scholarly journals Fasting blood glucose to HDL-C ratio as a novel predictor of clinical outcomes in non-diabetic patients after PCI

2020 ◽  
Vol 40 (12) ◽  
Author(s):  
Qian-Qian Guo ◽  
Ying-Ying Zheng ◽  
Jun-Nan Tang ◽  
Ting-Ting Wu ◽  
Xu-Ming Yang ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Clinical Outcomes ◽  
Cox Regression ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Bleeding Events ◽  
Cox Regression Analysis ◽  
Cholesterol Ratio

Abstract Background The present study was to assess the prognostic value of fasting blood glucose to high-density lipoprotein cholesterol ratio (GHR) in non-diabetic patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). Methods and results A total of 6645 non-diabetic patients from two independent cohorts, the CORFCHD-PCI study (n=4282) and the CORFCHD-ZZ (n=2363) study, were enrolled in Clinical Outcomes and Risk Factors of Patients with Coronary Heart Disease after PCI. Patients were divided into two groups according to the GHR value. The primary outcome included all-cause mortality (ACM) and cardiac mortality (CM). The average follow-up time was 36.51 ± 22.50 months. We found that there were significant differences between the two groups in the incidences of ACM (P=0.013) and CM (P=0.038). Multivariate Cox regression analysis revealed GHR as an independent prognostic factor for ACM. The incidence of ACM increased 1.284-times in patients in the higher GHR group (hazard ratio [HR]: 1.284 [95% confidence interval [CI]: 1.010–1.631], P<0.05). Kaplan–Meier survival analysis suggested that patients with high GHR value tended to have an increased accumulated risk of ACM. However, we did not find significant differences in the incidence of major adverse cardiac events, main/major adverse cardiovascular and cerebrovascular events (MACCE), stroke, recurrent myocardial infarction (MI) and bleeding events. Conclusions The present study indicates that GHR index is an independent and novel predictor of ACM in non-diabetic CAD patients who underwent PCI.

scholarly journals Correlation between glycated hemoglobin HbA1c and serum lipid profile in patients with type 2 diabetes

2021 ◽  
pp. 14-18
Author(s):  
Asmaa Alboueishi
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Blood Glucose ◽  
Serum Lipid ◽  
Clinical Laboratory ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Diabetic Patients

Background: Hyperlipidemia is a common risk factor for diabetes that leads to cardiovascular disease, one of the causes of death of diabetic patients. Theaimof this study was to investigate the association between HbA1c levels and serum lipids in Libyan patients withtype 2 diabetes. Material and methods: The study was conducted in 2019 on 325 patients (174 males, 151 females) with type 2 diabetes referred to a private clinical laboratory in Tripoli, Libya. Blood samples were collected for measurement of HbA1c, fasting blood glucose and serum lipid concentrations. Diabetes was defined according to the American Diabetes Association criteria.The data were analyzed using an independent t-test and Pearson’scorrelation test.Results: The ages of the patients ranged from 40 to 83 years, with a mean of 51.52 ± 14.32 years SD. No significant correlation between HbA1c and age was noted (r=0.011, p=0.063). There was a significant positive correlation betweenHbA1c level and fasting blood glucose (r =0.641, p=0.000), low-density lipoprotein (r = 0.240, p = 0.000), total cholesterol (r = 0.223, p = 0.000) and triglycerides(r=0.140,p 0.067). The correlation between HbA1c and high-density lipoprotein-C was negative but not significant (r= -0.088, p = 0.123). Conclusion: HbA1c could be used as a predictor of dyslipidemia and thus it may serve as anindicator of the development of cardiovascular disease in patients with type-2 diabetes mellitus.

scholarly journals Effect of Pilates on Glucose and Lipids: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Zehua Chen ◽  
Xiangling Ye ◽  
Yubo Xia ◽  
Huiting Song ◽  
Yi Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Glucose ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Dietary Treatments

Objective: The benefits of Pilates for blood glucose and lipids remain unclear. The purpose of this study was to examine the effect of Pilates on their levels.Methods: Searches were conducted in five databases to identify relevant articles published until October 29, 2020. Paired reviewers independently screened the articles and extracted data from each included study. Meta-analysis was performed to assess the effects of Pilates on blood glucose and lipids. Subgroup analyses and sensitivity analyses were conducted to explore heterogeneity.Results: According to the inclusion and exclusion criteria, 15 randomized controlled trials (RCTs) comprising 587 participants were included in the study. Overall, the Pilates group (PG) had a significantly greater reduction in post-prandial blood glucose than the control group (CG) (MD = −22.25 mg/dL, 95% CI: [−28.34, 16.17] mg/dL, P < 0.00001, I2 = 0%); glycated hemoglobin (HbA1c) (MD = −0.78%, 95% CI: [−1.13, −0.42]%, P < 0.0001, I2 = 88%); total cholesterol (TC) (MD = −20.90 mg/dL, 95% CI: [−37.21, −4.60] mg/dL, P = 0.01, I2 = 84%); triglycerides (TG) (MD = −12.59 mg/dL, 95% CI: [−19.88, −5.29] mg/dL, P = 0.0007, I2 = 86%); and low density lipoprotein cholesterol (LDL-C) (MD = −12.39 mg/dL, 95% CI: [−16.82, −7.95] mg/dL, P < 0.00001, I2 = 45%) compared to CG, whereas no significant difference was detected between the two groups in fasting blood glucose (MD = −7.04 mg/dL, 95% CI: [−17.26, 3.17] mg/dL, P = 0.18, I2 = 93%), insulin (MD = −1.44 μU/mL, 95% CI: [−4.30, 1.41] μU/mL, P = 0.32, I2 = 0%); and high density lipoprotein cholesterol (HDL-C) (MD = −2.68 mg/dL, 95% CI: [−9.03, 3.67] mg/dL, P = 0.41, I2 = 89%). However, by subgroup analysis, we found that compared to the CG, PG showed no significant improvement in blood glucose and lipids levels for non-diabetics, while it presented a significantly greater decrease in post-prandial blood glucose, TC, TG, and LDL-C for diabetic patients. Notably, for diabetic patients, Pilates and medication treatments showed no significant reduction in fasting blood glucose (MD = −7.00 mg/dL, 95% CI: [−26.06, 12.06] mg/dL, P = 0.40) and HbA1c (MD = −0.23%, 95% CI: [−0.58, 0.13]%, P = 0.21, I2 = 0%) than medications treatment used alone, and Pilates combined with medications and dietary treatments presented no significant improvement in fasting blood glucose than a combination of medications and dietary treatments (MD = −10.90 mg/dL, 95% CI: [−32.35, 10.54] mg/dL, P = 0.32, I2 = 94%).Conclusions: Overall, Pilates could improve post-prandial blood glucose, fasting blood glucose, HbA1c, TG, TC, and LDL-C for diabetic patients, which could be influenced by its duration and intensity. Moreover, it had no significant effect on blood glucose and lipids for non-diabetic individuals. However, Pilates, as an adjunctive treatment to medications was not superior to medications used alone in lowering fasting blood glucose and HbA1c. Furthermore, Pilates combined with medications and dietary treatments showed no significant improvement in fasting blood glucose, whereas it had a greater reduction in post-prandial blood glucose and HbA1c for diabetic patients.Systematic Review Registration:https://osf.io/xgv6w.

scholarly journals Myrmecodia platytyrea Methanol Tuber Extract Ameliorates Hyperglycemia In STZ-Induced Diabetic Sprague-Dawley Male Rats

2021 ◽  
pp. 338-348
Author(s):  
Mizaton Hazizul Hasan ◽  
Hasbullani Zakaria ◽  
Ibtisam Abdul Wahab ◽  
Thellie Ponto ◽  
Aishah Adam
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Diabetic Rats ◽  
Male Rats ◽  
Current Therapy ◽  
Diabetic Patients ◽  
Sprague Dawley ◽  
Tuber Extract

Type 2 diabetes mellitus (T2DM) is one of the main non-communicable chronic diseases that has many complications that compromise the quality of life. Hence, the need to find alternatives to replace the current therapy or as an adjuvant. Tubers of Myrmecodia platytytrea (Rubiaceae) has been used traditionally as an alternative therapy for the management of cancer and other inflammatory-related disorders. The aim of this study was to investigate the potency of M. platytytrea methanolic tuber extract (MPMTE) as an antihyperglycemic agent, in vivo. :The streptozotocin (STZ)-induced diabetic rats were treated orally with MPMTE (100, 200 and 400 mg/kg) and metformin (positive control, 100 mg/kg) daily for 14 days. Blood glucose level and other biochemistry analysis were conducted including histological examination on liver, kidney and pancreas.  The STZ-induced diabetic rats treated with MPMTE (200 and 400 mg/kg) had significant decreased (p<0.05) in fasting blood glucose, total cholesterol, triglycerides and low-density lipoprotein (LDL) with no significant changes in high-density lipoprotein (HDL) compared to STZ-induced untreated diabetic rats. Liver, kidney and pancreas were devoid of any damage caused by STZ.  MPMTE had strong antihyperglycaemic activity and was protective against any STZ-induced organ damage. Thus, MPMTE can be further developed into an adjuvant therapy for diabetic patients.

scholarly journals Impact of previous insulin therapy on the prognosis of diabetic patients with acute coronary syndromes

2010 ◽  
Vol 54 (7) ◽  
pp. 612-619 ◽  
Author(s):  
Natália António ◽  
Francisco Soares ◽  
Carolina Lourenço ◽  
Fátima Saraiva ◽  
Francisco Gonçalves ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Insulin Treatment ◽  
Cox Regression ◽  
Atherosclerotic Disease ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Cox Regression Analysis ◽  
Group A ◽  
Coronary Syndromes ◽  
Group B

OBJECTIVE: To determine whether previous insulin treatment independently influences subsequent outcomes in diabetic patients with ACS (acute coronary syndromes). SUBJECTS AND METHODS: 375 diabetic patients with ACS, divided in 2 groups: Group A (n = 69) - previous insulin and Group B (n = 306) - without previous insulin. Predictors of 1-year mortality and major adverse cardiac events (MACE) were analyzed by Cox regression analysis. RESULTS: Group A had more previous stroke (17.4% vs. 9.2%, p = 0.047) and peripheral artery disease (13.0% vs. 3.6%, p = 0.005). They had significantly higher admission glycemia and lower LDL cholesterol. There were no significant differences in the type of ACS, in 1-year mortality (18.2% vs. 10.4%, p = 0.103) or MACE (32.1% vs. 23.0%, p = 0.146) between groups. In multivariate analysis, insulin treatment was neither an independent predictor of 1-year mortality nor of MACE. CONCLUSION: Despite the more advanced atherosclerotic disease, diabetics under insulin had similar outcomes to those without insulin. Insulin may protect diabetics from the expected poor adverse outcome of an advanced atherosclerotic disease.

Abstract 19772: The Significance of Blood Pressure on Cardiovascular Risk Attributable to Diabetes

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ryosuke Komi ◽  
Fumitaka Tanaka ◽  
Shinji Makita ◽  
Toshiyuki Onoda ◽  
Kozo Tanno ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Cox Regression ◽  
Fasting Blood Glucose ◽  
Antihypertensive Agents ◽  
Hdl Cholesterol ◽  
Population Based ◽  
Cox Regression Analysis

Background: Diabetes mellitus (DM) is an established risk factor of atherosclerotic cardiovascular events (CVE). Individuals with DM often have elevated levels of blood pressure (BP) which is closely associated with CVE. Hypothesis: The risk of DM-related CVE may depend on BP levels. Methods: A population-based prospective cohort study was performed in 24,350 subjects aged 40 to 89 years (mean age = 63.0±10.0 years) who did not have a history of CVE. DM was defined as a casual blood glucose level ≥ 200 mg/dl or fasting blood glucose level ≥ 126 mg/dl, a glycated hemoglobin value ≥ 6.5%, and/or current anti-diabetic therapy. BP levels at the baseline examination were classified into three categories including normotension, pre-hypertension, and hypertension according to JNC7. This classification was applied also to subjects with antihypertensive agents use. After adjustment for age, sex, body mass index, eGFR, total and HDL cholesterol, smoking habits, and anti-hypertensive medication use, a multivariate Cox regression analysis was performed to examine an association and contribution of pre-hypertension and hypertension on the risk of CVE in DM and non DM. Results: During a mean follow-up period of 5.5 years, 746 subjects developed CVE which was defined as stroke or acute myocardial infarction/sudden cardiac death. In both DM and non DM, the hazard ratios for CVE were increased in pre-hypertensives (HR 1.25, p < 0.05; HR 2.59, p < 0.02, respectively) and in hypertensives (HR 1.82, p < 0.01; HR 3.66, p < 0.01, respectively) in comparison with normotensives. However, the population-attributable fractions (PAFs) of pre-hypertension and hypertension were apparently higher in DM (21.5%, 41.2%, respectively), as these were more than double compared to PAFs in non DM (6.7%, 20.3%, respectively). Conclusions: Approximately two-third of excess CVE attributable to DM is estimated to occur among individuals with elevated BP levels.

Abstract 9658: Generation Differences in Long-Term Clinical Outcomes in Diabetic Patients After PCI Across POBA-, BMS- and DES-Era

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ryo Naito ◽  
Katsumi Miyauchi ◽  
Hirokazu Konishi ◽  
Shuta Tsuboi ◽  
Manabu Ogita ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Cox Regression ◽  
Major Adverse Cardiovascular Events ◽  
Diabetic Patients ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
The Mean ◽  
Negative Predictor ◽  
Fatal Myocardial Infarction

Introduction: PCI has evolved with technological advance, improvement of operators’ techniques and medical therapy for secondary prevention. Despite these improvements, diabetes remains a negative predictor. To date, little is known regarding improvement of clinical outcomes in diabetic patients with PCI. We examined a temporal trend of long-term clinical outcomes in diabetic cohort across the different generations. Hypothesis: We hypothesized that clinical outcomes would improve with advances of PCI. Methods: We analyzed data of diabetic patients with PCI in Juntendo University from 1984 to 2010. The patients were divided into three groups according to the procedure data (POBA-era; January 1984 - December 1997, BMS-era; January 1998 - July 2004 and DES-era; August 2004 - February 2010). Primary endpoint was a composite of major adverse cardiovascular events including all-cause mortality, non-fatal myocardial infarction, non-fatal stroke and revascularization. Results: A total of 1544 patients were examined (POBA-era; 374, BMS-era; 494 and DES-era; 676). The mean age was higher in DES-era. A higher prevalence of hypertension and dyslipidemia was observed in DES-era. The success rate of PCI was lower among the patients in POBA-era. Kaplan-Meier estimation for 3-year MACE was significantly different among the eras (Figure 1). Multivariable Cox regression analysis showed that DES-era was a predictor for long-term MACE (DES- vs BMS era; HR 0.50, 95%, CI 0.38 - 0.66, P < 0.001, DES- vs POBA-era; HR 1.60, 95% CI 0.34-27.9, P = 0.6). Conclusions: Long-term clinical outcomes in diabetic patients who underwent PCI were more favorable in DES-era, despite the higher risk profiles.

scholarly journals Prediction of atrial fibrillation and sudden cardiac death in type 2 diabetic patients on insulin: a territory-wide observational cohort study

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
S Lee ◽  
K Jeevaratnam ◽  
T Liu ◽  
D Chang ◽  
WKK Wu ◽  
...  
Keyword(s):  
Cox Regression ◽  
Density Lipoprotein ◽  
Adverse Outcomes ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cox Regression Analysis ◽  
Hba1c Variability ◽  
Type 2 Diabetic

Abstract Funding Acknowledgements Type of funding sources: None. Introduction With the global shift towards a more personalized approach in the management of diabetes, there is an increasing interest in exploring the application of new parameters, such as HbA1c and lipid variability, to better monitor disease progression and evaluate the prognosis. Given that metabolic abnormalities may exacerbate the risk of adverse outcomes in patients with type 2 diabetes mellitus, patients who are partially or fully dependent on insulin are more likely to have severe disease and may be at higher risks of arrhythmias.  Purpose  The aim of the present study aims was to assess the predictive value of HbA1c and lipid variability towards ventricular tachycardia (VT), ventricular fibrillation (VF), or SCD, as well as incident AF in type 2 diabetic patients receiving insulin therapy. Methods The territory-wide retrospective observational study consists of type 2 diabetic patients prescribed with insulin, who attended publicly funded clinics and hospitals in Hong Kong between January 1st, 2009 to December 31st, 2009. Variability in total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglyceride, and HbA1c were assessed through their standard deviation (SD) and coefficient of variation (CV) for patients with at least three measurements of the respective indices. Univariate and multivariate Cox regression analysis was used to predict for the primary outcomes- incident SCD and AF. Results A total of 23329 patients (mean ± SD age: 64 ± 14 years old; 51% male; mean HbA1c 8.6 ± 1.3%) were included. In total, 2512 and 1846 patients experienced incident SCD and AF respectively over the course of follow-up. On multivariate analysis, higher HbA1c variability (SD: hazard ratio [HR]: 1.45, 95% confidence interval [CI] 1.21-1.75; p &lt; 0.0001) and triglyceride variability (SD: HR: 1.36, 95%CI: 1.24-1.49; p &lt; 0.0001) were associated with increased of SCD risk. By contrast, only the increase in LDL-C variability was predictive of AF (SD: HR 2.95, 95%CI 1.37-6.39; p= 0.006). Conclusions  Higher HbA1c variability and lipid variability were associated with increased of SCD risk while only higher LDL-C variability was predictive of incident AF.  Therefore, poor glucose control and variability in lipid parameters in diabetic patients are associated with SCD and incident AF.  These observations suggest the need to re-evaluate the extent of glycemic control required for outcome optimization.

scholarly journals Relationship of Glycated Haemoglobin with Lipid Profile among Patients with Type 2 Diabetes Mellitus

2017 ◽  
Vol 7 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Tasrina Shamnaz Samdani ◽  
Palash Mitra ◽  
Muhammad Abdur Rahim
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Lipid Profile ◽  
Significant Positive Correlation ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Diabetic Patients ◽  
Positive Correlation

Background: Glycated hemoglobin (HbA1c) is widely used as an index of mean glycaemia, a measure of risk for the development of diabetic complications and a measure of the quality of diabetes care. Patients with type 2 diabetes have an increased prevalence of dyslipidemia. Treatment of dyslipidaemia improves cardiovascular outcomes. The aim of this study was to determine the impact of glycemic control on lipid profile.Methods: This cross-sectional study was conducted among 300 type 2 diabetic patients admitted in BIRDEM General Hospital from November 2013 to April 2015. Fasting blood samples were collected and different lipid fractions along with fasting blood glucose and HbA1c were estimated. Pearson’s correlation test was applied to evaluate the correlation between HbA1c and components of lipid profile.Results: The mean value of total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDLC), fasting blood glucose (FBG) and HbA1c were higher and high density lipoprotein-cholesterol (HDL-C) was lower in females when compared with these values for males. HbA1c had significant positive correlation with LDL-C (p=0.045) and negative correlation with HDL-C (p=0.024). Serum lipid profile and glycaemic controls were significantly (p=0.000) better in older age group (age ? 50 years).Conclusions: Significant positive correlation of HbA1c with lipid profiles specially LDL-C suggested that HbA1c can also be used as predictor of dyslipidemia in addition to glycemic control.Birdem Med J 2017; 7(1): 43-47

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