive effect of xylitol on the carbohydrate metabolism of patients with infiltrative pulmonary tuberculosis with destructive changes and mycobacteria excretion. Conclusions. Based on the obtained data, it can be concluded that xylitol has a positive modeling effect on the dynamics of carbohydrate metabolism in patients with destructive pulmonary tuberculosis with bacterial excretion.

scholarly journals Pro-atherogenic lipid profile in pulmonary tuberculosis patients with concurrent insulin resistance

2021 ◽  
Vol 8 (2) ◽  
pp. 111-114
Author(s):  
Olga Shvets ◽  
Olga Shevchenko ◽  
Zoriana Piskur ◽  
Hanna Stepanenko ◽  
Olha Pohorielova
Keyword(s):  
Insulin Resistance ◽  
Lipid Metabolism ◽  
Pulmonary Tuberculosis ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Low Density ◽  
Tuberculosis Patients ◽  
Group 2 ◽  
Group 1

Background. The problem of studying lipid metabolism in patients with tuberculosis is of interest to scientists around the world. The purpose of the study - to investigate lipid profile in pulmonary tuberculosis patients with concurrent insulin resistance. Materials and methods. Forty-one patients with pulmonary tuberculosis were examined. Insulin resistance index (HOMA-IR), total cholesterol level (TC), triglycerides (TG) level, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, very-low-density lipoprotein (VLDL) cholesterol and atherogenic index (AI) were measured. Results. Group 1 - 26 patients with tuberculosis and insulin resistance (HOMA-IR ˃ 2.7); Group 2 – 15 patients with tuberculosis without insulin resistance (HOMA-IR ˂ 2.7). Group 1 patients had severe course of TB with fever, severe fatigue and weakness, profuse sweating, weight loss, cough and shortness of breath. Median TC indices differed at significant level (p = 0.012): group 1 - 4.82 mmol/l, group 2 - 4.25 mmol/l. TG level was higher in group 1 patients - 1.32 mmol/l than in group 2 patients - 1.28 mmol/l. LDL cholesterol values were higher in group 1 patients - 3.2 mmol/l vs 2.5 mmol/l in group 2. The AI was higher in group1 (p = 0.005): 3.9 units against 2.8 units in group 2 patients. Conclusions. Insulin resistance in pulmonary tuberculosis patients was associated with severe course of the disease, severe clinical manifestations and impaired external respiration. Pro-atherogenic disorders of lipid metabolism in pulmonary tuberculosis patients with concurrent insulin resistance can be considered as the degree of endogenous intoxication.

Dynamics of life quality in patients with pulmonary tuberculosis against the background of the appointment of an essential amino acids complex

2021 ◽  
pp. 15-24
Author(s):  
O.S. Shevchenko ◽  
O.O. Pohorielova
Keyword(s):  
Amino Acids ◽  
Pulmonary Tuberculosis ◽  
Life Quality ◽  
Essential Amino Acids ◽  
Tablet Form ◽  
Pathogenetic Therapy ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective — to investigate the dynamics of life quality in patients with pulmonary tuberculosis against the background of the appointment of an essential amino acids complex. Materials and methods. The study included 100 patients with pulmonary tuberculosis who received treatment and diagnosis in accordance with the WHO recommendations and current state protocols. The patients were divided into 3 groups: group 1 (n = 50) did not receive additional complex of amino acids in pathogenetic therapy; group 2 (n = 25) received a complex of amino acids in tablet form for 30 days; group 3 (n = 25) received injectable amino acids complex for 10 days and then was transferred to tablet form for 20 days. At the beginning of treatment, after 30 days and after 60 days, the patients were interviewed using the SF-36 questionnaire. Also, the patients were measured the level of Human-beta-defensine-1 in the blood plasma by ELISA at the beginning of treatment. Results and discussion. After 30 doses of anti-tuberculosis treatment, better quality of life parameters were observed in groups 2 and 3 than in group 1. Thus, the PF in group 1 was 54.73 ± 2.99, in group 2 — 80.87 ± 2.82, in group 3 — 66. 4.23; RP was in group 1 — 20.27 ± 3.47, in group 2 — 81.52 ± 3.92, in group 3 — 55.00 ± 7.07; GH was 16.68 ± 1.79 in group 1, 45.48 ± 3.09 in group 2, 34.04 ± 3.35 in group 3; VT was in group 1 — 13.38 ± 1.55, in group 2 — 45.87 ± 2.86, in group 3 — 33.60 ± 3.68; SF was 43.45 ± 2.39 in group 1, 69.02 ± 2.06 in group 2, and 60.50 ± 3.53 in group 3; RE was in group 1 — 27.03 ± 4.80, in group 2 — 95.65 ± 3.18, in group 3 — 73.33 ± 7.69; MH was in group 1 — 39.22 ± 1.36, in group 2 — 60.00 ± 2.12, in group 3 — 56.00 ± 2.71, p < 0.05. This ratio between the groups remained at 60 doses of chemotherapy: PF was 62.17 ± 3.47 in group 1, 82.95 ± 2.39 in group 2, and 76.52 ± 3.42 in group 3; RP in group 1 was 28.33 ± 4.90, in group 2 — 90.91 ± 3.09, in group 3 — 66.30 ± 7.14; GH was 22.97 ± 2.13 in group 1, 52.63 ± 3.14 in group 2, 46.78 ± 4.22 in group 3; VT was 19.33 ± 1.91 in group 1, 50.68 ± 2.72 in group 2, and 40.87 ± 3.98 in group 3; SF was 50.67 ± 2.31 in group 1, 75.00 ± 2.18 in group 2, and 68.48 ± 3.84 in group 3; RE was 36.67 ± 6.26 in group 1, 98.49 ± 1.52 in group 2, 82.61 ± 6.91 in group 3; MH was 42.73 ± 1.62 in group 1, 63.82 ± 2.01 in group 2, 59.83 ± 2.75 in group 3, p < 0.05. Conclusions. The appointment of a complex of amino acids as an additional pathogenetic therapy in patients with pulmonary tuberculosis improves the quality of life, and the appointment of an injectable form of amino acids accelerates patients’ adaptation and increases adherence to treatment, which is one of the key factors in the effectiveness of therapy.

scholarly journals INSULIN RESISTANCE IN PATIENTS WITH NEWLY DIAGNOSED PULMONARY TUBERCULOSIS WITH DIFFERENT TREATMENT OUTCOME

2019 ◽  
pp. 10-14 ◽  
Author(s):  
R. N. Yasinskyi
Keyword(s):  
Insulin Resistance ◽  
Pulmonary Tuberculosis ◽  
Fasting Glucose ◽  
Negative Impact ◽  
Fasting Insulin ◽  
Newly Diagnosed ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Group 2 ◽  
Group 1

The aim of the study – to evaluate fasting glucose, insulin levels and homeostasis model assessment (HOMA-IR) index in patients with newly diagnosed pulmonary tuberculosis treatment failure (TFT) compared to data of patients who have successfully completed course of treatment (NDT). Materials and methods. 49 newly diagnosed pulmonary tuberculosis patients were examined. Patients were divided into 2 groups. Group 1 included 28 patients with TFT. Group 2 (comparison group) included 21 NDT patients. Blood sampling in the patients was done before treatment, after 3 months of the treatment start and after 2–3 months of treatment of patients in the group 1. Fasting plasma glucose level was determined by the hexokinase method by using Beckman Coulter AU640 biochemical analyzer, Japan. Fasting serum insulin level was determined by electrochemiluminescence method on Cobas e411 analyzer, Switzerland. Insulin resistance index was calculated by HOMA-IR by Matthews et al., 1985. Results. Fasting glucose levels were normal and almost similar in both groups before and after treatment, p˃0.05. Fasting insulin levels were also normal, but they were higher in patients of the group 1 than in the group 2, p˂0.05. It means there was a relative slight hyperinsulinemia in TFT patients. HOMA-IR index was also significantly greater among patients in the group 1, p˂0.05. Fasting glucose levels increase was in 10.7 % of patients in the group 1 and in 4.8 % patient in the group 2. Decrease of glucose levels was in 4.8 % of patients from the group 2. Fasting insulin levels increase was determined in 1 case among the group 1 patients and there were not cases with increased insulin levels among the patients of the group 2; fasting insulin levels reduction was identified in 14.3 % of patients from the group 1 only, p˃0.05. There was HOMA-IR index increase among patients of the group 1 mostly: 9 cases (33.3 %) versus 1 case (4.8 %) in the group 2, p˂0.05. Thus, a relative slight hyperinsulinemia in normal glucose levels and HOMA-IR index increase could be a signs of preclinical disorders of carbohydrate metabolism in patients with TFT. Conclusion. It may indicate negative impact of virulent mycobacteria and more severe clinical and radiological changes on carbohydrate metabolism or/and negative impact of such disorders to prognosis of tuberculosis.

scholarly journals Patient and Doctor Delays in Smear-Negative and Smear-Positive Pulmonary Tuberculosis Patients Attending a Referral Hospital in Istanbul, Turkey

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gulbanu Horzum Ekinci ◽  
Esra Karakaya ◽  
Esra Akkutuk Ongel ◽  
Osman Haciomeroglu ◽  
Adnan Yilmaz
Keyword(s):  
Pulmonary Tuberculosis ◽  
Patient Delay ◽  
Common Reason ◽  
Tuberculosis Patients ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Smear Negative ◽  
Group 2 ◽  
Control Education ◽  
Structured Questionnaire ◽  
Group 1

Objectives.To measure delays from onset of symptoms to initiation of treatment in patients with smear-negative and smear-positive pulmonary tuberculosis and to identify reasons for these delays.Methods.A total of 136 newly diagnosed pulmonary tuberculosis patients were interviewed using a structured questionnaire.Results.The patients were divided into two groups. Group 1 included 65 smear-negative patients. There were 71 smear-positive patients in group 2. The median application interval was 10 days in group 1 and 14 days in group 2. While 24.6% of the patients had patient delay in group 1, patient delay was present in 33.8% of the patients in group 2 (P>0.05). The median health care system interval was 41 days in group 1 and 16 days in group 2 (P<0.0001). The most common reason for patient delay was neglect of symptoms by patient in both groups. A low index of suspicion for tuberculosis by physicians was the most common reason for doctor delays.Conclusions.Delays are common problem in smear-negative and smear-positive pulmonary tuberculosis patients. Delays should be reduced to reach an effective tuberculosis control. Education of public and physicians about tuberculosis is the most important effort to reduce delays.

scholarly journals Relationship between insulin and hypogonadism in men with metabolic syndrome

2009 ◽  
Vol 53 (8) ◽  
pp. 1005-1011 ◽  
Author(s):  
Amanda D. A. Caldas ◽  
Adriana Lofrano Porto ◽  
Lucilia Domingues Casulari da Motta ◽  
Luiz Augusto Casulari
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Serum Insulin ◽  
Resistance Index ◽  
Free Testosterone ◽  
Total Testosterone ◽  
Model Assessment ◽  
Insulin Levels ◽  
Group 2 ◽  
Group 1

OBJECTIVE: To evaluate the incidence of hypogonadism in men with metabolic syndrome and its correlation with serum insulin levels. METHODS: Observational, transversal study with 80 men with metabolic syndrome. The individuals were divided into two groups: Group 1: 56 patients (70%) with total testosterone > 300 ng/dL (normal gonadal function); Group 2: 24 patients (30%) with total testosterone < 300 ng/dL (hypogonadic). RESULTS: The subjects from Group 2 compared to Group 1 presented higher body mass index (BMI), waist and hip circumferences, insulin, homeostasis model assessment insulin resistance index (Homa-IR) and beta cell (Homa-β), and triglycerides, but lower SHBG and free testosterone values. Inverse correlations between insulin levels and total testosterone and SHBG, as well as between Homa-IR and total testosterone were observed. CONCLUSION: In this series of men with metabolic syndrome, hypogonadism was associated with insulin resistance and may be a marker of metabolic abnormalities.

scholarly journals PREOPERATIVE REVELATION OF INSULIN RESISTANCE AS A CRITERION OF DEBULKING NECESSITY IN PATIENTS WITH OBESITY

2017 ◽  
Vol 3 ◽  
pp. 38-43
Author(s):  
Kostyantyn Mylytsya ◽  
Olga Lavryk ◽  
Andrei Lavryk
Keyword(s):  
Insulin Resistance ◽  
Carbohydrate Metabolism ◽  
Glucose Level ◽  
Resistance Index ◽  
High Risk Group ◽  
Greater Omentum ◽  
Insulin Resistance Index ◽  
Resistance State ◽  
Index Estimation ◽  
Index Calculation

The article considers the questions of a necessity of widening the list of obligatory preoperative examinations of patients with obesity for the choice of adequate operation volume, especially for simultaneous debulking of a greater omentum. The aim of research is an estimation of possibility of using an insulin resistance index (НОМА – IR) as a necessity criterion of simultaneous debulking of a greater omentum at operative interventions in patients with obesity. There were examined 60 persons from the surgical stationary, divided in 2 groups. 1 group included 20 patients with the normal body mass, 2 – 40 patients with different degrees of obesity. Insulin resistance was revealed on the base of glucose and insulin estimation, HOMA-IR index calculation. It was revealed, that glucose level in all patients doesn’t reliably exceeds the upper threshold of norm, insulin rates don’t differ from the control ones, even in patients with obesity, and rise in 20 % of patients only at 3 degree of obesity. It creates an illusion about the normal state of carbohydrate metabolism in these patients, whereas insulin resistance index estimation allows to reveal a pre-clinic stage of these disorders and to make a timely decision as to a possibility and necessity of simultaneous palliative operation as an ometnectomy that doesn’t complicate a course of operation and postoperational period, but allows to decrease an expressiveness of carbohydrate metabolism disorders at obesity. The standard preoperative estimation of glucose level in blood doesn’t allow to diagnose an insulin resistance state, that is patients of the high risk group of metabolic syndrome development (especially the ones with obesity) need the additional insulin estimation and insulin resistance index calculation in preoperational period.

scholarly journals Effect of the Cut-Off Level for Thyroid-Stimulating Hormone on the Prevalence of Subclinical Hypothyroidism among Infertile Mexican Women

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 417
Author(s):  
Lidia Arce-Sánchez ◽  
Salvatore Giovanni Vitale ◽  
Claudia Montserrat Flores-Robles ◽  
Myrna Souraye Godines-Enriquez ◽  
Marco Noventa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Subclinical Hypothyroidism ◽  
Thyroid Autoimmunity ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Mexican Women ◽  
Cross Sectional ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The primary aim of this study was to compare the prevalence of subclinical hypothyroidism (SCH) using two different cut-off levels for TSH values (≥2.5 mIU/L versus ≥4.1 mIU/L). The secondary objective was to analyze the clinical-biochemical characteristics in women with and without SCH. This was a retrospective cross-sectional study. In total, 1496 Mexican women with infertility were included: Group 1, women with TSH levels ranging between 0.3 and 2.49 mIU/L, n = 886; Group 2, women with TSH between 2.5 and 4.09 mIU/L, n = 390; and Group 3, women with TSH ≥4.1 mIU/L n = 220. SCH prevalence was 40.7% (CI 95%: 38.3–43.3%) with TSH cut-off ≥ 2.5 mIU/L, and 14.7% (CI 95%: 12.7–16.5%) with TSH cut-off ≥ 4.1 mIU/L, (p = 0.0001). The prevalence of overweight was higher in Group 2 than in Groups 1 and 3. Thyroid autoimmunity, obesity and insulin resistance were higher in Group 3 than in Group 1 (p < 0.05). No other differences were observed between groups. Conclusions: The prevalence of SCH in our selected patients increased almost three times using a TSH cut-off ≥ 2.5 mIU/L compared with a TSH cut-off ≥ 4.1 mIU/L. Women with TSH ≥4.1 mIU/L compared with TSH cut-off ≤ 2.5 mIU/L more often presented with obesity, thyroid autoimmunity and insulin resistance.

scholarly journals Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy

2021 ◽  
Vol 10 (10) ◽  
pp. 2140
Author(s):  
Piotr Bienias ◽  
Zuzanna Rymarczyk ◽  
Justyna Domienik-Karłowicz ◽  
Wojciech Lisik ◽  
Piotr Sobieraj ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Heart Rate ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Carbohydrate Metabolism ◽  
Autonomic Function ◽  
Young Patients ◽  
Resistance Index ◽  
Class Iii

The effects of weight loss following bariatric surgery on autonomic balance, arrhythmias and insulin resistance are still of interest. We prospectively investigated 50 patients with BMI > 40 kg/m2, aged 36.5 (18–56) years who underwent laparoscopic sleeve gastrectomy. Among other examinations, all subjects had 24-h Holter monitoring with heart rate variability (HRV) and heart rate turbulence (HRT) evaluation. After a median of 15 months, BMI decreased from 43.9 to 29.7 kg/m2, the incidence of hypertension decreased from 54 to 32% (p = 0.04) and any carbohydrate disorders decreased from 24 to 6% (p = 0.02). Fasting insulin concentration and insulin resistance index improved significantly (p < 0.001). Improvements in HRV parameters related to the sympathetic autonomic division were also observed (p < 0.001), while HRT evaluation was not conclusive. The enhancement of autonomic tone indices was correlated with reduction of BMI (SDNN-I r = 0.281 p = 0.04; SDNN r = 0.267 p = 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0–0.1, p < 0.001). The incidence of arrhythmias was low and similar before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate metabolism and autonomic function is observed in relatively young patients after weight loss due to laparoscopic sleeve gastrectomy.

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