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Cao X, Pei X. Developing screening tools to estimate the risk of diabetic kidney disease in patients with type 2 diabetes mellitus. Technol Health Care 2024; 32:1807-1818. [PMID: 37980579 DOI: 10.3233/thc-230811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Diabetic kidney disease (DKD) is an important microvascular complication of diabetes mellitus (DM). OBJECTIVE This study aimed to develop predictive nomograms to estimate the risk of DKD in patients with type 2 diabetes mellitus (T2DM). METHODS The medical records of patients with T2DM in our hospital from March 2022 to March 2023 were retrospectively reviewed. The enrolled patients were randomly selected for training and validation sets in a 7:3 ratio. The models for predicting risk of DKD were virtualized by the nomograms using logistic regression analysis. RESULTS Among the enrolled 597 patients, 418 were assigned to the training set, while 179 were assigned to the validation set. Using the predictors included glycated hemoglobin A1c (HbA1c), high density lipoprotein cholesterol (HDL-C), presence of diabetic retinopathy (DR) and duration of diabetes (DD), we constructed a full model (model 1) for predicting DKD. And using the laboratory indexes of HbA1c, HDL-C, and cystatin C (Cys-C), we developed a laboratory-based model (model 2). The C-indexes were 0.897 for model 1 and 0.867 for model 2, respectively. The calibration curves demonstrated a good agreement between prediction and observation in the two models. The decision curve analysis (DCA) curves showed that the two models achieved a net benefit across all threshold probabilities. CONCLUSION We successfully constructed two prediction models to evaluate the risk of DKD in patients with T2DM. The two models exhibited good predictive performance and could be recommended for DKD screening and early detection.
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TG/HDL-C Ratio Is a Risk Factor Associated with CKD: Use in Assessing the Risk of Progression of CKD. PATHOPHYSIOLOGY 2022; 29:374-382. [PMID: 35893599 PMCID: PMC9326757 DOI: 10.3390/pathophysiology29030029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Dyslipidemia is highly prevalent in patients with chronic kidney disease (CKD), and the relationship between dyslipidemia and renal function in these patients remains controversial. Our objectives were to determine the triglycerides/HDL-cholesterol ratio (TG/HDL-C), evaluate the correlation between TG/HDL-C and the urine albumin/creatinine ratio (ACR), and estimate the glomerular filtration rate (eGFR) according to MDRD in CKD patients. Methods: A descriptive cross-sectional study was conducted on 152 patients with CKD at the Endocrine Clinic, the University of Medicine and Pharmacy Hospital, Ho Chi Minh City, Vietnam. Study subjects were medically examined and recorded information on the data collection form. Subjects were tested for total cholesterol, triglycerides, HDL-C, LDL-C, urea, creatinine and albumin, urine creatinine, and eGFR according to the MDRD formula. Data were analyzed using SPSS Statistics version 20.0. Results: The average age was 58.08 ± 15.69 years, and the overweight and obesity rate was 54%. Most patients had comorbidities, among which the most common diseases were hypertension and diabetes mellitus. Among the subjects, 57.3% were CKD stage 3 patients, and ACR was in the range of 30−300 mg/g. According to the classification of CKD using GFR and ACR categories, 40.8% of patients were at very high risk. The average TG/HDL-C ratio was 5.09 ± 4.26. There was a medium negative correlation between TG/HDL-C and eGFR (R = 0.44, p < 0.01) and a weak positive correlation between TG/HDL-C and ACR (R = 0.34, p < 0.01). Conclusions: The TG/HDL-C ratio was a risk factor associated with CKD and was noticeable in monitoring and assessing the risk of progression of CKD.
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Song K, Jeong J, Kim MK, Kwon H, Baek K, Ko S, Ahn Y. Discordance in risk factors for the progression of diabetic retinopathy and diabetic nephropathy in patients with type 2 diabetes mellitus. J Diabetes Investig 2019; 10:745-752. [PMID: 30300472 PMCID: PMC6497586 DOI: 10.1111/jdi.12953] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/09/2018] [Accepted: 10/02/2018] [Indexed: 11/30/2022] Open
Abstract
AIMS/INTRODUCTION We aimed to investigate whether there are differences in the risk factors or markers for the progression of diabetic retinopathy (DR) and diabetic nephropathy (DN) in type 2 diabetes mellitus. MATERIALS AND METHODS We carried out a 3-year retrospective cohort study of 604 patients with type 2 diabetes mellitus. The outcomes were the progression of DR (worsening of the DR stage) and DN (an estimated glomerular filtration rate decline >12%) at the 3-year follow up. The mean hemoglobin A1c (HbA1c) level and HbA1c variability (HbA1c-VAR) were calculated. RESULTS The mean HbA1c and HbA1c-VAR levels were higher in the DR progressors (n = 67) than in the DR non-progressors (n = 537). The mean HbA1c was a significant predictor for DR progression independent of the duration of diabetes and HbA1c-VAR levels. The urine albumin-to-creatinine ratio at baseline and HbA1c-VAR levels were higher in the DN progressors (n = 34) than in the DN non-progressors (n = 570). The triglyceride to high-density lipoprotein cholesterol ratio at baseline tended to be higher in the DN progressors than in the DN non-progressors. HbA1c-VAR levels and the triglyceride-to-high-density lipoprotein cholesterol ratio were significant predictors for DN progression independent of estimated glomerular filtration rate and the urine albumin-to-creatinine ratio. CONCLUSIONS Average glycemia was significantly associated with progression of DR, whereas glycemic variability and dyslipidemia were significantly associated with progression of DN in type 2 diabetes mellitus.
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Affiliation(s)
- Ki‐Ho Song
- Division of Endocrinology and MetabolismDepartment of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoulKorea
| | - Jee‐Sun Jeong
- Division of Endocrinology and MetabolismDepartment of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoulKorea
| | - Mee Kyoung Kim
- Division of Endocrinology and MetabolismDepartment of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoulKorea
| | - Hyuk‐Sang Kwon
- Division of Endocrinology and MetabolismDepartment of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoulKorea
| | - Ki‐Hyun Baek
- Division of Endocrinology and MetabolismDepartment of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoulKorea
| | - Seung‐Hyun Ko
- Division of Endocrinology and MetabolismDepartment of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoulKorea
| | - Yu‐Bae Ahn
- Division of Endocrinology and MetabolismDepartment of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoulKorea
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Braga D, Lemos LB, Silva CR, Andrade CEB, Reis JTR, Oliveira LL, Moreira RO. Avaliação dos níveis de albuminúria em adultos obesos e sua associação com marcadores de risco cardiovascular. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2018.v44.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: A obesidade é um dos fatores mais importantes para explicar o aumento incidência das Doenças Cardiovasculares (DCV). Dentre os múltiplos fatores de risco para estas doenças, a albuminúria é dos mais importantes. Objetivos: Avaliar os níveis de albuminúria e correlacionar com outros marcadores de risco cardiovascular em pacientes obesos que procuraram tratamento para obesidade. Materiais e métodos: Estudo transversal, retrospectivo, através dos prontuários de 183 pacientes de ambos os sexos, entre 18 e 65 anos, com índice de massa corpórea (IMC) ≥ 30 Kg/m². Todos os pacientes foram submetidos a exame físico e receberam um pedido de rotina laboratorial, incluindo de albuminúria em amostra isolada de urina. Resultados: Dados de albuminúria estavam disponíveis em 81 prontuários. Destes, 15 pacientes (18,5%) tinham valores acima de 17 mg/L de albuminúria. Nenhuma correlação foi encontrada entre os níveis de albuminúria e os parâmetros antropométricos (IMC, r=0,08; p=0,47; Cintura, r=0,17; p=0.11; Quadril, r=0,11; p=0,35; RCQ, r=0,03; p=0,75), Pressão Arterial (PA) sistólica (r=0,013; p=0,21) ou diastólica (r=0,11; p=0,32). Nenhuma diferença foi encontrada entre os pacientes que já usavam anti-hipertensivos ou não (p=0,25). Foi encontrada correlação entre os níveis de albuminúria e o high-density lipoprotein cholesterol (HDLc), (r=-0,27; p=0,012), além de uma tendência a significância com os níveis de Proteína C Reativa Ultrassensível (PCR-us; r=0,21; p= 0,081). Conclusão: Apesar da alta frequência (18,5%) de albuminúria em pacientes obesos, não foi encontrada correlação entre este marcador e os parâmetros antropométricos. Foi encontrado uma relação inversa da albuminúria com HDLc e uma tendência a significância com a PCR-us, sugerindo uma associação limitada entre a albuminúria e alguns marcadores específicos de risco cardiovascular.
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Relationship Between Uric Acid, Proteinuria, and Atherogenic Index of Plasma in Renal Transplant Patients. Transplant Proc 2018; 50:3376-3380. [PMID: 30503664 DOI: 10.1016/j.transproceed.2018.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/22/2018] [Accepted: 05/23/2018] [Indexed: 12/22/2022]
Abstract
This study aimed to determine the association of atherogenic index of plasma (AIP) with both hyperuricemia and proteinuria in renal transplant recipients. MATERIAL AND METHODS Between the years 2015 and 2017, 61 renal transplant recipients with at least 1 year of follow-up were included in this retrospective cohort study. Uric acid levels of ≥7 mg/dL in men and ≥6 mg/dL in women were accepted as hyperuricemia. The patients were separated into groups according to their serum uric acid and AIP levels. RESULTS The prevalence of patients with hyperuricemia was 37.7% (n = 23). The triglycerides (P = .009), AIP (P = .005), proteinuria (P = .04), and C-reactive protein (P = .049) were significantly higher in the hyperuricemic group compared with the nonhyperuricemic group. The levels of uric acid (P = .008) and proteinuria (P = .005) increased significantly with an elevation in AIP levels. Additionally, in multivariate linear regression analysis, uric acid (β = 0.325; P = .008) and estimated glomerular filtration rate (β = -0.291; P = .02) were found to be independently associated factors for proteinuria in renal transplant patients (R2 = 0.242; P < .001). CONCLUSION We indicated that uric acid, AIP, and proteinuria are closely related. Further prospective studies are needed to evaluate the causal relationship between uric acid, AIP, and proteinuria in this patient group.
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Choi JW, Oh IH, Lee CH, Park JS. Effect of synergistic interaction between abnormal adiposity-related metabolism and prediabetes on microalbuminuria in the general population. PLoS One 2017; 12:e0180924. [PMID: 28715448 PMCID: PMC5513435 DOI: 10.1371/journal.pone.0180924] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/23/2017] [Indexed: 12/27/2022] Open
Abstract
Central obesity and related metabolic components are important risks for microalbuminuria. To describe the effects of interactions between central obesity and related metabolic components on microalbuminuria, we conducted a nation-wide, population-based interaction analysis using cardio-metabolic index (CMI) as a candidate indicator of central obesity and related abnormal lipid metabolism. We recruited native Koreans aged 20 years or older with no medical illness. A total of 5398 participants were divided into quintiles according to CMI with sex as a covariate factor. Participants in the highest CMI quintile had elevated blood pressure (BP), increased glycemic exposure, poor lipid profile, and increased urine albumin-to-creatinine ratio compared to other lower quintiles. Multiple logistic regression models adjusted for age, sex, systolic BP, and diastolic BP showed that CMI had an independent association with increased glycemic exposure and increased urine albumin-to-creatinine ratio. Our interaction analysis revealed a significant interaction between the highest CMI quintile and prediabetes with an increased risk of microalbuminuria (adjusted RERI = 0.473, 95% CI = 0.464–0.482; adjusted AP = 0.276, 95% CI = 0.156–0.395; adjusted SI = 2.952, 95% CI = 1.234–4.670). Our findings suggest a significant association between central obesity-related abnormal lipid metabolism and prediabetes, and their interaction may exert a synergistic effect on renal vascular endothelial dysfunction even before the appearance of full-blown diabetes mellitus. To confirm these findings, large population-based prospective studies are needed.
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Affiliation(s)
- Jong Wook Choi
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Il Hwan Oh
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Chang Hwa Lee
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- * E-mail: (JSP); (CHL)
| | - Joon-Sung Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- * E-mail: (JSP); (CHL)
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Cho H, Kim JH. Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey. PLoS One 2017; 12:e0178716. [PMID: 28575100 PMCID: PMC5456094 DOI: 10.1371/journal.pone.0178716] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/17/2017] [Indexed: 12/18/2022] Open
Abstract
Background Microalbuminuria is a known early predictive factor for renal and cardiovascular diseases, not only for patients with diabetes mellitus or hypertension but also in the general population. However, the prevalence and risk factors associated with microalbuminuria in Korean youth are unknown. Objectives The aims of this study are to evaluate the prevalence of microalbuminuria and the association between microalbuminuria and obesity or cardiometabolic risk factors in Korean children and adolescents without diabetes. Methods This study examines data obtained from the Korea National Health and Nutrition Examination Survey (between 2011 and 2014). It includes a total of 1,976 participants aged between 10 and 19 years (boys 1,128 and girls 848). Microalbuminuria was defined as a urine albumin-to-creatinine ratio (UACR) of ≥ 30 mg/g and < 300 mg/g. Association between microalbuminuria and the risk factors for cardiometabolic diseases including insulin resistance was evaluated. Results The prevalence of microalbuminuria was found to be 3.0% in Korean children and adolescents over this time period. The mean UACR for non-obese youth was significantly greater than that found in obese youth (3.2 ± 0.1 mg/g in the non-obese group vs. 2.1 ± 0.2 mg/g in the obese group; P < 0.001). In multiple logistic regression analysis, microalbuminuria was associated with hyperglycemia (OR 2.62, 95% CI 1.09–6.30) and hemoglobin A1c (OR 3.34, 95% CI 1.09–10.17) in the non-obese group and hypertension (OR 14.10, 95% CI 1.12–177.98) and HbA1c (OR 6.68, 95% CI 1.87–23.95) in the obese group. Conclusions The prevalence of microalbuminuria is not prominent in obese children and adolescents. Our findings demonstrated that the presence of hypertension and hyperglycemia was associated with microalbuminuria. Especially Hemoglobin A1c was associated with microalbuminuria in youths regardless of weight status. Microalbuminuria in pediatric population can be a helpful marker for the risk of cardiovascular disease.
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Affiliation(s)
- Heeyeon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Hyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- * E-mail:
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Yun KJ, Kim HJ, Kim MK, Kwon HS, Baek KH, Roh YJ, Song KH. Risk Factors for the Development and Progression of Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Advanced Diabetic Retinopathy. Diabetes Metab J 2016; 40:473-481. [PMID: 27766790 PMCID: PMC5167712 DOI: 10.4093/dmj.2016.40.6.473] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 04/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some patients with type 2 diabetes mellitus (T2DM) do not develop diabetic kidney disease (DKD) despite the presence of advanced diabetic retinopathy (DR). We aimed to investigate the presence of DKD and its risk factors in patients with T2DM and advanced DR. METHODS We conducted a cross-sectional study in 317 patients with T2DM and advanced DR. The phenotypes of DKD were divided into three groups according to the urine albumin/creatinine ratio (uACR, mg/g) and estimated glomerular filtration rate (eGFR, mL/min/1.73 m²): no DKD (uACR <30 and eGFR ≥60), non-severe DKD (uACR ≥30 or eGFR <60), and severe DKD (uACR ≥30 and eGFR <60). Mean systolic and diastolic blood pressure, mean glycosylated hemoglobin (HbA1c) level, and HbA1c variability (standard deviation [SD] of serial HbA1c values or HbA1c-SD) were calculated for the preceding 2 years. RESULTS The prevalence of no DKD, non-severe DKD, and severe DKD was 37.2% (n=118), 37.0% (n=117), and 25.8% (n=82), respectively. HbA1c-SD and the triglyceride/high density lipoprotein cholesterol (TG/HDL-C) ratio correlated positively with uACR and negatively with eGFR. Multiple linear regression analyses showed that the HbA1c-SD and TG/HDL-C ratio were significantly related with eGFR. Multiple logistic regression analyses after adjusting for several risk factors showed that HbA1c-SD and the TG/HDL-C ratio were significant risk factors for severe DKD. CONCLUSION The prevalence of DKD was about 60% in patients with T2DM and advanced DR. HbA1c variability and TG/HDL-C ratio may affect the development and progression of DKD in these patients.
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Affiliation(s)
- Kyung Jin Yun
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hye Ji Kim
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Mee Kyoung Kim
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyuk Sang Kwon
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ki Hyun Baek
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Jung Roh
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ki Ho Song
- Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Lee SH, Kim DH, Kim YH, Roh YK, Ju SY, Nam HY, Nam GE, Choi JS, Lee JE, Sang JE, Han K, Park YG. Relationship Between Dyslipidemia and Albuminuria in Hypertensive Adults: A Nationwide Population-Based Study. Medicine (Baltimore) 2016; 95:e3224. [PMID: 27100412 PMCID: PMC4845816 DOI: 10.1097/md.0000000000003224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This study aimed to estimate the relationship between various lipid abnormalities and albuminuria in hypertensive Korean adults. Data obtained from the Korea National Health and Nutrition Examination Survey in 2011 to 2012 were analyzed. The study included 2330 hypertensive participants. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. Dyslipidemia parameters were defined as high TG ≥200 mg/dL, low HDL-C as HDL-C <40 mg/dL, high TC/HDL-C as TC/HDL-C ratio ≥4, high TG/HDL-C as TG/HDL-C ratio ≥3.8, and high LDL-C/HDL-C as LDL-C/HDL-C ratio ≥2.5. Albuminuria was defined as a urine albumin to creatinine ratio (ACR) ≥30 mg/g. Women with albuminuria showed significantly higher levels of TG, TC/HDL-C, and TG/HDL-C and a lower level of HDL-C than women without albuminuria (all P < 0.05). LogTG, TC/HDL-C, and logTG/HDL-C were positively correlated with ACR in both men and women; however, HDL-C was negatively correlated with ACR in women and non-HDL-C was positively correlated with ACR in men. In men, there was no association between ACR and lipid parameters. However, in women, higher values for logTG, TC/HDL-C, and logTG/HDL-C were associated with an increased odds ratio (OR) for albuminuria (OR [95% confidence interval]: 1.53 [1.06-2.21], 1.21 [1.02-1.45], and 1.78 [1.21-2.63], respectively) and HDL-C with a decreased OR for albuminuria (0.78 [0.67-0.92]) after adjusting for all covariates. LogTG, TC/HDL-C, and logTG/HDL-C were associated with an increased prevalence of albuminuria in hypertensive women. Screening and treatment for dyslipidemia may be necessary for hypertensive women to address potential albuminuria.
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Affiliation(s)
- Sung-Ho Lee
- From the Department of Family Medicine, Korea University, College of Medicine, Seoul (S-HL, DHK, Y-HK, H-YN, G-EN, J-SC, J-EL, J-ES); Department of Family Medicine, Hallym University, College of Medicine, Chunchon (YKR); Department of Family Medicine, Catholic University (SYJ); and Department of Biostatistics, The Catholic University of Korea, College of Medicine, Seoul (KDH, Y-GP), Republic of Korea
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Raj R, Bhatti JS, Badada SK, Ramteke PW. Genetic basis of dyslipidemia in disease precipitation of coronary artery disease (CAD) associated type 2 diabetes mellitus (T2DM). Diabetes Metab Res Rev 2015; 31:663-71. [PMID: 25470794 DOI: 10.1002/dmrr.2630] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 11/18/2014] [Indexed: 01/09/2023]
Abstract
Type 2 diabetes mellitus (T2DM) and its complications are linked to environmental, clinical, and genetic factors. This review analyses the disorders of lipids and their genetics with respect to coronary artery disease (CAD) associated with T2DM. Cell organelles, hepatitis C-virus infection, reactive oxygen species produced in mitochondria, and defective insulin signaling due to the arrest of G1 phase to S phase transition of β-cells have significant roles in the precipitation of the diseases. Adiponectin is anti-inflammatory and anti-atherosclerotic and improves insulin resistance. Low-density lipoprotein (LDL) is atherosclerotic, and LDL-cholesterol in T2DM is associated with high-cardiovascular risk. Further, LDL cholesterol reduction significantly reduces cardiovascular morbidity and mortality. High-density lipoprotein (HDL) is also anti-atherosclerotic due to HDL associated paraoxonase-1 serum enzyme, which prevents LDL oxidative modifications and the development of CAD. Moreover, elevated apolipoprotein B and apolipoprotein A-I (ApoB/ApoA-I) ratio in plasma is also a risk factor for CAD. LDL receptor, adiponectin, and endocannabinoid receptor-1 genes are independently associated with CAD and T2DM. Polymorphism of Apo E2 (epsilon2) is a positive factor to increase the T2DM risk and Apo E4 (epsilon4) is a negative factor to reduce the disease risk. Taq 1B polymorphism of cholesterol ester transfer protein (CETP) gene contributes to the development of atherosclerosis, whereas haplotypes of APOA5, APOC3, APOC4, and APOC5 genes are in the same cluster and are independently associated with high plasma triglyceride level, CAD and T2DM. In conclusion, because various genes, LDLR, CETP, APOA5, Apo E, Apo B, and Apo A-I, are associated with the precipitation of CAD associated with T2DM, a personalized diet-gene intervention therapy may be advocated to reduce the disease precipitation.
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Affiliation(s)
- Resal Raj
- Department of Computational Biology and Bioinformatics, Sam Higginbottom Institute of Agriculture, Technology and Sciences, Deemed to be University, Allahabad, India
| | - Jasvinder Singh Bhatti
- Department of Biotechnology & Bioinformatics, SGGS College, Sector 26, Chandigarh, India
| | | | - Pramod W Ramteke
- Department of Biological Sciences, Sam Higginbottom Institute of Agriculture, Technology and Sciences, Deemed to be University, Allahabad, India
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Upadhyay RK. Emerging risk biomarkers in cardiovascular diseases and disorders. J Lipids 2015; 2015:971453. [PMID: 25949827 PMCID: PMC4407625 DOI: 10.1155/2015/971453] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 12/16/2022] Open
Abstract
Present review article highlights various cardiovascular risk prediction biomarkers by incorporating both traditional risk factors to be used as diagnostic markers and recent technologically generated diagnostic and therapeutic markers. This paper explains traditional biomarkers such as lipid profile, glucose, and hormone level and physiological biomarkers based on measurement of levels of important biomolecules such as serum ferritin, triglyceride to HDLp (high density lipoproteins) ratio, lipophorin-cholesterol ratio, lipid-lipophorin ratio, LDL cholesterol level, HDLp and apolipoprotein levels, lipophorins and LTPs ratio, sphingolipids, Omega-3 Index, and ST2 level. In addition, immunohistochemical, oxidative stress, inflammatory, anatomical, imaging, genetic, and therapeutic biomarkers have been explained in detail with their investigational specifications. Many of these biomarkers, alone or in combination, can play important role in prediction of risks, its types, and status of morbidity. As emerging risks are found to be affiliated with minor and microlevel factors and its diagnosis at an earlier stage could find CVD, hence, there is an urgent need of new more authentic, appropriate, and reliable diagnostic and therapeutic markers to confirm disease well in time to start the clinical aid to the patients. Present review aims to discuss new emerging biomarkers that could facilitate more authentic and fast diagnosis of CVDs, HF (heart failures), and various lipid abnormalities and disorders in the future.
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Affiliation(s)
- Ravi Kant Upadhyay
- Department of Zoology, DDU Gorakhpur University, Gorakhpur 273009, India
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Nam GE, Han K, Kim DH, Park YG, Yoon YJ, Kim YE, Lee S, Lee S, Roh YK. Relationship between dyslipidemia and albuminuria in prediabetic adults: the Korea National Health and Nutrition Examination Survey 2011-2012. Endocrine 2015; 48:557-65. [PMID: 25205446 DOI: 10.1007/s12020-014-0411-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 08/27/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED This study aimed to estimate the relationship between various lipid abnormalities and albuminuria in Korean prediabetic adults. Data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) 2011-2012 were analyzed. The study consisted of 4,811 subjects in the normal glucose group and 3,872 in the prediabetic group. Prediabetes was defined by the fasting plasma glucose or hemoglobin A1c level. Albuminuria was defined as a urine albumin to creatinine ratio (UACR) ≥30 mg/g. Various parameters of dyslipidemia were assessed. No differences were observed in the prevalence of lipid abnormalities in prediabetic men with different values of UACR. Prediabetic women with increased urinary albumin excretion showed a significantly higher prevalence of lipid abnormalities. The proportion of mixed dyslipidemia was significantly higher in prediabetic women with albuminuria. Higher levels of total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and TC to HDL-C ratio, TG to HDL-C ratio, and LDL-C to HDL-C ratio were significantly associated with increased risk of albuminuria in prediabetic women. CONCLUSIONS Several lipid abnormalities were significantly associated with the increased risk of albuminuria in prediabetic women. Hence, screening for lipid abnormalities may be helpful for identification of risk for albuminuria in prediabetic subjects.
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Affiliation(s)
- Ga Eun Nam
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan-Si, Republic of Korea
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Huang GM, Huang KY, Lee TY, Weng J. An interpretable rule-based diagnostic classification of diabetic nephropathy among type 2 diabetes patients. BMC Bioinformatics 2015; 16 Suppl 1:S5. [PMID: 25707942 PMCID: PMC4331704 DOI: 10.1186/1471-2105-16-s1-s5] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background The prevalence of type 2 diabetes is increasing at an alarming rate. Various complications are associated with type 2 diabetes, with diabetic nephropathy being the leading cause of renal failure among diabetics. Often, when patients are diagnosed with diabetic nephropathy, their renal functions have already been significantly damaged. Therefore, a risk prediction tool may be beneficial for the implementation of early treatment and prevention. Results In the present study, we developed a decision tree-based model integrating genetic and clinical features in a gender-specific classification for the identification of diabetic nephropathy among type 2 diabetic patients. Clinical and genotyping data were obtained from a previous genetic association study involving 345 type 2 diabetic patients (185 with diabetic nephropathy and 160 without diabetic nephropathy). Using a five-fold cross-validation approach, the performance of using clinical or genetic features alone in various classifiers (decision tree, random forest, Naïve Bayes, and support vector machine) was compared with that of utilizing a combination of attributes. The inclusion of genetic features and the implementation of an additional gender-based rule yielded better classification results. Conclusions The current model supports the notion that genes and gender are contributing factors of diabetic nephropathy. Further refinement of the proposed approach has the potential to facilitate the early identification of diabetic nephropathy and the development of more efficient treatment in a clinical setting.
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Kurian GA, Manjusha V, Nair SS, Varghese T, Padikkala J. Short-term effect of G-400, polyherbal formulation in the management of hyperglycemia and hyperlipidemia conditions in patients with type 2 diabetes mellitus. Nutrition 2014; 30:1158-64. [DOI: 10.1016/j.nut.2014.02.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 01/20/2014] [Accepted: 02/15/2014] [Indexed: 01/23/2023]
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Tang L, Ye H, Hong Q, Wang L, Wang Q, Wang H, Xu L, Bu S, Zhang L, Cheng J, Liu P, Le Y, Ye M, Mai Y, Duan S. Elevated CpG island methylation of GCK gene predicts the risk of type 2 diabetes in Chinese males. Gene 2014; 547:329-33. [PMID: 24992032 DOI: 10.1016/j.gene.2014.06.062] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 06/06/2014] [Accepted: 06/27/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND The GCK gene encodes hexokinase 4, which catalyzes the first step in most glucose metabolism pathways. The purpose of our study is to assess the contribution of GCK methylation to type 2 diabetes (T2D). METHODS AND RESULTS GCK methylation was evaluated in 48 T2D cases and 48 age- and gender-matched controls using the bisulphite pyrosequencing technology. Among the four CpG sites in the methylation assay, CpG4 and the other three CpGs (CpG1-3) were not in high correlation (r<0.5). Significantly elevated methylation levels of GCK CpG4 methylation were observed in T2D patients than in the healthy controls (P=0.004). A breakdown analysis by gender indicated that the association between CpG4 methylation and T2D was specific to males (P=0.002). It is intriguing that another significant male-specific association was also found between GCK CpG4 methylation and total cholesterol (TC) concentration (r=0.304, P=0.036). CONCLUSION Our results showed that elevated GCK CpG4 methylation might suggest a risk of T2D in Chinese males. Gender disparity in GCK CpG4 methylation might provide a clue to elaborate the pathogenesis of T2D.
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Affiliation(s)
- Linlin Tang
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China; The Affiliated Hospital, School of Medicine, Ningbo University, Ningbo, Zhejiang 315000, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Huadan Ye
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Qingxiao Hong
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Lingyan Wang
- Bank of Blood Products, Ningbo No.2 Hospital, Ningbo, Zhejiang 315010, China
| | - Qinwen Wang
- The Affiliated Hospital, School of Medicine, Ningbo University, Ningbo, Zhejiang 315000, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Hongwei Wang
- Section of Endocrinology, Pritzker School of Medicine, The University of Chicago, Chicago, IL 60637, USA
| | - Leiting Xu
- The Affiliated Hospital, School of Medicine, Ningbo University, Ningbo, Zhejiang 315000, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Shizhong Bu
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Lina Zhang
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Jia Cheng
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Panpan Liu
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Yanping Le
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Meng Ye
- The Affiliated Hospital, School of Medicine, Ningbo University, Ningbo, Zhejiang 315000, China.
| | - Yifeng Mai
- The Affiliated Hospital, School of Medicine, Ningbo University, Ningbo, Zhejiang 315000, China.
| | - Shiwei Duan
- Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China; The Affiliated Hospital, School of Medicine, Ningbo University, Ningbo, Zhejiang 315000, China; Diabetes Center, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China.
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