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Dong H, Zhang Y, Hu P, Wang J, Lu N. Serum apolipoprotein A1 rather than apolipoprotein B is associated with hypertension prevalence in Chinese people with coronary artery disease. Blood Press Monit 2022; 27:121-127. [PMID: 34873074 DOI: 10.1097/mbp.0000000000000576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Studies on the association of apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) with hypertension (HTN) prevalence in patients with coronary artery disease (CAD) are limited. This cross-sectional study aimed to investigate this association in Chinese people in Wuhan, China. METHODS Serum ApoA1 and ApoB levels were measured by immunoturbidimetry assay. Logistic regression analysis was used to estimate the associations of ApoA1 and ApoB level and ApoB/A1 ratio with HTN prevalence. RESULTS We included 5192 individuals (3060 men, mean age 61 years; 4412 HTN cases) in this study. After adjusting for covariates, serum ApoA1 but not ApoB level or ApoB/A1 ratio was inversely associated with HTN prevalence. HTN prevalence was reduced with the fifth versus first quintile of ApoA1 level [odds ratio = 0.78 (95% confidence interval 0.62-0.98)]. In stratified analyses based on sex, the probability of HTN with the fifth versus first ApoA1 level was 0.71 (0.53-0.96) for men. The probability of HTN with the fifth versus first quintile of ApoB/A1 ratio was 1.54 (1.11-2.13) after adjustment. With quintiles 2-5 versus of ApoB level, the probability of HTN did not differ in both men and women. On path analyses, the association of ApoA1 level and ApoB/A1 ratio with HTN was mediated by BMI (β coefficients: -0.179 to 0.133). CONCLUSION In general, high serum ApoA1 level may be associated with a reduced probability of HTN prevalence in patients with CAD in China, and this association may be mediated by BMI.
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Affiliation(s)
- Hongli Dong
- Department of Child Healthcare and Scientific Education Section, Affiliated Matern & Child Care Hospital of Nantong University, Nantong
| | - Yaju Zhang
- Finance Section, Affiliated Traditional Chinese Medicine Hospital of Nantong University, Nantong
| | - Ping Hu
- Image Center, Wuhan Asia Heart Hospital, Wuhan
| | - Jie Wang
- Image Center, Wuhan Asia Heart Hospital, Wuhan
| | - Nan Lu
- Image Center, Wuhan Asia Heart Hospital, Wuhan
- Department of Cardiology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
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Dong H, Yang X, Zhang Y, Hu P, Liu Y, Liang S. Associations of serum apolipoprotein A1, B levels and their ratio with blood pressure in Chinese adults with coronary artery disease. Blood Press Monit 2021; 26:401-406. [PMID: 34074807 DOI: 10.1097/mbp.0000000000000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We examined the relationships of apolipoprotein A1 (ApoA1), ApoB levels and ApoB/A1 ratio with blood pressure (BP) in Chinese adults with coronary artery disease (CAD). METHODS This cross-sectional study included 4921 adults with CAD. SBP, DBP, serum ApoA1 and ApoB levels were measured. The associations between Apo and BP were assessed by analyses of covariance. RESULTS Serum ApoA1 was inversely associated with BP, whereas ApoB and the ApoB/A1 ratio exhibited positive associations with BP. For all subjects, a higher ApoA1 level was associated with lower SBP. Subjects in the fourth quartile for ApoA1 exhibited - 2.85 and - 2.63% lower DBP and mean arterial pressure (MAP), respectively than those in the third quartile. In contrast, higher ApoB and ApoB/A1 ratios were associated with higher SBP, DBP and MAP. The mean differences between ApoB quartiles 4 and 1 were 1.54% for SBP, 2.92% for DBP and 2.29% for MAP. The mean differences between the ApoB/A1 ratio quartiles 4 and 1 were 1.94% for SBP, 3.53% for DBP and 2.80% for MAP. In analyses stratified by gender, graded and inverse associations of ApoA1 with SBP, DBP and MAP were observed in both men and women, but positive associations were observed for ApoB and the ApoB/A1 ratio. Path analysis showed that BMI mediated the associations between ApoB and the ApoB/A1 ratio and SBP. CONCLUSIONS In general, serum ApoA1 was inversely associated with BP in persons with CAD. In contrast, serum ApoB and the ApoB/A1 ratio were positively associated with BP, and these associations were mediated by BMI.
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Affiliation(s)
- Hongli Dong
- Scientific Education Section and Department of Child Healthcare, Affiliated Maternity & Child Health Care Hospital of Nantong University, Nantong
| | - Xuemei Yang
- Department of Geriatric Medicine, Qingdao Municipal Hospital, Qingdao
| | - Yaju Zhang
- Department of Finance section, Affiliated Traditional Chinese Medicine Hospital of Nantong University, Nantong
| | - Ping Hu
- Image Center, Wuhan Asia Heart Hospital, Wuhan
| | - Yang Liu
- Department of Pharmacy, Nantong Health College of Jiangsu Province, Nantong
| | - Shuxia Liang
- Department of Health care, Linyi People's Hospital, Linyi, China
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Kask-Flight L, Durak K, Suija K, Rätsep A, Kalda R. Reduction of cardiovascular risk factors among young men with hypertension using an interactive decision aid: cluster-randomized control trial. BMC Cardiovasc Disord 2021; 21:543. [PMID: 34784891 PMCID: PMC8596802 DOI: 10.1186/s12872-021-02339-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronary heart disease (CHD) mortality among young men is very high and the prevention methods usable in family practice (FP) settings are limited (1,2). The objectives of this study were to investigate the cardiovascular risk profile among young males (18-50) visiting their family doctor (FD) and to find out if using an interactive computer-based decision aid (DA) has advantages in reducing cardiovascular risk factors compared to usual counselling at the FD's office. METHODS The study was a cluster-randomized controlled trial including hypertensive male patients aged 18-50 recruited by their FD in 2015-2016. Patients with cardiovascular complications were not included. FDs were randomly divided into intervention groups (n = 9) and control groups (n = 11). Altogether, FDs recruited 130 patients, 77 into the intervention group (IG) and 53 into the control group (CG). IG patients were counselled about cardiovascular risk factors using a computer-based DA. CG patients received usual counselling by their FD. Data was collected with questionnaires, clinical examinations and laboratory analyses at the baseline and at the follow-up visit three months later. We compared the cardiovascular risk factors of the IG and CG patients. RESULTS Baseline characteristics of the IG and CG patients were comparable. Of the whole study group, 51.5% (n = 67) of the patients had hypertension grade 1, 45.4% (n = 59) had grade 2 and 3.1% (n = 4) had grade 3. Twenty-seven per cent (n = 21) of the IG and 42% (n = 22) of the CG patients were smokers. We found that shared decision making with the DA was more effective in smoking reduction compared to usual FD counselling: 21 smoking patients in the IG reduced the number of cigarettes per day which is significantly more than the 22 smoking patients in the CG (- 3.82 ± 1.32 (SE Mean) versus + 2.32 ± 1.29; p = 0.001). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and the number of cigarettes per day, all showed a statistically significant reduction among patients who were using the DA. Male patients with hypertension grade 2 had a significantly greater reduction in their SBP (- 6.003 ± 2.59 (SE Mean) versus + 1.86 ± 2.58; p = 0.038) grade 1. Reduction of DBP, cigarettes per day and CVD risk in general were nearly significant in the IG whereas the CG showed an increase in all of these parameters. CONCLUSION Using interactive DAs at FD's offices for counselling of young hypertensive male patients is one possibility to help patients understand their risk factors and make changes in their treatment choices. DAs can be more effective in achieving behavioural changes like reducing smoking or blood pressure compared to normal counselling.
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Affiliation(s)
- Liina Kask-Flight
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia.
| | - Koray Durak
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kadri Suija
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Anneli Rätsep
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Ruth Kalda
- Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
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Zemtsovskaja G, Pilt K, Samarin A, Abina J, Meigas K, Viigimaa M. Construction of gender-specific regression models for aortic length estimation based on computed tomography images. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-019-00391-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sun P, Wang Q, Zhang Y, Huo Y, Nima N, Fan J. Association between homocysteine level and blood pressure traits among Tibetans: A cross-sectional study in China. Medicine (Baltimore) 2019; 98:e16085. [PMID: 31277103 PMCID: PMC6635152 DOI: 10.1097/md.0000000000016085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Studies on hypertension (HTN) in Tibetans who live in high altitude areas are less and whether total homocysteine level (tHcy) is associated with blood pressure (BP) levels or HTN status in Tibetans is unknown.A total of 1486 Tibetans with complete information from a cross-sectional survey conducted in Lhasa Chengguan County of Tibet were included in this study. Demographic data, self-reported history of disease, and life styles were collected using a questionnaire. Blood tHcy, creatinine, fasting plasma-glucose, total cholesterol, triglycerides, and BP were measured with equipment.The median tHcy level of the whole population was 14.60 (13.17-16.50) μmol/L, and the prevalence of HTN was 26.99%. Regression models, adjusted for possible covariates, showed that an average increase of 1 lnHcy (log transformation of tHcy level) was associated with an increase of 3.78 mmHg of systolic BP (SBP, P = .011) and 3.02 mmHg of diastolic BP (DBP, P = .003). The prevalence of HTN, levels of SBP and DBP in the third (OR for HTN: 1.60, P = .026; β for SBP: 3.41, P = .004; β for DBP: 2.57, P = .002) and fourth (OR for HTN: 2.19, P < .001; β for SBP: 5.08, P < .001; β for DBP: 3.09, P < .001) quartile of tHcy level were higher than those in the first quartile.THcy is associated with BP levels and HTN status among Tibetans. Both HTN management and tHcy level should be paid more attention in Tibetans.
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Affiliation(s)
- Pengfei Sun
- Department of Cardiology, Peking University First Hospital
| | - Qianqian Wang
- Department of Molecular Orthopaedics, Beijing Institute of Traumatology and Orthopaedics
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital
| | - Nima Nima
- Department of Cardiology, Lhasa People's Hospital, Lhasa, Xizang
| | - Jun Fan
- Department of Cardiology, Jishuitan Hospital, Beijing, China
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Valladares MJ, Rodríguez Sándigo NA, Rizo Rivera GO, Rodríguez Jarquín MA, Rivera Castillo RM, López Bonilla IM. Prevalence, awareness, treatment, and control of hypertension in a small northern town in Nicaragua: The Elieth-HIFARI study. Health Sci Rep 2019; 2:e120. [PMID: 31346554 PMCID: PMC6636515 DOI: 10.1002/hsr2.120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 03/29/2019] [Accepted: 03/29/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND AIMS Hypertension is considered the most important risk factor for cardiovascular disease and is associated with high levels of morbidity, mortality, and health care expenditure. The negative effects of hypertension and its complications are preventable if those at risk are appropriately treated and controlled. Continually monitoring the epidemiological trends of hypertension is essential to formulate and evaluate public health measures to limit its negative effects. The herein presented Elieth-HIFARI study sought to estimate the prevalence of hypertension, as well as the prevalence of related awareness, treatment, and control in a small town in Central America. METHODS A population survey to assess cardiovascular risk was conducted (n = 577, 55.3% women, mean age 42.4 years) in the municipality of San Rafael del Norte in northern Nicaragua, between November 2016 and March 2017, based on the STEPwise method by the World Health Organization and the recommendations by the World Hypertension League. RESULTS The overall prevalence of hypertension, awareness, treatment, and control was 28.1%, 72.2%, 68.5%, and 36.4%, respectively. Men had a lower prevalence of all indicators (22.5%, 60.3%, 53.4%, and 24.1%, respectively) compared with women (32.6%, 78.8%, 76.9%, and 43.3%, respectively). The median systolic blood pressure was 118.5 mm Hg (20.5 interquartile range [IQR]) (men: 123.0 mm Hg vs women: 115.5 mm Hg, Mann-Whitney U test P < .001), and the mean diastolic blood pressure was 78.0 mm Hg (13 IQR) (men: 77.0, women: 78.0). CONCLUSION Hypertension is highly prevalent in San Rafael del Norte, while control rates are low despite the relatively higher levels of awareness and treatment. Furthermore, women have much higher prevalence of hypertension than men, along with higher awareness, treatment, and control. However, the control rate for those treated for hypertension was low, irrespective of sex.
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Pulse wave velocity and its gender-related associations with cardiovascular risk factors in a high cardiovascular risk population. ARCHIVES OF MEDICAL SCIENCES. ATHEROSCLEROTIC DISEASES 2019; 3:e99-e105. [PMID: 30775598 PMCID: PMC6374584 DOI: 10.5114/amsad.2018.76919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 06/18/2018] [Indexed: 11/17/2022]
Abstract
Introduction Associations found between pulse wave velocity (PWV) and cardiovascular risk factors (CVrF) are diverse. We aimed to evaluate whether differences in PWV and its associations with CVrF in a high cardiovascular risk population exist between genders and between the whole population (WHgr) and groups of apparently healthy (AHgr) and those of hypertensive, obese or diabetics (Rgr). Material and methods Pulse wave velocity measured by Arteriograph was investigated in 805 adults aged 20-65, randomly selected from the Tallinn Population Register. Results Pulse wave velocity was the highest in Rgr and no differences were found between genders of the same group. In women of WHgr and AHgr age and SBP with addition of BMI and apolipoprotein B (ApoB) were associated with 54% and 48%, and without ApoB in Rgr with only 30% of PWV values. In men aged ≥ 50 of WHgr with elevated SBP odds ratios for increased PWV were 25.3 and 3.5, in Rgr 21.2 and 2.2, in those aged ≥ 50 AHgr 28.4. In women aged ≥ 50 of WHgr with elevated SBP and diabetes odds ratios were 5.5, 4.9 and 4.0, in Rgr with elevated SBP and diabetes 3.6 and 3.7, in those aged ≥ 50 AHgr 29.3. Conclusions The associations of ApoB and BMI with PWV and diabetes with elevated PWV indicative of increased aortic stiffness were unique for women. Aging and SBP were related to PWV even in AHgr, although age ≥ 50 years in Rgr women and normal SBP in AHgr were not associated with elevated PWV.
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Innos K, Sepp T, Baburin A, Kotsar A, Lang K, Padrik P, Aareleid T. Increasing kidney cancer incidence and survival in Estonia: role of age and stage. Acta Oncol 2019; 58:21-28. [PMID: 30280624 DOI: 10.1080/0284186x.2018.1512158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Kidney cancer rates in Estonia are high. The study aimed to examine long-term trends in kidney cancer incidence, mortality and survival in Estonia, with special focus on age, birth cohorts, morphology and TNM stage. MATERIAL AND METHODS Estonian Cancer Registry provided data on all incident cases of kidney cancer (ICD-10 C64), diagnosed in adults (age ≥15 years) in Estonia during 1995 - 2014. Relative survival ratios (RSR) were calculated and excess hazard ratios of dying were estimated with gender, age, period of diagnosis and TNM stage as independent variables. Joinpoint regression modeling was used to calculate estimated annual percentage change for incidence (1970-2014) and mortality (1995-2016) trends. Age-specific incidence rates were presented by birth cohort and period of diagnosis. RESULTS Incidence increased significantly in both sexes, with the steepest rise seen for localized cancer. Cohort effects were pronounced particularly in men, while period effects were seen from the mid-1980s to mid-1990s in both sexes. Age-standardized five-year RSR for total kidney cancer increased by 13 percentage units (from 53% to 65%) over the study period; the increase was larger for renal cell carcinoma (from 63% to 78%). Survival increases of about five percentage units were seen for stages I/II and III. Age and gender were not associated with excess risk of dying from renal cell carcinoma after adjusting for stage. CONCLUSION Estonia is currently among countries with the highest incidence of kidney cancer. The results suggest a combined effect of changing risk profiles in successive birth cohorts and increasing diagnostic activity around 1990. Large survival increase can mostly be attributed to earlier detection, but improved diagnosis and treatment have probably influenced stage-specific survival. High proportion of tumors with unspecified morphology and those with unknown stage among the elderly warrants further investigation of diagnostic and treatment practices.
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Affiliation(s)
- Kaire Innos
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Teesi Sepp
- Department of Urology and Kidney Transplantation, Clinic of Surgery, Tartu University Hospital, Tartu, Estonia
| | - Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Andres Kotsar
- Department of Urology and Kidney Transplantation, Clinic of Surgery, Tartu University Hospital, Tartu, Estonia
| | - Katrin Lang
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Peeter Padrik
- Clinic of Haematology and Oncology, Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Tiiu Aareleid
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
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Prevalence of cardiovascular disease risk factors in Tallinn, Estonia. Medicina (B Aires) 2017; 53:268-276. [DOI: 10.1016/j.medici.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 06/27/2017] [Accepted: 07/11/2017] [Indexed: 11/21/2022] Open
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Basit KA, Fawwad A, Munir MA, Siddiqui IA, Siddiqui S, Basit A. Differences in various biochemical and clinical parameters with respect to family history of Non Communicable Diseases in fourth year MBBS students of Karachi, Pakistan. Pak J Med Sci 2015; 31:965-9. [PMID: 26430439 PMCID: PMC4590368 DOI: 10.12669/pjms.314.7021] [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] [Indexed: 11/17/2022] Open
Abstract
Objective: To observe the differences of various biochemical and clinical parameters with respect to Family History (FH) of Non-communicable Diseases (NCDs) in fourth year Bachelor of Medicine, Bachelor of Surgery (MBBS) students. Methods: This observational study was conducted at Baqai Institute of Diabetology & Endocrinology from December 2013 to January 2014. Total 50 medical students from Dow University of Health Sciences (DUHS) participated in the study. Statistical Package for Social Sciences (SPSS) version 13 was used to analyze the data. For cross tabulation and mean comparison z-test and t test were applied. Results: Out of 50 subjects, there were 26 (52%) females. Mean age of the study population was 21.56 ± 0.90 years. Mean serum cholesterol levels with positive FH of NCDs was significantly higher than negative FH of NCDs (p=0.005). Mean value of low density lipoprotein (LDL) of positive family history of NCDs was found higher than those with negative FH (p=0.006) being statistically significant. The insulin levels in subjects with positive FH of NCDs were higher than subjects with negative FH of NCDs (p=0.685). However, serum leptin and plasma renin showed no significant difference with the negative FH of NCDs being higher compared to positive FH of NCDs (p=0.068) and (p=0.884) respectively. However, Waist circumference, Body mass index and central obesity in subjects with positive FH of NCDs shows increasing trend but no statistically significant difference (p > 0.05) was observed. Conclusion: In our study of various biochemical and clinical parameters with respect to FH of NCDs, Serum Cholesterol and LDL levels were observed higher and statistically significant.
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Affiliation(s)
- Khalid Abdul Basit
- Khalid Abdul Basit, Student, MBBS, Dow University of Health Sciences, Karachi, Pakistan
| | - Asher Fawwad
- Asher Fawwad, M.phil. Assistant Prof., Senior Research Scientist, Research Department, Baqai Medical University, Baqai Institute of Diabetology and Endocrinology, Plot No. 1-2, II-B, Nazimabad No.2, Karachi-74600, Pakistan
| | - Muhammad Asadullah Munir
- Asher Fawwad, M.phil. Assistant Prof., Senior Research Scientist, Research Department, Baqai Medical University, Baqai Institute of Diabetology and Endocrinology, Plot No. 1-2, II-B, Nazimabad No.2, Karachi-74600, Pakistan
| | - Iftikhar Ahmed Siddiqui
- Iftikhar Ahmed Siddiqui, PhD. Chairman & Professor of Biochemistry, Department of Biochemistry, Baqai Medical University, Karachi, Pakistan
| | - Sidra Siddiqui
- Sidra Siddiqui, M.Sc. Statistician, Research Department, Baqai Medical University, Baqai Institute of Diabetology and Endocrinology, Plot No. 1-2, II-B, Nazimabad No.2, Karachi-74600, Pakistan
| | - Abdul Basit
- Abdul Basit, F.R.C.P. Professor of Medicine, Department of Medicine, Baqai Medical University, Baqai Institute of Diabetology and Endocrinology, Plot No. 1-2, II-B, Nazimabad No.2, Karachi-74600, Pakistan
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