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Hyseni V, Elezi S, Gjikolli B, Bakalli A. Predictors of coronary artery calcium burden in asymptomatic patients with newly diagnosed type 2 diabetes mellitus. Diab Vasc Dis Res 2024; 21:14791641241242336. [PMID: 38523063 PMCID: PMC10962046 DOI: 10.1177/14791641241242336] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE Long-standing diabetes mellitus is often associated with cardiovascular complications. We aimed to evaluate the presence, extent and composition of subclinical atherosclerotic plaques in coronary arteries by Computed Tomography in patients with newly diagnosed type 2 diabetes mellitus (NDT2DM), and to identify the predictors. METHODS In this study 101 consecutive patients with NDT2DM were included. Patients were categorized into five groups based on their Coronary Artery Calcium Score (CACS) ranging from 0, 0-10, 11-100, 101-400 to >400. All parameters were compared across these groups. RESULTS The average patient age was 54.4 ± 11.6 years and 48 (47.5%) were females. Eight (7.9%) patients had CACS 0, 6.9% CACS 1-10, 42.6% CACS 11-100, 22.8% CACS 101-400 and 19.8% had CACS >400. Multiple regression analysis for the general data identified weight (p = .04) and systolic blood pressure (p = .033) as independent predictors for CACS. CONCLUSIONS Asymptomatic patients with NDT2DM in more than 90% of cases may present with calcified atherosclerotic plaques and this may be predicted by: patient weight and the level of systolic arterial pressure. Our study emphasizes the need for comprehensive care and early prevention of cardiovascular complications in individuals with NDT2DM.
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Affiliation(s)
- Violeta Hyseni
- Clinic of Cardiology, University Clinical Center of Kosova. Pristina, Kosovo
| | - Shpend Elezi
- Clinic of Cardiology, University Clinical Center of Kosova. Pristina, Kosovo
- Medical Faculty, University of Prishtina, Prishtina Kosovo
| | - Bujar Gjikolli
- Clinic of Radiology, University Clinical Center of Kosova. Pristina, Kosovo
| | - Aurora Bakalli
- Clinic of Cardiology, University Clinical Center of Kosova. Pristina, Kosovo
- Medical Faculty, University of Prishtina, Prishtina Kosovo
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Demir I, Yilmaz I, Horoz E, Calik B, Bilgir O. Matriptase as a potential biomarker and therapeutic target in newly diagnosed type 2 diabetes mellitus. Ir J Med Sci 2024; 193:223-230. [PMID: 37418107 DOI: 10.1007/s11845-023-03441-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that affects the processing of carbohydrates, proteins, and lipids. In T2DM, metabolic dysregulation occurs through various pathways caused by increased levels of many adipokines and inflammatory chemokines. Impaired insulin-glucose metabolism occurs in tissues. The proteolytic enzyme matriptase is thought to be closely related to glucose metabolism due to its glycolization sites. AIM Our study aimed to evaluate the correlation between matriptase, a proteolytic enzyme, and metabolic parameters in individuals recently diagnosed with T2DM. We also sought to investigate the potential involvement of matriptase in the development of diabetes. METHODS We measured all participants' metabolic laboratory parameters, including basic biochemical tests, hemograms, high-sensitivity C-reactive protein (hsCRP), and matriptase levels. RESULTS Our results showed a significant increase in circulating matriptase levels in individuals with T2DM compared to the control group. Furthermore, individuals with metabolic syndrome had significantly higher matriptase levels than those without in the T2DM and control groups. We also observed that T2DM patients had elevated levels of Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), hsCRP, and matriptase, which displayed a positive correlation. CONCLUSION Our study is the first to report elevated levels of matriptase in individuals with newly diagnosed T2DM and/or metabolic syndrome. Additionally, we found a significant positive correlation between matriptase levels and metabolic and inflammatory parameters, indicating a potential role for matriptase in the pathogenesis of T2DM and glucose metabolism. Further research on matriptase could lead to its recognition as a novel target for investigation.
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Affiliation(s)
- Ismail Demir
- Department of Internal Medicine, Health Sciences University, Izmir, Bozyaka Training and Research Hospital, 35170, Karabaglar, Izmir, Turkey.
| | - Ismail Yilmaz
- Faculty of Medicine, Department of Pharmacology and Toxicology, Izmir Kâtip Celebi University, Izmir, Turkey
| | - Ersan Horoz
- Faculty of Medicine, Department of Pharmacology and Toxicology, Izmir Kâtip Celebi University, Izmir, Turkey
| | - Bulent Calik
- Department of General Surgery, Health Sciences University Izmir, Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Oktay Bilgir
- Department of Internal Medicine, Health Sciences University, Izmir, Bozyaka Training and Research Hospital, 35170, Karabaglar, Izmir, Turkey
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Zhang R, Zhao Q, Li R. Predictors of acarbose therapeutic efficacy in newly diagnosed type 2 diabetes mellitus patients in China. BMC Pharmacol Toxicol 2022; 23:79. [PMID: 36258236 PMCID: PMC9580108 DOI: 10.1186/s40360-022-00621-2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
Background Acarbose is one of the optimal drugs for patients with the first diagnosis of type 2 diabetes mellitus (T2DM). But what kind of emerging patients has the best therapeutic response to acarbose therapy has never been reported. To this end, we investigated predictors of acarbose therapeutic efficacy in newly diagnosed T2DM patients in China. Methods A total of 346 T2DM patients received acarbose monotherapy for 48 weeks as part of participating in the Study of Acarbose in Newly Diagnosed Patients with T2DM in China (MARCH study) from November 2008 to June 2011. Change in glycated hemoglobin (ΔHbA1c) served as a dependent variable while different baseline variables including sex, age, disease duration, weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), HbA1c, fasting plasma glucose (FPG), 2-h postprandial blood glucose (2 h PG), fasting insulin (FINS), 2-h postprandial insulin (2 h INS), early insulin secretion index (IGI), homeostasis model assessment of insulin resistance index (HOMA-IR), homeostasis model assessment of beta cell function (HOMA-B), area under the curve (AUC) of glucagon, insulin and GLP-1 were assessed as independent predictors. Step-wise multiple linear regression was employed for statistical analysis. Results The results suggested that independent predictors of ΔHbA1c at 12 weeks included baseline body weight (β = − 0.012, P = 0.006), DBP (β = 0.010, P = 0.047), FPG (β = 0.111, P = 0.005) and 2 h PG (β = 0.042, P = 0.043). Independent predictors of ΔHbA1c at 24 weeks included disease duration (β = 0.040, P = 0.019) and FPG (β = 0.117, P = 0.001). Finally, independent predictor of ΔHbA1c at 48 weeks was disease duration (β = 0.038, P = 0.046). Conclusions Acarbose may be more effective in newly diagnosed T2DM patients with low FPG, low 2 h PG and obesity. The earlier T2DM is diagnosed and continuously treated with acarbose, the better the response to therapy.
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Affiliation(s)
- Rong Zhang
- Department of Geriatrics, Xijing Hospital of Air Force Medical University, No.127 West Changle Road, Xi'an, 710032, China
| | - Quanxi Zhao
- Department of Pharmacy, Second People's Hospital of Shaanxi Province, No.3 Shangqin Road, Xi'an, 710068, China
| | - Rong Li
- Department of Geriatrics, Xijing Hospital of Air Force Medical University, No.127 West Changle Road, Xi'an, 710032, China.
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Moustafa HAM, El Wakeel LM, Halawa MR, Sabri NA, El-Bahy AZ, Singab AN. Effect of Nigella Sativa oil versus metformin on glycemic control and biochemical parameters of newly diagnosed type 2 diabetes mellitus patients. Endocrine 2019; 65:286-294. [PMID: 31152309 DOI: 10.1007/s12020-019-01963-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/19/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Nature is a phenomenal treasure of remedies. Numerous previous studies reported that Nigella sativa NS improved glycemic control, reduced insulin resistance, and improved lipid profile. NS was never investigated before as a monotherapy for newly diagnosed type 2 diabetes mellitus T2DM patients. Our aim was to investigate the potential metabolic benefits of NS monotherapy in newly diagnosed T2DM patients. METHOD Prospective, open-label randomized clinical trial at outpatient endocrinology clinic at Ain-Shams University hospital. Eligible patients were randomly assigned to either metformin tablets or NS oil capsules. Both groups received treatment for 3 months. Glycemic index (FBG, 2 h pp, A1C, insulin sensitivity %S, secretory function %B, insulin resistance IR), lipid profile (TC, LDL, HDL, TG), liver and kidney functions (AST, ALT, Sr cr), total antioxidant capacity TAC, weight, waist circumference WC and body mass index BMI were assessed at baseline and at the end of treatment period. RESULTS A concentration of 1350 mg/day NS in newly diagnosed T2DM patients was inferior to metformin in terms of lowering FBG, 2 h pp, and A1C or increasing %B. However, NS was comparable to metformin in lowering weight, WC, and BMI significantly. NS was comparable to metformin in regards of their effects on fasting insulin, %S, IR, ALT, TC, LDL, HDL, TG, and TAC. Metformin showed significant increase in AST and creatinine which was reserved in NS group. CONCLUSION NS administration in newly diagnosed T2DM was tolerable with no side effects as compared to metformin; however, it was inferior to metformin in terms of diabetes management.
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Affiliation(s)
- Hebatallah Ahmed Mohamed Moustafa
- Department of pharmacy practice, Faculty of Pharmacy and drug technology, Heliopolis University for Sustainable Development, Cairo Governorate, Egypt
| | - Lamia Mohamed El Wakeel
- Department of Clinical Pharmacy, Faculty of pharmacy, Ain Shams University, Cairo Governorate, Egypt.
| | - Mohamed Reda Halawa
- Department of Internal Medicine and Endocrinology, Faculty of Pharmacy, Ain Shams University, Cairo Governorate, Egypt
| | - Nagwa Ali Sabri
- Department of Clinical Pharmacy, Faculty of pharmacy, Ain Shams University, Cairo Governorate, Egypt
| | - Alshaymaa Zaki El-Bahy
- Department of pharmacology & toxicology, faculty of pharmacy and drug technology, Heliopolis University for Sustainable Development, Cairo Governorate, Egypt
| | - Abdel Nasser Singab
- Department of Pharmacognosy, Faculty of Pharmacy, Ain Shams University, Cairo Governorate, Egypt
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Yan PJ, Xu Y, Wan Q, Feng J, Li H, Gao CL, Yang J, Zhong HH, Zhang ZH. Decreased plasma neuregulin 4 concentration is associated with increased high-sensitivity C-reactive protein in newly diagnosed type 2 diabetes mellitus patients: a cross-sectional study. Acta Diabetol 2017; 54:1091-1099. [PMID: 28918492 DOI: 10.1007/s00592-017-1044-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 08/21/2017] [Indexed: 12/18/2022]
Abstract
AIMS Inflammation has been reported to be involved in the pathogenesis of atherosclerosis. This principal objective of this study was to investigate if the secretion of neuregulin 4 (Nrg4), a soluble protein associated with metabolic syndrome and subclinical cardiovascular disease, is correlated with the inflammation marker high-sensitivity C-reactive protein (hs-CRP) in patients with newly diagnosed type 2 diabetes mellitus (nT2DM). METHODS A study group of 311 nT2DM patients was divided into three subgroups based on hs-CRP tertiles. Multiple linear regression was conducted to explore the association between plasma Nrg4 and hs-CRP levels. RESULTS The nT2DM patients with the highest hs-CRP levels (>2.46 mg/L) exhibited higher atherogenic coefficients and atherogenic index of plasma (AIP) levels, but lower levels of plasma Nrg4, as compared to those with the lowest hs-CRP levels (<0.63 mg/L). Plasma Nrg4 levels were inversely associated with white blood cell count, hs-CRP, and AIP and positively associated with high-density lipoprotein cholesterol (HDL-C), before and after adjustment for age, gender, body mass index (BMI), and body fat percentage (P < 0.01 or P < 0.05). hs-CRP was the factor most strongly associated with plasma Nrg4 levels. CONCLUSIONS These results indicate that lower plasma Nrg4 levels may be associated with elevated hs-CRP in nT2DM patients. It generates the hypothesis that decreased levels of Nrg4 may trigger the development of atherosclerosis through its proinflammatory effects. These findings need to be confirmed by further prospective studies.
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Affiliation(s)
- Pi-Jun Yan
- Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Yong Xu
- Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Qin Wan
- Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Jian Feng
- Department of Cardiovascular Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Hua Li
- Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Chen-Lin Gao
- Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Jun Yang
- Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Hai-Hua Zhong
- Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Zhi-Hong Zhang
- Department of General Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
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