Association of fibrosis index-4 (FIB-4) with chronic vascular complications of type 2 diabetes mellitus.

Double trouble: T2DM genetic risk factors play a causal role in CAD.

1. Relationship Between Hypertension and CAD e437 2. Prevention of Cardiovascular Events in Patients With Hypertension and CAD e443 3. BP Goals e445 4. Management of Hypertension in Patients With CAD and Stable Angina e449 5. Management of Hypertension in Patients With ACS e451

The studies on the risk of tuberculosis (TB) in patients with type 1 diabetes mellitus (T1DM) alone are limited. We examined this relationship using a population-based retrospective cohort study. From claims data of the National Health Insurance system of Taiwan, we identified 5195 patients with T1DM newly diagnosed from 2002 to 2011 and 20,780 randomly selected controls without T1DM, frequency matched by age, sex, and year of diagnosis. Both cohorts were followed up until the end of 2011 to evaluate the risk of TB. The overall incidence of TB was 4.07-fold higher in the T1DM cohort than in the control cohort (1.18 vs 0.29 per 1000 person-years, P < 0.001). Compared with the controls, the Cox model estimated adjusted hazard ratios (HRs) of TB in patients with T1DM were greater in men than in women (4.62 vs 3.59) and in adults than in children (4.06 vs 3.37), but not significant. The adjusted HR was much greater for those with comorbidities than those without comorbidities (14.6 vs 1.62, P < 0.001). Compared with the controls, the patients with T1DM were also more likely to develop TB with multiple emergency room visits (adjusted HR: 116.1, 95% confidence interval [CI] = 43.8–307.4) or hospitalizations (adjusted HR: 86.5, 95% CI = 33.7–222.4). Patients with T1DM are at elevated risks of developing TB with much higher HRs for those with comorbidities, within the first year of diagnosis, and with frequent emergency cares or hospitalizations.

The association between pulse wave velocity and peripheral neuropathy in patients with type 2 diabetes mellitus

Objective To investigate the relationship between heart rate variability （ HRV） and chronic complications in pa-tients with type 2 diabetes mellitus （T2DM）.Methods A total of 96 patients with T2DM was given chronic complication assessment . Demographic data were obtained .Diabetic retinopathy , diabetic kidney disease , diabetic peripheral neuropathy （ DPN） , and peripher-al artery disease （ PAD） were diagnosed according to international clinical classification .The parameters of HRV in the patients with diabetes and non-diabetes were examined with24 h Holter recorder .Results The HRV parameters of type 2 diabetic patients were significantly lower than those of non-diabetes （ P 〈0.05 ） .HRV time domain parameters [ standard deviation of normal RR intervals （SDNN）, standard deviation of 5-minute mean RR intervals （SDANN）, root mean square difference among successive RR normal in-tervals （ RMSSD） ] were especially impaired in diabetic patients with retinopathy compared to those without retinopathy .HRV parame-ters except low-to-high frequency ratio （ LF/HF） and MNN were lower in diabetic patients with kidney disease than those without kid-ney disease .HRV parameters were no significant difference between patients with or without PAD .Conclusions HRV of diabetic pa-tient is lower.Diabetic retinopathy and kidney disease impact on the HRV . Key words: Diabetes mellitus, type 2 ; Diabetic nephropathies ; Diabetic neuropathies ; Diabetic retinopathy ; Diabetic angiopa-thies; Heart rate; Autonomic nervous system/physiopathology

Co-Existence of Carotid Artery Disease, Renal Artery Stenosis, and Lower Extremity Peripheral Arterial Disease in Patients With Coronary Artery Disease

Background and aims: Depression and cognitive disorders were reported more frequently in patients with diabetes mellitus (DM). Our aim was to analyze the association of cognitive disorders and depression association with chronic complications of DM in a group of Romanian patients. Materials and methods: The data was analyzed from 181 patients, with a mean age of 58,3 years to whom we applied the MMSE (Mini- Mental State Examination) and MADRS (Montgomery-Asberg Depression Rating Scale) questionnaires. We also analyzed the presence of chronic DM complications, HbA1c and lipid profile. Results: Most patients with type 2 diabetes mellitus (T2DM) had mild cognitive impairment (92%), more common in the age group 50-59 years. Chronic macrovascular complications were present in 74.58%, while chronic microvascular complications were present in 61.87% of patients with T2DM who associated mild and moderate cognitive impairment (p = 0.013). The most common form of depression was mild depression (90.2%), present in most patients with DM, regardless of progression and type of treatment. MADRS depression test scores were statistically significant correlated with the presence of peripheral artery disease - PAD (p &lt;0.001), ischemic heart disease - IHD (p &lt;0.001) and chronic kidney disease - CKD (p =0.05). We did not find a statistically significant correlation with HbA1c and serum lipid values (p˃0,05). Conclusion: Chronic diabetes macrovascular complications (PAD, IHD) and CKD were more frequently associated with cognitive disorders and depression in patients with T2DM independent of the degree of metabolic control.

Spirometric restrictive ventilatory pattern and type 2 diabetes mellitus in a tertiary hospital in Cameroon: A comparative study

Disparities in metabolic dysfunction-associated steatotic liver disease and cardiometabolic conditions in low and lower middle-income countries: a systematic analysis from the global burden of disease study 2019

We examined the association between the ε4 allele of the apolipoprotein E gene and severity of peripheral neuropathy in 234 patients with type 2 diabetes mellitus (T2DM). Based on the Neuropathy Disability Score (NDS), patients were divided into group A (NDS ≤ 6: mild or no neuropathy) and group B (NDS > 6: severe neuropathy). In each group, patients were further divided into ε4 carriers and non-ε4 carriers. In multivariate analysis, a more than 5-fold increased risk of severe neuropathy was associated with ε4 carrier status (adjusted odds ratio [aOR]: 5.26, 95% confidence interval [CI]: 2.24-12.31, P = .0001). The other significant risk factors for severe neuropathy included male gender (aOR: 2.08, 95% CI: 1.05-4.14, P = .036), diabetes duration (aOR: 1.05, 95% CI: 1.00-1.09, P = .039), and hemoglobin A1c (aOR: 1.32, 95% CI: 1.05-1.66, P = .020). In conclusion, the ε4 carrier status appears to be associated with severe peripheral neuropathy in T2DM.

Background and Objectives: The complications of type 2 diabetes mellitus (T2DM) can occur in some organs, such as the heart, blood vessels, eyes, kidneys, and nerves. Stroke, one of such complications, is increasing every year. This study aims to investigate the prevalence of and risk factors for stroke among T2DM patients in Qatar. Methods: This was a secondary post hoc analysis of collected data from our previous study titled “Association of Vitamin D deficiency with dyslipidemia, glycemic control, and microalbuminuria in patients with T2DM in Qatar.” Results: The prevalence of stroke among our patients was 3.8%. A comparison between stroke and no-stroke groups showed a significant association between stroke and other diseases, namely, chronic kidney diseases (CKD) (p=0.007), coronary artery disease (CAD) (p=0.010), peripheral vascular disease (PVD) (p&lt;0 p=0.044), p=0.041), p=0.006), p=0.003).&gt; Conclusion: The prevalence of stroke among T2DM patients in Qatar was around 3.8%. The main risk factors were male gender, CKD, CAD, PVD, high HbA1c, prolonged duration of DM, and a high level of creatinine.

The aim – to evaluate the phenotypic characteristics of patients with type 2 diabetes mellitus (T2DM) with and without coronary artery disease (CAD), identify key features that may have prognostic significance, and assess their impact on the progression of these diseases. Materials and methods. We examined 246 patients with type 2 diabetes mellitus (T2DM), with and without coronary artery disease (CAD). All participants underwent anthropometric measurements, blood pressure assessment, and physical examination. Laboratory testing included fasting plasma glucose, glycated hemoglobin (HbA1c), C-peptide, total cholesterol, triglycerides, low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum creatinine, hematological parameters, and albuminuria. The estimated glomerular filtration rate (eGFR) was calculated. CAD was diagnosed using the Bruce protocol treadmill test and confirmed by coronary angiography. Chronic kidney disease (CKD), diabetic neuropathy (DN), and heart failure (HF) were diagnosed according to relevant clinical guidelines. Data on T2DM, hypertension, history of myocardial infarction, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) were obtained from medical records, including discharge summaries and clinical reports. Socioeconomic information was collected through questionnaires, covering family history of T2DM, smoking status, sleep quality, place of residence (urban or rural), and dietary habits. Statistical analysis was performed using IBM SPSS Statistics Version 20.0.0.2. Given the age difference between groups, age was included as a covariate. Statistical significance between groups was assessed using ANCOVA (Univariate Tests). Results and discussion. Patients with T2DM and concomitant CAD were significantly older than those without CAD (p&lt;0.05). The leukocyte count and serum creatinine levels were significantly higher in patients with CAD (p&lt;0.05). The prevalence of CKD among patients without CAD was 24 %, whereas in those with CAD it was significantly higher – 42 % (p&lt;0.05). Heart failure of NYHA functional class II was more frequently observed in the CAD group (48 % vs. 16 % in the non-CAD group, p&lt;0.05). The prevalence of peripheral neuropathy was also significantly higher in patients with T2DM and CAD (76 %) compared to those without CAD (55 %) (p&lt;0.05). Analysis of socioeconomic status revealed that parental history of T2DM was slightly more common among patients without CAD (15 % vs. 11 %), and the maternal history of diabetes was significantly more prevalent in this group (25 % vs. 14 %, p&lt;0.05). A significantly higher proportion of patients with T2DM and CAD reported parental exposure to famine (45 % for fathers and 46 % for mothers, p&lt;0.05). The proportion of patients living in urban areas was significantly lower in the CAD group (50 %) compared to the non-CAD group (70 %) (p&lt;0.05). According to our findings, patients with T2DM and CAD reported poorer sleep quality compared to those without CAD.Conclusions. The prevalence of CKD is significantly higher in patients with T2DM and concomitant CAD, suggesting an association between ischemic heart disease and the progression of renal damage. Elevated leukocyte counts in CAD patients indicate the presence of systemic inflammation, a key mechanism in the development of cardiovascular and renal complications. The significantly higher incidence of NYHA class II heart failure in patients with T2DM and CAD reflects more pronounced cardiovascular impairment, particularly myocardial ischemic damage and cardiac remodeling. Patients with T2DM and CAD also reported significantly poorer sleep quality, which may adversely affect overall health, increasing the risk of cardiovascular events and worsening metabolic control.

Rising burden of MASLD and CKM syndrome in Asia: A decade of trends and future projections.

Both chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) confer a high risk of cardiovascular disease and mortality. These entities frequently coincide. The separate and joint impact of CKD and T2DM on the risk of major cardiovascular events (MACE) and survival is unclear. In this prospective cohort study, patients with angiographically proven coronary artery disease were investigated according to their CKD and T2DM status (T2DM-/CKD-, T2DM+/CKD-, T2DM-/CKD+, T2DM+/CKD+) and followed for up to 18 years. A total of 1441 patients were included in the study of whom 39% experienced MACE (T2DM-/CKD-: 31%, T2DM+/CKD-: 43%, T2DM-/CKD+: 53%, T2DM+/CKD+: 61%) and 53% died. A log-rank test revealed significant differences between the event-free time period of the four groups (χ2 (3) = 112.57, p < 0.001). The presence of T2DM and CKD was associated with a 2.72-fold increase [1.98-3.73] in MACE compared to patients who suffered from neither condition (p < 0.001). T2DM alone led to a 1.37-fold increase [1.1-1.7], (p = 0.004), CKD alone to a 1.71-fold increase [1.31-2.25], (p < 0.001). T2DM and CKD in patients with coronary artery disease are mutually independent predictors of cardiovascular events. Patients with both CKD and T2DM are at an extremely high risk for cardiovascular events.

The metabolic syndrome (MetS), a cluster of metabolic abnormalities with insulin resistance as a major characteristic, has gone by several names over the past two decades. The diagnostic criteria proposed by the Adult Treatment Program III (ATP III) of the National Cholesterol Education Program (NCEP) have led to greater awareness of the components and treatment strategies.1 Five diagnostic traits are listed in the ATP III version of the MetS (Table; referred to as the “metabolic syndrome”), and the presence of any 3 of these factors is considered sufficient for diagnosis. This practical review will consider each in turn, providing advice for cardiologists, internists, and other health care providers who are diagnosing and treating persons with the syndrome in an effort to prevent a variety of clinical outcomes. View this table: Diagnostic Criteria for the Metabolic Syndrome The major adverse consequence of the MetS is cardiovascular disease (CVD). Several of the metabolic abnormalities associated with the syndrome, in fact, are CVD risk factors. One of these abnormalities, insulin resistance, also predisposes to the development of type 2 diabetes mellitus (T2DM). In age-adjusted estimates from the National Health and Nutrition Examination Survey III in 1998 to 1994, approximately 24% of adult Americans had ≥3 of the 5 MetS criteria. Key determinants of greater prevalence were age and ethnicity. Prevalence rates were highest in Mexican Americans and were successively lower in white, African American and other racial groups.2 These published estimates included persons with diabetes mellitus who had met the 1998 fasting glucose criteria (≥126 mg/dL [8.0 mmol/L]) of the American Diabetes Association.3 This article will focus on the features of the MetS in persons without diabetes mellitus, although most persons with T2DM also have the MetS. Moreover, the therapeutic approaches to metabolic risk factors described here also can be applied to …