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Kumari S, Kataria DK, Kumari S, Rani R, Ahuja N, Partab F, Raja S, Asif H, Sanam F, Ali M. Metabolic Syndrome Frequency in Type 2 Diabetics Using International Diabetes Federation (IDF) Criteria Analysis. Cureus 2024; 16:e59118. [PMID: 38803717 PMCID: PMC11128848 DOI: 10.7759/cureus.59118] [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: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Background The cluster of metabolic abnormalities known as metabolic syndrome has a significant association with the onset of type 2 diabetes mellitus (T2DM) and cardiovascular disease. The objective of this study was to evaluate the occurrence rate of metabolic syndrome among a group of patients diagnosed with T2DM, according to the standards set by the International Diabetes Federation (IDF). Methodology A descriptive cross-sectional study was conducted at Chandka Medical College, Larkana, Pakistan, from June 2019 to 2020. Using the IDF criteria for metabolic syndrome, 131 type 2 diabetics over age 30 were purposively sampled, excluding specific medical conditions and medications. Trained nurses recorded patient demographics, waist circumference, and blood pressure. Relevant laboratory tests were conducted, and metabolic syndrome prevalence was determined. Data were analyzed using IBM SPSS Statistics for Windows, Version 19, (Released 2010; IBM Corp., Armonk, New York, United States), considering both quantitative and qualitative variables. Results The research found that the occurrence of metabolic syndrome was 87.2%. It is worth mentioning that age did not have a considerable connection with metabolic syndrome incidence (p=0.873), as the overwhelming majority of participants in both groups were aged over 40 years. However, there was a clear link (p=0.001) between gender and the 'no metabolic syndrome' group, with more males in this category. Additionally, blood pressure was significantly linked to metabolic syndrome (p=0.001), with most individuals having normal blood pressure in the 'no metabolic syndrome' group. Although serum triglyceride levels were not significantly associated with metabolic syndrome (p=0.222), serum HDL cholesterol levels had a significant relationship (p<0.0001), where most people possessed HDL levels ≥40mg/dl in the 'no metabolic syndrome' category. Conclusion The findings of this investigation demonstrated a substantial occurrence of metabolic syndrome in patients with T2DM, wherein notable links were detected with gender, blood pressure, and HDL cholesterol levels. However, no significant correlation was observed with age or serum triglycerides. These results emphasize the necessity for an all-inclusive metabolic care approach for individuals with T2DM.
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Affiliation(s)
- Sheena Kumari
- Internal Medicine, Chandka Medical College, Larkana, PAK
| | - Disha K Kataria
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Sona Kumari
- Internal Medicine, People's University of Medical and Health Sciences for Women, Nawabshah, PAK
| | - Riya Rani
- Internal Medicine, People's University of Medical and Health Sciences for Women, Nawabshah, PAK
| | - Neha Ahuja
- General Medicine, Chandka Medical College, Larkana, PAK
| | - Fnu Partab
- Internal Medicine, Chandka Medical College, Larkana, PAK
| | - Sooraj Raja
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Hafsa Asif
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Fnu Sanam
- Internal Medicine, Chandka Medical College, Larkana, PAK
| | - Mohsin Ali
- Medicine, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, PAK
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Fajkić A, Jahić R, Begić E, Dervišević A, Kurtović A, Lepara O. Complete blood count inflammation derived indexes as predictors of metabolic syndrome in type 2 diabetes mellitus. Technol Health Care 2024:THC231101. [PMID: 38251075 DOI: 10.3233/thc-231101] [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: 01/23/2024]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a group of comorbidities related to regulating hyperglycemia and acute cardiovascular incidents and complications. With the increasing prevalence in individuals with type 2 diabetes mellitus (T2DM), MetS represents an increasing public health problem and clinical challenge, and early diagnosis is necessary to avoid the accelerated development of diabetic complications. OBJECTIVE To investigate the role of Complete Blood Count-derived Inflammation Indexes (CBCIIs) in predicting MetS in T2DM individuals. METHODS The study was designed as a two-year prospective study and included 80 T2DM individuals divided into MetS and non-MetS groups based on MetS development over two years. The sera samples were analyzed for complete blood count parameters and C-reactive protein (CRP). Based on the laboratory test results, 13 CBCIIs were calculated and analyzed. The receiver operating characteristic (ROC) curve and their corresponding areas under the curve (AUC) were used to determine prognostic accuracy. RESULTS There were significant differences between T2DM participants with Mets and those without MetS concerning Neutrophil to Platelet Ratio (NPR) values (p< 0.001), Neutrophil to Lymphocyte and Platelet Ratio (NLPR) (p< 0.001), Platelet to Lymphocyte Ratio (PLR) (p< 0.001), Lymphocyte to C-reactive protein Ratio (LCR) (p< 0.001), C-reactive protein to Lymphocyte Ratio (CRP/Ly) (p< 0.001), Systemic immune inflammation index (SII) (< 0.001), and Aggregate Index of Systemic Inflammation (AISI) (p= 0.005). The results of ROC curve analysis have shown that the LCR (AUC of 0.907), CRP/Ly (AUC of 0.907) can serve as excellent predictors, but NPR (AUC of 0.734), NLRP (AUC of 0.755), PLR (AUC of 0.823), SII (AUC of 0.745), and AISI (AUC of 0.688) as good predictors of MetS in T2 DM individuals. CONCLUSION This study confirms the reliability of the CBCIIs as novel, simple, low cost and valuable predictors of MetS developing in T2DM.
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Affiliation(s)
- Almir Fajkić
- Department of Pathophysiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Rijad Jahić
- General Hospital "Prim. Dr. Abdulah Nakas", Sarajevo, Bosnia and Herzegovina
| | - Edin Begić
- Department of Pharmacology, Sarajevo Medical School, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
- Department of Cardiology, General Hospital "Prim. Dr. Abdulah Nakas", Sarajevo, Bosnia and Herzegovina
| | - Amela Dervišević
- Department of Physiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Avdo Kurtović
- Clinical Center University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Orhan Lepara
- Department of Physiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Panneerselvam P, Biswas D, Singh H, Dilip Kumar K, Ravi Kumar P, Kalra P, Revankar S, Warrier S. Real-World Observational Study on Vildagliptin With Insulin (VIL-INS) or Vildagliptin and Metformin With Insulin (VIL-MET-INS) Therapy in Indian Patients With Type 2 Diabetes Mellitus. Cureus 2023; 15:e47190. [PMID: 38021574 PMCID: PMC10652290 DOI: 10.7759/cureus.47190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The therapeutic use of vildagliptin and insulin (VIL-INS) or vildagliptin and metformin in combination with insulin (VIL-MET-INS) in the Indian scenario has yet to be explored by generating real-world evidence. Therefore, the present study aimed to evaluate the demographic, clinical characteristics, and treatment patterns of patients with type 2 diabetes mellitus (T2DM) in Indian settings in the above context. METHODOLOGY This observational study conducted at 600 healthcare centers in India retrospectively analyzed data of adult patients with T2DM who had been treated with either vildagliptin with insulin or a combination of vildagliptin and metformin with insulin. Data were collected from medical records and analyzed by appropriate statistical tests. RESULTS A total of 12,603 patients with T2DM were included with a mean age of 53.4 years of which 63.8% were males. The majority of patients (n=6511; 51.7%) received a combination of vildagliptin and metformin on top of insulin. A significantly high proportion of patients in the age group of 18-40 years received this treatment compared to patients who were initiated on insulin treatment after vildagliptin and metformin combination (11.6% vs. 9.7%; P<0.001). Of all the patients, 70.0% were able to achieve target glycemic control with either VIS-INS or VIL-MET-INS. After treatment with VIL-INS or VIL-MET-INS, the mean glycated hemoglobin (HbA1c) levels significantly decreased with a mean change of 1.46%. Out of all patients, 13.5% experienced weight changes during treatment, with 67.4% of them showing weight loss. A total of 68 patients reported hypoglycemic events and among them, 49 patients had mild hypoglycemic events. Physician global evaluation of efficacy and tolerability showed a majority of patients rated their experience as good to excellent (86.3% and 86.0%, respectively). CONCLUSION Both treatment regimens were effective in terms of reduced HbA1c to achieve glycemic control. Furthermore, it is well tolerated without an increase in the risk of hypoglycemia or weight gain. Hence, this therapy has favorable outcomes for T2DM management in Indian clinical settings.
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Affiliation(s)
- P Panneerselvam
- Diabetes and Endocrinology, Aruna Diabetes Centre, Chennai, IND
| | - Dibakar Biswas
- Diabetes and Endocrinology, Dr D Biswas Clinic, Kolkata, IND
| | - Hema Singh
- Diabetes and Endocrinology, Dr Hema's Clinic, Jaipur, IND
| | - K Dilip Kumar
- Diabetes and Endocrinology, Careful Diagnostic Centre, Kolkata, IND
| | - P Ravi Kumar
- Diabetes and Endocrinology, R K Diabetes and Endocrinology Centre, Ranchi, IND
| | - Pramila Kalra
- Diabetes and Endocrinology, Pramila's Clinic, Bengaluru, IND
| | | | - Sona Warrier
- Scientific Services, USV Private Limited, Mumbai, IND
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Khot S, Chakraborty A, Vijaykumar S. Utilization of Hypolipidemic Drugs, Patterns, and Factors Affecting Dyslipidemia Among Type 2 Diabetes Mellitus at a Tertiary Care Teaching Hospital in South India. Cureus 2023; 15:e34748. [PMID: 36909102 PMCID: PMC9998133 DOI: 10.7759/cureus.34748] [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: 02/07/2023] [Indexed: 02/09/2023] Open
Abstract
Background The prevalence of dyslipidemia is higher in type 2 diabetes mellitus (T2DM) and hypolipidemic drugs like statins are effective for the primary and secondary prevention of cardiovascular events. Most of the patients with type 2 diabetes have a mixed type of dyslipidemia. This study aimed to evaluate the utilization of hypolipidemic drugs, patterns, and factors affecting dyslipidemia in T2DM participants. Methods This cross-sectional observational study was approved by the institutional ethics committee (IEC) of the Vydehi Institute of Medical Sciences and Research Center. It was conducted for a period of one year from July 2021 to June 2022. Participants with T2DM visiting the Department of General Medicine and Endocrinology were enrolled after obtaining informed consent. Demographic details, medication history, and laboratory data were recorded in case report form and statistical measures were applied. Results Out of 237 participants enrolled in the study, the predominance (n=133, 56%) was males. The mean age of the study population was 47.92±9.17 years, and the mean duration of diabetes was 6.8±5.3 years. Out of the total participants, 164 (69%) had deranged lipid profiles. Out of them, 129 (78.65%) were on hypolipidemic drugs. Regarding drug utilization, 122 (94.6%) received statins either rosuvastatin (54%) or atorvastatin (40%). In the deranged lipid profiles pattern, 24% (58) participants had one abnormal lipid parameter and the majority 70% (166) had combined lipid profile abnormality. Factors like increased BMI were significantly associated with dyslipidemia (p=0.004). Utilization of hypolipidemic drugs was also significantly associated with the control of dyslipidemia (p<0.001). It was observed that participants who were not on lipid-lowering drugs had 5.38 times more chance of dyslipidemia (OR=5.38; CI=2.82-10.28; p<0.001). Conclusion A high prevalence of dyslipidemia was observed among diabetic patients. Statins were the most prescribed drug in the study. BMI and lack of pharmacotherapy were found to have a statistically significant association with dyslipidemia in diabetic patients.
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Affiliation(s)
- Sandeep Khot
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Ananya Chakraborty
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
| | - Savitha Vijaykumar
- Pharmacology and Therapeutics, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, IND
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Rao NL, Kotian GB, Shetty JK, Shelley BP, Dmello MK, Lobo EC, Shankar SP, Almeida SD, Shah SR. Receptor for Advanced Glycation End Product, Organ Crosstalk, and Pathomechanism Targets for Comprehensive Molecular Therapeutics in Diabetic Ischemic Stroke. Biomolecules 2022; 12:1712. [PMID: 36421725 PMCID: PMC9687999 DOI: 10.3390/biom12111712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/03/2022] [Accepted: 11/05/2022] [Indexed: 08/10/2023] Open
Abstract
Diabetes mellitus, a well-established risk factor for stroke, is related to higher mortality and poorer outcomes following the stroke event. Advanced glycation end products(AGEs), their receptors RAGEs, other ligands, and several other processes contribute to the cerebrovascular pathomechanism interaction in the diabetes-ischemic stroke combination. Critical reappraisal of molecular targets and therapeutic agents to mitigate them is required to identify key elements for therapeutic interventions that may improve patient outcomes. This scoping review maps evidence on the key roles of AGEs, RAGEs, other ligands such as Leukotriene B4 (LTB4), High-mobility group box 1 (HMGB1) nuclear protein, brain-kidney-muscle crosstalk, alternate pathomechanisms in neurodegeneration, and cognitive decline related to diabetic ischemic stroke. RAGE, HMGB1, nitric oxide, and polyamine mechanisms are important therapeutic targets, inflicting common consequences of neuroinflammation and oxidative stress. Experimental findings on a number of existing-emerging therapeutic agents and natural compounds against key targets are promising. The lack of large clinical trials with adequate follow-up periods is a gap that requires addressing to validate the emerging therapeutic agents. Five therapeutic components, which include agents to mitigate the AGE-RAGE axis, improved biomarkers for risk stratification, better renal dysfunction management, adjunctive anti-inflammatory-antioxidant therapies, and innovative neuromuscular stimulation for rehabilitation, are identified. A comprehensive therapeutic strategy that features all the identified components is needed for outcome improvement in diabetic stroke patients.
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Affiliation(s)
- Nivedita L Rao
- Department of Biochemistry, Yenepoya Medical College, Yenepoya (deemed to be University), Mangalore 575018, Karnataka, India
| | - Greeshma B Kotian
- Department of Biochemistry, Yenepoya Medical College, Yenepoya (deemed to be University), Mangalore 575018, Karnataka, India
| | - Jeevan K Shetty
- Department of Biochemistry, School of Medicine, Royal College of Surgeons in Ireland Medical University of Bahrain, Muharraq 228, Bahrain
| | - Bhaskara P Shelley
- Department of Neurology, Yenepoya Medical College, Yenepoya (deemed to be University), Mangalore 575018, Karnataka, India
| | - Mackwin Kenwood Dmello
- Department of Public Health, KS Hegde Medical Academy, Nitte (Deemed to be University), Mangalore 575018, Karnataka, India
| | - Eric C Lobo
- Department of Biochemistry, Yenepoya Medical College, Yenepoya (deemed to be University), Mangalore 575018, Karnataka, India
| | - Suchetha Padar Shankar
- College of Physiotherapy, Dayananda Sagar University, Bangalore 560111, Karnataka, India
| | - Shellette D Almeida
- School of Physiotherapy, D. Y. Patil (Deemed to be University), Navi Mumbai 400706, Maharashtra, India
| | - Saiqa R Shah
- Department of Biochemistry, Yenepoya Medical College, Yenepoya (deemed to be University), Mangalore 575018, Karnataka, India
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Mohan P, Sharma AK, Sinha S, Sabarad R. An experimental study of rosuvastatin's analgesic effect and its interaction with etoricoxib, tramadol, amlodipine, and amitriptytline in albino mice. Med J Armed Forces India 2022; 78:S61-S68. [PMID: 36147401 PMCID: PMC9485845 DOI: 10.1016/j.mjafi.2021.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/14/2021] [Indexed: 11/22/2022] Open
Abstract
Background Statins are the mainstay for the treatment of dyslipidemia. Recently, rosuvastatin has also been demonstrated to possess analgesic properties in animal studies. The present study has been planned to further confirm the analgesic activity of rosuvastatin, etoricoxib, tramadol, amlodipine, and amitriptyline and study the interaction of rosuvastatin with the above-mentioned analgesics. The objective of the study was to confirm the analgesic activity of rosuvastatin and determine the minimum analgesic dose of rosuvastatin, etoricoxib, tramadol, amlodipine and amitriptyline and to study the analgesic effect of combination of subanalgesic doses of rosuvastatin with sub-analgesic doses of etoricoxib, tramadol, amlodipine, and amitriptyline. Method After IAEC approval, the study was carried out in albino mice in two phases. In phase I, the analgesic effect of rosuvastatin, etoricoxib, tramadol, amlodipine, and amitriptyline was confirmed by using tail-flick and writhing methods. In phase II, analgesic effect of combinations of subanalgesic dose of rosuvastatin with subanalgesic dose of etoricoxib, tramadol, amlodipine, and amitriptyline was studied. Results Minimal analgesic dose of rosuvastatin, etoricoxib, tramadol, amlodipine, and amitriptyline was observed as 5, 20, 10, 5, and 10 mg/kg, respectively. In phase II, combination of subanalgesic dose of rosuvastatin 2.5 mg/kg with subanalgesic doses of etoricoxib (10 mg/kg), tramadol (5 mg/kg), amlodipine (2.5 mg/kg), and amitriptyline (5 mg/kg), demonstrated synergistic analgesic activity. Conclusion Rosuvastatin exerts dose-dependent analgesic activity that is synergistic to that of etoricoxib, tramadol, amlodipine, and amitriptyline. If established in clinical studies as well, this finding can lead to the reduction of analgesic dosing in patients already on statins.
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Affiliation(s)
- Prafull Mohan
- Professor, Department of Pharmacology, Armed Forces Medical College, Pune, India
| | - Ashok Kumar Sharma
- Former Professor & Head, Department of Pharmacology, Armed Forces Medical College, Pune, India
| | - Sharmila Sinha
- Professor & Head, Department of Pharmacology, Armed Forces Medical College, Pune, India
| | - R. Sabarad
- Resident, Department of Pharmacology, Armed Forces Medical College, Pune, India
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Sebai I, Oueslati I, Yazidi M, Chaker F, Abdessalem H, Grira W, Amrouch C, Chihaoui M. Interest of the waist-to-height ratio to predict metabolic syndrome in type 2 diabetic patients. LA TUNISIE MEDICALE 2022; 100:137-142. [PMID: 35852248 PMCID: PMC9274779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Metabolic syndrome (MetS) is defined as a cluster of risk factors for cardiovascular disease. AIM To determine the optimal cut-off point of the waist-to-height ratio (WHtR) at which MetS can be identified with maximum sensitivity and specificity in a sample of Tunisian type 2 diabetic patients. METHODS We enrolled 457 type 2 diabetic patients in a cross-sectional study. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. WHtR was calculated. MetS was defined according to the IDF criteria. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cut-off value of WHtR in MetS screening with maximum sensitivity and specificity. RESULTS The overall prevalence of MetS was 79.8%, it was higher in women than in men (85.5% vs 61.4%; p.
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Affiliation(s)
- Imen Sebai
- 1- Outpatient department, National Institute of Nutrition, Tunis, Tunisia / Faculty of medicine of Tunis, Tunis El Manar University, Tunisia
| | - Ibtissem Oueslati
- 2- Department of endocrinology, La Rabta hospital, Tunis, Tunisia. / Faculty of medicine of Tunis, Tunis El Manar University, Tunisia.
| | - Meriem Yazidi
- 2- Department of endocrinology, La Rabta hospital, Tunis, Tunisia. / Faculty of medicine of Tunis, Tunis El Manar University, Tunisia.
| | - Fatma Chaker
- 2- Department of endocrinology, La Rabta hospital, Tunis, Tunisia. / Faculty of medicine of Tunis, Tunis El Manar University, Tunisia.
| | - Haifa Abdessalem
- 1- Outpatient department, National Institute of Nutrition, Tunis, Tunisia / Faculty of medicine of Tunis, Tunis El Manar University, Tunisia
| | - Wafa Grira
- 2- Department of endocrinology, La Rabta hospital, Tunis, Tunisia. / Faculty of medicine of Tunis, Tunis El Manar University, Tunisia.
| | - Chiraz Amrouch
- 1- Outpatient department, National Institute of Nutrition, Tunis, Tunisia / Faculty of medicine of Tunis, Tunis El Manar University, Tunisia
| | - Melika Chihaoui
- 2- Department of endocrinology, La Rabta hospital, Tunis, Tunisia. / Faculty of medicine of Tunis, Tunis El Manar University, Tunisia.
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Khandekar R, Senthil T, Nainappan M, Edward DP. Magnitude and Determinants of Diabetic Retinopathy Among Indian Diabetic Patients Undergoing Telescreening in India. Telemed J E Health 2021; 28:176-188. [PMID: 33999730 DOI: 10.1089/tmj.2021.0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To determine the magnitude, determinants, and public health issues related to diabetic retinopathy (DR) in India using 2019 data from a for-profit telescreening program. Methods: Digital retinal images were captured using a nonmydriatic fundus camera and transferred via the telescreening program to a reading center. Ophthalmologists trained in DR image reading created the DR status reports. Age/sex-adjusted rates of DR, sight-threatening DR (STDR), and diabetic macular edema (DME) were calculated and correlated with known risk factors. Results: Images of 51,760 Indian diabetic patients (103,520 eyes) were reviewed. The prevalence of DR, STDR, and DME was 19.1% (95% confidence interval [CI]: 18.9-19.5), 5.1% (95% CI: 4.9-5.3), and 3.9% (95% CI: 3.7-4.1), respectively. Based on these data, we projected 14.7 million cases of DR, 3.9 million with STDR, and 3.0 million DME cases in India. Statistically significant risk factors for DR were male gender (odds ratio [OR] = 1.19, p < 0.001), older age (χ2 = 270, df = 3, p < 0.001), history of cataract surgery (OR = 2.0, p < 0.001), longer duration of diabetes (χ2 = 1084, p < 0.001), and type 1 diabetes (OR = 3.9, p = 0.01). There was a statistically significant variation of DR by geographic zones (χ2 = 310, p < 0.001). Laser treatment coverage for STDR was 22%. Duration of diabetes (p < 0.001), cataract surgery in the past (p = 0.02), and females (p = 0.001) were predictors of STDR. Conclusion: This model of telescreening for DR provides an additional pathway for screening and preventing diabetes-related visual morbidity in India. The data from this study can be used for epidemiologic and ophthalmic health policies related to diabetes.
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Affiliation(s)
- Rajiv Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | | | - Deepak P Edward
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago, Chicago, Illinois, USA
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Kalra S, Unnikrishnan AG, Baruah MP, Sahay R, Bantwal G. Metabolic and Energy Imbalance in Dysglycemia-Based Chronic Disease. Diabetes Metab Syndr Obes 2021; 14:165-184. [PMID: 33488105 PMCID: PMC7816219 DOI: 10.2147/dmso.s286888] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/02/2020] [Indexed: 12/16/2022] Open
Abstract
Metabolic flexibility is the ability to efficiently adapt metabolism based on nutrient availability and requirement that is essential to maintain homeostasis in times of either caloric excess or restriction and during the energy-demanding state. This regulation is orchestrated in multiple organ systems by the alliance of numerous metabolic pathways under the master control of the insulin-glucagon-sympathetic neuro-endocrine axis. This, in turn, regulates key metabolic enzymes and transcription factors, many of which interact closely with and culminate in the mitochondrial energy generation machinery. Metabolic flexibility is compromised due to the continuous mismatch between availability and intake of calorie-dense foods and reduced metabolic demand due to sedentary lifestyle and age-related metabolic slowdown. The resultant nutrient overload leads to mitochondrial trafficking of substrates manifesting as mitochondrial dysfunction characterized by ineffective substrate switching and incomplete substrate utilization. At the systemic level, the manifestation of metabolic inflexibility comprises reduced skeletal muscle glucose disposal rate, impaired suppression of hepatic gluconeogenesis and adipose tissue lipolysis manifesting as insulin resistance. This is compounded by impaired β-cell function and progressively reduced β-cell mass. A consequence of insulin resistance is the upregulation of the mitogen-activated protein kinase pathway leading to a pro-hypertensive, atherogenic, and thrombogenic environment. This is further aggravated by oxidative stress, advanced glycation end products, and inflammation, which potentiates the risk of micro- and macro-vascular complications. This review aims to elucidate underlying mechanisms mediating the onset of metabolic inflexibility operating at the main target organs and to understand the progression of metabolic diseases. This could potentially translate into a pharmacological tool that can manage multiple interlinked conditions of dysglycemia, hypertension, and dyslipidemia by restoring metabolic flexibility. We discuss the breadth and depth of metabolic flexibility and its impact on health and disease.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
- Department of Endocrinology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | | | - Manash P Baruah
- Department of Endocrinology, Excel Hospitals, Guwahati, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
| | - Ganapathi Bantwal
- Department of Endocrinology, St. John’s Medical College and Hospital, Bangalore, Karnataka, India
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Bashir A, Pandey K, Azharuddin M, Kumari A, Rashid I, Siddiqui N, Lal CS, Murti K. Association between diet quality scores, adiposity, glycemic status and nutritional biomarkers among Indian population with type 2 diabetes mellitus: A cross-sectional study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Liu X, Zhang J, Wu J, Xu X, Tao L, Sun Y, Chen S, Han Y, Luo Y, Yang X, Guo X. The Impact of BMI Categories on Metabolic Abnormality Development in Chinese Adults Who are Metabolically Healthy: A 7-Year Prospective Study. Diabetes Metab Syndr Obes 2020; 13:819-834. [PMID: 32256097 PMCID: PMC7090202 DOI: 10.2147/dmso.s237550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/06/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To determine what metabolic abnormalities develop frequently among metabolically healthy adults over time according to different baseline body mass index (BMI) categories. PATIENTS AND METHODS A prospective cohort study was performed on 10,805 adults, who were metabolically healthy at the time of the 2008 survey. Participants were divided into four groups: metabolically healthy obese (MHO), metabolically healthy overweight (MHOW), metabolically healthy normal-weight (MHN), and metabolically healthy underweight (MHU). Modified Poisson regression models were used to evaluate the relationship of BMI with the development of metabolic abnormalities. Association rule mining was used to identify the most frequent abnormalities that developed over time. RESULTS Compared with the MHN group, the adjusted relative risks of the MHO group were 1.57 (95% CI: 1.09-2.27) and 2.08 (95% CI: 1.59-2.73) for developing elevated fasting glucose and elevated blood pressure, respectively, after adjusting for lifestyle behaviours and dietary factors. At the end of follow-up, 33 (19.1%) MHO subjects and 342 (16.6%) MHOW subjects had elevated blood pressure as the predominant metabolic syndrome component, whereas 236 (9.0%) MHU subjects had elevated plasma glucose. The results were similar after stratification by sex. CONCLUSION MHO and MHOW subjects developed elevated blood pressure most frequently, and MHU subjects developed elevated blood glucose most commonly, regardless of sex.
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Affiliation(s)
- Xiangtong Liu
- School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing, People’s Republic of China
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, PA, USA
| | - Xiaolin Xu
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Lixin Tao
- School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
| | - Yue Sun
- School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
| | - Shuo Chen
- Beijing Physical Examination Center, Beijing, People’s Republic of China
| | - Yumei Han
- Beijing Physical Examination Center, Beijing, People’s Republic of China
| | - Yanxia Luo
- School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
| | - Xinghua Yang
- School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, People’s Republic of China
- Correspondence: Xiuhua Guo School of Public Health, Capital Medical University, No. 10 Xitoutiao, You Anmen, Fengtai District, Beijing100069, People’s Republic of China Tel/Fax +86 010 8391 1508 Email
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Subramani SK, Yadav D, Mishra M, Pakkirisamy U, Mathiyalagen P, Prasad GBKS. Prevalence of Type 2 Diabetes and Prediabetes in the Gwalior-Chambal Region of Central India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234708. [PMID: 31779187 PMCID: PMC6926613 DOI: 10.3390/ijerph16234708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 12/15/2022]
Abstract
AIM This study evaluated the prevalence of prediabetes and type 2 diabetes mellitus in the Gwalior-Chambal region of India. METHODS A cross-sectional house-to-house survey was conducted on a population of 7608 subjects, aged between 20 and 79 years for fasting blood glucose level in finger-prick blood. Participants were stratified based on blood glucose levels, gender, age, family history, etc. to assess their impact. RESULT The prevalence of type 2 diabetes and prediabetes in the Gwalior-Chambal region was found to be 11.4% and 5.7%, respectively. The prevalence of diabetes was significantly higher in the urban population (12.7%) while that of prediabetes was higher in the rural population (7.9%). Male subjects recorded a higher prevalence of prediabetes (8.2%, OR 1.54 in rural; 5.1%, OR 1.26 in urban) as well as diabetes (rural 9.2%, OR 3.15; urban 16.5%, OR 1.57). Both prediabetes and diabetes were recorded as being higher in those subjects leading a sedentary lifestyle and in the aged population. The prevalence of hyperglycemia was much higher in those with a family history of type 2 diabetes (30.6% in rural, 21.5% in urban). Almost half of the diabetics in the rural population were diagnosed for the first time. The multivariate regression analysis identified male gender, increasing age of 30 years and above, and positive family history as significant risk factors for diabetes whereas age of 40 to 79 and less physical activity were significant risk factors for prediabetes. CONCLUSION Family history of diabetes, and sedentary lifestyle appeared as key factors promoting prediabetes and diabetes in the Gwalior-Chambal region. A lack of awareness appeared as one of the major causes of the high prevalence in the rural region.
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Affiliation(s)
- Senthil Kumar Subramani
- School of Studies in Biochemistry, Jiwaji University, Gwalior 474011, India;
- Department of Biotechnology, Tropilite Foods Pvt. Ltd., Davar’s Campus, Tansen Road, Gwalior-474002, India
| | - Dhananjay Yadav
- Department of Medical Biotechnology, Yeungnam University, Gyeongsan 38541, Korea;
| | - Meerambika Mishra
- Department of Infectious Diseases and Immunology, College of Veterinary medicine, University of Florida, Gainesville, FL 32601, USA;
| | - Umamaheswari Pakkirisamy
- Department of Pediatric Nursing, Shivnath Singh College of Nursing, Chirwai Naka, Shivpuri link road, Gwalior 474001, India;
| | - Prakesh Mathiyalagen
- Department of Community Medicine, Indira Gandhi Medical College and Research Institute, Puducherry 605 009, India;
| | - GBKS Prasad
- School of Studies in Biochemistry, Jiwaji University, Gwalior 474011, India;
- Correspondence:
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Gahlan D, Rajput R, Singh V. Metabolic syndrome in north Indian type 2 diabetes mellitus patients: A comparison of four different diagnostic criteria of metabolic syndrome. Diabetes Metab Syndr 2019; 13:356-362. [PMID: 30641725 DOI: 10.1016/j.dsx.2018.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/09/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Deepak Gahlan
- Department of Medicine, Maharaja Agrasen Medical College & Hospital, Agroha, 125047, Hisar, Haryana, India.
| | - Rajesh Rajput
- Department of Endocrinology and Medicine, Pt. B.D. Sharma PGIMS, Rohtak, 124001, Haryana, India.
| | - Vandana Singh
- Haryana School of Business, Guru Jambheswar University of Science & Technology, Hisar, 125001, Haryana, India.
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Pati S, Schellevis FG. Prevalence and pattern of co morbidity among type2 diabetics attending urban primary healthcare centers at Bhubaneswar (India). PLoS One 2017; 12:e0181661. [PMID: 28841665 PMCID: PMC5571911 DOI: 10.1371/journal.pone.0181661] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 07/05/2017] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE India has the second largest diabetic population in the world. The chronic nature of the disease and high prevalence of co-existing chronic medical conditions or "co morbidities" makes diabetes management complex for the patient and for health care providers. Hence a strong need was felt to explore the problem of co morbidity among diabetics and its dimensions in primary health care practices. METHOD This cross sectional survey was carried out on 912 type 2 diabetes patients attending different urban primary health care facilities at Bhubaneswar. Data regarding existence of co morbidity and demographical details were elicited by a predesigned, pretested questionnaire"Diabetes Co morbidity Evaluation Tool in Primary Care (DCET- PC)". Statistical analyses were done using STATA. RESULTS Overall 84% had one ormore than one comorbid condition. The most frequent co morbid conditions were hypertension [62%], acid peptic disease [28%], chronic back ache [22%] and osteoarthritis [21%]. The median number of co morbid conditions among both males and females is 2[IQR = 2]. The range of the number of co morbid conditions was wider among males [0-14] than females [0-6]. The number of co morbidities was highest in the age group > = 60 across both sexes. Most of the male patients below 40 years of age had either single [53%] or three co morbidities [11%] whereas among female patients of the same age group single [40%] or two co morbidities [22%] were more predominantly present. Age was found to be a strong independent predictor for diabetes co morbidity. The odds of having co morbidity among people above poverty line and schedule caste were found to be[OR = 3.50; 95%CI 1.85-6.62]and [OR = 2.46; CI 95%1.16-5.25] respectively. Odds were increased for retired status [OR = 1.21; 95% CI 1.01-3.91] and obesity [OR = 3.96; 95%CI 1.01-15.76]. CONCLUSION The results show a high prevalence of co morbidities in patients with type 2 diabetes attending urban primary health care facilities. Hypertension, acid peptic disease, chronic back ache and arthritis being the most common, strategies need to be designed taking into account the multiple demands of co morbidities.
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Affiliation(s)
- Sandipana Pati
- Department of Health & Family Welfare, Government of Odisha, Bhubaneswar, Odisha, India
| | - F. G. Schellevis
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands, and Department of General Practice & Elderly Care Medicine, Amsterdam Public Health Research Institute,VU University Medical Center, Amsterdam, the Netherlands
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Ghosh S, Trivedi S, Sanyal D, Modi KD, Kharb S. Teneligliptin real-world efficacy assessment of type 2 diabetes mellitus patients in India (TREAT-INDIA study). Diabetes Metab Syndr Obes 2016; 9:347-353. [PMID: 27877058 PMCID: PMC5108474 DOI: 10.2147/dmso.s121770] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND AIMS Teneligliptin was introduced in India in May 2015. It has gained popularity and is already widely prescribed in type 2 diabetes mellitus (T2DM). This "real life" data collection was conducted to assess the efficacy of teneligliptin in Indian T2DM patients. METHODS Predesigned structured proforma was used to collect information from the prescribing physicians regarding the efficacy of teneligliptin when prescribed as monotherapy as well as combination therapy with other antidiabetic drugs in T2DM patients. Information on the glycemic parameters at baseline prior to starting teneligliptin and at the end of 3 months therapy was collected. The efficacy was assessed by analyzing the mean change in 3-month values of glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and postprandial plasma glucose (PPG). RESULTS Data of 4305 patients was available for analysis. There was statistically significant improvement in mean HbA1c, FPG, and PPG with teneligliptin therapy. Means changes in HbA1c, FPG, and PPG were -1.37%±1.15%, 51.29±35.41 mg/dL, and 80.89±54.27 mg/dL, respectively. Subgroup analysis revealed that HbA1c (%) reduction with teneligliptin when used as monotherapy, add-on to metformin or add-on to metformin plus sulfonylureas combination, add-on to metformin plus alpha glucosidase inhibitor combination or add-on to insulin was 0.98±0.53, 1.07±0.83, 1.46±1.33, 1.43±0.80, and 1.55±1.05, respectively. CONCLUSION Real-world data suggests that teneligliptin significantly improves glycemic control in Indian patients with T2DM when prescribed either as monotherapy or as an add-on to one or more other commonly prescribed antidiabetic drugs.
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Affiliation(s)
- Sujoy Ghosh
- Department of Endocrinology, The Institute of Post Graduate Medical Education and Research (IPGMER), Kolkata, West Bengal
| | | | - Debmalya Sanyal
- Department of Endocrinology, KPC Medical College, Kolkata, West Bengal
| | - KD Modi
- Dr Modi’s Clinic (DMC), Department of Endocrinology at Medwin Hospital, Hyderabad, Telangana
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Mohammadbeigi A, Moshiri E, Mohammadsalehi N, Ansari H, Ahmadi A. Dyslipidemia Prevalence in Iranian Adult Men: The Impact of Population-Based Screening on the Detection of Undiagnosed Patients. World J Mens Health 2015; 33:167-73. [PMID: 26770936 PMCID: PMC4709432 DOI: 10.5534/wjmh.2015.33.3.167] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/04/2015] [Accepted: 10/17/2015] [Indexed: 01/22/2023] Open
Abstract
Purpose Dyslipidemia has been established as one of the most important modifiable risk factors for cardiovascular disease. Due to the higher prevalence of dyslipidemia in males, this study aimed to estimate the prevalence of dyslipidemia in Iranian urban men. Materials and Methods A screening program was conducted in 845 Iranian men 25 years of age and older in 2014. A health interview survey was conducted to evaluate the prevalence of self-reported dyslipidemia and to collect demographic data, as well as serum lipid profile screening by a reference laboratory. Lipoprotein levels was categorized based on the Adult Treatment Panel III criteria and the data were analyzed using the chi-square test and analysis of variance. Results The overall prevalence of dyslipidemia was 51.8%, and the prevalence of various forms of dyslipidemia was as follows: hypercholesterolemia (≥240 mg/dL), 11.4%; hyper-low-density lipoprotein cholesterol (≥160 mg/dL), 9.6%; hypertriglyceridemia (≥200 mg/dL), 25%; and hypo-high-density lipoprotein (HDL) cholesterol (<40 mg/dL), 34.3%. With the exception of hypo-HDL, all forms of dyslipidemia were significantly less common in men over 65 years of age (p<0.05). Conclusions The prevalence of hypo-HDL and hypertriglyceridemia was higher than expected in Iranian adult men, with half of men 25 years of age and older affected by at least one form of dyslipidemia. A large gap in primary and secondary care was observed, because nearly 80% of patients with dyslipidemia were unaware of their status. Urgent preventive programs and lifestyle changes are necessary to reduce the prevalence of cardiovascular risk factors.
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Affiliation(s)
- Abolfazl Mohammadbeigi
- Department of Epidemiology and Biostatistics, Health Policy and Promotion Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Esamil Moshiri
- Department of Anesthesiology, Arak University of Medical Sciences, Arak, Iran
| | - Narges Mohammadsalehi
- Health Policy and Promotion Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Ansari
- Health Promotion Research Center, Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Chandra M, Anand KS. Vascular disease burden in Indian subjects with vascular dementia. Australas Med J 2015; 8:227-34. [PMID: 26284127 DOI: 10.4066/amj.2015.2390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Vascular disease factors like hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease contribute to the development of vascular dementia. As comorbidity of vascular disease factors in vascular dementia is common, we investigated the vascular disease burden in subjects with vascular dementia. AIMS To investigate the vascular disease burden due to four vascular disease factors: hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease in Indian subjects with vascular dementia. METHODS In this study, 159 subjects with probable vascular dementia (as per NINDS-AIREN criteria) attending the memory clinic at a tertiary care hospital were assessed for the presence of hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease using standardised operational definitions and for severity of dementia on the Clinical Dementia Rating (CDR) scale. The data obtained was subjected to appropriate statistical analysis. RESULTS Dyslipidaemia (79.25 per cent) was the most common vascular disease factor followed by hypertension (73.58 per cent), ischaemic heart disease (58.49 per cent), and diabetes mellitus (40.80 per cent). Most subjects (81.1 per cent) had two or more vascular disease factors. Subjects with more severe dementia had more vascular disease factors (sig 0.001). CONCLUSION People with moderate to severe dementia have a significantly higher vascular disease burden; therefore, higher vascular disease burden may be considered as a poor prognostic marker in vascular dementia. Subjects with vascular dementia and their caregivers must manage cognitive impairment and ADL alongside managing serious comorbid vascular diseases that may worsen the dementia.
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Affiliation(s)
- Mina Chandra
- Post Graduate Institute of Medical Education and Research & Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Kuljeet Singh Anand
- Post Graduate Institute of Medical Education and Research & Dr Ram Manohar Lohia Hospital, New Delhi, India
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18
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Liu X, Tao L, Cao K, Wang Z, Chen D, Guo J, Zhu H, Yang X, Wang Y, Wang J, Wang C, Liu L, Guo X. Association of high-density lipoprotein with development of metabolic syndrome components: a five-year follow-up in adults. BMC Public Health 2015; 15:412. [PMID: 25896058 PMCID: PMC4409998 DOI: 10.1186/s12889-015-1747-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 02/25/2015] [Indexed: 12/14/2022] Open
Abstract
Background High-density lipoprotein (HDL) is associated with the incidence of metabolic syndrome (MetS). It is unclear whether subjects with different HDL levels develop different components of MetS over time. Our study aimed to determine what MetS components tend to emerge and change relative to different levels of HDL. Methods During the period 2007 to 2012, 4,905 adults in Tongren and Xiaotangshan Hospitals in Beijing were included with no MetS, self-reported type 2 diabetes, or cardiovascular disease at baseline. An association rule was used to determine the changes of MetS components over time. Results The incidence of MetS at follow-up was 3.40% for men and 1.50% for women in the high-normal HDL group; 6.65% and 4.55%, respectively, in the normal HDL group; and 11.05% and 6.45%, respectively, in the low HDL group. The most common transition was from healthy to healthy in normal-high or normal HDL groups (47.2% to 63.8%), whereas 11.7% to 39.9% of subjects with low HDL returned to healthy status or stayed unchanged in the low HDL group. The most common new-onset components were elevated blood pressure (9.2 to 10.0%), elevated high-density lipoprotein (5.5 to 11.0%), and raised fasting glucose (5.4 to 5.5%) in the groups with normal-high or normal HDL. Conclusions The incidence of MetS increased in parallel with the decrease in HDL. Adults with a low HDL level were more susceptible to developing MetS over time. Low HDL seemed to be a pre-existing phase of MetS and may be a crucial status for MetS prevention.
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Affiliation(s)
- Xiangtong Liu
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Lixin Tao
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Kai Cao
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Zhaoping Wang
- Physical Examination Department, Beijing Tongren Hospital Affiliated to Capital Medical University, No.1 Dongjiao Minxiang, Dongcheng District, Beijing, 100730, China.
| | - Dongning Chen
- Physical Examination Department, Beijing Tongren Hospital Affiliated to Capital Medical University, No.1 Dongjiao Minxiang, Dongcheng District, Beijing, 100730, China.
| | - Jin Guo
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Huiping Zhu
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Xinghua Yang
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Youxin Wang
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Jingjing Wang
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Chao Wang
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Long Liu
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, No. 10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China.
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