scholarly journals Arterial Parameters in Type-2 Diabetes and Healthy Subjects by using Impedance Plethysmography: A Case-control Study

2021 ◽  
Author(s):  
Yogesh Kishorbhai Kacha ◽  
Chetankumar Bhalabhai Desai ◽  
Hemant B Mehta ◽  
Chinmay J Shah
Keyword(s):  
Healthy Subjects ◽  
Arrival Time ◽  
Case Control Study ◽  
Impedance Plethysmography ◽  
Pulse Arrival Time ◽  
Males And Females ◽  
Pulse Arrival ◽  
Type 2 Diabetic ◽  
Control Study

Introduction: A reduced blood supply to lower limb, due to arterial disease, is a common cause of foot ulceration in patients with Diabetes Mellitus (DM). Impedance Plethysmography (IPG) is based on the measurement of changes in the electrical resistance (impedance) caused by blood volume changes. Aim: To compare parameters of type-2 diabetic subjects with those of healthy subjects along with different age group and to associate with Blood Flow Index (BFI), Fasting Blood Sugar (FBS), Post-Prandial Blood Sugar (PP2BS) and Body Mass Index (BMI). Materials and Methods: This case-control study was conducted at Government Medical College and in UHTC, Bhavnagar, Gujarat, India, from May 2012 to August 2013 on 100 healthy subjects and 100 type-2 diabetic subjects. IPG arterial parameters like BFI, Pulse Arrival Time (PAT), Pulse Termination Time (PTT), Differential Pulse Arrival Time (DPAT), Z0 (Basal impedance) recorded. The data were analysed by unpaired t-test and ANOVA test. Results: This study had 200 subjects of age more than 30 years. The diabetic subjects included 56 males and 44 females whereas the healthy subjects included 67 males and 33 females. There was bilateral significant reduction of BFI, PAT at knee, ankle and calf segment among diabetics group in males and females; and a bilateral significant reduction of PTT at ankle segment among diabetic males and females. DPAT value increased at knee, calf and ankle segment on both sides in male and female; except right ankle segment in diabetic group in females as compared to healthy subjects. Z0 increased at knee, ankle and calf segment in diabetic group on both side in males and females. BFI decreased with an increase in the duration of diabetes. The effect of FBS, PP2BS and BMI in diabetic subjects suggested a negative association with BFI. Conclusion: There was decrease in BFI, PAT, PTT and increase in DPAT in the knee, calf and ankle region of diabetic subjects. BFI negatively correlated with FBS, PP2BS and BMI among diabetics and decreased with increased duration of DM

scholarly journals Urine transferrin as an early endothelial dysfunction marker in type 2 diabetic patients without nephropathy: a case control study.

2021 ◽  
Author(s):  
José Juan Sánchez-Hidalgo ◽  
Juan Antonio SUÁREZ-CUENCA ◽  
José Juan Lozano-Nuevo ◽  
Víctor Hugo García-López ◽  
María Graciela Leal-Gutiérrez ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Endothelial Dysfunction ◽  
Case Control Study ◽  
Case Control ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Early Diabetic Nephropathy ◽  
Type 2 Diabetic ◽  
Control Study

Abstract Background Albumin, along with other proteins, is abnormally eliminated via the urine during early stages of diabetic nephropathy. Moreover, endothelial dysfunction (ED) accompanying early diabetic nephropathy may develop even before microalbuminuria is detectable. Transferrin has a molecular weight comparable to albumin, and transferrinuria and microalbuminuria in a 24-hour urine sample may comparably reflect early diabetic nephropathy. However, transferrin physiochemical properties may be related with ED, but these have not been elucidated yet. This case-control study was aimed to evaluate relation between ED and urinary transferrin concentration before early diabetic nephropathy is present. Methods Patients were enrolled from two study sites in Mexico City: Ticoman General Hospital to evaluate control patients; and Dr. Manuel Gonzalez Rivera Specialized Clinic for the Management of the Diabetic Patient for case patients. All patients provided written informed consent. The primary endpoint was the correlation between urinary transferrin concentration and endothelial dysfunction measured in type 2 diabetic patients without albuminuria. ED was evaluated by ultrasonographic validated measurements, which included carotid intima-media thickness (CIMT) and flow mediated dilation (FMD). A power calculation, to detect a statistical difference, with a p value of 0.05, mandated a sample of 60 patients. The patients were tested for serum biomarkers such as glycated hemoglobin, creatinine, cholesterol, triglycerides, and urinary dipstick for albuminuria and urinary tract infection; using inclusion, exclusion and elimination criteria as described. Results The group with type 2 diabetes was older and showed higher serum transferrin and lower urinary transferrin values. Likewise, the group with type 2 diabetes showed subclinical atherogenic risk characterized by lower FMD and higher CIMT and ABI values. Risk factors associated to endothelial dysfunction measured by CIMT were time from diagnosis of diabetes, insulin resistance, dyslipidemia, and male sex. Hba1c and time since diabetes diagnosis correlated both for risk associated to FMD and CIMT. CIMT was the only factor correlated with urinary transferrin values. Conclusion Urinary transferrin correlated to subclinical endothelial dysfunction measured by CIMT in type 2 diabetic patients without nephropathy and can be used to test for early nephropathy in patients without albuminuria.

scholarly journals Urine Transferrin as an Early Endothelial Dysfunction Marker in Type 2 Diabetic Patients Without Nephropathy: A Case Control Study.

2021 ◽  
Author(s):  
José Juan Sánchez-Hidalgo ◽  
Juan Antonio SUÁREZ-CUENCA ◽  
José Juan Lozano-Nuevo ◽  
Vìctor Hugo García-López ◽  
María Graciela Leal-Gutierrez ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Endothelial Dysfunction ◽  
Case Control Study ◽  
Case Control ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Early Diabetic Nephropathy ◽  
Type 2 Diabetic ◽  
Control Study

Abstract Background Albumin, along with other proteins, is abnormally eliminated via the urine during early stages of diabetic nephropathy. Moreover, endothelial dysfunction (ED) accompanying early diabetic nephropathy may develop even before microalbuminuria is detectable. Transferrin has a molecular weight comparable to albumin, and transferrinuria and microalbuminuria in a 24-hour urine sample may comparably reflect early diabetic nephropathy. However, transferrin physiochemical properties may be related with ED, but these have not been elucidated yet. This case-control study was aimed to evaluate relation between ED and urinary transferrin concentration before early diabetic nephropathy is present. Methods Patients were enrolled from two study sites in Mexico City: Ticoman General Hospital to evaluate control patients; and Dr. Manuel Gonzalez Rivera Specialized Clinic for the Management of the Diabetic Patient for case patients. All patients provided written informed consent. The primary endpoint was the correlation between urinary transferrin concentration and endothelial dysfunction measured in type 2 diabetic patients without albuminuria. ED was evaluated by ultrasonographic validated measurements, which included carotid intima-media thickness (CIMT) and flow mediated dilation (FMD). A power calculation, to detect a statistical difference, with a p value of 0.05, mandated a sample of 60 patients. The patients were tested for serum biomarkers such as glycated hemoglobin, creatinine, cholesterol, triglycerides, and urinary dipstick for albuminuria and urinary tract infection; using inclusion, exclusion and elimination criteria as described. Results The group with type 2 diabetes was older and showed higher serum transferrin and lower urinary transferrin values. Likewise, the group with type 2 diabetes showed subclinical atherogenic risk characterized by lower FMD and higher CIMT and ABI values. Risk factors associated to endothelial dysfunction measured by CIMT were time from diagnosis of diabetes, insulin resistance, dyslipidemia, and male sex. Hba1c and time since diabetes diagnosis correlated both for risk associated to FMD and CIMT. CIMT was the only factor correlated with urinary transferrin values. Conclusion Urinary transferrin correlated to subclinical endothelial dysfunction measured by CIMT in type 2 diabetic patients without nephropathy and can be used to test for early nephropathy in patients without albuminuria.

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