Association of Abnormal Brachial Index with Diabetic Nephropathy as an Independent Risk Factor for Coronary Arterial Disease in Type 2 Diabetic Patients - A Retrospective Single Centre Real-World Evidence Study in Indian Population

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Siddhant Trehan ◽  
Rajeev Chawla ◽  
Shalini Jaggi ◽  
Anushrita S ◽  
Srivani Palukuri ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Positive Outcomes ◽  
Type 2 Diabetic Patients ◽  
Coronary Arterial Disease ◽  
Real World Evidence

Objective: To study the association between ankle brachial index (ABI) and microvascular complications in Type 2 diabetes (T2DM) patients with the coronary arterial disease (CAD). Methodology: A retrospective study was carried out on 3,458 T2DM patients reportedly with CAD, G1 (n=33), and without CAD, G2 (n=3125), who had given the ABI test. ABI was defined as normal (1.0 - 1.4) and abnormal (<1.0 and >1.4). The logistic regression analysis was used to identify the determinants of CAD positive outcomes in T2DM patients. Results: Overall, patient percentage-wise CAD 10% (333), abnormal ABI 26% (913), neuropathy 37% (1278), nephropathy, 8% (293), and retinopathy <1% (24). The ABI abnormality and CAD positives were higher in patients with nephropathy (32 and 20%) than in neuropathy (28 and 13%). Age-wise, 52 and 62% of neuropathy and nephropathy patients, respectively, were >60 years and had shown increased ABI abnormality from age 50 years onwards. The logistic model had shown nephropathy patients, [OR-1.8 [1.26-2.58], - p-0.001] in association with abnormal ABI, [OR-1.27 [95% CI, 0.99–1.63], p- 0.057] predicted to have CAD positive outcomes. While neuropathy, OR-0.69, [0.54 - 0.90], and hypertension, OR-0.43 [0.33 - 0.57] were not contributing towards CAD in our study population. Conclusion: Type 2 diabetes patients with abnormal ABI were predicted to have a 27% increased odds ratio of CAD outcome and 80% in the presence of nephropathy. Thus, as part of comprehensive diabetes care, albuminuria screening along with ABI measurement is being suggested.

scholarly journals Serum Levels of Progranulin Are Closely Associated with Microvascular Complication in Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Lin Xu ◽  
Bo Zhou ◽  
Huixia Li ◽  
Jiali Liu ◽  
Junhui Du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Linear Regression Analysis ◽  
Serum Levels ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Objective. Progranulin (PGRN) was recently introduced as a novel marker of chronic inflammatory response in obesity and type 2 diabetes capable of directly affecting the insulin signaling pathway. This study aimed to investigate the correlation between PGRN and type 2 diabetics with microvascular complications.Methods. PGRN serum levels and glucose metabolism related substance were measured in 84 type 2 diabetic patients with or without microangiopathies and 12 health persons. Further analyses of serum PGRN in different stages of diabetic microangiopathies were conducted.Results. Serum levels of PGRN were markedly higher in type 2 diabetic patients with microangiopathies. PGRN serum levels increased with the progress of diabetic microangiopathies with significantly highest values detectable in clinical diabetic nephropathy (CDN) and proliferative diabetic retinopathy (PDR) groups. Serum PGRN concentrations in all individuals positively and markedly correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), triglyceride (TG), urinary albumin excretion rate (UAER), blood urea nitrogen (BUN), creatinine (CRE), white blood cell (WBC), disease duration, IL-6, and TNF-α, while correlating negatively and significantly with eGFR. Multiple linear regression analysis showed that only UAER and CRE were independently associated with serum PGRN.Conclusion. PGRN might be considered as a marker for diabetic microangiopathy and its severity.

scholarly journals Aerobic and resistance training do not influence plasma carnosinase content or activity in type 2 diabetes

2015 ◽  
Vol 309 (7) ◽  
pp. E663-E669 ◽  
Author(s):  
Sanne Stegen ◽  
Ronald J. Sigal ◽  
Glen P. Kenny ◽  
Farah Khandwala ◽  
Benito Yard ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Training ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Activity Levels ◽  
Type 2 Diabetic Patients ◽  
Beneficial Effects ◽  
Before And After ◽  
Consequent Reduction

A particular allele of the carnosinase gene (CNDP1) is associated with reduced plasma carnosinase activity and reduced risk for nephropathy in diabetic patients. On the one hand, animal and human data suggest that hyperglycemia increases plasma carnosinase activity. On the other hand, we recently reported lower carnosinase activity levels in elite athletes involved in high-intensity exercise compared with untrained controls. Therefore, this study investigates whether exercise training and the consequent reduction in hyperglycemia can suppress carnosinase activity and content in adults with type 2 diabetes. Plasma samples were taken from 243 males and females with type 2 diabetes (mean age = 54.3 yr, SD = 7.1) without major microvascular complications before and after a 6-mo exercise training program [4 groups: sedentary control ( n = 61), aerobic exercise ( n = 59), resistance exercise ( n = 63), and combined exercise training ( n = 60)]. Plasma carnosinase content and activity, hemoglobin (Hb) A1c, lipid profile, and blood pressure were measured. A 6-mo exercise training intervention, irrespective of training modality, did not decrease plasma carnosinase content or activity in type 2 diabetic patients. Plasma carnosinase content and activity showed a high interindividual but very low intraindividual variability over the 6-mo period. Age and sex, but not Hb A1c, were significantly related to the activity or content of this enzyme. It can be concluded that the beneficial effects of exercise training on the incidence of diabetic complications are probably not related to a lowering effect on plasma carnosinase content or activity.

Platelet-Derived NO in Subjects Affected by Type 2 Diabetes with and without Complications: Is there any Relationship with their Offspring?

2017 ◽  
Vol 125 (05) ◽  
pp. 290-296 ◽  
Author(s):  
Jacopo Sabbatinelli ◽  
Arianna Vignini ◽  
Eleonora Salvolini ◽  
Laura Nanetti ◽  
Laura Mazzanti ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
No Production ◽  
Type 2 Diabetic Patients ◽  
Adult Type ◽  
Male Adult ◽  
Type 2 Diabetic

Abstract Macro- and microvascular complications are currently the principal causes of morbidity and mortality in patients with diabetes mellitus. Aim of this study was to determine if type 2 diabetic patients with nephropathy and coronary artery disease showed altered platelet-derived nitric oxide (NO) production, compared with diabetic subjects without complications, and if this alteration is also present in their diabetic offspring. In this case-control observational study, platelet NO and peroxynitrite content was determined on plasma from 60 male adult type 2 diabetic patients and 60 male offspring type 2 diabetic patients. Plasmatic levels of homocysteine were also determined in the same individuals. Moreover, Western blot analysis of platelet lysates was performed with specific monoclonal antibody for endothelial (eNOS) and inducible (iNOS) nitric oxide synthase. Our study showed a lower piastrinic production of NO in the group of parents without complications (ADH), compared with the group of offspring without complications (YDH) and with the groups of parents with complications. Furthermore, we observed a lower synthesis of peroxynitrite in platelets from the ADH group than in the groups of patients with complications, and in the YDH group compared with all other groups. Subjects from YDH group also showed lower iNOS expression, compared with all other groups. Our data suggest that alterations in nitric oxide metabolism may represent potential risk factors in type 2 diabetes complications, such as nephropathy and cardiovascular diseases, leading to development of new therapeutic strategies in order to delay and prevent the onset of such complications.

scholarly journals Glucagon-like peptide-1 levels and dipeptidyl peptidase-4 activity in type 2 diabetes

2017 ◽  
pp. E188-E199
Author(s):  
Abdulhalim Senyigit ◽  
Omur Tabak ◽  
Timur Orhanoglu ◽  
Aytac Karadag ◽  
Serdal Ugurlu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Dipeptidyl Peptidase ◽  
Controlled Clinical Trial ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Dipeptidyl Peptidase 4 ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Purpose: Hyperglycemia is the major risk factor for microvascular complications in type 2 diabetes mellitus (T2DM) patients. This randomized controlled clinical trial aimed to investigate T2DM patients with microvascular complications with regard to possible relations among serum clusterin (CLU), amylin, secreted frizzled-related protein-4 (SFRP-4), glucagon-like peptide-1 (GLP-1) and dipeptidyl peptidase-4 (DPP-4) activities. Methods: Subject groups were defined as follows: T2DM without complications (n=25, F/M=9/16, age 53.9±11.1 years); T2DM+Retinopathy (n=25, F/M=13/12, age 63.8±7.1 years); T2DM+Nephropathy (n=25, F/M=13/12, age 58.7±14.4 years); T2DM+Neuropathy (n=25, F/M=15/10, age 63.2±9.6 years); and healthy control subjects (HC) (n=25). CLU, amylin, SFRP-4, DPP-4 and GLP-1 (total and active) activities were measured and compared in blood samples from type 2 diabetic patients with and without microvascular complications. Results: Significantly lower levels of DPP-4 and GLP-1total (P

scholarly journals HDL & LDL Status in Untreated Newly Detected Type 2 Diabetic Patients

2015 ◽  
Vol 14 (1) ◽  
pp. 31-33
Author(s):  
Abu Tarek Iqbal ◽  
M Jalal Uddin ◽  
Md Salehuddin ◽  
Hasan Murad
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Study Group ◽  
Type Ii ◽  
Newly Diagnosed ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Objective: The study was conducted with a view to find out HDL & LDL status in newly detected untreated Type II diabetic patients. Methods: Study was carried out on 116 (66 male & 50 female) newly diagnosed untreated type 2 diabetes patients aged 40 - 65 years and were selected randomly for study. Fifty (25 male & 25 female) non diabetic subjects aged 40 - 65 years were randomly selected as control. Results: LDL - C was significantly higher (P<.0001) and HDL -C was significantly lower (<.0001) in study group in comparison to control group.Conclusion: Dyslipidemia is commonly found in type - 2 diabetic patients. It is a risk factor for microvascular complications. So it should be controlled effectively. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22877 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 31-33

scholarly journals Association of serum Cyr61 levels with peripheral arterial disease in patients with type 2 diabetes

2020 ◽  
Author(s):  
Feng Bin ◽  
Guidong Xu ◽  
Kangyun Sun ◽  
Nannan Zhang ◽  
Bimin Shi
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Serum Levels ◽  
Arterial Disease ◽  
Stage Ii ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Fontaine Classification ◽  
Type 2 Diabetic

Abstract Background: The prevalence of peripheral artery disease (PAD) is obviously increased in diabetic patients. Existing evidences show that cysteine-rich angiogenic inducer 61 (Cyr61), a 40 kD secreted protein, plays important roles in regulating cellular physiological processes. Recent studies have demonstrated a significant correlation between serum Cyr61 levels and atherosclerosis. However, the relationship between Cyr61 levels and PAD in type 2 diabetic patients remains obscure.Methods:. A total of 306 subjects with type 2 diabetes were recruited. The extent of PAD was determined by using the Fontaine classification, which defines four stages. We analyzed Cyr61 serum levels by ELISA in patients with and without PAD at Fontaine’s stage II, III, or IV. Logistic regression models were used to examine the independent association of Cyr61 with PAD.Results: Out of the 306 patients enrolled in this study, 150 patients were free from PAD, while 156 had clinically significant PAD. In PAD patients, the prevalences of Fontaine classification stage II, III and IV were 48.7%, 32.1%, and 19.2%, respectively. Patients with more advanced PAD had significantly higher Cyr61 (P for trend <0.001). The prevalence of PAD on the basis of severity increased with ascending Cyr61 quartiles (all P for trend <0.001), and the severity of PAD was positively correlated with Cyr61 quartiles (r=0.227, P=0.006). The association of Cyr61 levels with PAD remained after adjusting for major risk factors in a logistic regression analysis.Conclusions: Our results demonstrated that Cyr61 was significantly increased in type 2 diabetic patients with PAD and that Cyr61 levels were positively associated with disease severity. It could be a promising biomarker and further studies are needed to assess its clinical utility.

scholarly journals Hba1c Variability Has a Strong Relationship With Peripheral Sensory And Motor Neuropathy in Type-2 Diabetes Mellitus

2021 ◽  
pp. 93-100
Author(s):  
MA Hossain ◽  
MK Sarkar ◽  
I Mahbub ◽  
SMS Islam
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Motor Neuropathy ◽  
Type 2 Diabetic Patients ◽  
Hba1c Variability ◽  
Type 2 Diabetic

Diabetic peripheral neuropathy (DPN) is one of the most common long-term microvascular complications of diabetes. This study was undertaken to investigate the association of HbA1c variability with diabetic peripheral neuropathy (sensory and motor) in patients with type-2 diabetes. In this cross-sectional study, a total of 150 type-2 diabetic patients were screened for DPN and undergone quarterly HbA1c measurements during the year preceding enrolment were recruited. DPN was confirmed in patients displaying both clinical manifestations of neuropathy and neurological abnormalities assessment. Among the recruited patients, 24% (n = 36) were found to have DPN, and these patients also presented with a higher HbA1c as compared to the patients without DPN (p<0.05). In addition, the advanced age and longer duration of diabetes were important and significant (p<0.05) risk factors for peripheral neuropathy. Overall study suggests that increased HbA1c level is strongly associated with DPN (sensory and motor) in type-2 diabetic patients and could be considered as a potent indicator for DPN in the recruited patients. J. Bio-Sci. 29(1): 93-100, 2021 (June)

Metabolic and endothelial effects of trimetazidine on forearm skeletal muscle in patients with type 2 diabetes and ischemic cardiomyopathy

2006 ◽  
Vol 290 (1) ◽  
pp. E54-E59 ◽  
Author(s):  
Lucilla D. Monti ◽  
Emanuela Setola ◽  
Gabriele Fragasso ◽  
Riccardo P. Camisasca ◽  
Pietro Lucotti ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lipid Oxidation ◽  
Ischemic Cardiomyopathy ◽  
Glucose Oxidation ◽  
Diabetic Patients ◽  
Vascular Effects ◽  
Type 2 Diabetic Patients ◽  
Double Blind ◽  
Endothelin 1

The aim of the present study was to evaluate the effect of prolonged inhibition of β-oxidation on glucose and lipid muscle forearm metabolism and cGMP and endothelin-1 forearm release in patients with type 2 diabetes mellitus and ischemic cardiomyopathy. Fifteen patients were randomly allocated in a double-blind cross-over parallel study with trimetazidine (20 mg tid) or placebo lasting 15 days. At the end of each period, all patients underwent euglycemic hyperinsulinemic clamps with forearm indirect calorimetry and endothelial balance of vasodilator and vasoconstricor factors. Compared with placebo, trimetazidine induced 1) an increase in insulin-induced forearm glucose uptake and glucose oxidation accompained by a reduction in forearm lipid oxidation and citrate release and 2) a decrease of endothelin-1 release paralleled by a significant increase in forearm cGMP release. Forearm glucose oxidation significantly correlated with cGMP release ( r = 0.37, P < 0.04), whereas forearm lipid oxidation positively correlated with endothelin-1 release ( r = 0.40, P < 0.03). In conclusion, for the first time, we demonstrated that insulin-induced forearm glucose oxidation and forearm cGMP release were increased whereas forearm endothelin-1 release was decreased during trimetazidine treatment. Muscle's metabolic and vascular effects of trimetazidine add new interest in the use of trimetazidine in type 2 diabetic patients with cardiovascular disease.

scholarly journals Association of Plasma Myeloperoxidase Level with Risk of Coronary Artery Disease in Patients with Type 2 Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Ping Song ◽  
Jin Xu ◽  
Yongfeng Song ◽  
Shiliang Jiang ◽  
Haitao Yuan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Logistic Analysis ◽  
Artery Disease

Aims. This study aimed to investigate whether the change of plasma myeloperoxidase (MPO) level would be associated with the incidence of coronary artery disease (CAD) among diabetic patients.Methods. 339 patients with type 2 diabetes mellitus (DM) underwent coronary angiography. Of them, 204 cases had CAD and were assigned to CAD group and 135 cases without CAD were assigned to non-CAD group.Results. Compared to non-CAD group, CAD group had higher level of plasma MPO (p<0.01). Multiple linear regression analysis showed that plasma MPO level was correlated with Gensini score. Multiple logistic analysis showed that the odds ratios for CAD across increasing tertiles of MPO level were 1.191 (0.971–1.547) and 1.488 (1.115–2.228) (p=0.048,p=0.009versus 1st tertile of MPO level, resp.) by adjusting for age, sex, and other conventional risk factors for CAD. The subjects were stratified into nine groups according to tertiles of MPO and HbA1c. The odds ratio for CAD was significantly higher in group with highest levels of MPO and HbA1c (OR = 4.08,p<0.01).Conclusion. Plasma MPO level was positively correlated with the degree of coronary artery stenosis in type 2 diabetic patients, and increasing blood glucose might amplify the association between MPO and CAD.

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