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Han F, Yu C, Hu F, Zhou W, Wang T, Zhu L, Huang X, Bao H, Cheng X. Association between serum uric acid levels and peripheral artery disease in Chinese adults with hypertension. Front Endocrinol (Lausanne) 2023; 14:1197628. [PMID: 37674616 PMCID: PMC10478083 DOI: 10.3389/fendo.2023.1197628] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/31/2023] [Indexed: 09/08/2023] Open
Abstract
Background Higher serum uric acid (SUA) can cause gout, which is principally characterized by arthritis due to monosodium urate crystal deposition in the lower extremities. High levels of SUA have been linked to endothelial dysfunction, oxidative stress, and inflammation, all of which are involved in the pathogenesis of peripheral artery disease(PAD). To date, the relationship between SUA levels and PAD is still poorly understood. Method An analysis of 9,839 Chinese adults with essential hypertension from the ongoing China H-type Hypertension Registry Study was conducted in this cross-sectional study. Patients with an ABI ≤0.9 was diagnosed with PAD. Hyperuricemia was defined as SUA levels >420 mol/L in men and >360 mol/L in women. The association between SUA levels and PAD was evaluated using multivariable logistic regression models based on odds ratios (ORs) and their 95% confidence intervals (CIs). Results The enrolled subjects ranged in age from 27 to 93 years, with a mean age of 63.14 ± 8.99 years. The proportion of male patients was 46.22%, and the prevalence of hyperuricemia was 50.72%. In males, hyperuricemia was positively associated with the risk of PAD (adjusted OR per SD increase: 1.72, 95% CI 1.17 to 2.53, P =0.006). Males in the highest SUA tertile were significantly more likely to have PAD (adjusted OR: 2.63, 95% CI 1.42 to 4.86, P = 0.002; P for trend = 0.001). However, this positive relationship was not observed in females (adjusted OR: 1.29, 95% CI 0.77 to 2.17, P = 0.327; P for trend = 0.347). Conclusion According to this cross-sectional study, higher SUA levels were positively associated with PAD in male hypertensive patients, while this positive relationship disappeared in female participants.
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Affiliation(s)
- Fengyu Han
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Feng Hu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Linjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Felício JS, de Melo FTC, Vieira GM, de Aquino VT, de Souza Parente F, da Silva WM, Said NM, da Silva ER, de Souza ACCB, de Oliveira MCNI, de Lemos GN, de Souza ÍJA, de Alcântara AL, de Moraes LV, Abrahão Neto JF, de Queiroz NNM, Mourão NAL, Piani PPF, Oliveira Dos Reis MDS, Felício KM. Peripheral arterial disease progression and ankle brachial index: a cohort study with newly diagnosed patients with type 2 diabetes. BMC Cardiovasc Disord 2022; 22:294. [PMID: 35761179 PMCID: PMC9238109 DOI: 10.1186/s12872-022-02722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 06/14/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Little is known about the evolution of peripheral arterial disease (PAD) since diagnosis and its association with glycemic and lipid control in patients with Type 2 Diabetes Mellitus (T2DM). OBJECTIVE Evaluate the actual criteria to start screening PAD with ankle-brachial index (ABI) in T2DM patients and assess its progression and relationship with glycemic and lipid control since diagnosis. METHODS We performed a 3-year prospective cohort study with two groups: group 1 (978 individuals with T2DM undergoing drug treatment) and group 2 [221 newly diagnosed drug-naive (< 3 months) patients with T2DM]. PAD diagnosis was by ABI ≤ 0.90, regardless any symptoms. RESULTS As expected, abnormal ABI prevalence was higher in group 1 vs. Group 2 (87% vs. 60%, p < 0.001). However, abnormal ABI prevalence did not differ between patients over and under 50 years in both groups. Our drug-naive group stabilizes ABI (0.9 ± 0.1 vs 0.9 ± 0.1, p = NS) and improved glycemic and lipid control during follow-up [glycated hemoglobin (HbA1c) = 8.9 ± 2.1 vs 8.4 ± 2.3%, p < 0.05; LDL = 132 ± 45 vs 113 ± 38 mg/dL, p < 0.01, respectively]. When compared, patients who evolved with normalization or maintained normal ABI levels at the end [Group A, N = 60 (42%)] with those who decreased ABI to abnormal levels (ABI basal 1.0 ± 0.1 vs final 0.85 ± 0.1, p < 0.001) [Group B, N = 26 (18%)], an improvement in HbA1c (9 ± 2 vs 8 ± 2%, p < 0.05) and a correlation between the final HbA1c with ABI (r = - 0.3, p = 0.01) was found only in the first. In addition, a correlation was found between albuminuria variation and ABI solely in group A (r = - 0.3; p < 0.05). CONCLUSION Our study suggests that ABI should be measured at diagnosis in T2DM patients, indicating that current criteria to select patients to screen PAD with ABI must be simplified. An improvement in albuminuria and glycemic and lipid control could be related with ABI normalization in newly diagnosed T2DM drug-naive patients.
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Affiliation(s)
- João Soares Felício
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil.
| | - Franciane Trindade Cunha de Melo
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Giovana Miranda Vieira
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Vitória Teixeira de Aquino
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Fernanda de Souza Parente
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Wanderson Maia da Silva
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Nivin Mazen Said
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Emanuele Rocha da Silva
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Ana Carolina Contente Braga de Souza
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Maria Clara Neres Iunes de Oliveira
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Gabriela Nascimento de Lemos
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Ícaro José Araújo de Souza
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Angélica Leite de Alcântara
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Lorena Vilhena de Moraes
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - João Felício Abrahão Neto
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Natércia Neves Marques de Queiroz
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Neyla Arroyo Lara Mourão
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Pedro Paulo Freire Piani
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Melissa de Sá Oliveira Dos Reis
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
| | - Karem Mileo Felício
- Endocrinology Division, University Hospital João de Barros Barreto, Federal University of Pará, Mundurucus Street, 4487, Guamá, Belém, Pará, 66073-000, Brazil
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Cardiovascular and metabolic changes in Brazilian truck drivers. JOURNAL OF VASCULAR NURSING 2022; 40:112-116. [DOI: 10.1016/j.jvn.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 05/20/2021] [Accepted: 05/01/2022] [Indexed: 12/24/2022]
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Reis RMDF, Azulay RSDS, Tavares MDG, Nascimento GC, Damianse SDSP, Rocha VCDC, Almeida AG, Lago DCF, Rodrigues V, Magalhães M, Sobral CS, Parente C, França J, Ribeiro J, Ferraz PCD, Junior CAA, Silva DA, Gomes MB, Faria MDS. Early Markers of Cardiovascular Disease Associated with Clinical Data and Autosomal Ancestry in Patients with Type 1 Diabetes: A Cross-Sectional Study in an Admixed Brazilian Population. Genes (Basel) 2022; 13:genes13020389. [PMID: 35205433 PMCID: PMC8872303 DOI: 10.3390/genes13020389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
Patients with type 1 diabetes (T1D) have a higher risk of developing cardiovascular disease (CVD), which is a major cause of death in this population. This study investigates early markers of CVD associated with clinical data and autosomal ancestry in T1D patients from an admixed Brazilian population. A cross-sectional study was conducted with 99 T1D patients. The mean age of the study sample was 27.6 years and the mean duration of T1D was 14.4 years. The frequencies of abnormalities of the early markers of CVD were 19.6% in the ankle-brachial index (ABI), 4.1% in the coronary artery calcium score (CACS), and 5% in the carotid Doppler. A significant percentage of agreement was observed for the comparison of the frequency of abnormalities between CACS and carotid Doppler (92.2%, p = 0.041). There was no significant association between the level of autosomal ancestry proportions and early markers of CVD. The ABI was useful in the early identification of CVD in asymptomatic young patients with T1D and with a short duration of disease. Although CACS and carotid Doppler are non-invasive tests, carotid Doppler is more cost-effective, and both have limitations in screening for CVD in young patients with a short duration of T1D. We did not find a statistically significant relationship between autosomal ancestry proportions and early CVD markers in an admixed Brazilian population.
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Affiliation(s)
- Roberta Maria Duailibe Ferreira Reis
- Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão-UFMA, Av. dos Portugueses, São Luís 65085-580, Brazil; (M.M.); (M.d.S.F.)
- Correspondence:
| | - Rossana Santiago de Sousa Azulay
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Maria da Glória Tavares
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Gilvan Cortês Nascimento
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Sabrina da Silva Pereira Damianse
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Viviane Chaves de Carvalho Rocha
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Ana Gregória Almeida
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís 65020-070, Brazil; (A.G.A.); (V.R.); (J.R.); (P.C.D.F.); (C.A.A.J.)
| | - Débora Cristina Ferreira Lago
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Vandilson Rodrigues
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís 65020-070, Brazil; (A.G.A.); (V.R.); (J.R.); (P.C.D.F.); (C.A.A.J.)
| | - Marcelo Magalhães
- Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão-UFMA, Av. dos Portugueses, São Luís 65085-580, Brazil; (M.M.); (M.d.S.F.)
| | - Carla Souza Sobral
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Conceição Parente
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Joana França
- Service of Endocrinology, University Hospital of the Federal University of Maranhão (HUUFMA/EBSERH), Rua Barão de Itapary, 227-Centro, São Luís 65020-070, Brazil; (R.S.d.S.A.); (M.d.G.T.); (G.C.N.); (S.d.S.P.D.); (V.C.d.C.R.); (D.C.F.L.); (C.S.S.); (C.P.); (J.F.)
| | - Jacqueline Ribeiro
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís 65020-070, Brazil; (A.G.A.); (V.R.); (J.R.); (P.C.D.F.); (C.A.A.J.)
| | - Paulo Cézar Dias Ferraz
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís 65020-070, Brazil; (A.G.A.); (V.R.); (J.R.); (P.C.D.F.); (C.A.A.J.)
| | - Carlos Alberto Azulay Junior
- Research Group in Clinical and Molecular Endocrinology and Metabology (ENDOCLIM), São Luís 65020-070, Brazil; (A.G.A.); (V.R.); (J.R.); (P.C.D.F.); (C.A.A.J.)
| | - Dayse Aparecida Silva
- DNA Diagnostic Laboratory (LDD), Rio de Janeiro State University (UERJ), R. São Francisco Xavier, Rio de Janeiro 20550-013, Brazil;
| | - Marília Brito Gomes
- Diabetes Unit, State University of Rio de Janeiro (UERJ), R. São Francisco Xavier, Rio de Janeiro 20550-013, Brazil;
| | - Manuel dos Santos Faria
- Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão-UFMA, Av. dos Portugueses, São Luís 65085-580, Brazil; (M.M.); (M.d.S.F.)
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Aikaeli F, Njim T, Gissing S, Moyo F, Alam U, Mfinanga SG, Okebe J, Ramaiya K, Webb EL, Jaffar S, Garrib A. Prevalence of microvascular and macrovascular complications of diabetes in newly diagnosed type 2 diabetes in low-and-middle-income countries: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000599. [PMID: 36962416 PMCID: PMC10021817 DOI: 10.1371/journal.pgph.0000599] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/19/2022] [Indexed: 11/19/2022]
Abstract
There is an excessive burden of diabetes complications in low-resource settings. We conducted a systematic review to determine the nature and frequency of diabetes complications in newly diagnosed with type 2 diabetes. A systematic search was performed using Medline, CINAHL and Global Health online databases from inception to July 2020. Articles reporting prevalence of microvascular or macrovascular complications within six months of type 2 diabetes diagnosis and published in English or French from low- and middle-income countries (LMICs) were eligible for analysis. Data were extracted using a standardized data extraction tool. Descriptive statistics were used to describe the prevalence of micro and macrovascular complications in newly diagnosed type 2 diabetes. Assessment of heterogeneity was conducted using the inconsistency index (I2) and Cochran-Q chi2 statistical tests. Publication bias was assessed by the Funnel plot and Egger test. A total of 3 292 records underwent title or abstract screening and 95 articles underwent full text review. Thirty-three studies describing 13 283 participants (aged 20 years and older) met the inclusion criteria. The eligible studies were from Asia (n = 24), Africa (n = 4), Oceania (n = 2), South America (n = 2) and the Caribbean (n = 1). For microvascular complications, the median prevalence (interquartile range) of retinopathy, nephropathy and neuropathy were 12% (6%-15%), 15% (7%-35%) and 16% (10%25%) respectively. For macrovascular complications, the median prevalence (interquartile range) was 10% (7%-17%) for ischaemic heart disease, 6% (1%-20%) for peripheral arterial disease and 2% (1%-4%) for stroke. There was evidence of substantial heterogeneity between studies for all outcomes (I2 > 90%. We found a high prevalence of complications in newly diagnosed type 2 diabetes in LMICs. Findings suggest that many people live with diabetes and are only diagnosed when they present with complications in LMICs. Research is needed to guide timely and effective identification of people living with diabetes in these settings.
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Affiliation(s)
- Faith Aikaeli
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar Es Salaam, Tanzania
| | - Tsi Njim
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Stefanie Gissing
- School of Public Health Yorkshire & Humber, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Faith Moyo
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Uazman Alam
- Institute of Life Course and Medical Sciences and the Pain Research Institute, University of Liverpool and Liverpool University Hospital NHS Foundation Trust, Liverpool, United Kingdom
- Division of Endocrinology, Diabetes and Gastroenterology, University of Manchester, Manchester, United Kingdom
| | - Sayoki G Mfinanga
- Muhimbili Medical Research Centre, National Institute for Medical Research, Dar Es Salaam, Tanzania
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Joseph Okebe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Emily L Webb
- Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shabbar Jaffar
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Anupam Garrib
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Beneficial effects of liraglutide on peripheral blood vessels. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp200423089z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Macroangiopathy is the major cause of death and disability in type 2 diabetic patients. Studies have shown that liraglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, can protect cardiovascular system by inhibiting chronic inflammation of diabetes. However, a study about the effects of liraglutide on peripheral blood vessels and peripheral blood leukocytes has not been reported yet. The aim of this study was to determine vasculoprotective effect, vascular protection and mechanism of action of liraglutide in addition to its hypoglycemic effect. Methods. A total of 60 hospitalized patients with type 2 diabetes were recruited from December 2013 to December 2014 at the First Affiliated Hospital of Dalian Medical University, PR China. Before the treatment with liraglutide, height and weight were measured to calculate body mass index (BMI). Blood urea nitrogen (BUN) and so on were detected. Homeostasis model assessment of insulin resistance (HOMA-IR) and islet ? cell function (HOMA-?) were computed. After applying liraglutide for three months, all indexes were measured again. The effects of liraglutide on these indexes were analyzed by paired sample t-test. Results. After the treatment with liraglutide, values of glycosylated hemoglobin ? HbA1c (8.46 ? 1.62 vs. 7.26 ? 1.40%) and 2h postprandial blood glucose ? 2hPBG (11.95 vs. 9.6 mmol/L) decreased significantly (p < 0.05). Body weight (87.3 vs. 82.5 kg) and BMI (30.37 vs. 28.63 kg/m2) decreased by 5.5% and 5.7%, respectively (p < 0.05). Also, levels of triglycerides (TG) (2.57 ? 1.54 vs. 1.81 ? 0.70 mmol/L) and LDL-cholesterol (2.92 ? 0.78 vs. 1.89 ? 0.66 mmol/L) reduced significantly (p < 0.05). Ankle-brachial index (ABI) decreased from 1.24 ? 0.10 to 1.14 ? 0.06 cm/s by 8%, while brachial-ankle pulse wave velocity (ba-PWV) decreased from 1,442.15 ? 196.26 to 1,316.85 ? 146.63 cm/s by 8.7%, and both differences were statistically significant (p < 0.001). Conclusion. Liraglutide, with a good hypoglycemic effect, can significantly reduce postprandial blood glucose and HbA1c, but cannot significantly improve fasting plasma glucose, insulin resistance and islet ? cell function. It also considerably decreased body weight, BMI and TG. Liraglutide can significantly lower ba-PWV and ABI to protect peripheral blood vessels.
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Analysis of Diabetes Mellitus-Related Amputations in the State of Espírito Santo, Brazil. ACTA ACUST UNITED AC 2020; 56:medicina56060287. [PMID: 32545366 PMCID: PMC7353856 DOI: 10.3390/medicina56060287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023]
Abstract
Background and objectives: Diabetes mellitus (DM) stands out among the most important public health problems worldwide since it represents a high burden on health systems and is associated with higher hospitalization rates, and a higher incidence of cardiovascular diseases. Amputations are among the most common complications, leading to disability and increasing care costs. This research aims to analyze the prevalence of DM-related amputations, comorbidities and associated risk factors in the diabetic population residing in the State of Espírito Santo, Brazil. Materials and Methods: This is a quantitative, exploratory, cross-sectional study with a time series design and the use of secondary data registered and followed by the system of Registration and Monitoring of Hypertension and Diabetes-SisHiperdia. Results: The sample consisted of 64,196 diabetic patients, out of them, 3.9% had type 1 DM, 10.9% with type 2 DM, and 85.2% with DM coexisting with hypertension. Most were female (66.6%), aged 40 to 59 years (45.6%), and 60 years and older (45.2%). The prevalence of DM-related amputations in the analyzed sample was 1.2% in type 1 DM, 1.5% in type 2 DM, and 2.2% in concomitant DM and hypertension. Higher amputation rates were observed in males in the age group above 60 years in type 1 DM and type 2 DM and were slightly higher in the age groups up to 29 years in DM with hypertension. A higher prevalence of amputation was related to smoking, physical inactivity, acute myocardial infarction (AMI), stroke, chronic kidney disease (CKD), and diabetic foot (DF) in all types of DM. Conclusions: The present study showed a significant prevalence of DM-related amputations. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM.
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