scholarly journals Prevalence and Risk Factors of Prolonged QTc Interval among Chinese Patients with Type 2 Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Xiang Li ◽  
Hui Ren ◽  
Zhang-rong Xu ◽  
Yan-jun Liu ◽  
Xiao-pin Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Waist Circumference ◽  
Qt Interval ◽  
Postprandial Glucose ◽  
Chinese Patients ◽  
Qtc Interval ◽  
Fasting Insulin

Objectives. The aim of this study was to evaluate the prevalence and the risk factors of prolonged QTc interval among Chinese patients with type 2 diabetes.Methods. The retrospective study included 3156 outpatients from the Diabetes Centre, the 306th Hospital of PLA, during the period from September 2003 to June 2010. QT interval was measured manually in the 12-lead conventional electrocardiogram. The QT interval corrected for heart rate (QTc) was calculated using Bazett’s formula. Additional demographic and laboratory data were also collected. Potential risk factors of prolonged QTc interval were assessed using multivariable regression.Results.The prevalence of prolonged QTc interval among Chinese patients with type 2 diabetes was 30.1%. Height (OR 0.156, 95% CI 0.032~0.748), waist circumference (OR 1.025, 95% CI 1.010~1.040), diastolic blood pressure (OR 1.016, 95% CI 1.007~1.026), postprandial glucose (OR 1.040, 95% CI 1.022~1.059), fasting insulin (OR 1.014, 95% CI 1.003~1.025), and presence of microalbuminuria (OR 1.266, 95% CI 1.033~1.551) were significant risk factors.Conclusions. The prevalence of prolonged QTc interval among Chinese patients with type 2 diabetes is high. Risk factors for prolongation of QTc interval were low height, high waist circumference, increasing diastolic blood pressure levels, high postprandial glucose levels, high fasting insulin levels, and presence of microalbuminuria.

scholarly journals Effect of tofogliflozin on arterial stiffness in patients with type 2 diabetes: prespecified sub-analysis of the prospective, randomized, open-label, parallel-group comparative UTOPIA trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Naoto Katakami ◽  
◽  
Tomoya Mita ◽  
Hidenori Yoshii ◽  
Toshihiko Shiraiwa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Conventional Treatment ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Open Label ◽  
Parallel Group ◽  
History Of

Abstract Background Tofogliflozin, an SGLT2 inhibitor, is associated with favorable metabolic effects, including improved glycemic control and serum lipid profile and decreased body weight, visceral adipose tissue, and blood pressure (BP). This study evaluated the effects of tofogliflozin on the brachial-ankle pulse wave velocity (baPWV) in patients with type 2 diabetes (T2DM) without a history of apparent cardiovascular disease. Methods The using tofogliflozin for possible better intervention against atherosclerosis for type 2 diabetes patients (UTOPIA) trial is a prospective, randomized, open-label, multicenter, parallel-group, comparative study. As one of the prespecified secondary outcomes, changes in baPWV over 104 weeks were evaluated in 154 individuals (80 in the tofogliflozin group and 74 in the conventional treatment group) who completed baPWV measurement at baseline. Results In a mixed-effects model, the progression in the right, left, and mean baPWV over 104 weeks was significantly attenuated with tofogliflozin compared to that with conventional treatment (– 109.3 [– 184.3, – 34.3] (mean change [95% CI] cm/s, p = 0.005; – 98.3 [– 172.6, – 24.1] cm/s, p = 0.010; – 104.7 [– 177.0, – 32.4] cm/s, p = 0.005, respectively). Similar findings were obtained even after adjusting the mixed-effects models for traditional cardiovascular risk factors, including body mass index (BMI), glycated hemoglobin (HbA1c), total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglyceride, systolic blood pressure (SBP), hypertension, smoking, and/or administration of drugs, including hypoglycemic agents, antihypertensive agents, statins, and anti-platelets, at baseline. The findings of the analysis of covariance (ANCOVA) models, which included the treatment group, baseline baPWV, and traditional cardiovascular risk factors, resembled those generated by the mixed-effects models. Conclusions Tofogliflozin significantly inhibited the increased baPWV in patients with T2DM without a history of apparent cardiovascular disease, suggesting that tofogliflozin suppressed the progression of arterial stiffness. Trial Registration UMIN000017607. Registered 18 May 2015. (https://www.umin.ac.jp/icdr/index.html)

scholarly journals Association between fasting insulin and C-reactive protein among adults without diabetes using a two-part model: NHANES 2005–2010

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Amanda L. Missel ◽  
Laura R. Saslow ◽  
Dina H. Griauzde ◽  
Donna Marvicsin ◽  
Ananda Sen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Waist Circumference ◽  
Low Grade ◽  
Fasting Insulin ◽  
C Reactive Protein ◽  
Glucose Levels ◽  
Reactive Protein ◽  
Part Model

Abstract Introduction Chronic inflammation is associated with the development, progression and long-term complications of type 2 diabetes. Hyperglycemia is associated with chronic low-grade inflammation, and thus has become the focus of many screening and treatment recommendations. We hypothesize that insulin may also be associated with inflammation and may be an additional factor to consider in screening and treatment. Methods This study used National Health and Nutrition Examination Survey data from 2005 to 2010 to analyze the association between fasting insulin and C-reactive protein (CRP). A two-part model was used due to the high number of values reported as 0.1 mg/L. Two models were analyzed, both with and without the addition of waist circumference to other covariates in the model. Results The final sample included 4527 adults with a mean age of 43.31 years. In the first model, higher fasting insulin was associated with increased odds of CRP > 0.1 mg/L (OR = 1.02, p < .001) and with higher CRP (β = 0.03, p < .001). In the adjusted model, including waist circumference as a covariate, higher fasting insulin was not associated with CRP > 0.1 mg/L (OR = 1.00, p = .307) but the association between higher fasting insulin and higher continuous CRP remained significant (β = 0.01, p = .012). Conclusion This study found that higher fasting insulin is associated with higher CRP. These results suggest that treatment approaches that simultaneously decrease insulin levels as well as glucose levels may provide additive anti-inflammatory effects, and therefore may improve long-term outcomes for adults with type 2 diabetes.

scholarly journals Type 2 diabetes is more predictable in women than men by multiple anthropometric and biochemical measures

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tangying Li ◽  
Huibiao Quan ◽  
Huachuan Zhang ◽  
Leweihua Lin ◽  
Lu Lin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Diastolic Blood Pressure ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Regression Coefficient ◽  
Regression Coefficients ◽  
Sexually Dimorphic ◽  
Fasting Insulin

AbstractMen and women are sexually dimorphic but whether common anthropometric and biochemical parameters predict type 2 diabetes (T2D) in different ways has not been well studied. Here we recruit 1579 participants in Hainan Province, China, and group them by sex. We compared the prediction power of common parameters of T2D in two sexes by association, regression, and Receiver Operating Characteristic (ROC) analysis. HbA1c is associated with FPG stronger in women than in men and the regression coefficient is higher, consistent with higher prediction power for T2D. Age, waist circumference, BMI, systolic and diastolic blood pressure, triglyceride levels, total cholesterol, LDL, HDL, fasting insulin, and proinsulin levels all predict T2D better in women. Except for diastolic blood pressure, all parameters associate or tend to associate with FPG stronger in women than in men. Except for diastolic blood pressure and fasting proinsulin, all parameters associate or tend to associate with HbA1c stronger in women than in men. Except for fasting proinsulin and HDL, the regression coefficients of all parameters with FPG and HbA1c were higher in women than in men. Together, by the above anthropometric and biochemical measures, T2D is more readily predicted in women than men, suggesting the importance of sex-based subgroup analysis in T2D research.

scholarly journals Early vascular aging risk assessment in patients with metabolic syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Salasyuk ◽  
S Nedogoda ◽  
I Barykina ◽  
V Lutova ◽  
E Popova
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Vascular Aging ◽  
Clinical Markers ◽  
Cvd Risk ◽  
Vascular Age

Abstract Background Metabolic syndrome (MetS) and abdominal obesity are one of the most common CVD risk factors among young and mature patients. However, the currently used CVD risk assessment scales may underestimate the CV risk in people with obesity and MS. Early vascular aging rather than chronological aging can conceptually offer better risk prediction. MetS, as accumulation of classical risk factors, leads to acceleration of early vascular aging. Since an important feature of MetS is its reversibility, an adequate risk assessment and early start of therapy is important in relation to the possibilities of preventing related complications. Purpose To derive a new score for calculation vascular age and predicting EVA in patients with MetS. Methods Prospective open cohort study using routinely collected data from general practice. The derivation cohort consisted of 1000 patients, aged 35–80 years with MetS (IDF,2005 criteria). The validation cohort consisted of 484 patients with MetS and carotid-femoral pulse wave velocity (cfPWV) values exceeding expected for average age values by 2 or more SD (EVA syndrome). Results In univariate analysis, EVA was significantly correlated with the presence of type 2 diabetes and clinical markers of insulin resistance (IR), body mass index (BMI), metabolic syndrome severity score (MetS z-score), uric acid (UA) level, hsCRP, HOMA-IR, total cholesterol (TC), triglycerides (TG), heart rate (HR), central aortic blood pressure (CBP), diastolic blood pressure (DBP). Multiple logistic regression shown, that presence of type 2 diabetes and IR were associated with greater risk of EVA; the odds ratios were 2.75 (95% CI: 2.34, 3.35) and 1.57 (95% CI: 1.16, 2.00), respectively. In addition, the risk of having EVA increased by 76% with an increase in HOMA-IR by 1 unit, by 17% with an increase in hsCRP by 1 mg/l, by 4% with an increase in DBP by 1 mm Hg, and by 1% with each 1 μmol / L increase in the level of UA. The area under the curve for predicting EVA in patients with MetS was 0,949 (95% CI 0,936 to 0,963), 0,630 (95% CI 0,589 to 0,671), 0,697 (95% CI 0,659 to 0,736) and 0,686 (95% CI 0,647 to 0,726), for vascular age, calculated from cfPWV, SCORE scale, QRISK-3 scale and Framingham scale, respectively. Diabetes mellitus and clinical markers of IR (yes/no), HOMA-IR and UA level were used to develop a new VAmets score for EVA prediction providing a total accuracy of 0.830 (95% CI 0,799 to 0,860). Conclusion cfPWV at present the most widely studied index of arterial stiffness, fulfills most of the stringent criteria for a clinically useful biomarker of EVA in patients with MetS. Although, parallel efforts for effective integration simple clinical score into clinical practice have been offered. Our score (VAmets) may accurately identify patients with MetS and EVA on the basis of widely available clinical variables and classic cardiovascular risk factors can prioritize using of vascular age in routine care. ROC-curves for predicting EVA in MetS Funding Acknowledgement Type of funding source: None

scholarly journals The effects of metformin plus sulfonylurea therapy on clinical features of the metabolic syndrome

2010 ◽  
Vol 63 (9-10) ◽  
pp. 611-615 ◽  
Author(s):  
Branka Koprivica ◽  
Teodora Beljic-Zivkovic ◽  
Tatjana Ille
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Waist Circumference ◽  
Glycemic Control ◽  
Body Mass ◽  
Combined Therapy

Introduction. Insulin resistance is a well-known leading factor in the development of metabolic syndrome. The aim of this study was to evaluate metabolic effects of metformin added to sulfonylurea in unsuccessfully treated type 2 diabetic patients with metabolic syndrome. Material and methods. A group of thirty subjects, with type 2 diabetes, secondary sulfonylurea failure and metabolic syndrome were administered the combined therapy of sulfonylurea plus metformin for six months. Metformin 2000 mg/d was added to previously used sulfonylurea agent in maximum daily dose. Antihypertensive and hypolipemic therapy was not changed. The following parameters were assessed at the beginning and after six months of therapy: glycemic control, body mass index, waist circumference, blood pressure, triglycerides, total cholesterol and its fractions, homeostatic models for evaluation of insulin resistance and secretion (HOMA R, HOMA B) and C- peptide. Results. Glycemic control was significantly improved after six months of the combined therapy: (fasting 7.89 vs. 10.61 mmol/l. p<0.01; postprandial 11.12 vs. 12.61 mmol/l. p<0.01, p<0.01; glycosylated hemoglobin 6.81 vs. 8.83%. p<0.01). the body mass index and waist circumference were significantly lower (26.7 vs. 27.8 kg/m2, p<0.01 and 99.7 vs. 101.4 cm for men, p<0.01; 87.2 vs. 88.5 for women, p<0.01). Fasting plasma triglycerides decreased from 3.37 to 2.45 mmol/l (p<0.001) and HOMA R from 7.04 to 5.23 (p<0.001). No treatment effects were observed on blood pressure, cholesterol, and residual insulin secretion. Conclusion. Administration of metformin in type 2 diabetes with metabolic syndrome decreased cardiovascular risk factors by reducing glycemia, triglycerides, BMI, central obesity and insulin resistance.

scholarly journals Risk Factors for Type 2 Diabetes Mellitus in Children

2010 ◽  
Vol 18 (5) ◽  
pp. 936-942 ◽  
Author(s):  
Suyanne Freire de Macêdo ◽  
Márcio Flávio Moura de Araújo ◽  
Niciane Pessoa Bandeira Marinho ◽  
Adman Câmara Soares Lima ◽  
Roberto Wagner Freire de Freitas ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Public Schools ◽  
Demographic Data ◽  
Healthy Habits ◽  
Capillary Glucose

This study investigates risk factors for type 2 diabetes mellitus in a population of children in public schools, Fortaleza, CE, Brazil. A total of 727 children aged 6 to 11 years old from 12 schools were evaluated between March and June 2008. A form addressing socio-demographic data, body mass index, blood pressure, capillary blood glucose and waist circumference was applied. A total of 54.1% of the children were female, 21.7% were overweight, 6.6% were obese, 27% had central obesity, 6.2% showed altered capillary glucose, and 17% high blood pressure. In relation to risk factors, 53.4% presented no risk factors; 24.3% had at least one factor and 18.8% two risk factors. Nurses can intervene in schools through educational health programs encouraging the adoption of healthy habits and identifying children at risk of type 2 diabetes mellitus.

scholarly journals Endothelin-1 predicts incident diabetic peripheral neuropathy in Type 2 Diabetes: a cohort study

2020 ◽  
Vol 182 (4) ◽  
pp. 429-438
Author(s):  
Sharon Li Ting Pek ◽  
Su Chi Lim ◽  
Keven Ang ◽  
Pek Yee Kwan ◽  
Wern Ee Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetes Duration ◽  
Endothelin 1

Introduction Diabetic peripheral neuropathy (DPN) is a common microvascular complication in patients with type 2 diabetes (T2D). Apart from hyperglycemia, few modifiable risk factors have been identified. Endothelin-1 is a potent vasoconstrictor peptide, implicated in the causal pathway of microangiopathy. We investigated whether baseline plasma endothelin-1 and other metabolic and vascular risk factors predicted the incidence of DPN. Design This is a 3-year observational, cohort study. Methods In patients with T2D (n = 2057), anthropometric data, fasting blood, and urine were collected for biochemistry and urine albumin/creatinine measurements. Forearm cutaneous endothelial reactivity was assessed by iontophoresis and laser Doppler flowmetry/imaging. Measurements were repeated on follow-up. Incident DPN was considered present if an abnormal finding in monofilament (<8 of 10 points) or neurothesiometer testing was ≥25 volts on either foot at 3-year follow-up, but normal at baseline. Plasma endothelin-1 was assessed by ELISA. Results At baseline, mean age of patients was 57.4 ± 10.8 years old and prevalence of DPN was 10.8%. Of the 1767 patients without DPN, 1250 patients returned for follow-up assessment ((2.9 ± 0.7) years), with a 10.7% incidence of DPN. Patients with incident DPN had significantly higher baseline endothelin-1 (1.43 (1.19–1.73) vs 1.30 (1.06–1.63)) pg/mL, P < 0.0001. Multivariable Cox proportional hazards ratio showed a 1-s.d. increase in log endothelin-1 (adjusted HR: 4.345 (1.451–13.009), P = 0.009), systolic blood pressure (per 10-unit) (adjusted HR: 1.107 (1.001–1.223), P = 0.047) and diabetes duration (adjusted HR: 1.025 (1.004–1.047), P = 0.017) predicted incident DPN, after adjustment for glycemic control, eGFR, albuminuria, peripheral arterial disease and retinopathy status. Conclusion Higher baseline endothelin-1, blood pressure and diabetes duration were significant and independent predictors for incident DPN. Validation of our findings in independent cohorts and molecular mechanistic studies will help better our understanding on the role of endothelin-1 in DPN.

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