scholarly journals Impaired Clinical Efficacy of Aspirin in Hypoalbuminemic Patients With Diabetes Mellitus

2021 ◽  
Vol 12 ◽  
Author(s):  
Angela Sciacqua ◽  
Francesco Andreozzi ◽  
Elena Succurro ◽  
Daniele Pastori ◽  
Vittoria Cammisotto ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Serum Albumin ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Cox Regression ◽  
Coronary Revascularization ◽  
Cox Regression Analysis ◽  
Fasting Plasma ◽  
Increased Risk ◽  
The Impact

Objective: To investigate the impact of albumin levels on the aspirin efficacy, since aspirin inhibits platelet aggregation (PA) by cyclooxygenase one irreversible acetylation that is less effective in patients with type 2 diabetes mellitus (T2DM).Patients and Methods: A total of 612 aspirin (100 mg/day)-treated T2DM patients were followed-up for 54.4 ± 7.3 months. The primary endpoint, a composite of cardiovascular events (CVEs) including CV death, myocardial infarction, ischemic stroke and coronary revascularization, was analysed according to baseline values of serum albumin (≥ or < 3.5 g/dL). Serum thromboxane (Tx)B2 was also measured.Results: 250 (40.8%) patients had serum albumin < 3.5 g/dL; these patients were overweight and had higher values of fibrinogen (p = 0.009), high sensitivity C-reactive protein (p = 0.001) and fasting plasma glucose (p < 0.0001) compared to those with albumin ≥ 3.5 g/dL. During follow-up, 86 CVEs were recorded, 49 and 37 in patients with serum albumin < or ≥3.5 g/dL, respectively (p = 0.001). At multivariable Cox regression analysis, serum albumin < 3.5 g/dL (hazard ratio [HR] 1.887, 95% confidence interval [CI] 1.136–3.135, p = 0.014), age (HR 1.552 for every 10 years, 95%CI 1.157–2.081, p = 0.003), fasting plasma glucose (HR 1.063, 95%CI 1.022–1.105, p = 0.002) and beta-blocker use (HR 0.440, 95%CI 0.270–0.717, p = 0.001) were associated to CVEs. Serum TxB2 levels (n = 377) were 0.32 ± 0.12 and 0.24 ± 0.12 ng/ml in patients with albumin < or ≥ 3.5 g/dL, respectively (p < 0.001).Conclusion: In T2DM patients, the efficacy of aspirin varies according to albumin levels. Hypoalbuminemia associated with impaired TxB2 inhibition and an increased risk of long-term CVEs.

CORRELATION OF SERUM MAGNESIUM LEVELS WITH FASTING PLASMA GLUCOSE IN TYPE 2 DIABETES MELLITUS

2021 ◽  
pp. 16-18
Author(s):  
Nishanth Kumar ◽  
Malathi R D ◽  
Ramadevi M
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Serum Magnesium ◽  
Fasting Blood Glucose ◽  
Mean Value ◽  
Control Group ◽  
Mean Values ◽  
Fasting Plasma ◽  
Increased Risk

Background: Diabetes mellitus is a metabolic disorder of multifactorial origin characterized by hyperglycemia and disturbances of glucose , fat and protein metabolism. Hypomagnesemia is been associated with chronic and uncontrolled diabetes mellitus. Magnesium deciency in diabetes is known to be associated with increased risk of microvascular and macrovascular complications. The aim of this study is to estimate fasting plasma glucose and serum magnesium levels and to assess the correlation of hypomagnesemia with abnormal fasting plasma glucose values. Material and Methods: The study was done at Government Medical College, Nizamabad. 80 subjects were recruited out of whom 40 apparently normal persons were taken as control group and the second group of 40 patients with known history of diabetes. The fasting plasma glucose(FPG) was estimated by GOD-POD method and serum Magnesium(Mg) levels were estimated using the Chemchek Mg kit which is based on Xylidyl Blue with ACTS method. Results :The mean values of fasting plasma glucose was 87.1 mg/dL in non diabetics when compared to 159.4 mg/dL in diabetics while Serum magnesium levels in control subjects had a mean value of 2.19mg/dLand 1.8mg/dLin diabetics. The data was analysed and found to be statistically signicant with a negative correlation between plasma magnesium and fasting blood glucose. Conclusion: There is signicant hypomagnesaemia which correlates increased fasting plasma glucose values in diabetics when compared to non diabetics and therefore assessing the serum magnesium levels may help in reducing risk of complications.

P4663Hyperinsulinemia, hypertension and two clusters of biomarkers predict aortic stenosis in 10,144 Finnish men

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Ojanen ◽  
R Jauhiainen ◽  
J Vangipurapu ◽  
T Kuulasmaa ◽  
J Kuusisto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Glucose Tolerance ◽  
Systolic Blood Pressure ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Plasma Insulin ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Fasting Plasma

Abstract BACKROUND Recent studies show that hypertension predicts aortic stenosis (AS). Other predictors of AS are not established. Purpose To investigate a large panel of biomarkers as predictors of AS in the population-based METSIM cohort. Methods Anthropometric, metabolic and inflammatory biomarkers were measured at baseline in the cohort of 10,197 Finnish men. Subjects with AS at baseline (n=53) were excluded from the analyses. Cases of AS were identified from the medical records. Cox regression analysis was used to identify variables predicting AS. Principal components analysis was applied to investigate clustering of variables predicting AS. Uni- and multivariate logistic regression analysis were used to investigate the clusters of biomarkers as predictors of AS. Results Over a mean follow-up time of 10.8 years, incident AS was diagnosed in 116 (1.1%) men. In Cox regression analysis, fasting plasma insulin (9.8±12.8 in men without AS vs. 14.5±18.2 mU/l in men with incident AS; P=6.13 x 10–6) and systolic blood pressure (138.2±16.7 vs. 146.3±19.4 mmHg; P=3.8 x 10–7) were associated with higher risk of AS (HR 1.44 (95% CI 1.23–1.68); P=4.04 x 10–5 and HR 1.54 (1.30–1.83); P=3.01 x 10–7, respectively). Other biomarkers, which significantly predicted AS were age, body mass index, waist, waist/hip ratio, body fat mass percentage, urine albumin, CRP, blood GHbA1C, fasting plasma glucose and proinsulin, oral glucose tolerance test (OGTT) 30 min plasma insulin and proinsulin, OGTT 120 min plasma insulin and proinsulin, and serum C-peptide. Glucose tolerance (ADA 2003), and insulin resistance and insulin secretion indices based on HOMA were significant predictors of AS. After adjusting for age, the same biomarkers except for OGTT 120 min plasma proinsulin, blood GHbA1C and fasting plasma glucose significantly predicted AS. After exclusion of diabetic subjects, all biomarkers mentioned above except for GHbA1C, fasting plasma glucose and glucose tolerance predicted AS in unadjusted Cox models. Two clusters of risk factors were found in principal components analysis, one consisting of fasting plasma insulin, HOMA insulin resistance index, waist/hip ratio, GHbA1c and CRP, and another consisting of age, systolic blood pressure and urine albumin, explaining 38.33 and 15.37% of the total variance, respectively. In univariate logistic regression analysis both clusters predicted AS (HR 1.35 (1.15–1.59); P=2.47 x 10–4 and HR 1.73 (1.46–2.04); P=1.53 x 10–10, respectively), and were statistically significant when entered in the multivariate model (HR 1.30 (1.11–1.52); P=1.01 x 10–3 and HR 1.69 (1.43–1.99); P=5.84 x 10–10, respectively). Conclusion In the present large-scale population-based study, several biomarkers, particularly hyperinsulinemia and systolic blood pressure, predicted AS. In addition, two clusters of biomarkers, one with high loading on insulin and another on systolic blood pressure, independently predicted AS. Acknowledgement/Funding Kuopio University Hospital ja Academy of Finland

scholarly journals Association of Serum Creatinine Levels and Risk of Type 2 Diabetes Mellitus in Korea

2020 ◽  
Author(s):  
Do Kyeong Song ◽  
Hyejin Lee ◽  
Young Sun Hong ◽  
Yeon-Ah Sung
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Serum Creatinine ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Fasting Plasma ◽  
Increased Risk

Abstract Reduced skeletal muscle has been suggested as a risk factor for type 2 diabetes mellitus (T2DM). Serum creatinine is used as a surrogate for muscle mass. Therefore, low serum creatinine levels may be associated with an increased risk of T2DM. We aimed to evaluate the association between serum creatinine levels and the risk of T2DM. We analyzed a total of 264,832 nondiabetic adults in Korea. In men, serum creatinine levels and the risk for T2DM showed an inverse J-shaped association even after adjustment for age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting plasma glucose. In women, there was a trend that serum creatinine levels were inversely associated with the risk of T2DM among those with serum creatinine below 1.1 mg/dl. However, serum creatinine levels were not significantly associated with the risk of T2DM after adjustment for age, BMI, SBP, DBP, and fasting plasma glucose. Reduced levels of serum creatinine were significantly associated with an increased risk of T2DM in men with creatinine below 1.20 mg/dl. There was a trend that decreased levels of serum creatinine were associated with an increased risk of T2DM among women, although this result was not statistically significant.

scholarly journals Hemoglobin A1c in combination with fasting plasma glucose trumps fasting plasma glucose alone as predictive indicators for diabetes mellitus: an ambidirectional cohort study of Thai people with impaired fasting glucose

2021 ◽  
Vol 9 (2) ◽  
pp. e002427
Author(s):  
Sangsulee Thamakaison ◽  
Thunyarat Anothaisintawee ◽  
Kanokporn Sukhato ◽  
Nattawut Unwanatham ◽  
Sasivimol Rattanasiri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cohort Study ◽  
Impaired Fasting Glucose ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Hemoglobin A1c ◽  
Fasting Glucose ◽  
Cox Regression Analysis ◽  
Fasting Plasma

IntroductionThis ambidirectional cohort study aimed to assess the performance of combining hemoglobin A1c (HbA1c) to fasting plasma glucose (FPG) for estimation of progression rate to diabetes mellitus (DM) and to explore the risk factors of DM in patients with impaired fasting glucose (IFG).Research design and methodsPatients with IFG were eligible for this study. IFG was defined as FPG of 100–125 mg/dL. Progression rates to DM were estimated using Kaplan-Meier analysis. Risk factors of DM were explored by Cox regression analysis.Results3011 patients were enrolled with median follow-up time of 8 years (range: 6 months–29 years). Progression rates to DM in patients with FPG 100–109 mg/dL and 110–125 mg/dL were 2.64 and 4.79 per 100 person-years. After adjusting covariables, compared with patients with FPG 100–109 mg/dL plus normal HbA1c (<5.7%), hazard ratios (95% CI) of patients with FPG 110–125 plus normal HbA1c, FBG 100–109 plus abnormal HbA1c (5.7%–6.49%), and FPG 110–125 plus abnormal HbA1c were 5.89 (2.37 to 14.63), 16.30 (8.59 to 30.92), and 33.84 (16.41 to 69.78), respectively. Body mass index ≥27.5 kg/m2, serum triglyceride level ≥150 mg/dL, family history of DM, and low level of high-density lipoprotein-cholesterol were independently associated with risk of DM in patients with IFG.ConclusionsPatients with both IFG and abnormal HbA1c had higher risk of DM than patients with IFG alone. Therefore, performing HbA1c in combination with FPG helps to identify subgroups of people with IFG at highest risk of DM. These patients should have the highest priority in diabetes prevention programs, especially in countries with low and limited resources.

scholarly journals Association of fasting plasma glucose variability with gestational diabetes mellitus: a nationwide population-based cohort study

2020 ◽  
Vol 8 (1) ◽  
pp. e001084
Author(s):  
Jung A Kim ◽  
Jinsil Kim ◽  
Eun Roh ◽  
So-hyeon Hong ◽  
You-Bin Lee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Insulin Therapy ◽  
National Health ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Fasting Plasma ◽  
Increased Risk

ObjectiveLong-term glycemic variability has recently been recognized as another risk factor for future adverse health outcomes. We aimed to evaluate the risk of gestational diabetes mellitus (GDM) according to the prepregnancy long-term fasting plasma glucose (FPG) variability.Research design and methodsA total of 164 053 women who delivered their first baby between January 1, 2012 and December 31, 2015, were selected from the Korean National Health Insurance data. All women underwent at least three national health screening examinations, and the last examination should be conducted within 2 years before their first delivery. GDM was defined as the presence of more than four times of claim of GDM (International Classification of Disease, 10th Revision (ICD-10) O24.4 and O24.9) or prescription of insulin under the ICD-code of GDM. FPG variability was assessed by variability independent of the mean (FPG-VIM), coefficient of variation, SD, and average successive variability.ResultsAmong the 164 053 women, GDM developed in 6627 (4.04%). Those in the higher quartiles of FPG-VIM showed a stepwise increased risk of GDM. In fully adjusted model, the ORs for GDM was 1.22 (95% CI 1.14 to 1.31) in women with the highest FPG-VIM quartile compared with those in the lowest quartile. The risk for GDM requiring insulin therapy was 48% increase in women in the highest quartile of FPG-VIM compared with those in the lowest quartile, while that for GDM not requiring insulin therapy was 19% increase. The association between high FPG variability and the risk of GDM was intensified in the obese and aged more than 35 years women.ConclusionsIncreased FPG variability in the prepregnancy state is associated with the risk of GDM independent of confounding factors. Therefore, prepregnancy FPG variability might be a surrogate marker of the risk of GDM.

scholarly journals Comparative Study of Fasting Plasma Glucose Concentration and Glucose Challenge Test for Screening Gestational Diabetes Mellitus

2014 ◽  
Vol 6 (2) ◽  
pp. 75-78
Author(s):  
Sujaya Sham ◽  
B Poornima R Bhat ◽  
Aruna Kamath
Keyword(s):  
Diabetes Mellitus ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Concentration ◽  
Challenge Test ◽  
Plasma Glucose Concentration ◽  
Fasting Plasma ◽  
Glucose Challenge Test ◽  
Glucose Challenge ◽  
Fasting Plasma Glucose Concentration

ABSTRACT Background To compare the sensitivity and specificity of fasting plasma glucose (FPG) with that of standard glucose challenge test (GCT). Materials and methods Eighty-nine eligible pregnant women underwent GCT between 24th and 28th gestational week, followed by a diagnostic 3 hours 100 gm oral glucose tolerance test within 1 week. Out patient clinic in Father Muller Medical College Hospital, Mangalore. Data was analyzed for significance by chi-square test. Results Fasting plasma glucose concentration at a threshold value of 90 mg/dl and GCT at recommended standard threshold of 140 mg/dl yielded sensitivities of 66.7% and 100% respectively and specificities of 87.3% and 46.5% respectively. Reducing the threshold value of FPG to 80 mg/dl increased the sensitivity of test to 91.7% with specificity of 54.9% which was comparable to standard GCT, in our study. Conclusion Measuring FPG concentration using a cut-off of. 80 mg/dl is an easier, tolerable and more cost effective procedure than GCT for detecting more severe cases of GDM, i.e. the diabetes mellitus group. In resource poor settings with population belonging to average risk or high risk category, FPG at a cut-off of 90 mg/dl can be used to screen GDM. How to cite this article Sham S, Bhat BPR, Kamath A. Comparative Study of Fasting Plasma Glucose Concentration and Glucose Challenge Test for Screening Gestational Diabetes Mellitus. J South Asian Feder Obst Gynae 2014;6(2):75-78.

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