scholarly journals Association Between C-Peptide Level and Subclinical Myocardial Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Ziwei Chen ◽  
Jing He ◽  
Qiang Ma ◽  
Mingbing Xiao
Keyword(s):  
Myocardial Injury ◽  
Cardiac Injury ◽  
Nhanes Iii ◽  
Multivariate Logistic Regression ◽  
Injury Score ◽  
C Peptide ◽  
Cardiometabolic Diseases ◽  
Health And Nutrition ◽  
Peptide Level ◽  
History Of

BackgroundPrevious studies have confirmed an association between C-peptide levels with the risk of cardiometabolic diseases. However, whether circulating C-peptide was related to subclinical myocardial injury (SC-MI) remains unknown.MethodsA total of 3,752 participants without a history of cardiovascular diseases were included in our study from National Health and Nutrition Examination Survey III (NHANES III). Multivariable linear regression was performed to explore the correlation between C-peptide and cardiac injury score (CIIS). Multivariate logistic regression was used to examine the association between C-peptide quartile and SC-MI.ResultsCirculating C-peptide was significantly associated with CIIS (β:0.09, 95% confidence interval [CI]: 0.00–0.17; p = 0.041). Compared with the lowest quartile, the highest quartile of circulating C-peptide increased a 1.48-fold risk of SC-MI (Odds ratio = 1.66, 95% CI: 1.18–1.87; p = 0.001).ConclusionsThe level of C-peptide was independently associated with CIIS and SC-MI, which could serve as a new risk factor of SC-MI.

scholarly journals The epidemiology and genetic analysis of children with idiopathic type 1 diabetes in the state of Qatar

2021 ◽  
Author(s):  
Tasneem Abdel-Karim ◽  
Basma Haris ◽  
Houda Afyouni ◽  
Shayma Mohammed ◽  
Amel Khalifa ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Wolfram Syndrome ◽  
Insulin Requirement ◽  
Monogenic Diabetes ◽  
C Peptide ◽  
Peptide Level ◽  
Uncertain Significance ◽  
Age Of Diagnosis ◽  
History Of

Abstract Background To study the epidemiology, describe the clinical characteristics and report results of genetic studies in pediatric patients with idiopathic type 1 diabetes. Methods Prospective study of type 1 diabetes patients attending Sidra Medicine from 2018-2020. Autoantibodies (GAD65, IAA, IA-2A and ZnT8) measured and genetic testing undertaken in patients negative for autoantibodies to rule out monogenic diabetes. Demographic and clinical data of patients with idiopathic type 1 diabetes compared to patients with autoimmune type 1 diabetes. Results 1157 patients had type 1 diabetes of which 63 were antibody negative. Upon genome sequencing, four had MODY, two had Wolfram syndrome, one had H syndrome and three had variants of uncertain significance in MODY genes. 53 patients had idiopathic type 1 diabetes. The most common age of diagnosis was 10-14 years and C-peptide level was low but detectable in 30 patients (56.6%) and normal in 23 patients (43.4%) The average BMI was in the normal range and 33% of the patients had history of DKA. Conclusions 4% of children have Idiopathic type 1 diabetes. There were statistically significant differences in the C-peptide level and insulin requirement between the two groups. DKA was less common in the idiopathic group. Mutations in MODY genes suggest the importance of autoantibody testing and genetic screening for known causes of monogenic diabetes in idiopathic type 1 diabetes. The mechanism of idiopathic type 1 diabetes is not known but could be due to defects in antibody production or due to autoantibodies that are not yet detectable or discovered.

scholarly journals Birth control pills and risk of hypothyroidism: a cross-sectional study of the National Health and Nutrition Examination Survey, 2007–2012

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046607
Author(s):  
Yuxuan Qiu ◽  
Yuanyuan Hu ◽  
Zhichao Xing ◽  
Qingyu Fu ◽  
Jingqiang Zhu ◽  
...  
Keyword(s):  
Birth Control ◽  
Hormone Replacement ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Cross Sectional ◽  
Thyroid Hormone Replacement ◽  
Health And Nutrition ◽  
History Of ◽  
Birth Control Pills

ObjectiveThe association between use of birth control pills and thyroid function in women has not ever been well studied, but potential risk has been implicated by small sample-sized studies. We aimed to determine this association using a large epidemiological survey.DesignCross-sectional study.SettingNational Health and Nutrition Examination Survey conducted in the USA from 2007 to 2012.ParticipantsFemale respondents aged 18+ who had data on history of taking birth control pills and thyroid function were included. History of taking birth control pills was based on responses on the reproductive health questionnaire. Participants not on antithyroid medication with thyroid-stimulating hormone (TSH) >5.6 mIU/L and those on thyroid hormone replacement regardless of TSH were categorised as hypothyroid. Participants not on thyroid hormone replacement or antithyroid medication who had TSH between 0.34 mIU/L and 5.6 mIU/L were classified as euthyroid.Primary and secondary outcome measuresAssociation between use of birth control pills and hypothyroidism based on multivariate logistic regression analysis.ResultsA total of 5116 female adults with history of taking birth control pills (n=3034) and without (n=2082) were included. A higher prevalence of hypothyroidism was found in those who have ever taken birth control pills (17.7% vs 14.1%; p=0.003). Multivariate logistic regression adjusted for confounding covariables, including age, race, education, body mass index, smoking status, alcohol use, history of thyroid disease, current thyroid disease, first menstrual age, pregnancy history, menopause status and history of hormone replacement use, demonstrated a significant association between history of taking birth control pills for more than 10 years and hypothyroidism (OR, 3.837; 95% CI 1.402 to 10.500; p=0.009).ConclusionsLonger history of using birth control pills was strongly associated with hypothyroidism, especially for more than 10 years.

scholarly journals Pembrolizumab-induced fulminant type 1 diabetes with C-peptide persistence at first referral

2020 ◽  
Vol 2020 ◽  
Author(s):  
Kazuhisa Kusuki ◽  
Saya Suzuki ◽  
Yuzo Mizuno
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Outpatient Visits ◽  
Peptide Level ◽  
Life Threatening ◽  
History Of ◽  
Fulminant Type

Summary A 72-year-old man with no history of diabetes was referred to our department due to hyperglycemia during pembrolizumab treatment for non-small-cell lung carcinoma. His blood glucose level was 209 mg/dL, but he was not in a state of ketosis or ketoacidosis. Serum C-peptide levels persisted at first, but gradually decreased, and 18 days later, he was admitted to our hospital with diabetic ketoacidosis (DKA). The patient was diagnosed with fulminant type 1 diabetes (FT1D) induced by pembrolizumab. According to the literature, the insulin secretion capacity of a patient with type 1 diabetes (T1D) induced by anti-programmed cell death-1 (anti-PD-1) antibody is depleted in approximately 2 to 3 weeks, which is longer than that of typical FT1D. Patients with hyperglycemia and C-peptide persistence should be considered for hospitalization or frequent outpatient visits with insulin treatment because these could indicate the onset of life-threatening FT1D induced by anti-PD-1 antibodies. Based on the clinical course of this patient and the literature, we suggest monitoring anti-PD-1 antibody-related T1D. Learning points: Immune checkpoint inhibitors, such as anti-PD-1 antibodies, are increasingly used as anticancer drugs. Anti-PD-1 antibodies can cause immune-related adverse events, including T1D. FT1D, a novel subtype of T1D, is characterized by the abrupt onset of hyperglycemia with ketoacidosis, a relatively low glycated hemoglobin level and depletion of C-peptide level at onset. In patients being treated with anti-PD-1 antibody, hyperglycemia with C-peptide level persistence should be monitored through regular blood tests. Because of C-peptide persistence and mild hyperglycemia, it is possible to miss a diagnosis of life-threatening FT1D induced by anti-PD-1 antibody. In particular, in patients who have no history of diabetes, hyperglycemia without DKA is likely to be the very beginning of anti-PD-1 antibody-induced T1D. Therefore, such patients must be considered for either hospitalization or frequent outpatient visits with insulin injections and self-monitoring of blood glucose.

scholarly journals FREQUENCY OF INCREASED PLASMA C-PEPTIDE LEVELS IN COLORECTAL CANCER PATIENTS

2021 ◽  
Vol 71 (6) ◽  
pp. 2180-83
Author(s):  
Muhammad Hasan Saleem ◽  
Shazia Nisar ◽  
Muhammad Zulqurnain Saleem ◽  
Husnain Saleem ◽  
Shoaib Mukhtar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Carcinoma ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Cross Sectional ◽  
C Peptide ◽  
Peptide Level ◽  
History Of ◽  
The Mean ◽  
Colorectal Cancer Patients

Objective: To assess the increased frequency of serum C-peptide levels in patients of colorectal carcinoma. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jul 2018 to Jan 2019. Methodology: A total of 100 cases of colorectal carcinoma were enrolled. Blood samples were obtained to assess C-peptide level. The C-peptide serum concentrations were deliberate through the Cobas 6000 by using the electro-chemi-luminescence immunoassay (ECLIA) method. If level of C-peptide was >2 pmol/mL, then it was noted. Results: The mean age of all patients was 58.3 ± 5.4 years. There was a total of 136 (68%) females and 64 (32%) were males. The mean BMI of patients was 28.96 ± 12.31 kg/m2. The family history of colorectal carcinoma was positive in 6 (6%) cases. The mean C-peptide level was 4.55 ± 2.37 pmol/L. There were 33 (33%) patients with raised C-peptide level while 67 (67%) had normal c-peptide level. Conclusion: It is concluded that increased C-peptide level is high in patients with colorectal cancer.

TYPE 2 DIABETES MELLITUS REMISSION AND ITS PREDICTION AFTER TWO-STAGE SURGICAL TREATMENT OF PATIENTS WITH MORBID OBESITY

2019 ◽  
Vol 72 (5) ◽  
pp. 739-743
Author(s):  
Oleksandr Yu. Ioffe ◽  
Mykola S. Kryvopustov ◽  
Yuri A. Dibrova ◽  
Yuri P. Tsiura
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Surgical Treatment ◽  
Two Stage ◽  
C Peptide ◽  
Peptide Level

Introduction: Morbid obesity (MO) has a significant impact on mortality, health and quality of life of patients. Type 2 diabetes mellitus (T2DM) is a common comorbidity in patients with MO. The aim is to study T2DM remission and to develop a prediction model for T2DM remission after two-stage surgical treatment of patients with MO. Materials and methods: The study included 97 patients with MO. The mean BMI was 68.08 (95% CI: 66.45 - 69.71) kg/m2. 70 (72,2%) patients with MO were diagnosed with T2DM. The first stage of treatment for the main group (n=60) included the IGB placement, for the control group (n=37) - conservative therapy. In the second stage of treatment the patients underwent bariatric surgery. The study addresses such indicators as BMI, percentage of weight loss, percentage of excess weight loss, ASA physical status class, fasting glucose level, HbA1c, C-peptide. Results: Two-stage treatment of morbidly obese patients with T2DM promotes complete T2DM remission in 68.1% of patients. The risk prediction model for failure to achieve complete T2DM remission 12 months after LRYGB based on a baseline C-peptide level has a high predictive value, AUC = 0.84 (95% CI: 0.69-0.93), OR = 0.23 ( 95% CI: 0.08-0.67). Conclusions: Two-stage treatment of patients with MO promotes improvement of carbohydrate metabolism indicators. With a C-peptide level > 3.7 ng/ml, prediction of complete T2DM remission 12 months after Laparoscopic Roux-en-Y Gastric Bypass is favorable.

High Risk of One-year Stroke Recurrence in Patients with Younger Age and Prior History of Ischemic Stroke

2019 ◽  
Vol 16 (3) ◽  
pp. 250-257 ◽  
Author(s):  
Jiann-Der Lee ◽  
Ya-Han Hu ◽  
Meng Lee ◽  
Yen-Chu Huang ◽  
Ya-Wen Kuo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Prior History ◽  
Multivariate Logistic Regression ◽  
Cart Analysis ◽  
Younger Age ◽  
History Of ◽  
One Year

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

Difference of myocardial injury, inflammation and early recurrence after pulmonary vein isolation among laser balloon ablation, radiofrequency catheter ablation and cryoballoon ablation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Yano ◽  
M Nishino ◽  
H Nakamura ◽  
Y Matsuhiro ◽  
K Yasumoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Myocardial Injury ◽  
Early Recurrence ◽  
Left Ventricular ◽  
Cryoballoon Ablation ◽  
Echocardiographic Parameters ◽  
History Of ◽  
Hs Crp ◽  
Balloon Ablation ◽  
Laser Balloon Ablation

Abstract Background Pulmonary vein isolation (PVI) has become well-established as the main therapy for patients with drug-refractory paroxysmal atrial fibrillation (PAF) and various isolation methods including radiofrequency ablation (RFA), cryoballoon ablation (CBA) and laser balloon ablation (LBA) were available. Pathological findings in each ablation methods such as myocardial injury and inflammation are thought to be different. High sensitive cardiac troponin I (hs-TnI), subunit of cardiac troponin complex, is a sensitive and specific marker of myocardium injury. High-sensitive C-reactive protein (hs-CRP) is a biomarker of inflammation and is elevated following cardiomyocyte necrosis. Relationship between myocardial injury and inflammation after ablation using RFA, CBA and LBA and early recurrence of atrial fibrillation (ERAF) remains unclear. Methods We enrolled consecutive PAF patients from Osaka Rosai Atrial Fibrillation (ORAF) registry who underwent PVI from January 2019 to October 2019. We compared the clinical characteristics including age, gender, hypertension, diabetes mellitus, history of heart failure, CHADS2Vasc score, renal function, serum BNP level and echocardiographic parameters including left ventricular dimensions, left atrial diameter (LAD) and left ventricular ejection fraction (LVEF) between RFA, CBA and LBA groups. We investigated the difference of relationship between myocardial injury marker (hs-TnI), inflammation markers (white blood cell change (DWBC) from post to pre PVI, neutrophil-to-lymphocyte ratio change (DNLR) from after to before PVI and hs-CRP) at 36–48 hours after PVI and ERAF (<3 months after PVI) between each group. Results We enrolled 187 consecutive PAF patients who underwent PVI. RFA, CBA and LBA groups comprised 108, 57 and 22 patients, respectively. There were no significant differences of age, gender, hypertension, diabetes mellitus, history of heart failure, CHADS2Vasc score, renal function, serum BNP level and echocardiographic parameters between each group. Serum hs-TnI in RFA group and LBA group were significantly lower than in CBA group (2.643 ng/ml vs 5.240ng/ml, 1.344 ng/ml vs 5.240 ng/ml, p<0.001, p=0.002, respectively, Figure). DWBC was significantly higher in LBA group than CBA group (1157.3/μl vs 418.4/μl, p=0.045). DNLR did not differ between each group. Hs-CRP in RFA group and LBA group were significantly higher than in CBA group (1.881 mg/dl vs 1.186 mg/dl, 2.173 mg/dl vs 1.186 mg/dl, p=0.010, p=0.003, respectively, Figure). Incidence of ERAF was significantly higher in LBA group than RFA group (36.4% vs 16.7%, p=0.035). Incidence of ERAF tended to be higher in LBA group than CBA group (36.4% vs 19.3%, p=0.112). Conclusion LBA may cause less myocardial injury than RFA and CBA, on the contrary LBA may cause more inflammation than CBA. Incidence of ERAF in LBA was highest between each procedure. Inflammation markers and ERAF Funding Acknowledgement Type of funding source: None

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