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Development of hypoglycemia in patients with COVID-19: coincidence or the result of treatment? COVID-19 患者出现低血糖:巧合还是治疗的结果?
Pub Date : 2024-02-23 DOI: 10.47855/jal9020-2024-5-4
O. Halushko, Yanina A. Saienko, Boris Mankovsky
Hypoglycemia is a common complication of diabetes mellitus (DM), which also complicates the course of COVID-19.The aim: The purpose of this work is to analyze the available scientific information on the causes and risk factors of hypoglycemia during the treatment of patients with COVID-19.Materials and methods. Full-text articles were searched and analysed in the PubMed, Web of Science, Google Scholar, and Scopus databases. The search was conducted using the keywords: "hypoglycemia in COVID-19 patients", "treatment of COVID-19 and hypoglycemia" and "COVID-19 vaccination and hypoglycemia" from the beginning of the pandemic in December 2019 to February 1, 2024.Results. The analysis of literary sources showed that hypoglycemia can occur when using drugs from many pharmacotherapeutic groups for the treatment and vaccination of patients with COVID-19. In addition, patients with DM often have chronic complications that contribute to hypoglycemia occurrence in the case of COVID-19. The lockdown during the COVID-19 pandemic has further complicated the problem of hypoglycemia by restricting access to food, clinics, health services, and medicines.Conclusions: Hypoglycemia can be an incidental clinical finding. But it can also be a natural consequence of treatment if it is carried out without taking into account the possible hypoglycemic effects of drugs and without careful monitoring of the patient's condition. In the case of determining the program of treatment and vaccination against COVID-19 in patients with DM, the known and possible hypoglycemic effects of drugs and vaccines should be taken into account, the level of glycemia should be carefully controlled, and sudden changes in the type and dose of drugs, polypharmacy and the use of dangerous combinations of drugs should be avoided._________________________________________________________________________________________Keywords: COVID-19, hypoglycemia, treatment, vaccination
低血糖是糖尿病(DM)的常见并发症,也使COVID-19的治疗过程复杂化。目的:本研究旨在分析COVID-19患者治疗期间低血糖的原因和风险因素的现有科学信息。在 PubMed、Web of Science、Google Scholar 和 Scopus 数据库中对全文文章进行了检索和分析。搜索关键词为"COVID-19患者低血糖症"、"COVID-19治疗与低血糖症 "和 "COVID-19疫苗接种与低血糖症"。对文献资料的分析表明,使用许多药物治疗组的药物治疗和接种 COVID-19 患者时可能会发生低血糖。此外,DM 患者通常有慢性并发症,这也是 COVID-19 发生低血糖的原因之一。COVID-19 大流行期间的封锁限制了人们获得食物、诊所、医疗服务和药品的机会,从而使低血糖问题变得更加复杂:结论:低血糖可能是一种偶然的临床发现。结论:低血糖可能是一种偶然的临床发现,但如果在治疗过程中没有考虑到药物可能产生的低血糖效应,也没有仔细监测患者的病情,低血糖也可能是治疗的自然结果。在确定DM患者的COVID-19治疗和疫苗接种方案时,应考虑到药物和疫苗已知和可能的低血糖作用,仔细控制血糖水平,避免突然改变药物种类和剂量、使用多种药物和危险的药物组合。_________________________________________________________________________________________关键字:COVID-19COVID-19;低血糖;治疗;疫苗接种
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引用次数: 0
Effects of war-related stress on the cardiovascular system, metabolism and the rate of ageing in women 与战争有关的压力对妇女心血管系统、新陈代谢和衰老速度的影响
Pub Date : 2024-02-09 DOI: 10.47855/jal9020-2024-5-3
A. Pisaruk, Ervin Asanov, S. Naskalova, I. Antoniuk-Shcheglova, Olena Bondarenko, I. Dyba, L. Mekhova, Ludmila Pisaruk, V. Shatilo
Chronic war-related stress (WRS) due to disruption of adaptation mechanisms can affect physiological processes in the body, in particular, metabolism, neuroendocrine regulation, and the state of the cardiovascular and respiratory systems. WRS can also cause changes in the body's rate of ageing. Purpose of the Study: To investigate the effects of WRS on the cardiovascular system, metabolism and the rate of ageing in women.The study included 91 women aged from 30 to 74 years who experienced chronic WRS and 79 women examined before the Russian-Ukrainian war (control group). The biological age (BA) was determined according to the indicators of hemodynamics, heart rate variability and metabolism (cardiometabolic age) using a formula that was obtained by multiple stepwise regression. The indicators were selected, which correlate as much as possible with age and little among themselves.During the war, no statistically significant changes in heart rate, or systolic and diastolic blood pressure were observed, but a significant reduction in overall HRV in the supine position was obtained. Additionally, indices of parasympathetic nervous system activity are significantly lower during the war. In women, examined during the war, there is a statistically significant higher concentration of blood plasma glucose at fasting and 2-hour post-standard oral glucose tolerance test, they also exhibit higher plasma insulin concentration and a higher HOMA-IR index. An increased frequency of prediabetic disorders was observed. So, in the group of women examined before the war, an elevated fasting blood plasma glucose level was found in 6 %, while during the war it was observed in 19 %. Impaired glucose tolerance before the war was present in 10 % of women, and during the war, it increased to 25 %. To assess the effect of WRS on the rate of ageing, the BA of women before and during war was calculated. The formula for calculating BA was obtained on a group of healthy women before the war, and the ageing rate was calculated as the difference between BA and chronological age (CA). The average BA in the group of women before the war was 56.5±1.4 years, and in the group during the war – 64.7 ± 1.1 years. The difference between BA and CA is (0.02 ± 0.79) years in the women before the war and (10.8 ± 1.36) years during the war (p < 0.05). Chronic WRS leads to the disruption of the cardiovascular system's functioning and simultaneously triggers an imbalance in the autonomic nervous control in women. These changes indicate a state of heightened stress. Women exposed to chronic WRS experience unfavourable alterations in carbohydrate and lipid metabolism, increasing the risk of diabetes mellitus development. Chronic WRS accelerates the rate of cardiometabolic ageing in women._________________________________________________________________________________________Keywords: cardiovascular system; metabolism; biological age; war-related stress; woman
由于适应机制受到破坏而导致的与战争有关的慢性压力(WRS)会影响人体的生理过程,特别是新陈代谢、神经内分泌调节以及心血管和呼吸系统的状态。战时应激反应还可能导致人体衰老速度发生变化。研究目的研究对象包括 91 名经历过慢性 WRS 的 30 至 74 岁女性和 79 名在俄乌战争前接受检查的女性(对照组)。生物年龄(BA)是根据血液动力学、心率变异性和新陈代谢(心脏代谢年龄)的指标,通过多元逐步回归公式确定的。在战争期间,没有观察到心率、收缩压和舒张压发生统计学意义上的显著变化,但仰卧位时整体心率变异显著降低。此外,副交感神经系统的活动指数在战争期间也明显降低。在战争期间接受检查的女性中,空腹血浆葡萄糖浓度和标准口服葡萄糖耐量试验后 2 小时的血浆葡萄糖浓度在统计学上明显较高,她们还表现出较高的血浆胰岛素浓度和较高的 HOMA-IR 指数。此外,还观察到患糖尿病前期疾病的频率增加。因此,在战前接受检查的妇女群体中,发现空腹血浆葡萄糖水平升高的占 6%,而在战争期间则占 19%。战前有 10% 的妇女糖耐量受损,而战争期间则增加到 25%。为了评估 WRS 对衰老速度的影响,计算了战前和战时妇女的 BA。计算 BA 的公式是从一组战前健康妇女身上获得的,而老化率则是根据 BA 与实际年龄(CA)之差计算得出的。战前妇女组的平均 BA 为 56.5±1.4 岁,战时妇女组的平均 BA 为 64.7±1.1 岁。战前妇女的 BA 和 CA 之间的差异为(0.02±0.79)岁,战时为(10.8±1.36)岁(p < 0.05)。长期的 WRS 导致心血管系统功能紊乱,同时引发女性自律神经控制失衡。这些变化表明女性处于高度紧张状态。长期处于 WRS 状态下的妇女的碳水化合物和脂质代谢会发生不利的变化,从而增加患糖尿病的风险。慢性战争应激反应加速了女性心血管代谢老化的速度。_________________________________________________________________________________________ 关键字:心血管系统;新陈代谢;生物年龄;战争应激反应;女性
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引用次数: 0
Dietary patterns, plasma and hair trace element in Ukrainian cohort of adults during COVID-19 pandemic: a cross-sectional study COVID-19 大流行期间乌克兰成人组群的膳食模式、血浆和毛发中的微量元素:一项横断面研究
Pub Date : 2024-01-26 DOI: 10.47855/jal9020-2024-5-2
L. Piven, Mariana Romanenko, Svitlana Fus, Evgen Kyrylenko, Tetiana Papurina, L. Synieok
Adequate mineral intake is important for optimal immune protection against viral infections. However, there is insufficient data on the mineral status of the Ukrainian adult population during the COVID-19 pandemic. The study included people aged 35-80 years with a history of COVID-19 (study group, n=35) and those without (control group, n=26). Dietary intake was assessed using 7-day weighted food records. Trace element analysis of plasma and hair was performed by X-ray fluorescence spectrometry (Elvatech, Ukraine). Low levels of zinc, copper, and, to a lesser extent, iron and selenium were found in the participants' plasma and hair samples. Low hair zinc levels were found in 75.8 % of participants in the study group and 95.8% in the control group (p=0.065). Hair zinc was positively associated with plasma levels (β 0.09, CI 0.03 to 0.15, p=0.007). Participants with a COVID-19 history had higher hair zinc levels than the control group, but still below normal. The difference between groups may be explained by the higher proportion of zinc supplementation (62.9% vs 16.0%, p=0.0005). The low supply of trace elements was independent of estimated dietary intake and history of COVID-19. With increasing age of the participants, the selenium content in their hair decreased (β -0.02, CI -0.03 to -0.01, p=0.001). Current findings show the need to improve the nutrition of Ukrainians, as well as to monitor the supply of minerals for the development of optimal nutritional interventions._________________________________________________________________________________________Keywords: trace elements; zinc; selenium; dietary intake; age; COVID-19
摄入充足的矿物质对抵御病毒感染的最佳免疫保护非常重要。然而,有关 COVID-19 大流行期间乌克兰成年人矿物质状况的数据并不充分。这项研究包括 35-80 岁、有 COVID-19 病史的人群(研究组,人数=35)和没有 COVID-19 病史的人群(对照组,人数=26)。饮食摄入量通过 7 天加权食物记录进行评估。血浆和头发的微量元素分析采用 X 射线荧光光谱法(Elvatech,乌克兰)进行。在参与者的血浆和头发样本中发现锌、铜含量较低,铁和硒含量也较低。研究组 75.8% 的参与者和对照组 95.8% 的参与者头发锌含量偏低(p=0.065)。头发锌含量与血浆锌含量呈正相关(β 0.09,CI 0.03 至 0.15,p=0.007)。与对照组相比,有 COVID-19 病史的参与者头发锌水平较高,但仍低于正常水平。组间差异的原因可能是补锌比例较高(62.9% 对 16.0%,P=0.0005)。微量元素供应量低与估计的膳食摄入量和 COVID-19 病史无关。随着参与者年龄的增长,他们头发中的硒含量也在下降(β -0.02,CI -0.03至-0.01,p=0.001)。目前的研究结果表明,有必要改善乌克兰人的营养状况,并监测矿物质的供应情况,以制定最佳的营养干预措施。_________________________________________________________________________________________ 关键词:微量元素;锌;硒;膳食摄入量;年龄;COVID-19
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引用次数: 0
Risk of sarcopenia in subjects with osteoporosis and osteoarthritis 骨质疏松症和骨关节炎患者出现肌少症的风险
Pub Date : 2024-01-26 DOI: 10.47855/jal19020-2024-5-1
N. Zaverukha, N. Grygorieva, А.S. Musiіenko, M. Bystrytska
The study aimed to determine the relationship between the risk of sarcopenia (SP) and common age-related diseases of the musculoskeletal system, such as osteoporosis (OP) and osteoarthritis (OA). There were examined 460 women aged 50-85 years (mean age 66.4 ± 8.8 years) and they were divided into 4 groups. Group I included 176 women without bone and joint diseases (BJD); Group II included 137 persons with a diagnosis of systemic OP; Group III included 95 subjects with knee and/or hip OA (2nd-3rd degree of Kellgren-Lawrence grades); IV group included 52 females with OP and large joints OA (2nd-3rd degree of Kellgren-Lawrence grades). Bone mineral density (BMD) and trabecular bone score (TBS) were determined in all patients using dual-energy X-ray absorptiometry (DXA), which was subsequently taken into account in the calculation of the 10-year probability of the major osteoporotic fractures according to the Ukrainian version of FRAX®. The following questionnaires were used: SARC-F, IADL, Desmond Fall Risk Questionnaire, and KOOS-12. Also, we used the chair stand test (5 times sit-to-stand) and hand grip dynamometer test. The frequency of persons with risk of SP in Group I was 20.3 %, and it was significantly higher in women with OP (33.5 %, χ2= 6.9 [3.4 – 23.0], p < 0.05), subjects with OA (34.7 %, χ2= 6.7 [3.4 – 25.7], p < 0.05), and women with combined pathology (44.2 %, χ2= 12.1 [9.8 – 38.2], p < 0.05). In patients with OA and risk of SP, pain intensity was significantly higher (43.7 [31.3 – 62.5] points compared to patients with OA without risk of SP - 68.8 [50.0 – 93.8] points, Z = 3.6, p < 0.05), as well as function, and daily living (43.8 [31.3 – 68.8] and 75.0 [56.3 – 100.0] points, respectively, Z = 4.1, p < 0.05 and quality of life 43.8 [37.5 – 62.8] and 75.0 [43.8 – 87.5] points, respectively (Z = 3.0, p < 0.05) according to the KOOS-12. The probability of the major OP fracture was significantly higher in the group of OP and risk of SP (11.0 [8.5 – 12.0] % compared to patients with OP without risk of SP - 8.1 [5.4 – 10.0] %, Z = - 3.8, p < 0.05). The same differences were found for the 10-year probability of hip fracture (5.0 [2.8 – 7.3] and 2.1 [1.5 – 3.5] %, respectively, Z = - 4.9, p < 0.05). High Risk of SP, falls and the need for external assistance were recorded significantly more often in women with OP pathology, and their skeletal muscle strength was significantly lower. Women with a high risk of SP had significantly lower skeletal muscle strength (according to hand grip dynamometry), a higher risk of falls and fractures, and a greater need for assistance. The combination of a risk of SP and OA was associated with more severe joint pain intensity, lower function, and quality of life, and the risk of SP and OP combination was associated with a higher risk of OP fracture._________________________________________________________________________________________Keywords: sarcopenia; osteoporosis; osteoarthritis; FRAX; fracture; fall
这项研究旨在确定肌肉疏松症(SP)风险与肌肉骨骼系统常见老年性疾病(如骨质疏松症(OP)和骨关节炎(OA))之间的关系。接受研究的 460 名妇女年龄在 50-85 岁之间(平均年龄为 66.4 ± 8.8 岁),她们被分为 4 组。第一组包括176名无骨关节疾病(BJD)的女性;第二组包括137名确诊为全身性OP的人;第三组包括95名患有膝关节和/或髋关节OA(凯尔格伦-劳伦斯分级2-3级)的受试者;第四组包括52名患有OP和大关节OA(凯尔格伦-劳伦斯分级2-3级)的女性。所有患者的骨质密度(BMD)和骨小梁评分(TBS)均采用双能 X 射线吸收测量法(DXA)测定,随后根据乌克兰版 FRAX® 计算 10 年重大骨质疏松性骨折的概率。使用了以下调查问卷SARC-F、IADL、戴斯蒙德跌倒风险问卷和 KOOS-12。此外,我们还使用了椅子站立测试(5 次坐立)和手握力计测试。在第一组中,有SP风险的人数占20.3%,在患有OP的女性(33.5%,χ2= 6.9 [3.4 - 23.0],P < 0.05)、OA 患者(34.7%,χ2= 6.7 [3.4 - 25.7],P < 0.05)和合并病变的女性(44.2%,χ2= 12.1 [9.8 - 38.2],P < 0.05)。在有 OA 和 SP 风险的患者中,疼痛强度明显更高(43.7 [31.3 - 62.5] 分,而无 SP 风险的 OA 患者为 68.8 [50.0 - 93.8] 分,Z = 3.6,P < 0.05),功能和日常生活也明显更高(43.7 [31.3 - 62.5] 分,Z = 3.6,P < 0.05)。8 [31.3 - 68.8]和 75.0 [56.3 - 100.0]分,Z = 4.1,p < 0.05;根据KOOS-12,生活质量分别为43.8 [37.5 - 62.8]和75.0 [43.8 - 87.5]分(Z = 3.0,p < 0.05)。在有 SP 风险的 OP 组中,发生 OP 重度骨折的概率明显更高(11.0 [8.5 - 12.0] %,而无 SP 风险的 OP 患者为 8.1 [5.4 - 10.0] %,Z = - 3.8,p < 0.05)。髋部骨折的 10 年概率也存在同样的差异(分别为 5.0 [2.8 - 7.3] % 和 2.1 [1.5 - 3.5] %,Z = - 4.9,p < 0.05)。有 OP 病变的妇女发生 SP、跌倒和需要外部帮助的风险明显更高,她们的骨骼肌强度也明显更低。SP风险高的妇女骨骼肌力量明显较低(根据手部握力测定法),跌倒和骨折的风险较高,需要的帮助也更多。SP风险和OA风险的组合与更严重的关节疼痛强度、更低的功能和生活质量有关,SP风险和OP风险的组合与更高的OP骨折风险有关。_________________________________________________________________________________________ 关键字:肌肉疏松症;骨质疏松症;骨关节炎;FRAX;骨折;跌倒;疼痛;生活质量。
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Ageing &amp; Longevity
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