scholarly journals Relationship between Altered Platelet Morphological Parameters and Retinopathy in Patients with Type 2 Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Tolga Yilmaz ◽  
Ahu Yilmaz
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Platelet Count ◽  
Large Cell ◽  
Distribution Width ◽  
Group 4 ◽  
Significant Difference ◽  
Group 2

Purpose. To investigate whether platelet morphology or function is altered in patients with diabetic retinopathy (DR).Methods. This prospective study enrolled 85 healthy controls (HCs) (group 1) and 262 patients with Type 2 diabetes mellitus (T2DM). Patients were subclassified into three groups according to ocular findings: no DR (group 2;n=88); nonproliferative DR (group 3;n=88), and proliferative DR (group 4;n=86). Mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (PLCR), plateletcrit (PCT) values, and platelet count were measured in the studied groups.Results. MPV, PDW, and PLCR levels were significantly altered in groups 2–4 compared with HCs (p<0.05,p<0.05,p<0.05). Compared with group 2, both DR groups had higher MPV and PDW levels, with a significant difference between groups 2 and 4 for both MPV (p=0.036) and PDW (p=0.006). PLCR correlated with retinopathy stage, but no significant difference was found between the DR groups. Platelet count and PCT values were not significantly different between the groups (p>0.05).Conclusion. Our findings suggest an association between mean platelet indices (MPI) (i.e., MPV, PDW, and PLCR) and DR stage. Therefore, MPI could be a beneficial prognostic marker of DR in patients with T2DM.

scholarly journals PERBANDINGAN JUMLAH TROMBOSIT PADA PASIEN DIABETES MELITUS TIPE 2 YANG MENGGUNAKAN ASPIRIN DAN TIDAK MENGGUNAKAN ASPIRIN

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Dwi P. Palimbunga ◽  
Karel Pandelaki ◽  
Arthur E. Mongan ◽  
Firginia Manoppo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Platelet Count ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Fourfold Increase ◽  
Significant Difference ◽  
Diabetes Melitus

Abstract: Patients with type-2 diabetes mellitus are characterized by an acceleration thrombopoiesis, an increased platelet turnover and a decreased platelet survival time which affect platelet count, that cause the increasing of proportion of large and reactive platelets, and hence more thrombogenic. People with diabetes have a two- to fourfold increase in the risk of dying from the complications of cardiovascular disease. Aspirin therapy is recommended for the primary and secondary prevention of cardiovascular events in most people with diabetes. This study was an descriptive analytic method with cross sectional study design. The subjects in this study involve 112 people, 56 people treated with aspirin, and the 56 others were not who signed in endocrine metabolic department of RSUP Prof. Dr. R. D Kandou Manado. Data were taken from medical record. The Mann-Whitney test showed that there was no significant difference between the platelet count in patients with type-2 diabetes mellitus treated with aspirin and patients who were not. Conclusion: There was no significant difference between the platelet count in patients with type-2 diabetes mellitustreated with aspirin and patients who were not. Key word:Aspirin, Type-2 Diabetes Mellitus, Platelet Count  Abstrak: Pada pasien diabetes melitus tipe-2 terjadi percepatan trombopoiesis, peningkatan pergantian trombosit dan penurunan waktu hidup trombosit yang mempengaruhi jumlah trombosit, yang menyebabkan terjadinya peningkatan ukuran trombosit yang lebih besar dan reaktif, sehingga bersifat trombogenik. Risiko kematian karena komplikasi penyakit jantung meningkat dua sampai empat kali lipat. Aspirin digunakan sebagai pencegahan primer dan sekunder terhadap kejadian kardiovaskular pada pasien diabetes. Tujuan penelitian ini untuk melihat perbedaan jumlah trombosit pada pasien diabetes melitus tipe-2 yang menggunakan aspirin dan tidak menggunakan aspirin. Penelitian ini bersifat deskriptif analitik dengan rancang penelitian cross sectional. Subjek dalam penelitian ini berjumlah 112 orang, 56 orang yang menggunakan aspirin dan 56 orang lainnya tidak menggunakan aspirin yang terdaftar di Poliklinik Endokrin Metabolik RSUP Prof. Dr. R. D. Kandou Manado. Data diambil dari catatan rekam medik. Hasil penelitian menggunakan uji Mann-Whitney,menunjukkan bahwa tidak terdapat perbedaan yang signifikan antara jumlah trombosit pada pasien diabetes melitus tipe-2 yang menggunakan aspirin dan tidak menggunakan aspirin (p=0,059). Simpulan: Tidak terdapat perbedaan signifikan antara jumlah trombosit pada pasien diabetes melitus tipe 2 yang menggunakan aspirin dan tidak menggunakan aspirin. Kata Kunci: Aspirin, Diabetes Melitus Tipe-2, Jumlah Trombosit

Evaluation of platelet count and mean platelet volume in type 2 diabetes mellitus

2020 ◽  
Vol 14 (2) ◽  
pp. 34-37
Author(s):  
Priya Bhatt ◽  
◽  
Jignasa Bhalodia ◽  
Mehul Patel ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Platelet Count ◽  
Mean Platelet Volume ◽  
Platelet Volume

scholarly journals Application value of combination therapy of periodontal curettage and root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Yonghuan Bian ◽  
Changhao Liu ◽  
Zhaojiang Fu
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Blood Glucose ◽  
Chronic Periodontitis ◽  
Root Planing ◽  
Tnf Α ◽  
Significant Difference ◽  
Hs Crp

Abstract Background Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Methods There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Results Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). Conclusion The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.

scholarly journals Red cell distribution width and erythrocyte osmotic stability in type 2 diabetes mellitus

2021 ◽  
Vol 25 (5) ◽  
pp. 2505-2516
Author(s):  
Maria Aparecida Knychala ◽  
Mario da Silva Garrote‐Filho ◽  
Breno Batista da Silva ◽  
Samantha Neves de Oliveira ◽  
Sarah Yasminy Luz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Red Cell Distribution Width ◽  
Red Cell ◽  
Cell Distribution ◽  
Distribution Width ◽  
Osmotic Stability

Glycemic Control Comparative of Metformin and Glimepiride in Monotherapy of Type 2 Diabetes Mellitus Patient at Islamic Jemursari Hospital Surabaya in 2018

2021 ◽  
Vol 71 (1) ◽  
pp. 24-29
Author(s):  
Rachma Putri Nariswari ◽  
Gwenny Ichsan Prabowo ◽  
Hermina Novida ◽  
Nurina Hasanatuludhhiyah
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Adult Population ◽  
Secondary Data ◽  
Diabetes Mellitus Patient ◽  
Significant Difference ◽  
Tissue Sensitivity

Introduction: Type 2 diabetes mellitus is caused by decreased tissue sensitivity to insulin. The prevalence of diabetes in the world has almost doubled since 1980, from 4.7% to 8.5% in adult population. Early diagnosis and treatment aimed at normalizing glycemic control are very important. The objective of this study was to evaluate and compare glycemic control of metformin and glimepiride in monotherapy of type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya. Method: This was a retrospective observational study using secondary data (medical record), include glycemic control (RPG) before and two months after receiving therapy of outpatients’ type 2 diabetes mellitus with metformin or glimepiride therapy in 2018. 96 samples were found that fit the inclusion criteria. The data were analyzed by Mann-Whitney test. Result: Most patients were female, aged 50-69 years old, and dosage of metformin therapy 1500 mg/day or glimepiride therapy 2 mg/day. There was no significant difference (p>0.05) of glycemic control (RPG) of metformin compared to glimepiride therapies in type 2 diabetes mellitus patients at Islamic Jemursari Hospital Surabaya in 2018. Conclusion: Metformin and glimepiride were not significantly different in glycemic control (RPG). There were patients with RPG >200 mg/dl after two months of metformin or glimepiride therapy.  

Lack of effect of the SLC47A1 and SLC47A2 gene polymorphisms on the glycemic response to metformin in type 2 diabetes mellitus patients

2018 ◽  
Vol 33 (4) ◽  
pp. 175-185 ◽  
Author(s):  
Gerard Marshall Raj ◽  
Jayanthi Mathaiyan ◽  
Mukta Wyawahare ◽  
Rekha Priyadarshini
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Adverse Effects ◽  
Assay Method ◽  
Glycemic Response ◽  
Dose Requirement ◽  
Eligibility Criteria ◽  
Significant Difference

Abstract Background This work aimed to evaluate the influence of single nucleotide polymorphisms (SNPs) in the SLC47A1 (922-158G>A; rs2289669) and SLC47A2 (−130G>A; rs12943590) genes on the relative change in HbA1c in type 2 diabetes mellitus (T2DM) patients of South India who are taking metformin as monotherapy. It also aims to study the effects of these SNPs on the dose requirement of metformin for glycemic control and the adverse effects of metformin. Methods Diabetes patients on metformin monotherapy were recruited based on the eligibility criteria (n=105). DNA was extracted and genotyping was performed with a real-time PCR system using TaqMan® SNP genotyping assay method. The HbA1c levels were measured using Bio-Rad D-10™ Hemoglobin Analyzer. Results After adjusting for multiple comparisons (Bonferroni correction) the difference found in the glycemic response between the “GG” genotype and “AG/AA” genotype groups of the SLC47A2 gene was not significant (p=0.027; which was greater than the critical value of 0.025). Patients with “GG” genotype showed a 5.5% decrease in HbA1c from baseline compared to those with the “AG/AA” genotype (0.1% increase). The SNP in the SLC47A1 gene also did not influence the glycemic response to metformin (p=0.079). The median dose requirements based on the genotypes of the rs12943590 variant (p=0.357) or rs2289669 variant (p=0.580) were not significantly different. Similarly, there was no significant difference in the occurrence of adverse effects across the genotypes in both the SLC47A1 (p=0.615) and SLC47A2 (p=0.309) genes. Conclusions The clinical response to metformin was not associated with the SNPs in the SLC47A1 and SLC47A2 genes coding for the multidrug and toxin extrusion protein (MATE) transporters. Furthermore, the studied SNPs had no influence on the dose requirement or adverse effects of metformin.

scholarly journals INFLUENCE OF HORMONAL DISORDERS ON ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBIDE ENDOCRINOPATHIES

2019 ◽  
Vol 6 (3) ◽  
pp. 132-136
Author(s):  
O. Bilovol ◽  
V. Nemtsova ◽  
I. Ilchenko ◽  
V. Zlatkina
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Endothelial Dysfunction ◽  
Arterial Hypertension ◽  
Subclinical Hypothyroidism ◽  
Control Group ◽  
Group 2 ◽  
Group 1

Abstract. INFLUENCE OF HORMONAL DISORDERS ON ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ARTERIAL HYPERTENSION AND COMORBIDE ENDOCRINOPATHIES Bilovol O.M., Nemtsova V.D., Ilchenko I.A., Zlatkina V.V. Purpose: to investigate the effect of hormonal changes on endothelial dysfunction (ED) in patients with a comorbid course of hypertension (H), type 2 diabetes mellitus (T2DM) and subclinical hypothyroidism (SHT). Methods: 183 patients with  H stage II were divided into 3 groups: Group 1 (n=50) - with isolated H (comparison group); Group 2 (n=63) - with a combined course of H and T2DM; Group 3 (n=70) - with comorbidity of H, T2DM and SHT. Blood pressure levels, carbohydrate, lipid and thyroid metabolism, plasma insulin concentration, insulin resistance (IR) the HOMA-IR index, vascular endothelial growth factor (VEGF-A) plasma levels were investigated. Results: Dyslipidemia was more pronounced in group 2 than in group 1. The addition of SHT was accompanied by a tendency to increase all the atherogenic lipids. IR was observed in all patients groups and was significantly higher than in control group (p<0.05). Significant increase of VEGF-A levels in all patients groups in comparison with the control (p<0.05) was found. In group 2 VEGF-A was lower than in group 1, which is probably due to the protective effect of metformin. Analysis  of the influence of thyroid dysfunction degree on ED revealed significant increase of VEGF-A levels in TSH>6.0 μMU/ml subgroup (352.55±17.64 pg/ml vs 461.74±20.13 pg/ml (p<0.05)). Conclusion: Hormonal disorders contribute to aggravation of endothelial dysfunction in patients with hypertension and comorbid endocrinopathies - type 2 diabetes mellitus and subclinical hypothyroidism. Even minor decrease in thyroid function lead to the progression of endothelial dysfunction. Key words: hypertension, type 2 diabetes mellitus, subclinical hypothyroidism, endothelial dysfunction   Резюме. ВПЛИВ ГОРМОНАЛЬНИХ ПОРУШЕНЬ НА ЕНДОТЕЛІАЛЬНУ ДИСФУНКЦІЮ УПАЦІЄНТІВ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ ТА КОМОРБІДНИМИ ЕНДОКРИНОПАТІЯМИ Біловол О.М., Немцова В.Д., Ільченко І.А., Златкіна В.В. Мета: дослідити вплив гормональних змін на ендотеліальну дисфункцію (ЕД) у пацієнтів з коморбідним перебігом артеріальної гіпертензії (АГ), цукрового діабету 2 типу (ЦД2Т) тасубклінічного гіпотиреозу (СГТ). Матеріали та методи: 183 пацієнта з АГ II стадії були розділені на 3 групи: 1-а група (n=50) - з ізольованою АГ (група порівняння); Група 2 (n=63) - з поєднаним перебігом АГ та ЦД2Т; Група 3 (n 70) – з комбінованим перебігом АГ, ЦД2Т і СГТ. Вивчали рівні артеріального тиску, показники вуглеводного, ліпідного і тиреоїдного обміну, концентрацію інсуліну в плазмі, індекс інсулінорезистентності (ІР) - HOMA-IR, рівні васкулоендотеліального фактора росту (VEGF-A) в плазмі. Результати. Ступінь дисліпідемії у 2-й групі була більш вираженою, ніж в 1-й. Приєднання СГТ супроводжувалося тенденцією до збільшення всіх атерогенних фракцій ліпідів. ІР спостерігалася у всіх групах пацієнтів і була достовірно більше, ніж у контрольній групі (р<0,05). Виявлено достовірне підвищення рівнів VEGF-A у всіх групах пацієнтів в порівнянні з контролем (р<0,05). В 2-й групі рівні VEGF-A були нижче, ніж в 1-й групі, що, ймовірно, пов'язано з протективним ефектом метформіну. Аналіз впливу ступеня гіпофункції щитовидної залози на ЕД виявив значне збільшення рівнів VEGF-A в підгрупі TSH> 6,0 мкМ / мл (352,55 ± 17,64 пг / мл і 461,74 ± 20,13 пг / мл відповідно, р <0,05). Висновки. Гормональні порушення сприяють погіршенню ендотеліальної дисфункції у пацієнтів з артеріальною гіпертензією та супутніми ендокринопатіями - цукровим діабетом 2 типу та субклінічним гіпотиреозом. Навіть незначне зниження функції щитовидної залози призводить до прогресування ендотеліальної дисфункції. Ключові слова:  гіпертензія, цукровий діабет 2 тип, субклінічний гіпотиреоз, ендотеліальна дисфункція    Резюме. ВЛИЯНИЕ ГОРМОНАЛЬНЫХ НАРУШЕНИЙ НА ЭНДОТЕЛИАЛЬНУЮ ДИСФУНКЦИЮ У ПАЦИЕНТОВ С АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИЕЙ И КОМОРБИДНЫМИ ЭНДОКРИНОПАТИЯМИ Беловол О.М., Немцова В.Д., Ильченко И.А., Златкина В.В. Цель: исследовать влияние гормональных изменений на эндотелиальную дисфункцию (ЭД) у пациентов с коморбидным течением артериальной гипертензии (АГ), сахарного диабета 2 типа (СД2Т) и субклинического гипотиреоза (СГТ). Материалы и методы: 183 пациента с АГ IIстадии были разделены на 3 группы: 1-я группа (n = 50) - с изолированной АГ (группа сравнения); Группа 2 (n = 63) - с сочетанным течением АГ и СД2Т; Группа 3 (n = 70) - комбинированное течение АГ, СД2Т и СГТ. Изучали уровни артериального давления,  показатели  углеводного, липидного и тиреоидного обмена, концентрацию инсулина в плазме, индекс инсулинорезистентности (ИР)- HOMA-IR, уровни васкулоэндотелиального фактора роста(VEGF-A) в плазме. Результаты. Степень дислипидемии во 2-й группе была более выраженной, чем в 1-й.  Присоединение СГТ сопровождалось тенденцией к увеличению всех атерогенных фракций липидов. ИР наблюдалась во всех группах пациентов и была достоверно больше, чем в контрольной группе (р<0,05). Выявлено достоверное повышение уровней VEGF-A во всех группах пациентов по сравнению с контролем (р <0,05). Во 2-й группе уровни VEGF-A были ниже, чем в 1-й группе, что, вероятно, связано с протективным эффектом метформина. Анализ влияния степени дисфункции щитовидной железы на ЭД выявил значительное увеличение уровней VEGF-A в подгруппе TSH> 6,0 мкМ/мл (352,55 ± 17,64 пг / мл и 461,74 ± 20,13 пг / мл соответственно, р<0,05). Заключение. Гормональные нарушения способствуют ухудшению эндотелиальной дисфункции у пациентов с артериальной гипертензией и сопутствующими эндокринопатиями - сахарным диабетом 2 типа и субклиническим гипотиреозом. Даже незначительное снижение функции щитовидной железы приводит к прогрессированию эндотелиальной дисфункции. Ключевые слова: гипертензия, сахарный диабет 2 тип, субклинический гипотиреоз, эндотелиальная дисфункция     

scholarly journals Type 2 diabetes mellitus – IL-8 and IL-10 profile in patients with intraabdominal postoperative abscesses

2020 ◽  
Vol 73 (2) ◽  
pp. 220-223
Author(s):  
Valeriy V. Boyko ◽  
Artem S. Riga
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Nosocomial Infection ◽  
Perioperative Period ◽  
Serum Levels ◽  
Surgical Trauma ◽  
Abdominal Abscesses ◽  
Group 2

The aim: To assess of pro-inflammatory IL-8 and anti-inflammatory IL-10 serum concentration in patients with T2DM with intraabdominal postoperative abscesses in perioperative period. Materials and methods: The 48 participants, aged 40 – 75 years, among them 24 males and 24 females. All patients were divided into groups: group 1 – 12 patients with T2DM and intra-abdominal postoperative abscesses, group 2 – 12 patients without T2DM but with intra-abdominal postoperative abscesses and 24 healthy individuals. The level of IL-8and IL-10 serum was determined on the day before surgery, on the 2-3rd and 5-7th day after surgery in patients with type 2 diabetes and intra-abdominal postoperative abscesses. Results and conclusions: The trajectories of the level of interleukins in patients with type 2 Diabetes mellitus were different from the trajectories of their level in patients without diabetes, which indicates a special immune response to nosocomial infection and surgical trauma. The mechanism of changes in serum levels of IL-8 and IL-10 in patients with type 2 Diabetes mellitus and postoperative intra-abdominal abscesses should be further studied in future studies on the specific causative agent of nosocomial infection and the cytokine response to it.

scholarly journals Prevalence of osteoporosis and osteoporotic fractures in postmenopausal women with type 2 diabetes mellitus

2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Lamia Oulkadi ◽  
Bouchra Amine ◽  
Imane El binoune ◽  
Samira Rostom ◽  
Rachid Bahiri
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Postmenopausal Women ◽  
Mineral Density ◽  
Control Subjects ◽  
Increased Risk ◽  
Significant Difference ◽  
Prevalence Of Osteoporosis

Type 2 diabetes mellitus (T2DM) and osteoporosis are chronic diseases with increasing prevalence. The aim of this study was to determine the prevalence of osteoporosis and osteoporotic fracture in women with T2DM and to identify predictive factors of fracture occurrence. The prevalence of osteoporosis and fractures in postmenopausal women with T2DM was 23.1% and 16.9%, respectively. 46.2% of T2DM patients had normal bone mineral density (BMD) (P<0.01) and 58.5% of control subjects had osteopenia (P<0.01). Incidence of fracture in T2DM patients with osteopenia was significantly increased versus control subjects when stratified according the BMD (P=0.009). By stratifying T2DM patients according to fractures, factors that were significantly associated with occurrence included T2DM duration (P=0.038), use of insulin (P=0.017), and lower BMD (P=0.048). Our study suggests that there was a higher prevalence of fracture in T2DM patients compared to control subjects and a significant difference in BMD was found between the groups. We also showed that insulin use, low BMD, and long duration of T2DM are factors associated with an increased risk of bone fracture.

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