Pub Date : 2019-02-02DOI: 10.15226/2374-6890/6/1/001124
R. A. Al-Asa'd, A. Alzu’bi, Susan Eteiwi, A. Eyadeh, Khaldon K Al-Sarihin, Reem Moh’d Al-Qaddah, A. Zayadeen, A. Al-Omari, F. Haddad, Dina Nasri, Gharam Alawabdeh, Ferdos Faraieh, Reema Nsairat
Primary hyperparathyroidism is the most common cause of hypercalcemia in outpatients and it is usually attributed to parathyroid adenoma, which is managed by surgical resection of the adenoma. Successful management requires accurate localization of the adenoma prior to surgery. Objective: To describe our institution’s experience in assessing the diagnostic value of parathyroid Fine Needle Aspirate (FNA) and PTH washout in localizing and confirming parathyroid adenoma. Methods: Twenty three patients (91.3% females) diagnosed to have primary hyperparathyroidism(PHPT) were enrolled in our study: parathyroid scanning (sestamibi), Ultrasound (US)and USguided FNA of the suspected parathyroid adenoma done to all patients by the same radiologist. The aspirate form FNA was washed out with one centimeter cubic normal saline and PTH was measured in the washout. Results: Mean(±SD) age was 51.3±13.5 year. Mean serum PTH ( 289.3±384.7) pg/ml and mean serum Calcium was (10.9±1.2) mg/ dl. Mean (±SD) PTH values in the washout is1172.3 ± 1877.6 pg/ml. Three patients had negative sestamibi scan but had positive results in PTH washout. The sensitivity and specificity of PTH washout are 82% and 100% respectively, with 100% positive predictive value and 67 % negative predictive value. For Sestamibi scan are 76.5% and 83.3% respectively with 92.9 % positive predictive value and 55.6 % negative predictive value and for ultrasound are 76 % and 67 % respectively with 87% positive predictive value and 50% negative predictive value. Conclusion: This study highlights the superiority of Parathyroid FNA with PTH washout over US or sestamibi scanning in confirming a parathyroid adenoma. Received: January 11,2019; Accepted: January 24 ,2019; Published: February 02, 2019 *Corresponding author : Dr. Rania Al-asa’d, Endocrine Division, King Hussein Medical Center, Royal Medical Services, Jordan,Tel: +962 772447568;E-mail: Raniamd@yahoo.com
{"title":"Parathyroid Gland FNA and PTH Washout; Diagnostic Value in Patients with Primary Hyperparathyroidism","authors":"R. A. Al-Asa'd, A. Alzu’bi, Susan Eteiwi, A. Eyadeh, Khaldon K Al-Sarihin, Reem Moh’d Al-Qaddah, A. Zayadeen, A. Al-Omari, F. Haddad, Dina Nasri, Gharam Alawabdeh, Ferdos Faraieh, Reema Nsairat","doi":"10.15226/2374-6890/6/1/001124","DOIUrl":"https://doi.org/10.15226/2374-6890/6/1/001124","url":null,"abstract":"Primary hyperparathyroidism is the most common cause of hypercalcemia in outpatients and it is usually attributed to parathyroid adenoma, which is managed by surgical resection of the adenoma. Successful management requires accurate localization of the adenoma prior to surgery. Objective: To describe our institution’s experience in assessing the diagnostic value of parathyroid Fine Needle Aspirate (FNA) and PTH washout in localizing and confirming parathyroid adenoma. Methods: Twenty three patients (91.3% females) diagnosed to have primary hyperparathyroidism(PHPT) were enrolled in our study: parathyroid scanning (sestamibi), Ultrasound (US)and USguided FNA of the suspected parathyroid adenoma done to all patients by the same radiologist. The aspirate form FNA was washed out with one centimeter cubic normal saline and PTH was measured in the washout. Results: Mean(±SD) age was 51.3±13.5 year. Mean serum PTH ( 289.3±384.7) pg/ml and mean serum Calcium was (10.9±1.2) mg/ dl. Mean (±SD) PTH values in the washout is1172.3 ± 1877.6 pg/ml. Three patients had negative sestamibi scan but had positive results in PTH washout. The sensitivity and specificity of PTH washout are 82% and 100% respectively, with 100% positive predictive value and 67 % negative predictive value. For Sestamibi scan are 76.5% and 83.3% respectively with 92.9 % positive predictive value and 55.6 % negative predictive value and for ultrasound are 76 % and 67 % respectively with 87% positive predictive value and 50% negative predictive value. Conclusion: This study highlights the superiority of Parathyroid FNA with PTH washout over US or sestamibi scanning in confirming a parathyroid adenoma. Received: January 11,2019; Accepted: January 24 ,2019; Published: February 02, 2019 *Corresponding author : Dr. Rania Al-asa’d, Endocrine Division, King Hussein Medical Center, Royal Medical Services, Jordan,Tel: +962 772447568;E-mail: Raniamd@yahoo.com","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43825815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.15226/2374-6890/6/3/001137
Mark B Zimering, Deesha Patel, Gideon Bahn
Aims: Obese type 2 diabetes and traumatic brain injury are associated with persistent peripheral and neuro-inflammation, respectively. We tested whether adult type 2 diabetes increased the hazard rate for neurodegeneration complications following traumatic brain injury.
Methods: Retrospective chart review of patients treated at the Veterans Affairs New Jersey Healthcare System between 2016-2019 and having a diagnosis of prior traumatic brain injury was performed in adult veterans, age 50 years or older. Cox proportional hazards regression analysis was used to identify risk factors predictive of an increased risk of neurodegeneration, i.e. worsening major depression, dementia or Parkinson's disease following traumatic brain injury.
Results: Type 2 diabetes predicted a nearly three-fold increased hazard ratio (HR = 2.95, 95% CI 1.15-7.56, P =0.02) for the occurrence of worsening major depression, dementia or Parkinson's disease in eighty adults age 50 years or older who had experienced prior traumatic brain injury. After adjusting for other covariates, hypertension (HR= 4.15, 95% CI 1.21-14.29, P =0.02) was significant and body mass index (HR=1.14, 95% CI 0.99-1.30; P=0.06) modestly significant predictors of the risk for the time to first occurrence of the composite neurodegenerative outcome.
Conclusion: Type 2 diabetes, hypertension and higher body mass index increase the hazard for the occurrence of worsening depression, Parkinson's disease and dementia following traumatic brain injury in middle-aged and older adults.
目的:肥胖型2型糖尿病和创伤性脑损伤分别与持续的周围和神经炎症有关。我们测试了成人2型糖尿病是否会增加创伤性脑损伤后神经退行性并发症的危险率。方法:回顾性分析2016-2019年期间在新泽西州退伍军人事务医疗保健系统治疗的50岁及以上成年退伍军人中既往诊断为创伤性脑损伤的患者。使用Cox比例风险回归分析来确定预测神经变性风险增加的危险因素，即创伤性脑损伤后重度抑郁症、痴呆或帕金森病的恶化。结果:在80名50岁及以上曾经历过创伤性脑损伤的成年人中，2型糖尿病预测重度抑郁症、痴呆或帕金森病恶化的风险比增加近3倍(HR = 2.95, 95% CI 1.15-7.56, P =0.02)。校正其他协变量后，高血压(HR= 4.15, 95% CI 1.21-14.29, P =0.02)和体重指数(HR=1.14, 95% CI 0.99-1.30;P=0.06)为首次发生复合神经退行性结局的时间风险的适度显著预测因子。结论:2型糖尿病、高血压和较高的体重指数增加了中老年人创伤性脑损伤后抑郁加重、帕金森病和痴呆发生的危险。
{"title":"Type 2 Diabetes Predicts Increased Risk of Neurodegenerative Complications in Veterans Suffering Traumatic Brain Injury.","authors":"Mark B Zimering, Deesha Patel, Gideon Bahn","doi":"10.15226/2374-6890/6/3/001137","DOIUrl":"10.15226/2374-6890/6/3/001137","url":null,"abstract":"<p><strong>Aims: </strong>Obese type 2 diabetes and traumatic brain injury are associated with persistent peripheral and neuro-inflammation, respectively. We tested whether adult type 2 diabetes increased the hazard rate for neurodegeneration complications following traumatic brain injury.</p><p><strong>Methods: </strong>Retrospective chart review of patients treated at the Veterans Affairs New Jersey Healthcare System between 2016-2019 and having a diagnosis of prior traumatic brain injury was performed in adult veterans, age 50 years or older. Cox proportional hazards regression analysis was used to identify risk factors predictive of an increased risk of neurodegeneration, i.e. worsening major depression, dementia or Parkinson's disease following traumatic brain injury.</p><p><strong>Results: </strong>Type 2 diabetes predicted a nearly three-fold increased hazard ratio (HR = 2.95, 95% CI 1.15-7.56, P =0.02) for the occurrence of worsening major depression, dementia or Parkinson's disease in eighty adults age 50 years or older who had experienced prior traumatic brain injury. After adjusting for other covariates, hypertension (HR= 4.15, 95% CI 1.21-14.29, P =0.02) was significant and body mass index (HR=1.14, 95% CI 0.99-1.30; P=0.06) modestly significant predictors of the risk for the time to first occurrence of the composite neurodegenerative outcome.</p><p><strong>Conclusion: </strong>Type 2 diabetes, hypertension and higher body mass index increase the hazard for the occurrence of worsening depression, Parkinson's disease and dementia following traumatic brain injury in middle-aged and older adults.</p>","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6905496/pdf/nihms-1061802.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9591970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-29DOI: 10.15226/2374-6890/6/1/001123
S. Ghosal, B. Sinha
Sir, Recent diabetes guidelines have upgraded the position of sodium glucose cotransporter 2 inhibitors (SGLT-2i) based on the publication of cardiovascular outcomes trials (CVOT). However, divergent signals have emerged from the 3 CVOTs. It is speculated that these differences were due to differing patient population and cardiovascular (CV) risk status, suggesting that the benefits of SGLT-2i were driven primarily by their effect on the pump (hospitalization for heart failure (hHF) and CV death) and not on the pipe (myocardial infarction, stroke & peripheral arterial disease). [1]
{"title":"SGLT-2i and Cardiovascular Outcomes: A Meta-Analysis of The Asian Cohort","authors":"S. Ghosal, B. Sinha","doi":"10.15226/2374-6890/6/1/001123","DOIUrl":"https://doi.org/10.15226/2374-6890/6/1/001123","url":null,"abstract":"Sir, Recent diabetes guidelines have upgraded the position of sodium glucose cotransporter 2 inhibitors (SGLT-2i) based on the publication of cardiovascular outcomes trials (CVOT). However, divergent signals have emerged from the 3 CVOTs. It is speculated that these differences were due to differing patient population and cardiovascular (CV) risk status, suggesting that the benefits of SGLT-2i were driven primarily by their effect on the pump (hospitalization for heart failure (hHF) and CV death) and not on the pipe (myocardial infarction, stroke & peripheral arterial disease). [1]","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45202306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-17DOI: 10.15226/2374-6890/5/6/001122
A. Lounici, E. Tabti, A. Benmekki, Mohammed Hadi Bestaoui
{"title":"Adrenal Adenoma Causing Secondary Hypertension. A Review of the Literature","authors":"A. Lounici, E. Tabti, A. Benmekki, Mohammed Hadi Bestaoui","doi":"10.15226/2374-6890/5/6/001122","DOIUrl":"https://doi.org/10.15226/2374-6890/5/6/001122","url":null,"abstract":"","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45008419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-28DOI: 10.15226/2374-6890/5/6/001121
Maddy Narváez-Méndez, Samantha Morgan, M. Coronado-Malagón, C. A. Arce-Salinas, Antonio Barajas, Isabel Arenas, A. Svarch, D. E. Garcia
{"title":"Biomarkers Through The Development, Progression and Chronic Complications of Diabetes Mellitus: A Mini-Review","authors":"Maddy Narváez-Méndez, Samantha Morgan, M. Coronado-Malagón, C. A. Arce-Salinas, Antonio Barajas, Isabel Arenas, A. Svarch, D. E. Garcia","doi":"10.15226/2374-6890/5/6/001121","DOIUrl":"https://doi.org/10.15226/2374-6890/5/6/001121","url":null,"abstract":"","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42563333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-13DOI: 10.15226/2374-6890/5/6/001120
P. Dabla, V. Dabla
The dynamics of the diabetes epidemic are changing rapidly. It is a matter of concern on global scale from a public health perspective and also in relation to rising societal costs. Once a disease of the West, type 2 diabetes has now spread to every country in the world from affluence to poor. The rising cost and ever increasing burden on health care resources to treat and monitor diabetes and its complications put a heavy financial and manpower burden on national health care systems. Asia’s large population and rapid economic development have made it an epicenter of the epidemic. Asian populations tend to develop diabetes at younger ages and lower BMI levels than Caucasians. Interactions between Westernized diet and lifestyle and genetic background may accelerate the growth of diabetes in the context of rapid nutrition transition. This epidemic is primarily driven by rapid urbanization, nutrition transition, and increasingly sedentary lifestyles. It reflects affluence and exposure to increased calorie intake in combination with sedentary lifestyle and less human energy expenditure. However, primary prevention through changes in public policies, the food and built environments, health systems and promotion of a healthy diet and lifestyle should be a global public policy priority.
{"title":"Global Burden of Diabetes- Rising Expenditures on Healthcare Economy","authors":"P. Dabla, V. Dabla","doi":"10.15226/2374-6890/5/6/001120","DOIUrl":"https://doi.org/10.15226/2374-6890/5/6/001120","url":null,"abstract":"The dynamics of the diabetes epidemic are changing rapidly. It is a matter of concern on global scale from a public health perspective and also in relation to rising societal costs. Once a disease of the West, type 2 diabetes has now spread to every country in the world from affluence to poor. The rising cost and ever increasing burden on health care resources to treat and monitor diabetes and its complications put a heavy financial and manpower burden on national health care systems. Asia’s large population and rapid economic development have made it an epicenter of the epidemic. Asian populations tend to develop diabetes at younger ages and lower BMI levels than Caucasians. Interactions between Westernized diet and lifestyle and genetic background may accelerate the growth of diabetes in the context of rapid nutrition transition. This epidemic is primarily driven by rapid urbanization, nutrition transition, and increasingly sedentary lifestyles. It reflects affluence and exposure to increased calorie intake in combination with sedentary lifestyle and less human energy expenditure. However, primary prevention through changes in public policies, the food and built environments, health systems and promotion of a healthy diet and lifestyle should be a global public policy priority.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49280738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.15226/2374-6890/5/6/001119
Nayana Devang, P. Adhikari, M. Nandini
Obesity is believed to be the major contributing factor for type 2 diabetes. Obese subjects have 2-3 fold higher risk of developing type 2 diabetes. Obesity in type 2 diabetes increases the risk of hypertension, dyslipidemia and cardiovascular diseases. The current study was aimed to classify type 2 diabetic patients phenotypically based on the obesity indices and to study the prevalence of each phenotype. Methodology: This study included 336 type 2 diabetic patients who attended Kasturba Medical College Hospital, Mangalore. Their waist circumference and body mass index were measured. Based on these measurements they were classified into four phenotypes as follows: Generalized obesity: high values of waist circumference and body mass index. Truncal obesity: high values of waist circumference and normal body mass index. Non-obesity: Normal values of waist circumference and body mass index. The details of glycaemic index, anti-diabetic drug usage, and diabetic complications exhibited were collected from case records. Results: 71% (n=238) of type 2 diabetic patients had generalized obesity, 16% (n=54) of type 2 diabetic patients had truncal obesity, and 13% (n=44) of type 2 diabetic patients were non-obese/lean. There was no significant difference in the HbA1c level between obese and non-obese diabetics. Conclusion: Among the three phenotypes of type 2 diabetes, generalized obesity appears to be the highly prevalent phenotype.
{"title":"Phenotypical Classification of Type 2 Diabetes Mellitus","authors":"Nayana Devang, P. Adhikari, M. Nandini","doi":"10.15226/2374-6890/5/6/001119","DOIUrl":"https://doi.org/10.15226/2374-6890/5/6/001119","url":null,"abstract":"Obesity is believed to be the major contributing factor for type 2 diabetes. Obese subjects have 2-3 fold higher risk of developing type 2 diabetes. Obesity in type 2 diabetes increases the risk of hypertension, dyslipidemia and cardiovascular diseases. The current study was aimed to classify type 2 diabetic patients phenotypically based on the obesity indices and to study the prevalence of each phenotype. Methodology: This study included 336 type 2 diabetic patients who attended Kasturba Medical College Hospital, Mangalore. Their waist circumference and body mass index were measured. Based on these measurements they were classified into four phenotypes as follows: Generalized obesity: high values of waist circumference and body mass index. Truncal obesity: high values of waist circumference and normal body mass index. Non-obesity: Normal values of waist circumference and body mass index. The details of glycaemic index, anti-diabetic drug usage, and diabetic complications exhibited were collected from case records. Results: 71% (n=238) of type 2 diabetic patients had generalized obesity, 16% (n=54) of type 2 diabetic patients had truncal obesity, and 13% (n=44) of type 2 diabetic patients were non-obese/lean. There was no significant difference in the HbA1c level between obese and non-obese diabetics. Conclusion: Among the three phenotypes of type 2 diabetes, generalized obesity appears to be the highly prevalent phenotype.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49410252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-26DOI: 10.15226/2374-6890/5/6/001118
Mohammed Idrees Khan, Fauzia Ashfaq
Objectives: The aim of the study was to determine glycosylated hemogobin (HbA1c) cut-off and lipid correlation, duration of diabetes with level of proteinuria. Materials And Methods: Cross sectional study was done on 250 patients with type-2 diabetes mellitus subjects attending medicine clinic , King george’s medical university (KGMU) lucknow, india. Subjects were screened for diabetic nephropathy depending on the base line parameter, clinical history of disease and documented in pretested proforma. Routine blood parameters, HbA1C and 24 hrs urine microalbumin level were carried out in department of pathology. Result: The level of HbA1c was higher among the patients of nephropathy (8.54±0.97) compared with non-nephropathy (7.32±0.84, 95%CI=7.17-7.47). Increased HbA1c was found among both 5-10 and >10 years diabetic duration . However, HbA1c was similar among all duration of diabetes groups within non-nephropathy. The total cholesterol (TC), HDL cholesterol (HDL-c), LDL cholesterol (LDL-c) and VLDL cholesterol (VLDL-C) were almost similar in HbA1c range <7, 7-8.9 and 9-10.9 and without insignificant differences (p>0.05). Although, Triglyceride (TG) level was significantly higher in HbA1c 9-10.9 (174.20±48.95mg%) than 7-8.9 (159.66±31.47mg%) and <7 (158.82±29.67mg%) . High prevalence of nephropathy was found among HbA1c range 9-10.9 (Urine albumin :246.35±126.29mg/d) compared with 7-8.99 (Urine albumin :159.89±70.16mg/d) and <7 (Urine albumin :132.80±90.33mg/d) respectively. Conclusion : HbA1c cut-off >7 % should be considered as an index of glycemic control as well as important tool for over all metabolic derangement and target organ damage among diabetes population. Hence, establishment of HbA1c cut-off value with long duration of diabetes might be useful for prediction of treatment control and prevention of renal failure. Keywords; Diabetic Nephropathy; Glycosylated Hemoglobin; Triglyceride; Renal failure Received: August 28,2018; Accepted: September 19,2018; Published: October 26,2018 *Corresponding author : Mohammed Idrees Khan , Assistant Professor, Department of Clinical Nutrition, College of Applied Health Sciences in Arras, Qassim University (K.S.A),Tel: +966-537234624,E-mail: mohdidreesh06@gmail.com
{"title":"Variation of Glycosylated Hemoglobin (HbA1C) Cutoff among type-2 diabetic nephropathy Patients","authors":"Mohammed Idrees Khan, Fauzia Ashfaq","doi":"10.15226/2374-6890/5/6/001118","DOIUrl":"https://doi.org/10.15226/2374-6890/5/6/001118","url":null,"abstract":"Objectives: The aim of the study was to determine glycosylated hemogobin (HbA1c) cut-off and lipid correlation, duration of diabetes with level of proteinuria. Materials And Methods: Cross sectional study was done on 250 patients with type-2 diabetes mellitus subjects attending medicine clinic , King george’s medical university (KGMU) lucknow, india. Subjects were screened for diabetic nephropathy depending on the base line parameter, clinical history of disease and documented in pretested proforma. Routine blood parameters, HbA1C and 24 hrs urine microalbumin level were carried out in department of pathology. Result: The level of HbA1c was higher among the patients of nephropathy (8.54±0.97) compared with non-nephropathy (7.32±0.84, 95%CI=7.17-7.47). Increased HbA1c was found among both 5-10 and >10 years diabetic duration . However, HbA1c was similar among all duration of diabetes groups within non-nephropathy. The total cholesterol (TC), HDL cholesterol (HDL-c), LDL cholesterol (LDL-c) and VLDL cholesterol (VLDL-C) were almost similar in HbA1c range <7, 7-8.9 and 9-10.9 and without insignificant differences (p>0.05). Although, Triglyceride (TG) level was significantly higher in HbA1c 9-10.9 (174.20±48.95mg%) than 7-8.9 (159.66±31.47mg%) and <7 (158.82±29.67mg%) . High prevalence of nephropathy was found among HbA1c range 9-10.9 (Urine albumin :246.35±126.29mg/d) compared with 7-8.99 (Urine albumin :159.89±70.16mg/d) and <7 (Urine albumin :132.80±90.33mg/d) respectively. Conclusion : HbA1c cut-off >7 % should be considered as an index of glycemic control as well as important tool for over all metabolic derangement and target organ damage among diabetes population. Hence, establishment of HbA1c cut-off value with long duration of diabetes might be useful for prediction of treatment control and prevention of renal failure. Keywords; Diabetic Nephropathy; Glycosylated Hemoglobin; Triglyceride; Renal failure Received: August 28,2018; Accepted: September 19,2018; Published: October 26,2018 *Corresponding author : Mohammed Idrees Khan , Assistant Professor, Department of Clinical Nutrition, College of Applied Health Sciences in Arras, Qassim University (K.S.A),Tel: +966-537234624,E-mail: mohdidreesh06@gmail.com","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46826182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-10-02DOI: 10.15226/2374-6890/5/5/001116
B. Yurekli, G. Kocabas, C. Mirili, A. Suner, M. Aksit, I. Yurekli, N. Kutbay, I. Şimşir, G. Bozkaya
Purpose: Diabetes mellitus is associated with atherosclerotic and cardiovascular diseases. Our aim was to investigate the levels of lipocalin-2 (LCN-2) and soluble Lectin-like oxidized low-density lipoprotein receptor-1(sLOX-1) levels in both diabetics and prediabetic with comparison to non-diabetic subjects. We also examined the association of LCN-2 with sLOX-1 and albuminuria Methods: One hundred forty-two subjects with type 2 diabetes mellitus, 32 prediabetic subjects, 58 non-diabetic controls were consecutively enrolled in this study. LCN-2 and sLOX-1 levels were measured with ELISA assays. Results: LCN-2 levels didn’t show significant difference between diabetics, prediabetic and control groups (p = 0.864). sLOX-1 levels were significantly lower in diabetic group (2.53 ng/mL, median) compared with prediabetic (2.84 ng/mL, median; p = 0.041) and control groups (3.00 ng/mL, median; p = 0.001). Multiple linear regression analysis showed that urinary albumin excretion and sLOX1 were independently associated with LCN-2. When logistic regression analysis was performed LCN-2 was independent factor determining albuminuria (p = 0.021; OR, 1.001; (1.000-1.001) 95% CI). Conclusion: Our study provides the first clinical evidence demonstrating serum LCN-2 concentrations are independently associated with sLOX-1 levels which were found to be lower in type 2 diabetics unexpectedly. LCN-2 was also associated with albuminuria. Received: September 24,2018; Accepted: October 01,2018; Published: October 02,2018 *Corresponding author : Banu Sarer Yurekli, Ege University Faculty of Medicine, Department of Endocrinology, Ankara Street, Bornova, Izmir, Turkey, 35100,Tel: +90 5055250373;Fax: +902323247880;E-mail: bsareryurekli@yahoo.com
{"title":"Circulating Lipocalin-2 Levels Are Associated With Soluble Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Levels In Type 2 Diabetic Patients","authors":"B. Yurekli, G. Kocabas, C. Mirili, A. Suner, M. Aksit, I. Yurekli, N. Kutbay, I. Şimşir, G. Bozkaya","doi":"10.15226/2374-6890/5/5/001116","DOIUrl":"https://doi.org/10.15226/2374-6890/5/5/001116","url":null,"abstract":"Purpose: Diabetes mellitus is associated with atherosclerotic and cardiovascular diseases. Our aim was to investigate the levels of lipocalin-2 (LCN-2) and soluble Lectin-like oxidized low-density lipoprotein receptor-1(sLOX-1) levels in both diabetics and prediabetic with comparison to non-diabetic subjects. We also examined the association of LCN-2 with sLOX-1 and albuminuria Methods: One hundred forty-two subjects with type 2 diabetes mellitus, 32 prediabetic subjects, 58 non-diabetic controls were consecutively enrolled in this study. LCN-2 and sLOX-1 levels were measured with ELISA assays. Results: LCN-2 levels didn’t show significant difference between diabetics, prediabetic and control groups (p = 0.864). sLOX-1 levels were significantly lower in diabetic group (2.53 ng/mL, median) compared with prediabetic (2.84 ng/mL, median; p = 0.041) and control groups (3.00 ng/mL, median; p = 0.001). Multiple linear regression analysis showed that urinary albumin excretion and sLOX1 were independently associated with LCN-2. When logistic regression analysis was performed LCN-2 was independent factor determining albuminuria (p = 0.021; OR, 1.001; (1.000-1.001) 95% CI). Conclusion: Our study provides the first clinical evidence demonstrating serum LCN-2 concentrations are independently associated with sLOX-1 levels which were found to be lower in type 2 diabetics unexpectedly. LCN-2 was also associated with albuminuria. Received: September 24,2018; Accepted: October 01,2018; Published: October 02,2018 *Corresponding author : Banu Sarer Yurekli, Ege University Faculty of Medicine, Department of Endocrinology, Ankara Street, Bornova, Izmir, Turkey, 35100,Tel: +90 5055250373;Fax: +902323247880;E-mail: bsareryurekli@yahoo.com","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44087593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-04DOI: 10.15226/2374-6890/5/5/001115
Hien Lau, Nicole Corrales, Sarah Lee, Jennifer Heng, Kevin Zhang, Michae, Alexander, J. Lakey
Background: orcine islets have been proposed as an alternative islet source for islet transplantation in patients with type 1 diabetes. Our focus on pre-weaned porcine islets (4-11 days old; PPIs) has shown that this model of porcine islets is a cost effective and viable mean to isolate and culture islets for transplantation. Exendin-4 (Ex4) could improve islet viability, islet expansion, and insulin secretion. PPIs are immature after islet isolation and the addition of growth factors could accelerate their maturation. This study investigated the effects of exposure to Ex-4 on the maturation of freshly isolated PPIs during in vitro culture. Methods: Pancreata from pre-weaned piglets (4-11 days old) were partially digested using low-dose collagenase and culture at 37°C and 5% CO2 for up to 3 days. 10nM of Ex-4 was added to culture media of freshly isolated PPIs. After 3-day culture, islets were assessed for islet yield, size, purity, membrane integrity, cellular viability and composition, and in vitro function. Results: Islet count (IC) was significantly higher in the Ex-4 group than in the control group. Islets treated with Ex-4 were significantly smaller than islets from the control group. The percentages of major endocrine cells (β-cells, α-cells, and δ-cells) were similar in both groups. Ex-4 supplementation significantly increased insulin secretion in response to glucose challenge. Conclusions: The addition of Ex-4 to culture media of freshly isolated PPIs could improve islet counts and produce islets with enhanced glucose-stimulated function. Culturing PPIs in Ex-4 could be beneficial to improve islet quality before transplantation.
{"title":"Exendin-4 Improves Yield and Function of Isolated Pre- Weaned Porcine Islets","authors":"Hien Lau, Nicole Corrales, Sarah Lee, Jennifer Heng, Kevin Zhang, Michae, Alexander, J. Lakey","doi":"10.15226/2374-6890/5/5/001115","DOIUrl":"https://doi.org/10.15226/2374-6890/5/5/001115","url":null,"abstract":"Background: orcine islets have been proposed as an alternative islet source for islet transplantation in patients with type 1 diabetes. Our focus on pre-weaned porcine islets (4-11 days old; PPIs) has shown that this model of porcine islets is a cost effective and viable mean to isolate and culture islets for transplantation. Exendin-4 (Ex4) could improve islet viability, islet expansion, and insulin secretion. PPIs are immature after islet isolation and the addition of growth factors could accelerate their maturation. This study investigated the effects of exposure to Ex-4 on the maturation of freshly isolated PPIs during in vitro culture. Methods: Pancreata from pre-weaned piglets (4-11 days old) were partially digested using low-dose collagenase and culture at 37°C and 5% CO2 for up to 3 days. 10nM of Ex-4 was added to culture media of freshly isolated PPIs. After 3-day culture, islets were assessed for islet yield, size, purity, membrane integrity, cellular viability and composition, and in vitro function. Results: Islet count (IC) was significantly higher in the Ex-4 group than in the control group. Islets treated with Ex-4 were significantly smaller than islets from the control group. The percentages of major endocrine cells (β-cells, α-cells, and δ-cells) were similar in both groups. Ex-4 supplementation significantly increased insulin secretion in response to glucose challenge. Conclusions: The addition of Ex-4 to culture media of freshly isolated PPIs could improve islet counts and produce islets with enhanced glucose-stimulated function. Culturing PPIs in Ex-4 could be beneficial to improve islet quality before transplantation.","PeriodicalId":73731,"journal":{"name":"Journal of endocrinology and diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67332623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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