Association of Microalbuminuria and Bevacizumab Therapy Outcomes in Diabetic Retinopathy Patients

Background: Diabetic retinopathy (DR) is a visual impairment-related eye disease developed by long-term hyperglycemic status. Diabetic condition in DR patients leads to diabetic organopathies (e.g., renal failure). Albuminuria, as a hallmark of renal failure, can be correlated with visual indicators in DR patients. Objectives: This study aimed to investigate the role of albuminuria status in visual acuity (VA) and bevacizumab therapy outcomes in DR patients. Methods: In this retrospective study, 48 DR patients were admitted to the Ophthalmology Center of Ayatollah Rouhani Hospital, affiliated with Babol University of Medical Sciences, Babol, Iran. The retinopathy status and VA were identified before and after treatment through 45 days of bevacizumab therapy. In addition, fast blood sugar, hemoglobin A1c, urine albumin, and urine creatinine were evaluated using standard laboratory methods. Results: The VA value before treatment in microalbuminuric DR patients (0.106 ± 0.036) was significantly lower than non-microalbuminuric DR patients (0.347 ± 0.286; P < 0.001). Furthermore, VA value after treatment in microalbuminuric DR patients (0.115 ± 0.071) was significantly lower than non-microalbuminuric DR patients (0.355 ± 0.272; P < 0.001). There was no significant difference in the percentage of VA increase between microalbuminuric and non-microalbuminuric patients. Moreover, the albumin-to-creatinine ratio (ACR) was correlated with a lower VA level before and after treatment (P < 0.001 for both). There was no correlation between the percentage of VA increase with ACR, albumin, and creatinine. Conclusions: The current study results showed that different VA before and after bevacizumab therapy status was correlated with microalbuminuria status. Additionally, microalbuminuria status did not affect the percentage of VA increase in the treatment of DR patients.

Association between vitamin D deficiency and prevalence of metabolic syndrome in female population: a systematic review

BackgroundThe increasing prevalence of metabolic syndrome (MS) especially in female population, has become a major problem in health care systems. In this regards, it is necessary to identify the risk factors. Vitamin D deficiency is now proposed as one of the possible risk factors for metabolic syndrome, we investigated the relationship between vitamin D status and MS in female.MethodsWe searched observational studies with keywords Vitamin D, metabolic syndrome, metabolic syndrome X, insulin-resistance syndrome, metabolic cardiovascular syndrome and Reaven Syndrome X and female in pubmed, scopus, science direct, cochrane, web of science, google scholar and SID databases, regardless of publication time. Two hundred ninety five studies were found, and finally only 12 articles were selected according to exclusion and inclusion criteria.ResultsIn nine studies that reported the prevalence of MS, the prevalence of MS among women with vitamin D deficiency was higher than female with normal vitamin D (34.5 vs. 30.2%). The prevalence of abdominal obesity, high blood pressure, high TG and HDL deficiency is higher in women with vitamin D deficiency. Also, the mean waist circumference, blood pressure, fast blood sugar (FBS), TG and BMI were higher. The most incident factor was high blood pressure (61.4 vs. 56.5%) and the lowest prevalence is associated with high FBS (32.2 vs. 33.5% in the other group).ConclusionThe prevalence of MS is significantly associated with vitamin D deficiency, and among related factors, HDL, TG and blood pressure are statistically associated with vitamin D status.

How Much Hypertension is Attributed to Overweight, Obesity, and Hyperglycemia Using Adjusted Population Attributable Risk in Adults?

Background. High blood pressure (HBP) is a proven risk factor for cardiovascular diseases. So, determining the extent of the contribution of the factors associated with HBP seems to be necessary. Accordingly, this study aimed to investigate how much the prevalence of HBP attributed to obesity and high blood glucose (HBG). Methods. Data were collected from 7612 participants extracted from a screening program in 2018, in Iran, which was conducted on the subjects with the age of 30 years old and older to investigate the prevalence of HBP and their associated risk factors. To collect data, we used a standard checklist in terms of the WHO STEPS manual, and a stratified multistage sampling method was also applied. The adjusted population attributable risk of overweight, obesity, and HBG for HBP was calculated by the logistic regression model using the aflogit module. Results. Among the studied people, 7.4% of male and 10.8% of female subjects were hypertensive. The adjusted analysis showed that, in men, 27% and 41% and, among women, 19% and 37% of HBP prevalence rates were attributable to obesity (BMI ≥ 30) and fast blood sugar (FBS) (≥126), respectively. In people with both obesity and HBG, 59% of the prevalence rate of HBP in men and 46% of the prevalence in women were due to the abovementioned risk factors altogether. The results show that, if obesity and HBG were eliminated, the prevalence of HBP could be theoretically decreased from 7.4% to 5.4% and 4.3% in male subjects and from 10.8% to 8.7% and 6.8% in female subjects, respectively. Conclusions. Our findings indicate that how much the prevalence of HBP attributes to obesity and HBG in middle-age and older population. It seems that the prevention programs should be administered in the general population, and excess body weight prevention programs should also be implemented in childhood.