scholarly journals Effects of Primary Aldosteronism and Different Therapeutic Modalities on Glucose Metabolism

2019 ◽  
Vol 8 (12) ◽  
pp. 2194 ◽  
Author(s):  
Mi Kyung Kwak ◽  
Jee Yang Lee ◽  
Beom-Jun Kim ◽  
Seung Hun Lee ◽  
Jung-Min Koh

Despite findings that aldosterone impairs glucose metabolism, studies concerning the effect of primary aldosteronism (PA) and its treatment on glucose metabolism are controversial. We aimed to determine glucose metabolism in PA and the effect of the treatment modality. We compared glucose metabolism between PA patients (N = 286) and age-, sex-, and body mass index-matched controls (N = 816), and the changes in glucose metabolism depending on the treatment modality (adrenalectomy vs. spironolactone treatment). Hyperglycemia including diabetes mellitus (DM; 19.6% vs. 13.1%, p = 0.011) was more frequent in PA patients. Hyperglycemia was also more frequent in PA patients without subclinical hypercortisolism (SH: p < 0.001) and in those regardless of hypokalemia (p < 0.001–0.001). PA patients and PA patients without SH had higher DM risk (odds ratio (OR); 95% confidence interval (CI): 1.63; 1.11–2.39 and 1.65; 1.08–2.51, respectively) after adjusting confounders. In PA patients, there was significant decrease in the DM prevalence (21.3% to 16.7%, p = 0.004) and fasting plasma glucose (p = 0.006) after adrenalectomy. However, there was no significant change in them after spironolactone treatment. Adrenalectomy was associated with more improved glucose status than spironolactone treatment (OR; 95% CI: 2.07; 1.10–3.90). Glucose metabolism was impaired in PA, regardless of hypokalemia and SH status, and was improved by adrenalectomy, but not spironolactone treatment.

Author(s):  
Inger W. Johnsson ◽  
Emelie Lindberger ◽  
Fredrik Ahlsson ◽  
Jan Gustafsson ◽  
Maria E. Lundgren

Abstract This study aimed to investigate how maternal birthweight is related to early pregnancy obesity, gestational diabetes mellitus (GDM), and offspring birthweight. Females born term and singleton in Sweden between 1973 and 1995 (N = 305,893) were studied at their first pregnancy. Information regarding their birthweight, early pregnancy body mass index, and pregnancy complications was retrieved from the Swedish Medical Birth Register, as were data on their mothers and offspring. High maternal birthweights (2–3 standard deviation scores (SDS) and >3 SDS) were associated with greater odds of early pregnancy obesity, odds ratio (OR) 1.52 (95% confidence interval (CI) 1.42–1.63) and OR 2.06 (CI 1.71–2.49), respectively. A low maternal birthweight (<2 SDS) was associated with greater odds of GDM (OR 2.49, CI 2.00–3.12). No association was found between high maternal birthweight and GDM. A maternal birthweight 2–3 SDS was associated with offspring birthweight 2–3 SDS (OR 3.83, CI 3.44–4.26), and >3 SDS (OR 3.55, CI 2.54–4.97). Corresponding ORs for a maternal birthweight >3 SDS were 5.38 (CI 4.12–7.01) and 6.98 (CI 3.57–13.65), respectively. In conclusion, a high maternal birthweight was positively associated with early pregnancy obesity and offspring macrosomia. A low, but not a high maternal birthweight, was associated with GDM.


2019 ◽  
Vol 8 ◽  
pp. 204800401986323 ◽  
Author(s):  
Dina Eufemia D San Gabriel ◽  
Julia Slark

Background There is a paucity of data relating to the association of gout with the occurrence of hypertension and diabetes mellitus in patients with stroke. This study aimed to determine the association of gout with the risk of hypertension and diabetes mellitus in a cohort of stroke patients from Auckland, Aotearoa New Zealand. Methods A cross-sectional study was conducted among stroke survivors in South and East Auckland, New Zealand from the years 2010 to 2014. Electronic health record data were collected and analysed using Statistical Package for Social Science version 23. Multivariate logistic regression modelling adjusted for age, gender, and ethnicity was conducted to determine the association of gout with the risk of hypertension and diabetes mellitus in patients discharged with a diagnosis of stroke. Results The age-, gender-, and ethnicity-adjusted odds ratio for having hypertension and diabetes mellitus among stroke survivors with gout history were 3.25 (95% confidence interval 1.32–8.03) and 1.94 (95% confidence interval 1.12–3.36), respectively. Māori stroke survivors with gout history had the highest risk of having diabetes mellitus with age- and gender-adjusted odds ratio of 5.10 (95% confidence interval 1.90–18.93). Conclusion The findings from this study suggest gout may be independently associated with an increased risk of hypertension and diabetes mellitus in patients with stroke. Māori who are the indigenous population of New Zealand show a greater risk of diabetes mellitus associated with a gout diagnosis compared to other populations. This finding highlights the importance of the need for further research with Māori stroke survivors and other indigenous populations.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Rong Yang ◽  
Chengli Du ◽  
Jinming Xu ◽  
Linpeng Yao ◽  
Siying Zhang ◽  
...  

Abstract Background Video-assisted thoracoscopic surgery has been widely used in thoracic surgery worldwide. Our goal was to identify the risk factors for postoperative pneumonia in patients undergoing video-assisted thoracoscopic surgery lobectomy. Methods A retrospective analysis of adult patients undergoing video-assisted thoracoscopic surgery lobectomy between 2016 and 05 and 2017–04 was performed. We used univariate analyses and multivariate analyses to examine risk factors for postoperative pneumonia after lobectomy. Results The incidence of postoperative pneumonia was 19.7% (n = 143/727). Patients with postoperative pneumonia had a higher postoperative length of stay and total hospital care costs when compared to those without postoperative pneumonia. Multivariate analysis showed that body mass index grading ≥24.0 kg/m2 (vs. <24.0 kg/m2: odds ratio 1.904, 95% confidence interval 1.294–2.802, P = 0.001) and right lung lobe surgery (vs. left lung lobe surgery: odds ratio 1.836, 95% confidence interval 1.216–2.771, P = 0.004) were independent risk factors of postoperative pneumonia. Total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL was also identified as the risk factors (vs. 1000 to < 1500 mL: odds ratio 2.060, 95% confidence interval 1.302–3.260, P = 0.002). Conclusions Major risk factors for postoperative pneumonia following video-assisted thoracoscopic surgery lobectomy are body mass index grading ≥24.0 kg/m2, right lung lobe surgery and total intravenous crystalloid infusion grading in the postoperative 24 h ≥ 1500 mL.


2014 ◽  
Vol 99 (3) ◽  
pp. E447-E452 ◽  
Author(s):  
A. E. Joham ◽  
S. Ranasinha ◽  
S. Zoungas ◽  
L. Moran ◽  
H. J. Teede

Context: Polycystic ovary syndrome (PCOS) affects 6%–21% of women. PCOS has been associated with an increased risk of dysglycemia including gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM). Objective: The objective of the study was to assess the prevalence of dysglycemia and the impact of obesity in young reproductive-aged women with and without PCOS in a community-based cohort. Design: This was a cross-sectional analysis of data from a large longitudinal study (the Australian Longitudinal Study on Women's Health). Setting: The setting for the study was the general community. Participants: Women were randomly selected from the national health insurance database. Standardized data collection occurred at five survey time points (years 1996, 2000, 2003, 2006, and 2009). Data from survey 4 (2006, n = 9145, 62% of original cohort aged 18–23 y) were examined for this study. Main Outcome Measures: Self-reported PCOS, GDM, and T2DM were measured. Results: In women aged 28–33 years, PCOS prevalence was 5.8% [95% confidence interval (CI) 5.3%–6.4%]. The prevalence of GDM (in women reporting prior pregnancy) and T2DM was 11.2% and 5.1% in women with PCOS and 3.8% and 0.3% in women without PCOS, respectively (P for both &lt; .001). PCOS was associated with an increased odds of GDM and T2DM. After adjusting for age, body mass index, hypertension, smoking, and demographic factors, the odds of GDM (odds ratio 2.1, 95% CI 1.1–3.9, P = .02) and T2DM (odds ratio 8.8, 95% CI 3.9–20.1, P &lt; .001) remained increased in women reporting PCOS. Conclusions: In a large community-based cohort of reproductive-aged women, PCOS was independently associated with a higher risk of GDM and T2DM, independent of body mass index. Aggressive screening, prevention, and management of dysglycemia is clearly warranted in women with PCOS.


2017 ◽  
Vol 13 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Mark M. Mitsnefes ◽  
Aisha Betoko ◽  
Michael F. Schneider ◽  
Isidro B. Salusky ◽  
Myles Selig Wolf ◽  
...  

Background and ObjectivesHigh plasma concentration of fibroblast growth factor 23 (FGF23) is a risk factor for left ventricular hypertrophy (LVH) in adults with CKD, and induces myocardial hypertrophy in experimental CKD. We hypothesized that high FGF23 levels associate with a higher prevalence of LVH in children with CKD.Design, setting, participants, & measurementsWe performed echocardiograms and measured plasma C-terminal FGF23 concentrations in 587 children with mild-to-moderate CKD enrolled in the Chronic Kidney Disease in Children (CKiD) study. We used linear and logistic regression to analyze the association of plasma FGF23 with left ventricular mass index (LVMI) and LVH (LVMI ≥95th percentile), adjusted for demographics, body mass index, eGFR, and CKD-specific factors. We also examined the relationship between FGF23 and LVH by eGFR level.ResultsMedian age was 12 years (interquartile range, 8–15) and eGFR was 50 ml/min per 1.73 m2 (interquartile range, 38–64). Overall prevalence of LVH was 11%. After adjustment for demographics and body mass index, the odds of having LVH was higher by 2.53 (95% confidence interval, 1.28 to 4.97; P<0.01) in participants with FGF23 concentrations ≥170 RU/ml compared with those with FGF23<100 RU/ml, but this association was attenuated after full adjustment. Among participants with eGFR≥45 ml/min per 1.73 m2, the prevalence of LVH was 5.4%, 11.2%, and 15.3% for those with FGF23 <100 RU/ml, 100–169 RU/ml, and ≥170 RU/ml, respectively (Ptrend=0.01). When eGFR was ≥45 ml/min per 1.73 m2, higher FGF23 concentrations were independently associated with LVH (fully adjusted odds ratio, 3.08 in the highest versus lowest FGF23 category; 95% confidence interval, 1.02 to 9.24; P<0.05; fully adjusted odds ratio, 2.02 per doubling of FGF23; 95% confidence interval, 1.29 to 3.17; P<0.01). By contrast, in participants with eGFR<45 ml/min per 1.73 m2, FGF23 did not associate with LVH.ConclusionsPlasma FGF23 concentration ≥170 RU/ml is an independent predictor of LVH in children with eGFR≥45 ml/min per 1.73 m2.


2021 ◽  
Vol 9 ◽  
pp. 205031212110606
Author(s):  
Betelhem Walelgn ◽  
Mehd Abdu ◽  
Prem Kumar

Introduction: Diabetic patients have a higher tendency of developing all infections, especially infections of the genitourinary tract. Urinary tract infections cause considerable disorders in diabetic patients, and if complicated, can cause renal failure. In Ethiopia, the magnitude of diabetes mellitus-associated urinary tract infections increased from 7.1% in 2005 to 33.9% in 2019. The successful management of patients suffering from urinary tract infections in diabetic patients depends upon the identification of risk factors. This study aimed to determine the magnitude and factors affecting the urinary tract infections among diabetic patients which enable professionals to prevent infections and manage them effectively. Methods: Hospital-based cross-sectional study was conducted with 365 diabetic patients selected by systematic sampling technique from March to April 2020. Data were collected by trained BSc nurses via face-to-face interview and patient chart review. Urine microscopy was done to diagnose urinary tract infections. Data were coded and entered using Epi data version 3.1 and exported to Statistical Package of Social Sciences version 26 for analysis. Variables with p-value < 0.25 in bivariable logistic regression were included multivariable logistic regression and variables with a p-value < 0.05 were considered statistically significant. Results: The magnitude of urinary tract infections was 22.3% (95% confidence interval: 18–27). The odds of being infected by urinary tract infections were significantly higher in diabetic females (adjusted odds ratio: 2.46; 95% confidence interval: 1.40–4.32), duration of diabetes mellitus diagnosis of ⩾5 years (adjusted odds ratio: 1.98; 95% confidence interval: 1.05–3.72), with comorbidity (adjusted odds ratio: 4.87; 95% confidence interval: 2.76–8.59) and khat chewer (adjusted odds ratio: 1.84; 95% confidence interval: 1.04–3.24) compared with their counter. Conclusion and recommendation: Urinary tract infections were high among diabetic patients. Predictors like sex, duration of diagnosis, comorbidity, and khat chewer were found to be associated with urinary tract infections. Improvement of the regular screening of patients with diabetes mellitus for urinary tract infections will provide more effective measures in prevention and management.


2020 ◽  
Vol 41 (13) ◽  
pp. 972-980
Author(s):  
Mikołaj Kamiński ◽  
Andrzej Gawrecki ◽  
Aleksandra Araszkiewicz ◽  
Agnieszka Szadkowska ◽  
Bogda Skowrońska ◽  
...  

AbstractThe aim of the study was to investigate factors related to the occurrence of nighttime hypoglycemia after a football tournament in children with type 1 diabetes mellitus. The multicenter study (GoalDiab study) included 189 children and adolescents with type 1 diabetes mellitus, from 11 diabetes care centers in Poland. Hypoglycemia was defined according to the International Hypoglycemia Study Group Statement. We analyzed the data of 95 participants with completed protocols with regards to nighttime hypoglycemia (82% male), aged 11.6 (9.8–14.2) years, diabetes duration 5.0 (2.0–8.0) years. There were 47 episodes of nighttime Level 1 hypoglycemia (≤3.9 mmol/L). Occurrence of clinically important Level 2 hypoglycemia (<3.0 mmol/L) during a game period was positively associated with nighttime hypoglycemia (≤3.9 mmol/L) incident (Odds Ratio=10.7; 95% Confidence Interval: 1.1–100.2; p=0.04). Using Continuous Glucose Monitoring was negatively associated with the occurrence of nighttime hypoglycemia (≤3.9 mmol/L) compared with using glucose meters or Flash Glucose Monitoring (Odds Ratio=0.31; 95% Confidence Interval: 0.12–0.83; p=0.02). The occurrence of clinically important hypoglycemia related to physical activity is associated with the occurrence of hypoglycemia during the night. Continuous Glucose Monitoring is negatively associated with nighttime hypoglycemia after a day of competition.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 152-152
Author(s):  
Kayode Ajayi ◽  
Ibidayo Alebiosu

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.


2019 ◽  
Vol 11 (2) ◽  
pp. 55-61 ◽  
Author(s):  
Ensiyeh Jenabi ◽  
Salman Khazaei ◽  
Yousef Veisani

Background: Many epidemiologic studies have been conducted to assess factors that were associated to endometriosis, but there is no consistency in results. Therefore, we conducted this meta-analysis to investigate the association between body mass index and the risk of endometriosis. Methods: In this meta-analysis, relevant studies that published in major international electronic bibliographic databases of PubMed, Scopus and Web of Science were systematically searched during November 2017. The Begg and Egger’s test was used to investigate publication bias in included studies. The Q-statistic and I2 tests were carried out for measuring heterogeneity. The random-effects model was conducted to obtain pooled odds ratio. Results: Our results showed a direct association between underweight and endometriosis in woman (odds ratio = 1.41, 95% confidence interval = 1.16–1.66), so underweight woman had 41% higher chance for endometriosis. However, we did not find linear association between overweight and endometriosis (odds ratio = 0.95; 95% confidence interval: 0.72–1.18) and obesity and endometriosis (odds ratio = 0.88; 95% confidence interval: 0.54–1.21), respectively. Conclusions: Our results suggested that underweight was a risk factor for the endometriosis, while overweight and obesity were not protective factors for endometriosis.


Author(s):  
Juleimar S.C. Amorim ◽  
Juliana L. Torres ◽  
Sérgio V. Peixoto

This study examined isolated and combined associations of physical activity (PA) and sitting time (ST) with body mass index (BMI) among older Brazilian adults. We have analyzed baseline data of 8,177 participants aged 50 years and older from the Brazilian Longitudinal Study of Aging. Respondents were categorized into sufficient PA/low ST, sufficient PA/high ST, insufficient PA/low ST, or insufficient PA/high ST using the Short Version of International Physical Activity Questionnaire. Multinomial logistic regression analysis examined the associations of being underweight (BMI, <18 kg/m2), overweight (BMI, 25–29.9 kg/m2), and obese (BMI, ≥30 kg/m2) with PA and ST categories. High ST (≥165 min/day) was associated with overweight (odds ratio, 1.26; 95% confidence interval [1.11, 1.44]) and obesity (odds ratio, 1.43; 95% confidence interval [1.21, 1.70]). However, no association was observed between PA and BMI. Participants in the insufficient and sufficient PA/high ST categories were more likely to be obese after adjusting for sociodemographic and health condition. Our findings call for public health initiatives that consider reducing ST in older adults.


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