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Banerjee A, Lnu J, Lnu P, Bansal A. Lipoprotein Ratios: Correlation With Glycated Hemoglobin (HbA1c) Among Thyroid Disorders' Patients. Cureus 2024; 16:e54191. [PMID: 38496179 PMCID: PMC10942125 DOI: 10.7759/cureus.54191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION Thyroid disorders and diabetes mellitus are prevalent conditions in the modern era. Moreover, glycated hemoglobin (HbA1c) is the established (prognostic as well as diagnostic) marker for long-term glycemic control, whereas the lipid profile is the marker for cardiovascular risks. The association of hypothyroidism with dyslipidemia is also a well-established fact. The current study explores a correlation between thyroid profile, glycemic status, and various lipoprotein indices. OBJECTIVE To look for an association between thyroid profile, glycemic status, and various lipoprotein indices. METHODOLOGY The cross-sectional study conducted at AIIMS Gorakhpur included a total of 108 subjects, with 37 normal subjects (Group I) and 71 patients) with T2DM (Type-2 diabetes mellitus) (Group II). Baseline characteristics of the two groups were compared for age, sex, presence of hypertension, fasting blood glucose, and body mass index (BMI). Blood samples were collected from the patients. The sera were analyzed for HbA1c and lipid profile, which included total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Serum samples were also used to estimate the thyroid stimulating hormone (TSH) and triiodothyronine (fT3). The association between thyroid profile, glycemic status, and various lipoprotein indices was calculated. STATISTICAL ANALYSIS Kolmogorov-Smirnov test for normality of the data. Spearmann correlation was used for nonparametric data. RESULTS There were significantly higher levels of total cholesterol, triglycerides, and LDL-C levels in T2DM subjects than in non-diabetic subjects. There was also a significant positive correlation observed between TSH and TC among the normal control group (ρ =0.348, P=0.04). Similarly, significant positive correlations were found for TG (ρ =0.354, P=0.04) and LDL-C (ρ =0.431, P=0.03) among non-diabetic subjects. Among patients with T2DM, TSH was significantly correlated positively with TG (ρ =0.530, P=0.006) and LDL-C (ρ =0.443, P=0.03). Similarly, in the same group, among lipid ratios, TG/HDL-C (ρ =0.311, P=0.04) and LDL-C/HDL-C (ρ =0.227, P=0.05) were significantly correlated to TSH. Furthermore, there were significant positive correlations between TSH and HbA1c (ρ =0.301, P=0.04). fT3 was found to have a strong negative correlation with HbA1c among patients with T2DM (ρ =-0.454, P=0.02). CONCLUSION Thyroid disorders exert significant effects on glycemic control and lipid metabolism, which may impact HbA1c levels and lipid profile parameters.
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Affiliation(s)
- Ayan Banerjee
- Biochemistry, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Jagriti Lnu
- Biochemistry, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Prabhat Lnu
- Biochemistry, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Akash Bansal
- Biochemistry, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
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Bakthavatchalam R, Bakthavatchalam S, Chandran I, Gaur A, Natarajaboopathy R, Geetha J, Reddy KS, Sindhura G, Varatharajan S. Association of Vitamin D with Risk Factors for Coronary Artery Disease. MAEDICA 2023; 18:563-570. [PMID: 38348080 PMCID: PMC10859193 DOI: 10.26574/maedica.2023.18.4.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Introduction:Vitamin D safeguards cardiovascular health by reducing inflammation and susceptibility to atheroma. This study aimed to evaluate the association of coronary artery disease (CAD) and its risk factors like body mass index (BMI), glycated hemoglobin (HbA1c), and lipid profile with vitamin D. Methods:Patients of both genders aged over 18 years, who underwent coronary angiogram for cardiac symptoms such as chest pain, breathlessness, palpitation, or syncope, were enrolled in the present study. Demographic and anthropometric data were collected. Glycated hemoglobin, lipid profile and 25-hydroxyvitamin D were measured. The severity of CAD was analyzed along with the SYNTAX scoring. Results:The study population was divided into three groups based on vitamin D levels: Group I (vitamin D level <20 ng/mL), Group II (20-30 ng/mL) and Group III (>30 ng/mL). There was a significantly higher number of patients with diabetes mellitus and triple vessel disease in Group I. On multivariable suplogistic regression, vitamin D had a significant odds ratio (OR) of 1.21 (1.03-1.43) for single vessel disease and 0.92 (1.13-1.43) for triple vessel disease. SYNTAX score had a significant OR of 0.697 (0.557-0.873) for single vessel disease and 1.27 (1.13-1.43) for triple vessel disease. There was a significant negative correlation between HbA1c and vitamin D (r =-0.269, p= 0.008). Vitamin D levels negatively correlated with triple vessel disease (r =-0.252, p= 0.013). Conclusions:Incidence of diabetes mellitus and levels of HbA1c were both higher among patients with vitamin D deficiency. Vitamin D deficiency was a risk factor for single and triple vessel disease.
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Affiliation(s)
| | - Sriram Bakthavatchalam
- Department of Orthopedics, Vellore Medical College and Hospital, Vellore, Tamilnadu, India
| | - Indhu Chandran
- Department of Ophthalmology, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, Tamilnadu, India
| | - Archana Gaur
- Department of Physiology, All India Institute of Medical Sciences Bibinagar, Hyderabad, Telangana, India
| | | | - Jeganathan Geetha
- Department of General Medicine, KarpagaVinayaga Institute of Medical Sciences and Research Center, Maduranthgam, Tamilnadu, India
| | - Kotha Sugunakar Reddy
- Department of General Medicine, All India Institute of Medical Sciences Bibinagar, Hyderabad, Telangana, India
| | - Gajula Sindhura
- Department of General Medicine, All India Institute of Medical Sciences Bibinagar, Hyderabad, Telangana, India
| | - Sakthivadivel Varatharajan
- Department of General Medicine, All India Institute of Medical Sciences Bibinagar, Hyderabad, Telangana, India
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Liu F, Chen Q, Cao B, Du M, Cui Y, Huang A, Li Y, Wei H. Status and related factors of anxiety of primary caregivers of children with type 1 diabetes: a prospective study. Endocr J 2023; 70:875-882. [PMID: 37357391 DOI: 10.1507/endocrj.ej22-0640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Primary caregivers of children with type 1 diabetes mellitus (T1DM) are prone to negative emotions. This study explored the anxiety status of the caregivers and analyzed the related factors. In this prospective study, 245 primary caregivers of T1DM children who were reexamined in the outpatient clinic of Children's Hospital affiliated to Zhengzhou University between April 2020 and Sep 2022 were surveyed with a questionnaire and the Hamilton Anxiety Rating Scale (HAMA). The detection rate of anxiety symptoms in T1DM primary caregivers was 21.2%, with a total score of HAMA score of 11.74 ± 2.50. There were significant differences between the anxiety and non-anxiety groups in treatment method, HbA1C to standard (≤7.0%), severe hypoglycemia in the last 1 year and the number of adolescent cases (χ2 = 15.798, p = 0.000; χ2 = 4.197, p = 0.040; χ2 = 5.291, p = 0.021; χ2 = 14.279, p = 0.000). Multivariable logistic regression analysis showed that insulin pump treatment, HbA1C to standard (≤7.0%) and adolescence were associated with anxiety in primary caregivers (OR = 4.040, 95%CI 1.969-8.289, p = 0.000; OR = 0.472, 95%CI 0.237-0.955, p = 0.037; OR = 2.952, 95%CI 1.495-5.831, p = 0.002). Pediatric endocrine care should pay more attention to the anxiety of the caregivers of adolescent T1DM children treated with insulin pumps while helping the children manage their disease.
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Affiliation(s)
- Fang Liu
- Department of Endocrinology and Inherited Metabolic, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Zhengzhou, Henan 450018, China
| | - Qiong Chen
- Department of Endocrinology and Inherited Metabolic, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Zhengzhou, Henan 450018, China
| | - Bingyan Cao
- Department of Endocrinology, Genetics, and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Mengmeng Du
- Department of Endocrinology and Inherited Metabolic, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Zhengzhou, Henan 450018, China
| | - Yan Cui
- Department of Endocrinology and Inherited Metabolic, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Zhengzhou, Henan 450018, China
| | - Ai Huang
- Department of Endocrinology and Inherited Metabolic, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Zhengzhou, Henan 450018, China
| | - Yangshiyu Li
- Department of Endocrinology and Inherited Metabolic, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Zhengzhou, Henan 450018, China
| | - Haiyan Wei
- Department of Endocrinology and Inherited Metabolic, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Henan Provincial Key Laboratory of Children's Genetics and Metabolic Diseases, Zhengzhou, Henan 450018, China
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Yazdani AN, Pletsch M, Chorbajian A, Zitser D, Rai V, Agrawal DK. Biomarkers to monitor the prognosis, disease severity, and treatment efficacy in coronary artery disease. Expert Rev Cardiovasc Ther 2023; 21:675-692. [PMID: 37772751 PMCID: PMC10615890 DOI: 10.1080/14779072.2023.2264779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/26/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION Coronary Artery Disease (CAD) is a prevalent condition characterized by the presence of atherosclerotic plaques in the coronary arteries of the heart. The global burden of CAD has increased significantly over the years, resulting in millions of deaths annually and making it the leading health-care expenditure and cause of mortality in developed countries. The lack of cost-effective strategies for monitoring the prognosis of CAD warrants a pressing need for accurate and efficient markers to assess disease severity and progression for both reducing health-care costs and improving patient outcomes. AREA COVERED To effectively monitor CAD, prognostic biomarkers and imaging techniques play a vital role in risk-stratified patients during acute treatment and over time. However, with over 1,000 potential markers of interest, it is crucial to identify the key markers with substantial utility in monitoring CAD progression and evaluating therapeutic interventions. This review focuses on identifying and highlighting the most relevant markers for monitoring CAD prognosis and disease severity. We searched for relevant literature using PubMed and Google Scholar. EXPERT OPINION By utilizing the markers discussed, health-care providers can improve patient care, optimize treatment plans, and ultimately reduce health-care costs associated with CAD management.
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Affiliation(s)
- Armand N. Yazdani
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - Michaela Pletsch
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - Abraham Chorbajian
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - David Zitser
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - Vikrant Rai
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
| | - Devendra K. Agrawal
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA 91766
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Li RY, Yu JW, Chen XH, Han QQ, Ge H, Li C, Ju S, Zhao DL. Association of pre-diabetes and type 2 diabetes mellitus with intracranial plaque characteristics in patients with acute ischemic stroke. Br J Radiol 2023; 96:20220802. [PMID: 36350061 PMCID: PMC9975357 DOI: 10.1259/bjr.20220802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/17/2022] [Accepted: 10/28/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the association of pre-diabetes(i.e., the early stages of glucometabolic disturbance) and Type 2 diabetes mellitus (T2DM) with intracranial plaque characteristics in patients with acute ischemic stroke using three-dimensional high-resolution MR imaging. METHODS One hundred and forty-three symptomatic patients with acute ischemic stroke attribute to intracranial atherosclerotic plaque were prospectively enrolled. All participants were further divided into three groups: normal glucose metabolism(non-diabetes) group(n = 41), pre-diabetes group(n = 45), and T2DM group(n = 57) according to glucometabolic status. Culprit plaque characteristics (such as plaque burden, normalized wall index and enhancement ratio), total plaque number, and global plaque enhancement score were analyzed and compared among the three glucometabolic groups. The association between pre-diabetes and T2DM with intracranial plaque characteristics was assessed by logistic regression and multivariate linear regression. RESULTS Plaque number was higher in patients with pre-diabetes and T2DM compared with those with non-diabetes(3.71 ± 1.83 and 3.75 ± 1.71 vs 2.24 ± 1.46, p = 0.006). Multivariate logistic regression showed a significant association of multiple intracranial plaques with pre-diabetes(OR 3.524, 95% CI 1.082 ~ 11.479, p = 0.037), T2DM(OR 3.760, 95% CI 1.098 ~ 12.872, p = 0.035) and luminal stenotic rate. Both pre-diabetes and T2DM were significantly associated with culprit plaque enhancement ratio(β = 0.527 and β = 0.536; respectively; p < 0.001) and global plaque enhancement score(β = 0.264 and β = 0.373; respectively; p < 0.05). CONCLUSIONS Patients with pre-diabetes and T2DM had similar intracranial atherosclerotic plaque vulnerability, as demonstrated by multiple plaques, increased culprit plaque enhancement ratio and global plaque enhancement score. ADVANCES IN KNOWLEDGE Pre-diabetes might be a risk factor for intracranial plaque vulnerability. It is necessary to monitor a slight increase in blood glucose in non-diabetes patients with acute ischemic stroke.
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Affiliation(s)
- Rui-Ying Li
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, China
| | - Jia-Wei Yu
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, China
| | - Xiao-Hui Chen
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, China
| | | | - Hong Ge
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, China
| | - Cheng Li
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, China
| | - Shenghong Ju
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, China
| | - Deng-Ling Zhao
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, China
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The Level of HbA1c Evaluates the Extent of Coronary Atherosclerosis Lesions and the Prognosis in Diabetes with Acute Coronary Syndrome. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7796809. [PMID: 35912151 PMCID: PMC9337927 DOI: 10.1155/2022/7796809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/04/2022] [Accepted: 03/12/2022] [Indexed: 11/17/2022]
Abstract
Background The level of HbA1c can reflect the average level of blood glucose over 3 months, which is the gold standard indicator for monitoring blood glucose. The relationship between the level of HbA1c and the extent of coronary atherosclerosis lesions or the prognosis in diabetes with acute coronary syndrome (ACS) remains poorly understood. Aims To explore whether the level of HbA1c can evaluate the extent of coronary atherosclerosis lesions or the prognosis in diabetes with acute coronary syndrome (ACS) using the SYNTAX score, the Global Registry of Acute Coronary Events (GRACE) score, left ventricular function (LVEF), left ventricular end-diastolic volume (LVEDV), and major adverse cardiac events (MACEs) in the hospital and 12 months after discharge. Methods This study was a prospective, randomized, open-label, and parallel group study. Patients with diabetes with ACS were recruited into this study indiscriminately, and all the participants were divided into two groups according to the level of HbA1c: HbA1c level ≤ 7%group and HbA1c level > 7%group. The followings were used as the evaluation indicators: SYNTAX score, GRACE score, LVEF, LVEDV, and MACEs in hospital and 12 months after discharge. Results A total of 233 patients with diabetes and ACS were enrolled and assigned to two groups according to their level of HbA1c: the HbA1c ≤ 7%group (n = 92) and the HbA1c > 7%group (n = 141). The results showed that the proportion of STEMI was higher in the HbA1c ≤7% group (p < 0.05), while the proportion of NSTEMI has not significantly higher in the HbA1c >7% group (p > 0.05). Regression analysis indicated that HbA1c level was significantly positively correlated with GRACE score (r = 0.156, F = 5.784, p = 0.017, n = 233) and SYNTAX score (r = 0.237, F = 13.788, p < 0.001, n = 233), and there were no statistically significant differences in LVEDV and LVEF between the two groups (p > 0.05). The total MACEs rate showed no significant difference between the two groups during hospitalization (p > 0.05) but showed significant differences at 12 months after discharge (p < 0.05). Conclusions This study shows that HbA1c level was positively correlated with the extent of coronary atherosclerosis lesions and the prognosis in diabetes with ACS. The higher the HbA1c level is, the more severe the coronary atherosclerotic lesion and the worse the prognosis in diabetes with ACS are.
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Atherogenic index of plasma predicts coronary artery disease severity and major adverse cardiac events in absence of conventional risk factors. Coron Artery Dis 2022; 33:523-530. [PMID: 35811555 DOI: 10.1097/mca.0000000000001166] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Various overlapping risk factors lead to coronary artery disease (CAD). The atherogenic index of plasma (AIP) is a marker for CAD severity and progression. However, little is known about its contribution to the residual risk of CAD observed in the absence of all typical risk factors. METHODS A prospective cohort study of 366 Indian patients undergoing coronary computed tomography (CT) angiography and diagnosed with stable CAD. Diabetes, hypertension, hypercholesterolemia, smoking, previous CAD, alcohol or lipid-lowering medication intake, renal, liver or thyroid dysfunction were exclusion criteria. Coronary stenosis was graded using the CAD-reporting and data system (CAD-RADS™) system. Lipid profile, HbA1c, uric acid, highly sensitive C-reactive protein (hsCRP) and anthropometric measurements were taken. AIP, triglyceride/high-density lipoprotein cholesterol (HDLc) and total cholesterol (Tc)/HDLc ratios were calculated. Independent predictors of CAD severity and the occurrence of major adverse cardiac events (MACE) during 2.57 (0.52) years of follow-up were identified using logistic regression and Cox proportional hazards regression. RESULTS Sixty patients experienced a MACE during a cumulative 887.03 person-years. HbA1c, uric acid, hsCRP, Tc/HDLc and AIP were independent predictors of severe coronary lesions (CAD-RADS 4,5) on multivariate analysis with odds ratio 4.52 (2.37-8.61), 1.41 (1.08-1.84), 1.33 (1.09-1.62), 1.76 (1.27-2.44) and 1.29 (1.11-1.50), respectively. Only AIP and Tc/HDLc were independent predictors of MACE with hazard ratios of 1.41 (1.20-1.65) and 1.78 (1.33-2.39) besides patient age and CAD severity. CONCLUSION AIP is associated with both the severity of CAD and the occurrence of MACE within 3 years. It could serve as an effective marker of residual risk of CAD in patients devoid of traditional risk factors. Lipid-profile ratios, such as AIP are cost-effective and accessible parameters suitable for low and middle-income settings.
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Cheng X, Li Z, Yang M, Liu Y, Wang S, Huang M, Gao S, Yang R, Li L, Yu C. Association of HbA1c with carotid artery plaques in patients with coronary heart disease: a retrospective clinical study. Acta Cardiol 2022; 78:442-450. [PMID: 35356852 DOI: 10.1080/00015385.2022.2040822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Haemoglobin A1c (HbA1c) levels have been shown to be related to carotid artery plaques. However, studies on the relationship between HbA1c levels and carotid artery plaques in patients with coronary heart disease (CHD) are limited and inconsistent. Our objective was to examine the correlation between HbA1c levels and carotid artery plaques in patients with CHD. METHODS The study comprised 9275 Chinese adults with CHD from January 1, 2014, to September 30, 2020. HbA1c levels were assessed, and colour Doppler ultrasound was used to evaluate the carotid artery, including plaque presence, intima-media thickness, and plaque echo properties, to investigate the association between HbA1c and carotid plaque. A logistic regression model was used to assess the association between carotid artery plaques, carotid plaque echogenicity, and HbA1c. RESULTS The HbA1c level of the plaque-present group was higher than that of the plaque-absent group [6.1 (5.6-7.2) vs. 5.8 (5.5-6.5), p < 0.001]. In multiple linear regression analysis, intima-media thickness was associated with HbA1c (p < 0.001). Logistic regression showed that a higher HbA1c level was associated with plaque incidence as well as hyperechoic and heterogeneous plaques (p < 0.001). These associations persist after adjusting for age, sex, blood pressure, lipid profiles, alcohol consumption, and tobacco exposure. CONCLUSION HbA1c levels are notably associated with carotid artery plaque incidence, intima-media thickness, and plaque echogenicity in patients with CHD. These findings show that different levels of HbA1c may be an indicator for carotid artery plaques and thus, should be observed in patients with CHD.
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Affiliation(s)
- Xufeng Cheng
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhu Li
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mingjie Yang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yijia Liu
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shuo Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mengnan Huang
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shan Gao
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Rongrong Yang
- School of Health Science and Engineering, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lin Li
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chunquan Yu
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Liu C, Zhao Q, Ma X, Cheng Y, Sun Y, Zhang D, Liu X, Zhou Y. Prognostic implication of serum glycated albumin for patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. Cardiovasc Diabetol 2022; 21:11. [PMID: 35045846 PMCID: PMC8772172 DOI: 10.1186/s12933-022-01446-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 12/28/2021] [Indexed: 02/06/2023] Open
Abstract
Background It has been demonstrated that glycated albumin (GA) is significantly associated with diabetes complications and mortality. However, among patients diagnosed with non-ST-elevation acute coronary syndrome (NSTE-ACS) administered percutaneous coronary intervention (PCI), the predictive value of GA for poor prognosis is unclear. Methods This study eventually included 2247 NSTE-ACS patients in Beijing Anzhen Hospital, Capital Medical University in January-December 2015 who received PCI. All patients were followed up until death or for 48 months post-discharge. The primary endpoint was major adverse cardio-cerebral events (MACCEs), including all-cause death, non-fatal myocardial infarction, ischemia-induced revascularization and non-fatal ischemic stroke. Results In total, 547 (24.3%) MACCEs were recorded during the follow-up period. Upon adjusting for potential confounders, GA remained an important risk predictor of MACCEs (As nominal variate: hazard ratio [HR] 1.527, 95% confidence interval [CI] 1.236–1.886, P < 0.001; As continuous variate: HR 1.053, 95% CI 1.027–1.079, P < 0.001). GA addition significantly enhanced the predictive ability of the traditional risk model (Harrell’s C-index, GA vs. Baseline model, 0.694 vs. 0.684, comparison P = 0.002; continuous net reclassification improvement (continuous-NRI) 0.085, P = 0.053; integrated discrimination improvement (IDI) 0.007, P = 0.020). Conclusion GA is highly correlated with poor prognosis in NSTE-ACS patients undergoing PCI, suggesting that it may be a major predictive factor of adverse events among these individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01446-3.
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Kayali Y, Ozder A. Glycosylated hemoglobin A1c predicts coronary artery disease in non-diabetic patients. J Clin Lab Anal 2020; 35:e23612. [PMID: 33034919 PMCID: PMC7891500 DOI: 10.1002/jcla.23612] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/13/2020] [Accepted: 09/16/2020] [Indexed: 12/21/2022] Open
Abstract
Background In primary care, there is a need for simple and cost‐effective tool that will allow the determination of the risk of coronary artery disease (CAD). We aimed to research the value of glycosylated hemoglobin (HbA1c) in the prediction of coronary artery disease. Methods Patients admitted to the outpatient clinic of the Cardiology for angiography were retrospectively screened. Patients with diabetes or with HbA1c of 6.5 or above were excluded. Comparative HbA1c data were obtained according to the stenosis groups. Logistic regression analysis was used to investigate the risk factors affecting stenosis positivity. Results Of the study group, 120 patients were without any stenosis in any coronary artery, 56 patients were with >50% stenosis in one coronary artery, and 71 patients were with >50% stenosis in more than one coronary artery. There was a statistically significant difference between HbA1c measurements according to the degree of stenosis (P = .001 and P < .01, respectively). The odd ratio for HbA1c was 6.260 (95% CI: 3,160‐12,401). According to the stenosis positivity, the cutoff point for HbA1c was found to be 5.6 and above. In the regression analysis, HbA1c was an independent risk factor for CAD. One unit increase in HbA1c level increases the risk of stenosis up to 12.4‐fold (95% CI: 5,990‐25,767). Conclusion The study showed HbA1c can be used as an independent marker in determining the probability and severity of coronary artery disease in non‐diabetic individuals and as a useful marker in primary care predicting CAD.
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Affiliation(s)
- Yildiz Kayali
- Medical Faculty, Department of Family Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Aclan Ozder
- Medical Faculty, Department of Family Medicine, Bezmialem Vakif University, Istanbul, Turkey
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