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Obasi DC, Ogugua VN. Effect of Ruzu Herbal Bitters on the Liver Function and Lipid Profile Parameters of Alloxan-Induced Diabetic Rats. J Clin Exp Hepatol 2024; 14:100929. [PMID: 38799007 PMCID: PMC11123546 DOI: 10.1016/j.jceh.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/12/2021] [Indexed: 05/29/2024] Open
Abstract
Background Ruzu herbal bitters (RHB) is a polyherbal mixture produced in Nigeria indicated for diabetes and other ailments. The consumers of the product testify of its efficacy, but there are not much scientific information on RHB. The study determined the effect of RHB on the liver function and lipid profile parameters of alloxan-induced diabetic rats. Method Fifty-four adult albino rats were divided into nine groups of six rats each. Group 1 was the normal control, while groups 2-6 were diabetic. Group 2 was not treated, while groups 3-6 were respectively treated with 5 mg/kg b.w of glibenclamide, 0.14, 0.29, and 0.57 ml/kg b.w of RHB. Groups 7-9 were not diabetic but treated as groups 4-6. Diabetes was induced by intraperitoneal injection of freshly prepared alloxan into adult male albino Wister rats with a single dose of 120 mg/kg body weight. The blood sugar level, weight, liver function, and lipid profile of the rats were tested using standard methods. Result The results showed a significant (P < 0.05) increase in the blood glucose level and decrease in weight in the diabetic-untreated group compared to the normal group. The liver function and lipid profile tests showed significant (P<0.05) increases in the activities of gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST); increases in the levels of total bilirubin, total cholesterol (T.CHOL), triglycerides (TG), very low-density lipoprotein (VLDL) and lowdensity lipoprotein (LDL); decreases in the levels of total protein, albumin and high-density lipoproteins (HDL), in the diabetic-untreated group compared to the normal group. However, treatment of the diabetic rats with different doses of RHB caused the reversal of these effects to near-normal levels in a dose-dependent manner. Conclusions Our study reveals that RHB has antidiabetic, hepatoprotective, and antihyperlipidemic effects.
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Affiliation(s)
- David C. Obasi
- Department of Biochemistry, Evangel University, Akaeze, Ebonyi State, Nigeria
- Department of Medical Biochemistry, David Umahi Federal University of Health Sciences, Uburu, Ebonyi State, Nigeria
| | - Victor N. Ogugua
- Department of Biochemistry, University of Nigeria, Nsukka, Nigeria
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Liu T, Fan Z, Xiao B, He C, Wang S. Association of sodium-glucose cotransporter 2 inhibitors with risk of major adverse cardiovascular events in type 2 diabetes patients with acute coronary syndrome: a propensity score‑matched analysis. Cardiovasc Diabetol 2024; 23:106. [PMID: 38528542 PMCID: PMC10964669 DOI: 10.1186/s12933-024-02200-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND This study aimed to investigate the association of sodium-glucose cotransporter 2 inhibitors (SGLT2i) use with cardiovascular (CV) clinical outcomes in type 2 diabetes (T2D) patients with acute coronary syndrome (ACS). METHODS Data of T2D patients hospitalized for ACS at Civil Aviation General Hospital from January 2019 to December 2022 were collected. Based on SGLT2i use or not, patients were stratified as SGLT2i group and SGLT2i-free group. A 1:1 nearest-neighbor propensity score-matched (PSM) was performed to adjust for the confounding factors and facilitate the robust comparisons between groups. The first occurrence of major adverse cardiovascular events (MACE) with 1 year follow-up, which consisted of CV death, all cause death, non-fatal myocardial infarction or stroke, coronary revascularization or heart failure readmission, was assessed. Kaplan-Meier analysis and Cox regressions were conducted to evaluate the prognostic significance of SGLT2i use. Subgroup analyses were performed to assess the interaction between subgroups and SGLT2i use. RESULTS A total of 925 patients were included, and the SGLT2i use increased from 9.9% in 2019 to 43.8% in 2022. 226 pairs were finally matched using the PSM model. During 1 year follow-up period, a total of 110 patients experienced MACE in the matched cohort, with a rate of 24.3%. Survival analyses showed cumulative incidence of MACE, CV death, and heart failure readmission in the SGLT2i group were significantly lower than the SGLT2i-free group. Additionally, the adjusted Cox analyses demonstrated that SGLT2i was associated with a 34.1% lower risk of MACE (HR 0.659, 95% CI 0.487-0.892, P = 0.007), which was primarily driven by a decrease in the risk of CV death by 12.0% (HR 0.880, 95% CI 0.7830.990, P = 0.033), and heart failure readmission by 45.5% (HR 0.545, 95% CI 0.332-0.893, P = 0.016). This MACE preventive benefit was consistent across different subgroups (P interaction > 0.05 for all comparisons). CONCLUSIONS In T2D patients with ACS, there was a clear increasing trend in SGLT2i use. SGLT2i was associated with a significantly lower risk of MACE, driven by the decrease in the risk of CV death, and heart failure readmission. Our study confirmed real-world use and efficacy of SGLT2i in a general T2D population with ACS.
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Affiliation(s)
- Tao Liu
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China
| | - Zeyuan Fan
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China.
| | - Bing Xiao
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China
| | - Chang He
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China
| | - Shicong Wang
- Department of Coronary Heart Disease, Civil Aviation General Hospital, No. 1 Gaojingjia Road, Chaoyang District, Beijing, China
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Jonas RA, Crabtree TR, Jennings RS, Marques H, Katz RJ, Chang HJ, Stuijfzand WJ, van Rosendael AR, Choi JH, Doh JH, Her AY, Koo BK, Nam CW, Park HB, Shin SH, Cole J, Gimelli A, Khan MA, Lu B, Gao Y, Nabi F, Nakazato R, Schoepf UJ, Driessen RS, Bom MJ, Thompson RC, Jang JJ, Ridner M, Rowan C, Avelar E, Généreux P, Knaapen P, de Waard GA, Pontone G, Andreini D, Al-Mallah MH, Guglielmo M, Bax JJ, Earls JP, Min JK, Choi AD, Villines TC. Diabetes, Atherosclerosis, and Stenosis by AI. Diabetes Care 2023; 46:416-424. [PMID: 36577120 PMCID: PMC9887618 DOI: 10.2337/dc21-1663] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/14/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study evaluates the relationship between atherosclerotic plaque characteristics (APCs) and angiographic stenosis severity in patients with and without diabetes. Whether APCs differ based on lesion severity and diabetes status is unknown. RESEARCH DESIGN AND METHODS We retrospectively evaluated 303 subjects from the Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia (CREDENCE) trial referred for invasive coronary angiography with coronary computed tomographic angiography (CCTA) and classified lesions as obstructive (≥50% stenosed) or nonobstructive using blinded core laboratory analysis of quantitative coronary angiography. CCTA quantified APCs, including plaque volume (PV), calcified plaque (CP), noncalcified plaque (NCP), low-density NCP (LD-NCP), lesion length, positive remodeling (PR), high-risk plaque (HRP), and percentage of atheroma volume (PAV; PV normalized for vessel volume). The relationship between APCs, stenosis severity, and diabetes status was assessed. RESULTS Among the 303 patients, 95 (31.4%) had diabetes. There were 117 lesions in the cohort with diabetes, 58.1% of which were obstructive. Patients with diabetes had greater plaque burden (P = 0.004). Patients with diabetes and nonobstructive disease had greater PV (P = 0.02), PAV (P = 0.02), NCP (P = 0.03), PAV NCP (P = 0.02), diseased vessels (P = 0.03), and maximum stenosis (P = 0.02) than patients without diabetes with nonobstructive disease. APCs were similar between patients with diabetes with nonobstructive disease and patients without diabetes with obstructive disease. Diabetes status did not affect HRP or PR. Patients with diabetes had similar APCs in obstructive and nonobstructive lesions. CONCLUSIONS Patients with diabetes and nonobstructive stenosis had an association to similar APCs as patients without diabetes who had obstructive stenosis. Among patients with nonobstructive disease, patients with diabetes had more total PV and NCP.
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Affiliation(s)
- Rebecca A. Jonas
- Department of Internal Medicine, Thomas Jefferson University Medical Center; Philadelphia, PA
- Corresponding author: Rebecca A. Jonas,
| | | | | | - Hugo Marques
- Faculdade de Medicina da Universidade Católica Portuguesa, Lisboa, Portugal
| | - Richard J. Katz
- The George Washington University School of Medicine & Health Sciences, Washington, DC
| | - Hyuk-Jae Chang
- Division of Cardiology, Severance Cardiovascular Hospital and Severance Biomedical Science Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Wijnand J. Stuijfzand
- Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | | | | | - Joon-Hyung Doh
- Division of Cardiology, Inje University Ilsan Paik Hospital, Goyang, South Korea
| | - Ae-Young Her
- Kang Won National University Hospital, Chuncheon, South Korea
| | - Bon-Kwon Koo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Chang-Wook Nam
- Cardiovascular Center, Keimyung University Dongsan Hospital, Daegu, South Korea
| | - Hyung-Bok Park
- Division of Cardiology, Department of Internal Medicine, International St. Mary’s Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea
| | - Sang-Hoon Shin
- Division of Cardiology, Department of Internal Medicine, Ewha Women’s University Seoul Hospital, Seoul, South Korea
| | - Jason Cole
- Mobile Cardiology Associates, Mobile, AL
| | - Alessia Gimelli
- Department of Imaging, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | - Bin Lu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China
| | - Yang Gao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China
| | | | - Ryo Nakazato
- Cardiovascular Center, St. Luke’s International Hospital, Tokyo, Japan
| | | | - Roel S. Driessen
- Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Michiel J. Bom
- Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | | | - James J. Jang
- Kaiser Permanente San Jose Medical Center, San Jose, CA
| | | | - Chris Rowan
- Renown Heart and Vascular Institute, Reno, NV
| | - Erick Avelar
- Oconee Heart and Vascular Center at St Mary’s Hospital, Athens, GA
| | - Philippe Généreux
- Gagnon Cardiovascular Institute at Morristown Medical Center, Morristown, NJ
| | - Paul Knaapen
- Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Guus A. de Waard
- Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the Netherlands
| | - Gianluca Pontone
- Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Daniele Andreini
- Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | | | - Marco Guglielmo
- Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Jeroen J. Bax
- Department of Cardiology, Leiden University Medical Center, Amsterdam, the Netherlands
| | | | | | - Andrew D. Choi
- The George Washington University School of Medicine & Health Sciences, Washington, DC
| | - Todd C. Villines
- Division of Cardiovascular Medicine, University of Virginia Health System, Charlottesville, VA
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Mrgan M, Nørgaard BL, Dey D, Gram J, Olsen MH, Gram J, Sand NPR. Coronary flow impairment in asymptomatic patients with early stage type-2 diabetes: Detection by FFR CT. Diab Vasc Dis Res 2020; 17:1479164120958422. [PMID: 32985257 PMCID: PMC7919222 DOI: 10.1177/1479164120958422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE To determine the occurrence of physiological significant coronary artery disease (CAD) by coronary CT angiography (CTA) derived fractional flow reserve (FFRCT) in asymptomatic patients with a new diagnosis (<1 year) of type-2 diabetes mellitus (T2DM). METHODS FFRCT-analysis was performed from standard acquired coronary CTA data sets. The per-patient minimum distal FFRCT-value (d-FFRCT) in coronary vessels (diameter ⩾1.8 mm) was registered. The threshold for categorizing FFRCT-analysis as abnormal was a d-FFRCT ⩽0.75. Total plaque volume and volumes of calcified plaque, non-calcified plaque, and low-density non-calcified plaque (LD-NCP) were assessed by quantitative plaque analysis. RESULTS Overall, 76 patients; age, mean (SD): 56 (11) years; males, n (%): 49(65), were studied. A total of 57% of patients had plaques. The d-FFRCT was ⩽0.75 in 12 (16%) patients. The d-FFRCT, median (IQR), was 0.84 (0.79-0.87). Median (range) d-FFRCT in patients with d-FFRCT ⩽0.75 was 0.70 (0.6-0.74). Patients with d-FFRCT⩽0.75 versus d-FFRCT >0.75 had numerically higher plaque volumes for all plaques components, although only significant for the LD-NCP component. CONCLUSION Every sixth asymptomatic patient with a new diagnosis of T2DM has hemodynamic significant CAD as evaluated by FFRCT. Flow impairment by FFRCT was associated with coronary plaque characteristics.
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Affiliation(s)
- Monija Mrgan
- Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark
| | | | - Damini Dey
- Department of Biomedical Sciences
(Biomedical Imaging Research Institute), Cedars-Sinai Medical Center, Los Angeles,
CA, USA
| | - Jørgen Gram
- Unit for Thrombosis Research, University
of Southern Denmark, Odense
- Department of Clinical Biochemistry,
University Hospital of Southern Denmark, Esbjerg, Denmark
| | - Michael Hecht Olsen
- Cardiology Section, Department of
Internal Medicine, Holbæk Hospital, Holbæk, Sjaelland, Denmark
- Centre for Individualized Medicine in
Arterial Diseases (CIMA), University of Southern Denmark, Denmark
| | - Jeppe Gram
- Department of Endocrinology, University
Hospital of Southern Denmark, Esbjerg, Denmark
| | - Niels Peter Rønnow Sand
- Department of Cardiology, University
Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research,
University of Southern Denmark, Denmark
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5
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Relationship of visual impairment and peripheral artery disease with the occurrence of diabetic foot ulcers in Dr. Moewardi Hospital. FRONTIERS OF NURSING 2019. [DOI: 10.2478/fon-2019-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Objective
One of the diabetes mellitus (DM) complications is foot ulcers. Foot ulcers are influenced by many factors. DM puts patients at risk of injury because of visual impairment. Hyperglycemia can damage blood vessels, which results in peripheral artery disease (PAD). The purpose of this study was to find the relationship of visual impairment and PAD with diabetic foot ulcers.
Methods
This research used observational analytic study with case–control methods. It used purposive sampling in 34 DM patients with foot ulcers and 34 DM patients without foot ulcers. The research instruments were an interview guide to assess visual impairment, physical examination to assess PAD, and documentation study, which was used to know the incidence of diabetic ulcers.
Results
The results showed that the respondents who experienced ulcers with visual impairment were 44.1% and the respondents who had foot ulcers with PAD were 73.5%. The results of statistical tests showed that there was no relationship between visual impairment and the incidence of ulcers (P = 0.166). The respondents with PAD will have a chance to suffer from foot ulcers 5.808 times higher than those who do not have PAD.
Conclusions
There is no relationship between visual impairment and the incidence of diabetic foot ulcers in Dr. Moewardi Hospital, but there is relationship between PAD and the incidence of diabetic foot ulcers in Dr. Moewardi Hospital. Suggestions of this study are to do foot screening and educate about the importance of foot care to prevent the occurrence of diabetic ulcers.
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6
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Ramanathan R, Dey D, Nørgaard BL, Goeller M, Bjerrum IS, Antulov R, Diederichsen ACP, Sidelmann JJ, Gram JB, Sand NPR. Carotid plaque composition by CT angiography in asymptomatic subjects: a head-to-head comparison to ultrasound. Eur Radiol 2019; 29:5920-5931. [PMID: 30915562 DOI: 10.1007/s00330-019-06086-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/27/2019] [Accepted: 02/08/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To describe carotid plaque composition by computed tomography angiography (CTA) in asymptomatic subjects and to compare this to carotid plaque assessment by ultrasound, coronary plaques by coronary CTA, and inflammatory biomarkers in plasma. METHODS Middle-aged asymptomatic men, n = 43, without known cardiovascular disease and diabetes were included. Plaques in coronary and carotid arteries were evaluated using CTA. Total plaque volumes and plaque composition were assessed by a validated plaque analysis software. The 60% centile cut point was used to divide the population into low or high carotid total plaque volumes. The occurrence of carotid plaques and intima-media thickness (IMT) was estimated by ultrasound. RESULTS Carotid plaque by ultrasound was undiagnosed in 13 of 28 participants (46%) compared to CTA. Participants having carotid plaques by ultrasound had significantly higher absolute volumes of all CTA-defined carotid plaque subtypes and a higher fraction of calcified plaque. A high carotid total plaque volume was independently associated with age (adjusted odds ratio (OR) 1.41 [95% confidence interval (CI) 1.14-1.74], p = 0.001), IMT (adjusted OR 2.26 [95% CI 1.10-4.65], p = 0.03), and D-dimer (adjusted OR 8.86 [95% CI 1.26-62.37], p = 0.03). All coronary plaque features were significantly higher in participants with a high carotid total plaque volume. CONCLUSION The occurrence of carotid plaques in asymptomatic individuals is underestimated by ultrasound compared to plaque assessment by CTA. Carotid plaque composition by CTA is different in individuals with and without carotid plaques by ultrasound. KEY POINTS • The occurrence of carotid plaques by ultrasound was underestimated in 46% of participants who had plaques by carotid CTA. • Participants with carotid plaques by ultrasound had higher volumes of all plaque subtypes and a higher calcified plaque component as determined by carotid CTA compared to participants without carotid plaques by ultrasound. • A high carotid total plaque volume was independently associated with age, intima-media thickness, and D-dimer.
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Affiliation(s)
- Ramshanker Ramanathan
- Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
- Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark.
- Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark.
| | - Damini Dey
- Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, 90048, USA
| | - Bjarne L Nørgaard
- Department of Cardiology, Skejby University Hospital, Aarhus, Denmark
| | - Markus Goeller
- Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, 90048, USA
| | - Ida S Bjerrum
- Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Ronald Antulov
- Department of Radiology, University Hospital of Southern Denmark, Esbjerg, Denmark
| | | | - Johannes J Sidelmann
- Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
- Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Jørgen B Gram
- Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
- Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark
| | - Niels Peter R Sand
- Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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7
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Mrgan M, Gram J, Hecht Olsen M, Dey D, Linde Nørgaard B, Gram J, Rønnow Sand NP. Sex differences in coronary plaque composition evaluated by coronary computed tomography angiography in newly diagnosed Type 2 diabetes: association with low-grade inflammation. Diabet Med 2018; 35:1588-1595. [PMID: 29931809 DOI: 10.1111/dme.13768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2018] [Indexed: 12/23/2022]
Abstract
AIM To determine differences in coronary plaque composition and inflammatory biomarkers between men and women with newly diagnosed Type 2 diabetes without known cardiovascular disease. METHODS A total of 88 people with newly diagnosed (<1 year) Type 2 diabetes underwent contrast-enhanced coronary computed tomography angiography. Advanced coronary plaque analysis was performed using semi-automated software. Plasma concentrations of inflammatory biomarkers were determined. RESULTS There were no significant differences between men (n=60) and women (n=28) regarding age or cardiovascular risk factors (all P>0.05). The median (quartiles) serum levels of fibrinogen [10.9 (9.8-12.6) μmol/l vs 9.7 (8.8-10.9) μmol/l], fibrin d-dimer [0.3 (0.2-0.4) mg/l vs 0.27 (0.2-0.4) mg/l] and C-reactive protein [3.1 (1.1-5.2) mg/l vs (0.8-2.6) 1.6 mg/l] were significantly higher in women (all P<0.05). Overall, men more often had multi-vessel involvement [28 men (47%) vs 4 women (14%)], and higher total plaque burden [median (quartiles) 11.6 (2.3-36.0)% vs 2.0 (0.4-5.4)%; both P<0.05]. The median (quartiles) total plaque volume [269.9 (62.6-641.9) mm3 vs 61.1 (7.6-239.9) mm3 ] and absolute calcified plaque volume [33.5 (8.3-148.3) mm3 vs 4.7 (0.9-17.3) mm3 ] were higher in men (both P<0.05). Women had a lower relative proportion of the calcified plaque component [median (quartiles) 7.8 (4.7-15.4)% vs 23.7 (8.4-31.1)%] and a higher relative proportion (median [quartiles]) of the non-low-density non-calfied plaque component [77.6 (66.0-86.0)% vs 63.6 (54.0-72.9)%; both P<0.05]. CONCLUSIONS In people with newly diagnosed Type 2 diabetes, women had lower absolute coronary plaque volumes but a more unfavourable plaque composition and enhanced systemic inflammation compared with men.
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Affiliation(s)
- M Mrgan
- Department of Cardiology, Hospital of Southwest Denmark, Esbjerg, Denmark
| | - J Gram
- Unit for Thrombosis Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry, Hospital of Southwest Denmark, Esbjerg, Denmark
| | - M Hecht Olsen
- Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - D Dey
- Department of Biomedical Sciences (Biomedical Imaging Research Institute), Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - B Linde Nørgaard
- Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
| | - J Gram
- Department of Endocrinology, Hospital of Southwest Denmark, Esbjerg, Denmark
| | - N P Rønnow Sand
- Department of Cardiology, Hospital of Southwest Denmark, Esbjerg, Denmark
- Institute of Regional Health Research, University of Southern, Denmark, Odense
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8
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Lee CH, Lee SW, Park SW. Diabetes and Subclinical Coronary Atherosclerosis. Diabetes Metab J 2018; 42:355-363. [PMID: 30362301 PMCID: PMC6202561 DOI: 10.4093/dmj.2018.0041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/20/2018] [Indexed: 12/19/2022] Open
Abstract
It is well known that diabetic patients have a high risk of cardiovascular events, and although there has been a tremendous effort to reduce these cardiovascular risks, the incidence of cardiovascular morbidity and mortality in diabetic patients remains high. Therefore, the early detection of coronary artery disease (CAD) is necessary in those diabetic patients who are at risk of cardiovascular events. Significant medical and radiological advancements, including coronary computed tomography angiography (CCTA), mean that it is now possible to investigate the characteristics of plaques, instead of solely evaluating the calcium level of the coronary artery. Recently, several studies reported that the prevalence of subclinical coronary atherosclerosis (SCA) is higher than expected, and this could impact on CAD progression in asymptomatic diabetic patients. In addition, several reports suggest the potential benefit of using CCTA for screening for SCA in asymptomatic diabetic patients, which might dramatically decrease the incidence of cardiovascular events. For these reasons, the medical interest in SCA in diabetic patients is increasing. In this article, we sought to review the results of studies on CAD in asymptomatic diabetic patients and discuss the clinical significance and possibility of using CCTA to screen for SCA.
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Affiliation(s)
- Chang Hoon Lee
- Department of Cardiology, Veterans Health Service Medical Center, Seoul, Korea
| | - Seung Whan Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Seong Wook Park
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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9
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Bhowmik B, Siddiquee T, Mujumder A, Afsana F, Ahmed T, Mdala IA, do V Moreira NC, Khan AKA, Hussain A, Holmboe-Ottesen G, Omsland TK. Serum Lipid Profile and Its Association with Diabetes and Prediabetes in a Rural Bangladeshi Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1944. [PMID: 30200612 PMCID: PMC6165005 DOI: 10.3390/ijerph15091944] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 12/28/2022]
Abstract
Dyslipidemia is commonly associated with diabetes (T2DM). This has been demonstrated for the Caucasian population, but few data are available for Asian Indians. The paper aims to investigate serum lipids (separately or in combination) and their association with glucose intolerance status (T2DM and prediabetes) in a rural Bangladeshi population. A sample of 2293 adults (≥20 years) were included in a community based cross-sectional survey in 2009. Anthropometric measures, blood pressure, blood glucose (fasting and 2-h oral glucose tolerance test) and fasting serum lipids (total cholesterol, T-Chol; triglycerides, Tg; low density lipoprotein cholesterol, LDL-C and high density lipoprotein cholesterol, HDL-C) were registered. Analysis of covariance (ANCOVA) and regression analysis were performed. High Tg levels were seen in 26% to 64% of the participants, depending on glucose tolerance status. Low HDL-C levels were seen in all groups (>90%). Significant linear trends were observed for high T-Chol, high Tg and low HDL-C with increasing glucose intolerance (p for trend <0.001). T2DM was significantly associated with high T-Chol (Odds ratio (OR): 2.43, p < 0.001), high Tg (OR: 3.91, p < 0.001) and low HDL-C (OR: 2.17, p = 0.044). Prediabetes showed a significant association with high Tg (OR: 1.96, p < 0.001) and low HDL-C (OR: 2.93, p = 0.011). Participants with combined high Tg and low HDL-C levels had a 12.75-fold higher OR for T2DM and 4.89 OR for prediabetes. In Asian Indian populations an assessment of serum lipids is warranted not only for T2DM patients, but also for those with prediabetes.
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Affiliation(s)
- Bishwajit Bhowmik
- Department of Community Medicine and Global Health, University of Oslo, 0318 Oslo, Norway.
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh.
| | - Tasnima Siddiquee
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh.
| | - Anindita Mujumder
- Department of Pathology, Ibrahim Medical College, Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh.
| | - Faria Afsana
- Bangladesh Institute of Research & Rehabilitation of Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka 1000, Bangladesh.
| | - Tareen Ahmed
- Bangladesh Institute of Research & Rehabilitation of Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka 1000, Bangladesh.
| | - Ibrahimu A Mdala
- Department of Community Medicine and Global Health, University of Oslo, 0318 Oslo, Norway.
| | | | - Abul Kalam Azad Khan
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh.
| | - Akhtar Hussain
- Centre for Global Health Research, Diabetic Association of Bangladesh, Dhaka 1000, Bangladesh.
- Faculty of Health Science, NORD University, 8049 Bodo, Norway.
| | - Gerd Holmboe-Ottesen
- Department of Community Medicine and Global Health, University of Oslo, 0318 Oslo, Norway.
| | - Tone Kristin Omsland
- Department of Community Medicine and Global Health, University of Oslo, 0318 Oslo, Norway.
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