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Kosmalski M, Frankowski R, Różycka-Kosmalska M, Sipowicz K, Pietras T, Mokros Ł. The Association between Personality Factors and Metabolic Parameters among Patients with Non-Alcoholic-Fatty Liver Disease and Type 2 Diabetes Mellitus-A Cross-Sectional Study. J Clin Med 2023; 12:4468. [PMID: 37445503 DOI: 10.3390/jcm12134468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The increasing prevalence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) states a serious problem for public health. The introduction of effective methods of treatment and prevention is crucial to avoid complications of these diseases. Among them, we can specify psychological factors that affect everyday life and determine the patient's attitude towards therapy, and what follows, their compliance in treatment. The literature indicates these connections in various ways; in our study, we extend this view to include a broader perspective of human personality. OBJECTIVE We decided to investigate the associations between personality factors and metabolic parameters in patients with NAFLD and T2DM in order to better understand the patient's approach to the treatment of a chronic disease, such as those mentioned, and to establish the basis for further research implementing psychological interventions in the treatment of NAFLD and T2DM. METHODS One hundred participants with NAFLD and T2DM underwent blood tests and anthropometric measures. Each of them was asked to complete five questionnaires evaluating their personality properties. RESULTS We revealed that a rise in body mass index is related to a fall in the emotional intelligence factor of utilizing emotions, and a rise in emotional perception. The decrease in task-oriented coping style and a rise in emotion-oriented coping style are associated with a waist-hip ratio increase. The increase in fasting plasma glucose is predicted by a decrease in task-oriented coping style score. A fall in social diversion coping style score is associated with a high-density lipoprotein increase; in turn, a triglycerides increase is connected with a decline in rhythmicity score. CONCLUSIONS The personality factors are in relationship in the management of NAFLD and T2DM. They affect a patient's approach to treatment, which is very important, because we know lifestyle and dietary interventions are an important part of the treatment of these diseases. The compliance manifests by lifestyle modifications, taking medications regularly, measuring blood glucose, and inspection visits in outpatients' clinics are a large part of a diabetic's life. Future studies introducing psychological intervention to improve, e.g., coping styles or rhythmicity are needed to implement new methods of patient management.
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Affiliation(s)
- Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Rafał Frankowski
- Students' Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | | | - Kasper Sipowicz
- Department of Interdisciplinary Disability Studies, The Maria Grzegorzewska University in Warsaw, 02-353 Warsaw, Poland
| | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
| | - Łukasz Mokros
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
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Kosmalski M, Frankowski R, Deska K, Różycka-Kosmalska M, Pietras T. Exploring the Impact of Nutrition on Non-Alcoholic Fatty Liver Disease Management: Unveiling the Roles of Various Foods, Food Components, and Compounds. Nutrients 2023; 15:2838. [PMID: 37447164 DOI: 10.3390/nu15132838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
There is a need to introduce standardized treatment options for non-alcoholic fatty liver disease (NAFLD) due to its global prevalence and the complications of this disease. Many studies have revealed that food-derived substances may be beneficial in dealing with this disease. Therefore, this review aims to evaluate the recently published studies on the food-derived treatment options for NAFLD. A comprehensive search of the PubMed database using keywords such as "NAFLD", "nutrition", "food", "derived", "therapy", and "guidelines" yielded 219 relevant papers for our analysis, published from 2004 to 2023. The results show the significant benefits of food-derived treatment in NAFLD therapy, including improvements in liver histology, hepatic fat amounts, anthropometric measures, lipid profile, and other metabolic measures. The availability of the substances discussed makes them a significant adjuvant in the treatment of this disease. The usefulness of Viusid as additional therapy to diet and physical activity should be emphasized due to improvements in liver histology; however, many other substances lead to a decrease in liver fat amounts including, e.g., berberine or omega-3 fatty acids. In addition, the synbiotic Protexin seems to be useful in terms of NAFLD treatment, especially because it is effective in both obese and lean subjects. Based on the latest research results, we suggest revising the therapeutic recommendations for patients suffering from NAFLD.
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Affiliation(s)
- Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Rafał Frankowski
- Students' Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Kacper Deska
- Students' Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | | | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
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Frankowski R, Kobierecki M, Wittczak A, Różycka-Kosmalska M, Pietras T, Sipowicz K, Kosmalski M. Type 2 Diabetes Mellitus, Non-Alcoholic Fatty Liver Disease, and Metabolic Repercussions: The Vicious Cycle and Its Interplay with Inflammation. Int J Mol Sci 2023; 24:ijms24119677. [PMID: 37298632 DOI: 10.3390/ijms24119677] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
The prevalence of metabolic-related disorders, such as non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (DM2), has been increasing. Therefore, developing improved methods for the prevention, treatment, and detection of these two conditions is also necessary. In this study, our primary focus was on examining the role of chronic inflammation as a potential link in the pathogenesis of these diseases and their interconnections. A comprehensive search of the PubMed database using keywords such as "non-alcoholic fatty liver disease", "type 2 diabetes mellitus", "chronic inflammation", "pathogenesis", and "progression" yielded 177 relevant papers for our analysis. The findings of our study revealed intricate relationships between the pathogenesis of NAFLD and DM2, emphasizing the crucial role of inflammatory processes. These connections involve various molecular functions, including altered signaling pathways, patterns of gene methylation, the expression of related peptides, and up- and downregulation of several genes. Our study is a foundational platform for future research into the intricate relationship between NAFLD and DM2, allowing for a better understanding of the underlying mechanisms and the potential for introducing new treatment standards.
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Affiliation(s)
- Rafał Frankowski
- Students' Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Mateusz Kobierecki
- Students' Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Andrzej Wittczak
- Students' Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | | | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Kasper Sipowicz
- Department of Interdisciplinary Disability Studies, The Maria Grzegorzewska University in Warsaw, 02-353 Warsaw, Poland
| | - Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
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Kosmalski M, Frankowski R, Ziółkowska S, Różycka-Kosmalska M, Pietras T. What's New in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD). J Clin Med 2023; 12:jcm12051852. [PMID: 36902639 PMCID: PMC10003344 DOI: 10.3390/jcm12051852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 03/02/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a serious health problem due to its high incidence and consequences. In view of the existing controversies, new therapeutic options for NAFLD are still being sought. Therefore, the aim of our review was to evaluate the recently published studies on the treatment of NAFLD patients. We searched for articles in the PubMed database using appropriate terms, including "non-alcoholic fatty liver disease", "nonalcoholic fatty liver disease", "NAFLD", "diet", "treatment", "physical activity", "supplementation", "surgery", "overture" and "guidelines". One hundred forty-eight randomized clinical trials published from January 2020 to November 2022 were used for the final analysis. The results show significant benefits of NAFLD therapy associated with the use of not only the Mediterranean but also other types of diet (including low-calorie ketogenic, high-protein, anti-inflammatory and whole-grain diets), as well as enrichment with selected food products or supplements. Significant benefits in this group of patients are also associated with moderate aerobic physical training. The available therapeutic options indicate, above all, the usefulness of drugs related to weight reduction, as well as the reduction in insulin resistance or lipids level and drugs with anti-inflammatory or antioxidant properties. The usefulness of therapy with dulaglutide and the combination of tofogliflozin with pioglitazone should be emphasized. Based on the results of the latest research, the authors of this article suggest a revision of the therapeutic recommendations for NAFLD patients.
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Affiliation(s)
- Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
- Correspondence: ; Tel.: +48-728-358-504
| | - Rafał Frankowski
- Students’ Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Sylwia Ziółkowska
- Department of Medical Biochemistry, Medical University of Lodz, 92-215 Lodz, Poland
| | | | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
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Kosmalski M, Deska K, Bąk B, Różycka-Kosmalska M, Pietras T. Pharmacological Support for the Treatment of Obesity-Present and Future. Healthcare (Basel) 2023; 11:healthcare11030433. [PMID: 36767008 PMCID: PMC9914730 DOI: 10.3390/healthcare11030433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/25/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Obesity is a growing civilization problem, associated with a number of negative health consequences affecting almost all tissues and organs. Currently, obesity treatment includes lifestyle modifications (including diet and exercise), pharmacologic therapies, and in some clinical situations, bariatric surgery. These treatments seem to be the most effective method supporting the treatment of obesity. However, they are many limitations to the options, both for the practitioners and patients. Often the comorbidities, cost, age of the patient, and even geographic locations may influence the choices. The pharmacotherapy of obesity is a fast-growing market. Currently, we have at our disposal drugs with various mechanisms of action (directly reducing the absorption of calories-orlistat, acting centrally-bupropion with naltrexone, phentermine with topiramate, or multidirectional-liraglutide, dulaglutide, semaglutide). The drugs whose weight-reducing effect is used in the course of the pharmacotherapy of other diseases (e.g., glucose-sodium cotransporter inhibitors, exenatide) are also worth mentioning. The obesity pharmacotherapy is focusing on novel therapeutic agents with improved safety and efficacy profiles. These trends also include an assessment of the usefulness of the weight-reducing properties of the drugs previously used for other diseases. The presented paper is an overview of the studies related to both drugs currently used in the pharmacotherapy of obesity and those undergoing clinical trials, taking into account the individual approach to the patient.
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Affiliation(s)
- Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Łódź, Poland
- Correspondence: (M.K.); (K.D.)
| | - Kacper Deska
- Students’ Scientific Association Clinical Pharmacology, Medical University of Lodz, 90-153 Łódź, Poland
- Correspondence: (M.K.); (K.D.)
| | - Bartłomiej Bąk
- 2nd Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, 02-957 Warszawa, Poland
| | | | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Łódź, Poland
- 2nd Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, 02-957 Warszawa, Poland
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Kosmalski M, Różycka-Kosmalska M, Basiak M, Okopień B, Pietras T. Diagnosis and management of hyperglycaemia in patients treated with antipsychotic drugs. Endokrynol Pol 2022; 73:872-884. [PMID: 35971924 DOI: 10.5603/ep.a2022.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 11/25/2022]
Abstract
Research results indicate the presence of an association between mental disorders, certain antipsychotics, and the risk of developing prediabetes (preDM) and specific type diabetes mellitus (DM). However, there are no precise recommendations for their diagnosis and treatment. The obtained data suggest the necessity to perform diagnostics of carbohydrate disorders at the onset of the first symptoms of psychosis, even before the implementation of antipsychotic drugs, and the oral glucose tolerance test (OGTT) seems to be the optimal tool. There is a lot of controversy regarding the timing of control tests addressing the development of dysglycaemia during the use of antipsychotic drugs. We suggest that it should be carried out during the first 4-8 weeks, and in the absence of disorders it should be repeated once a year or with a change in antipsychotic treatment. The diagnostic regimen should then include the need for OGTT supported by routine determination of the percentage of glycated haemoglobin. If dysglycaemia is diagnosed, the therapeutic management should include non-pharmacological management and hypoglycaemic agents. These recommendations should be individually tailored to each patient and take into account the presence of obesity, which is often found in this group of patients. Weight reduction can be achieved with a properly balanced diet, physical effort, and in justified situations also with drugs effectively reducing body weight. For this reason, drugs are recommended that, if preDM and DM are diagnosed, simultaneously lower glucose levels and reduce body weight. So far, effectiveness in this area has been demonstrated for 2 incretinomimetics: exenatide and liraglutide. Due to the mechanism of preDM/DM development in patients using antipsychotics, the usefulness of other hypoglycaemic drugs with insulin-sensitizing potential - metformin and pioglitazone - has also been suggested. To date, there has been no research on the benefits of other hypoglycaemic drugs in this group of patients.
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Kosmalski M, Różycka-Kosmalska M, Sikora J, Pietras T. Diabetes mellitus in patients using psychotropic
medications: How does it work? POSTEP HIG MED DOSW 2021. [DOI: 10.5604/01.3001.0014.9330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Diabetes mellitus (DM) is not a single disease, but a group of diseases that are characterized
by chronic hyperglycemia and risk of damage to tissues and organs. The mechanisms of its
development are different and due mainly to disorders of insulin secretion or its effects. For
this reason, 4 types of DM have been distinguished. One of them is a specific type of DM, determined,
inter alia, by the use of certain psychotropic medications. Chronic hyperglycemia
often occurs in association with some of these drugs, but in many cases it is categorized erroneously
as type 2 (T2DM) or 1 (T1DM). The relationship between DM and psychiatric disorders
is bi-directional, involving two mutually independent risk factors for the development
of the disease. However, not all patients with a mental illness develop carbohydrate metabolism
disorders, which is due to a varied diabetogenic potential and mechanisms of action
of psychotropic medications. In clinical practice, questions concerning the frequency of this
type of DM, risk factors of its development and hyperglycemic mechanism of psychotropic
medications arise. Therefore, the aim of this article is to attempt to answer these questions.
From a practical point of view, obtaining such information should allow for the development
of appropriate diagnostic and therapeutic procedures.
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Affiliation(s)
- Marcin Kosmalski
- Medical University of Lodz, Department of Clinical Pharmacology, Lodz, Poland
| | | | - Joanna Sikora
- Medical University of Lodz, Laboratory of Bioanalysis, Department of Pharmaceutical Chemistry Drug Analysis and Radiopharmacy, Lodz, Poland
| | - Tadeusz Pietras
- Medical University of Lodz, Department of Clinical Pharmacology, Lodz, Poland
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Wranicz JK, Drożdż J, Różycka-Kosmalska M, Kasprzak JD, Lubiński A, Piotrowski G, Kosmalski M, Życiński P, Ciurus T, Ptaszyński P, Kaczmarek K. Impact of the COVID-19 pandemic on the performance of selected cardiac electrotherapy and electrophysiology procedures. Kardiol Pol 2021; 79:452-454. [PMID: 33754584 DOI: 10.33963/kp.15884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kosmalski M, Różycka-Kosmalska M, Witusik A, Pietras T. The coincidence of diabetes mellitus and asthma, their probable causal relationships and therapeutic opportunities. Adv Respir Med 2020; 88:590-598. [PMID: 33393652 DOI: 10.5603/arm.a2020.0168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 11/25/2022]
Abstract
Both the epidemiological data and the everyday medical practice demonstrate the coincidence of various types of diabetes mellitus (DM) in patients with asthma. Specific correlations between the risk of DM in pregnancy, asthma and the consequences of these diseases to the mother and her baby are also explored. The discussion concerning, on the one hand, the impact of asthma-related inflammatory condition on the metabolism of carbohydrates, and, on the other, the presence of chronic hyperglycemia and inflammatory markers observed in patients with asthma, is still ongoing. In the case of asthma and type 1 diabetes mellitus (T1DM), a correlation with the dysfunction of the immune system and the genetic background has been suggested, and in the case of type 2 (T2DM), the vital role of obesity and insulin resistance (IR) to promote excessive proinflammatory immune response. The data indicate that both asthma and DM affect mutually their clinical presentations, including the prognostic values and therapeutic possibilities. The ongoing controversy concerning the effective and safe anti-asthma and hypoglycemizing therapy does not allow for a definitive therapeutic consensus in this group of patients, despite the suggested role of metformin and hyperglycemizing effects of glucocorticoids. Therefore, the objective of the presented paper is a review of the knowledge in the field of DM and asthma coincidence, their probable causal relationships and therapeutic opportunities.
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Affiliation(s)
- Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland.
| | | | - Andrzej Witusik
- Faculty of Composition, Theory of Music, Conducting , Eurhythmics and Music Education, Music Therapy Course, Grażyn a and Kiejstut Bacewicz Memorial Academy of Music in Lodz, Lodz, Poland
| | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
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Różycka-Kosmalska M, Kosmalski M, Wranicz JK. Impact of admission glycaemia on the annual risk of major cardiovascular events and development of type 2 diabetes mellitus in patients with non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention. Pol Merkur Lekarski 2019; 47:207-211. [PMID: 31945020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
UNLABELLED Elevated admission glycaemia (ABG) in a patient with or without type 2 diabetes (T2DM) is associated with adverse consequences. There is still a lack of accurate data on the adverse effects of ABG on the risk of major cardiovascular events and the development of T2DM in patients hospitalized for unstable angina (UA) or non-ST elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention. AIM The main aim of this study was to evaluate the effect of ABG to the risk of major cardiovascular events and the development of T2DM during one year follow-up in patients with UA and NSTEMI. MATERIALS AND METHODS 100 consecutive patients (68% men, mean age 64.2±10.5 years) hospitalized due to non-ST-elevation acute coronary syndrome (NSTE-ACS) were included in observational study. In each patient, medical history was taken and physical examination, standard diagnostics procedures, including venous glucose deterioration and coronarography were performed. Patients were assigned to two groups: UA or NSTEMI and observed during hospitalization and one year after discharge. RESULTS 74 patients were diagnosed with NSTEMI and 26 with UA. 41 patients were treated for T2DM and 28 were diagnosed with impaired fasting glucose (IFG) prior to hospitalization. Both carbohydrate disorders occurred with a similar frequency in the compared groups of patients, and its incidence was comparable in both groups. During observation, T2DM was diagnosed only in 8 patients with IFG. Out of the 8 patients whose ABG was >250mg/dl, 7 died during one year, including three during hospitalization, and two during the first month after discharge. These patients were diagnosed with T2DM before hospitalization. CONCLUSIONS Different degrees of impaired glucose homeostasis are present before or develop after occurrence NSTE-ACS. ABG >250mg/ dl in this group of patients is associated with the highest risk of death, regardless of the diagnosis of UA or NSTEMI.
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Affiliation(s)
- Monika Różycka-Kosmalska
- Medical University of Lodz, Poland: Department of Electrocardiology, Chair of Interventional Cardiology and Electrocardiology
| | - Marcin Kosmalski
- Medical University of Lodz, Poland: Department of Clinical Pharmacology, 1st Chair of Internal Medicine
| | - Jerzy Krzysztof Wranicz
- Medical University of Lodz, Poland: Department of Electrocardiology, Chair of Interventional Cardiology and Electrocardiology
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Różycka-Kosmalska M, Michalak R, Kosmalski M, Ptaszyński P, Wranicz JK, Zieleniewski W, Cygankiewicz I. [Clinical procedure in amiodarone-induced thyroid dysfunction]. Pol Merkur Lekarski 2016; 40:46-52. [PMID: 26891437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Amiodarone is an antiarrhythmic drug frequently used in everyday clinical practice. Its mechanism of action involves the interaction with many receptors, including those in the cardiac conduction system. Amiodarone usefulness is protect in the treatment of a variety of tachyarrhythmias, both benign and life-threatening. In contrast to other antiarrhythmic drugs, amiodarone is characterized by high therapeutic efficacy, both in patients with normal and impaired left ventricular systolic function. A significant limitation of its is associated with side effects including thyroid gland dysfunction. Disturbances of this organ associated with amiodarone are an important diagnostic and therapeutic problem. They may contribute to the occurrence of both Amiodarone- Induced Thyrotoxicosis (AIT) and Amiodarone-Induced Hypothyroidism (AIH). The risk of such complications should be considered for each patient individually, taking into account thyroid function at the beginning of pharmacotherapy. Appropriate procedure, both before and after treatment allows a rapid diagnosis and treatment of thyroid disturbances. It seems that the best parameter used to assess the hormonal imbalance during amiodarone therapy is the concentration of the free triiodothyronine (fT3). The evaluation of thyroid function should be performed before starting pharmacotherapy, and then repeated every six months. In the case of a thyroid dysfunction, assessment must be performed immediately according to standard diagnostic and therapeutic regimens. Despite abnormal thyroid function, high efficiency of amiodarone and relatively small risk of thyroid damage allows continuation therapy. Amiodarone therapy requires a care from both cardiologist and endocrinologist. The aim of this paper is to present the state of art of evaluation of the thyroid function and procedures implemented in care of thyroid dysfunction before and during treatment with amiodarone.
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Affiliation(s)
- Monika Różycka-Kosmalska
- Medical University of Lodz. Poland: Department of Electrocardiology, Chair of Cardiology and Cardiac Surgery
| | - Renata Michalak
- Medical University of Lodz. Poland: Department of Cardiology, Chair of Cardiology and Cardiac Surgery
| | - Marcin Kosmalski
- Department of Internal Diseases, Diabetology and Clinical Pharmacology, Medical University of Lodz
| | - Paweł Ptaszyński
- Medical University of Lodz. Poland: Department of Electrocardiology, Chair of Cardiology and Cardiac Surgery
| | - Jerzy Krzysztof Wranicz
- Medical University of Lodz. Poland: Department of Electrocardiology, Chair of Cardiology and Cardiac Surgery
| | | | - Iwona Cygankiewicz
- Medical University of Lodz. Poland: Department of Electrocardiology, Chair of Cardiology and Cardiac Surgery
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