scholarly journals Is metformin use associated with changes in urinary parameters in stone formers?

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Daniel Rosen ◽  
Jacob N. Bamberger ◽  
Elie Kaplan-Marans ◽  
Ishan Paranjpe ◽  
Arjun Kapoor ◽  
...  

Introduction: Diabetes mellitus (DM) is associated with an increased risk of nephrolithiasis and is often treated with metformin. The relationship between metformin and nephrolithiasis formation remains unclear as studies have demonstrated conflicting results. Methods: We conducted a cross-sectional analysis of stone-forming patients at our stone clinic prior to the initiation of stone-directed medical management. Patients were grouped based on diabetic status and diabetic medication regimen. Outcomes evaluated were 24-hour urinary parameters and specimen stone type using univariate Kruskal-Wallis and Chi-squared analyses. Multivariate analyses controlling for metabolic syndrome components and HbA1c were performed. Results: Data were available for 505 patients, of whom 147 were diabetic and 358 were not. On multivariate analyses controlling for HbA1c and other comorbidities, diabetic patients on metformin still had worse urinary parameters, including urine pH, than non-diabetic patients (pH = -0.33, -0.37, p<0.05). Patients with DM on metformin did not exhibit significant differences in 24-hour urine findings compared to patients with DM not on metformin (p>0.05 for all urinary parameters). Conclusions: Stone-forming patients with DM on metformin were associated with urinary abnormalities similar to those not on metformin. Cohort studies comparing urinary parameters of patients prospectively started on metformin are necessary to further elucidate metformin’s role, if any, in combatting nephrolithiasis.

2018 ◽  
Author(s):  
Tyler S. Jones ◽  
Deborah Rupert

Medical student wellbeing is a topic of growing concern. Medical students experience high levels of stress and burnout and are at increased risk for depression and suicidal ideation compared to the general population. Even more concerning, medical students are disproportionately less likely to seek help for their mental health issues. Identifying and preventing these problems early can have lasting positive consequences over the course of a physician’s lifetime. We implemented a wellness program at our medical school in the spring of 2016 with the goals of decreasing burnout and depression, heightening awareness of mental health issues, and encouraging help-seeking behaviors. To analyze the impact of our program, we have implemented a quality assurance survey. Here we report lifestyle factors associated with positive screens for depression from that data and propose institutional initiatives that can be spearheaded by medical students for medical students to impact positive change.


1970 ◽  
Vol 19 (4) ◽  
pp. 2839-2845
Author(s):  
Juno Okukpon ◽  
Oziegbe Okukpon

Background: Tears are a critical body extracellular fluid coating the surface epithelial cells of the cornea and conjunctiva, and providing the optically smooth surface necessary for refraction of light onto the retina. The biological and chemical properties of tears change in response to systemic disease.Objectives: This study assessed the concentration of calcium, magnesium and phosphate levels in tears of diabetics.Methods: A comparative cross-sectional study involving twenty diabetics visiting Department for Health Services, University of Benin and forty non-diabetics within the University between 35 to 65 years participated in the study. Calcium, magnesium and phosphorous were analysed in tears sample collected with 75mm glass capillary tubes.Results: The fasting blood sugar (FBS) and age of diabetic patients was 7.48±1.88mmol/l and 56.75±5.82years and non-diabetics was 4.83±0.52mmol/l and 53.58±6.16years respectively. Magnesium showed no differences (P<0.05) between diabetics (0.76±0.45mmol/l) and non-diabetics (0.93±0.59mmol/l). Calcium was elevated (P=0.041) and phosphate (P=0.044) was decreased in diabetics (3.14±1.65mmol/l and 0.074±0.058mmol/l) than non-diabetics (2.41±1.05mmol/l and 0.11±0.081mmol/l).Conclusion: This study concluded that being diabetic can affect the levels of some tear electrolytes in the tear fluid which may lead to an increased risk of diabetic ocular complications.Keywords: Tears, diabetics, mag nesium, calcium, phosphorus.


Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3098
Author(s):  
Young-Ae Cho ◽  
Jeong-Hwa Choi

Carbohydrates consist of a large proportion of calories in the Asian diet. Therefore, we aimed to investigate the association between carbohydrate intake and metabolic syndrome in Korean women. A cross-sectional analysis was conducted with a total of 4294 Korean women aged 40–69 years from the Korean Genomic and Epidemiology Study (KoGES). Carbohydrate intake was calculated based on a validated food frequency questionnaire. Metabolic syndrome was defined by using the National Cholesterol Education Program, Adult Treatment Panel III (NCEPIII). Logistic regression was used to estimate the association of carbohydrate intake with metabolic syndrome and its components. In this study, high carbohydrate intake seemed to be associated with low socioeconomic status and an imbalanced diet. After adjusting for confounding factors, subjects with higher carbohydrate intake showed an increased risk of metabolic syndrome (odds ratio (OR) 1.34, 95% confidence interval (CI) 1.08–1.66, p-trend = 0.004, highest vs. lowest quartile [≥75.2 vs. <67.0% of energy]), particularly elevated waist circumference. This association was stronger among those with low levels of C-reactive protein (CRP) and those with low dairy intake. In conclusion, higher carbohydrate intake is associated with a higher risk of metabolic syndrome, particularly abdominal obesity, in Korean women. This association may differ according to individuals’ CRP level and dairy intake.


2013 ◽  
Vol 7 (3-4) ◽  
pp. e190-2 ◽  
Author(s):  
Alfonso Fernandez ◽  
Andrew Fuller ◽  
Reem Al-Bareeq ◽  
Linda Nott ◽  
Hassan Razvi

Introduction: The aim of this study was to compare the metabolic profiles of diabetic and non-diabetic patients with uric acid stones to understand whether preventive strategies should be tailored to reflect different causative factors.Methods: The results of the metabolic evaluation of patients with uric acid stones identified prospectively from the Metabolic Stone Clinic at St. Joseph’s Hospital, London, Canada were reviewed. Information included patients’ clinical histories, 24 hour urine collections, blood chemistry and stone analysis.Results: Complete data were obtained from 68 patients with uric acid stones. Twenty-two patients had diabetes. There were no statistically significant differences in mean age, body mass index, or history of gout. Among diabetics, pure uric acid stones were identified in 14 patients (63%) and mixed uric acid in 8 (36%). Pure uric acid stones were more common in the diabetic cohort (63% vs. 46%, p = 0.16). Urine pH, serum and urine uric acid levels and 24-hour urine volumes were similar in both groups. The diabetic group had an increased average oxalate excretion (424 μmol/d vs. 324 μmol/d, p = 0.003).Conclusion: The exact etiological basis for the higher oxalate excretion in diabetic uric acid stone formers is unclear. Whether this is a metabolic feature of diabetes, due to dietary indiscretion or the iatrogenic consequence of dietary advice requires further investigation.


Thorax ◽  
2019 ◽  
Vol 74 (8) ◽  
pp. 740-748 ◽  
Author(s):  
Sabariah Noor Harun ◽  
Nicholas H G Holford ◽  
Keith Grimwood ◽  
Claire E Wainwright ◽  
Stefanie Hennig

BackgroundWhile Aspergillus detection rates in adults, adolescents and older children with cystic fibrosis (CF) have increased, the risk of acquiring this fungal pathogen in young children is unknown.AimTo determine the risk and explanatory factors of acquiring Aspergillus in children with CF by age 5 years.MethodsCross-sectional analysis of clinical, bronchoalveolar lavage and treatment data from the Australasian Cystic Fibrosis Bronchoalveolar Lavage study was used to identify predictive factors for detecting Aspergillus at age 5 years. A parametric repeated time-to-event model quantitatively described the risk and factors associated with acquiring Aspergillus and Pseudomonas aeruginosa from birth until age 5 years.ResultsCross-sectional analysis found that the number of P. aeruginosa eradication courses increased the odds of detecting Aspergillus at age 5 years (OR 1.61, 95% CI 1.23 to 2.12). The median (IQR) age for the first P. aeruginosa positive culture was 2.38 (1.32–3.79) years and 3.69 (1.68–4.74) years for the first Aspergillus positive culture. The risk of P. aeruginosa and Aspergillus events changes with time after the first year of study entry. It also decreases for P. aeruginosa after completing P. aeruginosa eradication (HR 0.15, 95% CI 0.00 to 0.79), but increases for Aspergillus events (HR 2.75, 95% CI 1.45 to 5.41). The risk of acquiring both types of events increases after having had a previous event.ConclusionIn young children with CF, completing P. aeruginosa eradication therapy and previous Aspergillus events are associated with increased risk of acquiring Aspergillus.


Author(s):  
Angela Fonseca ◽  
Vicente Bagnoli ◽  
Josefina Massabki ◽  
Wilson Arie ◽  
Raymundo Azevedo ◽  
...  

Purpose The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age. Design This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a cross-sectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data. Results The age of the patients on their first clinic visit ranged from 65 to 98 years, with a mean age of 68.56 ± 4.47 years; their mean age at the time of natural menopause was 48.76 ± 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n = 188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the body mass index (BMI) found decreases in BMI with increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n =  70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years. Conclusions Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.


2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Nasya Aisah Latif ◽  
Yulia Sofiatin ◽  
Maya Kusumawati ◽  
Rully Marsis Amirullah Roesli

Background: Diabetic patients have low sensitivity towards sweet taste, thus consuming more sugar. A young adult with family history of diabetes mellitus (FHD) who lives with diabetic parents may have an increased risk of overconsumption of sugar due to a similar dietary pattern, leading to diabetes. This study aimed to explore the difference in the sweet taste threshold (STT) between students with and without a family history of diabetes mellitus. Methods: This cross-sectional study was conducted in October –November 2018 on Class 2018 medical students living in a student dormitory who were divided into those with family history of diabetes (FHD) and those without it (non-FHD). Family history of diabetes and other known diseases were self-reported. The three-Ascending Forced Choice method was used to determine the sweet recognition threshold. Mann-Whitney analysis was used to compare the sweet taste thresholds between the two groups. Result: A total of 183 subjects participated in this study. The non-FHD group had a higher rank of sweet taste threshold than subjects in the FHD group (94.21 vs 81.16), albeit insignificant (p=0.192). Interestingly, the modes of best estimation threshold (BET) for non-FHD group was than the FHD group (0.067 M vs 0.043 M). Conclusion: The BET for students without family history of diabetes is higher than those with family history of diabetes. It is imperative that low sugar consumption campaign should also aim young people without FHD.


Biomedicine ◽  
2021 ◽  
Vol 41 (3) ◽  
pp. 576-579
Author(s):  
K. Sumathi ◽  
Gayathri Dilliraj ◽  
Sridevi Chaganti ◽  
Shenbaga Lalitha

Introduction and Aim:Diabetes mellitus, especially type II DM is one among the most prevalent metabolic diseases in the global scale. One of the commonest complications of diabetes mellitus is vestibulopathy affecting the inner ear. Malondialdehyde (MDA) obtained from lipid peroxidation of poly unsaturated fatty acids (PUFA) is an important compound that generally serves as one of the key markers for oxidative stress. The aim of the study is to prove the significance of MDA in Vestibulopathy in Type-2 i.e.,non-insulin dependent diabetes mellitus.   Methodology: A cross-sectional study of 100 diabetic patients of age group between 35 years and 50 years were tested for vestibular function by electronystagmography(Commonly used test to determine and evaluate vestibular system). Based on the biothermal caloric stimulation the Clausen butterfly chart was generated and thus the code is ascertained. Serum levels of Malon-di-aldehyde were assayed by TBARS method (Thiobarbituric acid Reactive substances).   Results: The study proved, that there was a 4 times increased risk of developing vestibulopathy with increasing duration of diabetes. It also proved that there was an increased risk of developing vestibulopathy in diabetic patients, having MDA > 2?mol/L.   Conclusion: Thereby the study confirmed the clinical significance of periodic screening of MDA levels, in diabetic patients, particularly those with uncontrolled/poor glycemic control & with longer duration of diabetes. Estimation of their serum MDAlevels and vestibular function by the electronystagmography test, is advised in order to prevent the occurrence of diabetic vestibulopathy at the earliest and also to prevent the worsening of any such, other complications associated with the disease.  


1970 ◽  
Vol 28 (5) ◽  
Author(s):  
Belete Biadgo ◽  
Tadele Melak ◽  
Sintayehu Ambachew ◽  
Habtamu Wondifraw Baynes ◽  
Miteku Andualem Limenih ◽  
...  

BACKGROUND: Metabolic syndrome is a cluster of risk factors that is responsible for the risk of coronary heart disease and stroke. Therefore, the aim of this study was to assess the prevalence of MetS and its components among T2DM patients.METHODS: A cross-sectional study was conducted at the Diabetes Clinic of the Hospital, from June to July, 2015. Data were entered into EPI INFO software and exported to SPSS 20 for analysis. MetS prevalence was estimated using NCEP ATPIII and IDF criteria. Anthropometric measurements, investigations of serum glucose and lipid profiles were done. Logistic regression analysis was used to evaluate associated factors. A P-value ≤ 0.05 wasconsidered statistically significant.RESULT: A total of 159 participants were included in the study; 119 (59.7%) were females with mean (±SD) age of (49.8±8.7) year. The prevalence of MetS was 66.7% in NCEP-ATP III and 53.5% in IDF definitions. The most prevalent component of MetS was elevated triglyceride (56.6% in ATPIII and 62.3% in IDF criteria), followed by abdominal obesity (61%) IDF and elevated blood pressure (55.4%) NCEP-ATPIII criteria. The regression analysis showed that increased age, being female, high BMI, having diabetes for over 5 years and poor glycemic control were significantly associated with metabolic syndrome.CONCLUSION: The prevalence of MetS and its components among T2DM patients were high, suggesting that diabetic patients are at increased risk of CVD and other complications. Efforts should be geared towards addressing these abnormalities through lifestyle modification, health awareness and medications in order to reduce this complication. 


Author(s):  
Jihyun Lee ◽  
Donghwan Kwon ◽  
Youngjang Lee ◽  
Inchan Jung ◽  
Daesung Hyun ◽  
...  

Lung function is often impaired in diabetic patients, especially in a restrictive pattern, which has recently been described as the diabetic lung. Since hypertension (HTN) is common in diabetic patients, our study investigated whether HTN acts as an aggravating factor in diabetic lung. Within the cross-sectional study from the 6th Korean National Health and Nutrition Examination Survey (KNHANES), fasting plasma glucose (FPG), blood pressure (BP), pulmonary function, and laboratory data were examined in 4644 subjects aged between 40 and 79 years. A multivariate regression model was used to investigate the relationship between BP, FPG, and pulmonary function. Lung function was significantly reduced in the HTN (p = 0.001), impaired fasting glucose (IFG) (p < 0.001), and diabetes mellitus (DM) (p < 0.001) groups. Next, a multivariate logistic regression model was used to derive the odds ratio (OR) of reduced lung function based on the presence of IFG, DM, and HTN. The OR of reduced forced vital capacity (FVCp < 80%) was 3.30 (p < 0.001) in the HTN-DM group and 2.30 (p < 0.001) in the normal BP-DM group, when compared with the normal BP-normal FPG group. The combination of HTN and DM had the strongest negative effect on FVC. The results presented in this study indicate that diabetes and hypertension have a synergistic association with impaired lung function.


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