Biochemical Investigation to Determine the Factors Involved in Renal Failure Formation for Dialysis Patients

Renal failure is on the top list of kidney diseases as being frequently reported in many medical facilities around the globe. Human kidneys play an important role in excreting, reabsorbing, secreting and filtrating substances in the body. Healthy kidney must excrete the waste products of the body in urine and preserve albumin, and other useful substances in the body. The current study aims to figure out the expected factors of renal failure formation in dialysis patients. Likewise, it is designed to search for any correlation between the imbalanced levels of electrolytes and kidney deterioration. The current study was conducted in Ramadi city-Iraq with the assistance of Al-Ramadi Educational Hospital (REH). The (14th) samples of renal failure patients were collected from dialysis unit at (REH). (2-3 mL) of blood was taken from a patient’s vein. The serum was separated from plasma with the use of a centrifuge. All samples were undergone centrifuging for (4-7 min) at (550 rpm). Afterward, samples were subjected to biochemical examinations to determine the levels and quantities of some biochemical elements and other substances in the selected cases. It was found that some patients had been recorded with a decrease in glomerular filtration rate (GFR), high HbA1c level (˃ 6.5 mg/dL) (21.5%), anemia (˂ 12.0 mg/dL) (%100) in women and (˂ 13.5 mg/dL) in men (%100), Uremia (˃ 45mg/dL) (%100), hypercalcemia (˃10.5 mg/dL) (%7.14), hyperkalemia (˃ 5.1 mg/dL) (%92.8), and Hypernatremia (˃145 mg/dL) (%28.5). Some results obtained, imbalanced levels of the mentioned substances, are either progressed with kidney deterioration, or they are the causes of renal failure. Changes in the levels of some blood substances were observed, and positive results were obtained regarding the aim of the study. Levels or quantities of some blood substances play an important role in preserving kidneys good performance. For instance, when the level of glucose in blood raises, a severe damage to the blood vessels of the kidney takes place and results in poor kidney's performance. While, an increment in the K serum level causes a sudden cardiac death. Changing in some levels and quantities of blood substances could be a core cause of renal failure formation, however, some of them develops when kidney deteriorates.

The Association Between Diabetes Mellitus and Risk of Sarcopenia: Accumulated Evidences From Observational Studies

AimWe performed a meta-analysis of observational studies to evaluate the association between the presence of sarcopenia and HbA1c, prediabetes, diabetes and diabetic complications.MethodThe PubMed, Embase, Cochrane and Web of Science databases were searched from inception to May 2021. We included full-text English language articles that reported the prevalence of sarcopenia in patients with and without diabetes. Quality assessment was performed according to the Newcastle- Ottawa scale for observational studies.ResultsSixteen studies were included in the meta-analysis. Three studies showed that high HbA1c levels lead to loss of muscle mass, and one study involving prediabetes showed that people with prediabetes had lower muscle mass, strength, and performance than non-diabetic population. Seven studies showed that people with diabetes had a higher risk of sarcopenia than those without diabetes (combined OR: 2.09, 95% CI:1.62-2.70). The remaining five studies suggested that diabetic complications increased the risk of sarcopenia (combined OR: 2.09,95% CI:1.62-2.70).ConclusionHigh HbA1c levels, prediabetes, diabetes and diabetes complications were associated with an increased risk of sarcopenia. Therapeutic strategies addressed to avoid the conversion of IGT to diabetes and to optimize glycemic control are warranted to prevent or arrest sarcopenia in the diabetic population

30-Year Cardiovascular Disease in Type 1 Diabetes: Risk and Risk Factors Differ by Long-Term Patterns of Glycemic Control

<b>Objective:</b> We hypothesized that there is heterogeneity in long-term patterns of glycemic control with respect to cardiovascular disease (CVD) development in type 1 diabetes and that risk factors for CVD differ by glycemic control pattern. Thus, we estimated associations between data-derived latent HbA1c trajectories and 30-year CVD risk in the Pittsburgh Epidemiology of Diabetes Complications (EDC) study of childhood-onset (<17 years old) type 1 diabetes.<b> </b> <p><b>Research Design and Methods: </b>Participants (n=536 with ≥2 HbA1c measurements [median 6] and CVD-free at baseline; mean age 27 and diabetes duration 18 years) were followed from 1986-88 to 2016-18 to ascertain CVD incidence (CVD death, myocardial infarction, stroke, coronary revascularization or blockage ≥50%, ischemic ECG, or angina). Latent HbA1c trajectories and their association with time-to-CVD incidence were simultaneously assessed using Joint Latent Class Mixed Models.</p> <p><b>Results:</b> Two HbA1c trajectories with respect to differential CVD risk were identified: Low (HbA1c ~8% [64 mmol/mol] and improving over follow-up, 76% of cohort) and High (HbA1c ~10% [86 mmol/mol] and stable, 24%). Overall, 30-year CVD incidence was 47.4% (n=253); MACE incidence 31.0% (n=176). High HbA1c was associated with 3-fold increased CVD risk versus Low HbA1c. Both groups had similar age and diabetes duration. Non-HDLc and estimated glomerular filtration rate were associated with CVD risk only in Low HbA1c; albumin excretion rate was associated with CVD risk only in High HbA1c.<b> </b></p> <p><b>Conclusions: </b>These risk factor differences suggest that pathways to CVD may differ by glycemic control, potentially resulting in important implications for prognosis in type 1 diabetes.</p>

Association between Self-Reported Chewing Status and Glycemic Control in Japanese Adults

This cross-sectional study investigated the relationship between self-reported chewing status and glycemic control in 30,938 Japanese adults who participated in health checkups. Chewing status was evaluated using a self-reported questionnaire. We defined high hemoglobin A1c (HbA1c) levels as a HbA1c level ≥6.5%; 692 (2.2%) respondents met this criterion. After adjusting for gender, age, smoking status, exercise habits, body mass index and eating speed, high HbA1c levels was found to be associated with male gender (odds ratio (OR), 1.568; 95% confidence interval (CI), 1.310 to 1.878; p < 0.001), older age (OR, 1.077; 95% CI, 1.068 to 1.087; p < 0.001), higher body mass index (OR, 1.246; 95% CI, 1.225 to 1.268; p < 0.001), current smoker status (OR, 1.566; 95% CI, 1.303 to 1.882; p < 0.001) and chewing difficulty (OR, 1.302; 95% CI, 1.065 to 1.591; p < 0.05). In conclusion, self-reported chewing difficulty was associated with high HbA1c levels in Japanese adults.

A Positive Association of Overactivated Immunity with Metabolic Syndrome Risk and Mitigation of Its Association by a Plant-Based Diet and Physical Activity in a Large Cohort Study

The association between immunity and metabolic syndrome (MetS) has been studied, but its interaction with lifestyles remains unclear. We studied their association and interactions with lifestyles in 40,768 adults aged over 40 years from a large-scale, hospital-based cohort study collected during 2010–2013. White blood cell counts (WBC) and serum C-reactive protein concentrations (CRP) were used as indexes of immune status. The participants were categorized into four groups by the cutoff points of 6.2 × 109/L WBC(L-WBC) and <0.5 mg/dL CRP(L-CRP): L-WBC+L-CRP(n = 25,604), H-WBC+L-CRP(n = 13,880), L-WBC+H-CRP(n = 464), and H-WBC+H-CRP(n = 820). The participants in the H-WBC+L-CRP were younger and had higher numbers of males than the L-WBC+L-CRP. MetS risk was higher by 1.75- and 1.86-fold in the H-WBC+L-CRP and H-WBC+H-CRP, respectively, than the L-WBC+L-CRP. MetS components, including plasma glucose and triglyceride concentrations, and SBP were elevated in H-WBC+L-CRP and H-WBC+H-CRP compared with L-WBC+L-CR+P. The risk of hyperglycemia and high HbA1c was the highest in the H-WBC+H-CRP among all groups. Areas of WBC counts and serum CRP concentrations were 0.637 and 0.672, respectively, in the receiver operating characteristic curve. Daily intake of energy, carbohydrate, protein, and fat was not significantly different in the groups based on WBC counts and CRP. However, a plant-based diet (PBD), physical activity, and non-smoking were related to lowering WBC counts and CRP, but a Western-style diet was linked to elevating CRP. A high PBD intake and smoking status interacted with immunity to influence MetS risk: a low PBD and current smoking were associated with a higher MetS risk in the H-WBC+H-CRP. In conclusion, overactivated immunity determined by CRP and WBC was associated with MetS risk. Behavior modification with PBD and physical activity might be related to immunity regulation.

Effect of Glycated Hemoglobin (HbA1c) and Duration of Disease on Lung Functions in Type 2 Diabetic Patients

Diabetes mellitus is a highly challenging global health care problem. This study aimed to assess the effect of glycated hemoglobin (HbA1c) and duration of diabetes on lung function in type 2 diabetic patients and assess whether duration or high HbA1c is more noxious to damage the lung functions. A total of 202 participants, 101 patients with type 2 diabetes mellitus (T2DM), and 101 age-, gender-, height-, and weight-matched controlled subjects were recruited. The HbA1c was measured through a clover analyzer, and lung function test parameters were recorded by spirometry. The results revealed a significant inverse correlation between HbA1c and Vital Capacity (VC) (r = −0.221, p = 0.026), Forced Vital Capacity (FVC) (r = −0.261, p = 0.008), Forced Expiratory Volume in First Second (FEV1) (r = −0.272, p = 0.006), Forced Expiratory Flow 25% (FEF-25%) (r = −0.196, p = 0.050), Forced Expiratory Flow 50% (FEF-50%) (r = −0.223, p = 0.025), and Forced Expiratory Flow 75% (FEF-75%) (r = −0.169, p = 0.016). Moreover, FEV1 (p = 0.029), FEV1/FVC% (p = 0.006), FEF-50% (p = 0.001), and FEF-75% (p = 0.003) were significantly lower in the diabetic group with duration of disease 5–10 and >10 years compared to the control group. The overall results concluded that high HbA1c or uncontrolled diabetes mellitus has a more damaging effect on lung function impairment compared to the duration of diabetes mellitus. Physicians must regularly monitor the HbA1c level while treating diabetic patients, as good glycemic control is essential to minimize the complications of DM, including lung function impairment in patients with T2DM.

Association of HbA1c levels with diabetic retinopathy

To study the association of HbA1C levels with diabetic retinopathy. A total of 330 diagnosed diabetic subjects of all age groups and genders participated in the study. They were grouped according to presence or absence of diabetic retinopathy. All patients HbA1C levels along with fasting blood glucose levels was obtained. Observations were made to find the association between HbA1C levels and diabetic retinopathy. Mean HbA1c level among diabetic retinopathy subjects (9.50) was higher than subjects without retinopathy (8.49). The difference was found to be statistically significant (p &#60; 0.05). With high HbA1c levels high mean fasting blood glucose levels were associated (R value: 0.5856). This is a moderate positive correlation. As glycosylated haemoglobin (HbA1c) levels increases prevalence of diabetic retinopathy also increases and there is a strong relationship between HbA1c levels and diabetic retinopathy.