SNP (Single Nucleotide Polymorphism) at Adiponectin Gene in Type 2 Diabetes Mellitus (T2DM) Patients

Background: Vitamin D receptor (VDR) gene polymorphisms are possibly involved in the development of type 2 diabetes mellitus (T2DM). However, the data to date have been inconclusive. Previous studies have suggested an influence of vitamin D receptor alleles on glucose metabolism and on susceptibility to type 2 diabetes mellitus in different ethnic populations through the action of vitamin D endocrine system which related with calcification and lipolysis, insulin secretion, and may be associated with many complicated disease including diabetes. To investigate the relationship between a single nucleotide polymorphism (SNP) of VDR gene and T2DM more studies had been done. However, different results have been found in different spots of the world. Therefore, more studies are needed to understand the variation in these results. This is the first study that shows the implication of the SNP of VDR gene in T2DM in Iraqi patients. Objective: To assess the correlation between serum 25(OH)D3 levels, and vitamin D receptor (VDR) polymorphisms (Fok1, BsmI, TaqI and ApaI), and glycemic control in obese T2DM Iraqi population, this study was performed. Materials and methods: 200 clinically diagnosed T2DM patients, distributed into three subgroups according to therapeutic pattern and 75 healthy controls from the Iraqi population were recruited in this study. The association between the VDR gene SNPs and the T2DM was determined using Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique, and genotype and allele frequencies were calculated between the T2DM and control groups. Results: No significant differences between mean age and the body mass index between both case and control groups were observed. According to current glycemic control consensus, results demonstrated only 20.5 percent of the T2DM patients met this target, which meant that 79.5 percent of the cases were suffering from poor glycemic control 25(OH)D3 levels were significantly lower in the T2DM patients than in the control group, being 17.49 ± 1.12 ng/ml and 31.26 ± 1.25 ng/ml, in the patient and control groups, respectively (p 20 < 30 ng/ml (chi-squared test, p<0.0001). The gene polymorphism analysis for T2DM showed that genotype and alleles frequencies for the VDR genes were in agreement with Hardy–Weinberg equilibrium in all cases. Conclusion: VDR gene polymorphism analysis revealed that neither genotypes nor alleles of VDR BsmI, ApaI showed a significant variation between T2DM patients and controls. In contrast‚ the FF genotype of VDR FokI and TT genotype of VDR TaqI showed a significant (P<0.0001) increase in T2DM patients in comparison to controls. FF and TT homozygotes had significantly higher baseline fasting glucose and HOMI-IR levels than f allele carriers. In addition, data found significantly elevated interlukin IL-6, TNF-α, IL -1β and decreased osteocalcin in association with the Taq1 polymorphism.

Background: Data from previous studies on the role of inflammatory cytokines as biomarkers for diabetic kidney disease (DKD) are contradictory. The association of a particular inflammatory cytokine single nucleotide polymorphism (SNP) with susceptibility to DKD has not been consistently replicated. We aimed to investigate the utility of inflammatory cytokines as biomarkers for DKD in type 2 diabetes mellitus (T2DM) patients. Association of inflammatory cytokine gene SNPs with the development of DKD was also explored.Subjects and Methods: One hundred and fifty-nine Kuwaiti subjects were recruited in this study, including 50 T2DM patients without DKD, 67 diabetic DKD patients and 42 healthy subjects. Plasma levels of interleukin-6 (IL-6), IL-10, interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) were measured by enzyme-linked immunosorbent assays. Nine SNPs, including 2 SNPs in IL-6, 3 SNPs in IL-10, 1 SNP in IFN-γ and 3 SNPs in TNF-α, were genotyped using TaqMan SNP genotyping assays.Results: Diabetic DKD patients showed higher IL-6, IL-10, IFN-γ and TNF-α levels than those without DKD. Diabetic DKD patients had a significantly higher frequency of IL-10 − 1082 A allele than those without DKD (p = 0.001). No significant association of IL-6 − 174/−597 haplotypes with DKD risk was detected (p = 0.188). Distribution of IL-10 − 592/−819/−1082 haplotypes differ significantly between T2DM patients with/without DKD (p = 0.014). Diabetic DKD patients had a significantly lower frequency of IL-10 − 592C/−819C/−1082G haplotype than those without DKD (p = 0.002).Conclusions: Although inflammatory cytokine genotypes and, more importantly, haplotypes may have the potential to identify those patients at risk of DKD, hence, improving DKD predisposition prediction, further investigations regarding their real clinical significance is warranted in a large cohort of patients.

Subclinical left ventricular (LV) dysfunction is prevalent in type 2 diabetes (T2DM). As obesity has been proposed as one causal factor in the disease process, this could bias the reported prevalences. We wanted to characterize echocardiographic LV dysfunction in obese T2DM subjects as compared to non-diabetic obese controls. One hundred patients with T2DM without clinical signs of heart failure (29% females, mean ± SD age 58.4 ± 10.5 years, body mass index (BMI) 30.1 ± 5.5 kg/m(2), blood pressure (BP) 141 ± 18/83 ± 9 mmHg) and 100 non-diabetic controls (29% females) matched for age (58.6 ± 10.5 years), BMI (29.8 ± 4.0 kg/m(2) and systolic BP (140 ± 14 mmHg) underwent echocardiography and color tissue Doppler imaging (TDI). Diastolic function was evaluated with conventional Doppler recordings and early (e') and late (a') myocardial velocities. The ratio between early transmitral filling (E) and the corresponding myocardial tissue velocity (e') served as an index of LV filling pressure. T2DM patients had more concentric hypertrophy with a relative wall thickness of 0.42 ± 0.07 vs controls 0.38 ± 0.07, P < 0.001. The T2DM group had signs of diastolic dysfunction with lower E/A ratio (0.91 ± 0.27 vs. 1.12 ± 0.38, P < 0.001), deceleration time (195 ± 49 vs 242 ± 72 ms, P < 0.001), e' (5.7 ± 2.0 vs. 6.6 ± 1.8 cm/s, P = 0.001), and a' (6.5 ± 2.0 vs. 7.6 ± 1.5 cm/s, P < 0.001) compared to the controls, and higher E/e' (13.3 ± 4.7 vs. 11.1 ± 3.5, P < 0.001). Thus, there were indications of pseudo normalization and increased filling pressure in the T2DM group, whereas the controls had evidence for relaxation abnormalities without elevated filling pressure. Compared to a non-diabetic obese group, more advanced subclinical impairment of diastolic function was seen in T2DM.

Objective To investigate the relationship between levels CA242 , sialic acid and Lewis blood-group substance in type 2 diabetes mellitus (T2DM) patients. Methods Lewis blood group, serum CA242, siaiic acid (SA) and HbAlc levels were separately detected by agglutination test, ABC-ELISA assay, enzymatic method and immunoturbidimetric assay and the correlations between them were analyzed in 2000 T2DM patients and 500 healthy controls. Results The mean level and positive ratio of serum CA242 in T2DM patients were (20 470 ± 14 860) U/L and 6. 0% (121/2 000) , which were obviously higher than those of controls[(10 950 ±8 490) U/L,0.4% (2/500)]. There were significantly statistical differences (t′ = 18. 87,P<0.01,χ~2 =26. 1,P <0.01). The SA level of T2DM patients was(51.5 ± 18.6) μg/L, which was obviously lower than that of controls[ (56.3 ±13. 8) μxg/L] (t′ = 6. 45, P <0. 01). The CA242 levels were negatively correlated with SA ( r = - 0. 693 , P < 0. 01) but positively correlated with HbAl c ( r = 0. 547, P < 0. 01) in CA242-positive T2DM patients.The Lewis blood group in 98. 3% (119/121) CA242 positive T2DM patients belong to type-I chain substrate. After treatment, the CA242 levels were decreased in CA242-positive T2DM patients whereas SA levels were increased obviously. The CA242 and SA levels of pre- and post-therapy were 30 570 (27 040-42 630), (22 350 ± 13 400) U/L and (44. 5 ± 13. 5), (55. 5 ± 17. 2) μg/L, respectively. There were significantly statistical differences ( U = 5. 32, P < 0. 01, t′ =5.53,P<0.01). Conclusions The elevation of serum CA242 levels in T2DM patients is probably due to reaction between type-1 chain substrate and SA by non-enzymatic mode. It is not the consequence ofmalignancy. In T2DM patients, CA242 level can be effectively controlled by regulating blood sugar levels. Key words: Diabetes mellitus; type 2; Antigens; tumor-associated; carbohydrate; Sialic acids; Lewis blood-group system; Hemoglobin A; glycosylated

Diabetes mellitus (DM) is the ninth leading cause of death worldwide. Mortality from DM is largely attributed to disease complications. Glycemic control of DM patients reduces mortality. Studies indicated that the lack of glycemic control in DM patients could be influenced by the genetic background of the patients. Evidence suggests that adiponectin levels are dysregulated in DM patients with poor glycemic control. Serum adiponectin level is a heritable trait influenced by single nucleotide polymorphisms (SNPs) in the ADIPOQ gene. It is hypothesized that SNPs in ADIPOQ could modify glycemic control in DM patients. To test this hypothesis, 375 type 2 DM (T2DM) patients were recruited. Patients were classified into good vs. poor glycemic control according to hemoglobin A1c levels. Study subjects were genotyped for variations of four SNPs in ADIPOQ (rs17300539, rs266729, rs2241766, and rs1501299). Adiponectin levels were measured from the serum. Our analysis showed that reduced serum adiponectin, a longer duration of treatment, and increased insulin resistance were all significant predictors of poor glycemic control. Moreover, the T allele and the TT genotype of rs2241766 were significantly more frequent in patients with poor glycemic control (P < 0.05). Individuals with the TT genotype of rs2241766 had significantly lower levels of serum adiponectin (P < 0.05). It was concluded that lower levels of serum adiponectin and the T allele of rs2241766 SNP in ADIPOQ were associated with poor glycemic control in T2DM patients.

BACKGROUND: Vascular endothelial growth factor (VEGF) protein levels in diabetes mellitus (DM) patients with ulcerative foot will tend to decrease. Matrix metalloproteinases (MMPs) and their inhibitors have also been identified in regulating capillary tubes formation (morphogenesis) with the collagen matrix, associated with the formation and regression of granulation tissue during the wound healing process. AIM: This study was aimed to determine the relationship between gene polymorphism VEGF rs699947 with VEGF and MMP-14 protein levels in cases of diabetic foot ulcers (DFUs). METHODS: This study was an observational research with cross-sectional comparative study design. The population in this study were type-2 DM patients who met the inclusion criteria. According to the Meggitt-Wagner classification, the study sample was divided into two groups: Type 2 DM group without DFU and type 2 DM group with DFU Grades 1–3. RESULTS: In this study, there were differences in the protein levels of MMP-14 (p = 0.039) VEGF (p = 0.002) between type-2 DM patients with and without FDU. However, there was no difference in the VEGF gene polymorphism rs6999947 between type-2 DM patients with and without FDU (p = 0.099). In addition, the results showed that type-2 DM patients with MMP-14 protein levels ≤ 3.864 had a 3.6 times greater risk of suffer FDU compared to type-2 DM patients with MMP-14 protein levels &gt; 3.864 but not significant (PR = 3.600 (IK 5 % 1.142–11.346); p = 0.052). Meanwhile, type 2 DM patients with VEGF protein levels ≤567.42 were significantly more at risk of 9048 times to suffer FDU compared to type 2 DM patients with VEGF protein levels &gt; 567.42 (PR = 9.048 (CI 5% 2.571–31.842); p = 0.001). CONCLUSION: In type 2 DM patients with FDU, there were lower levels of MMP-14 and VEGF compared to patients without FDU. There is a significant relationship between VEGF protein levels and the incidence of FDU in type 2 DM patients, but there is no relationship between MMP-14 and the gene polymorphism VEGF rs6999947 with the incidence of FDU in type 2 DM patients.

Background: Non-psychotic mental disorders including non-severe depressive, anxiety and organic disorders can have an impact on the course and prognosis of the underlying disease in patients with diabetes mellitus (DM). Therefore, assessment of their epidemiologic aspects is extremely important. Aim: Investigation of the types and prevalence of the major mental disorders among both type 1 DM (T1DM) and type 2 DM (T2DM) in-patients, determination of possible etiology of the organic involvement of the brain in T1DM patients as well as of the rate of diagnostics and management of mental disorders in DM patients in routine medical practice. Materials and methods: Part 1 was a cross-sectional study in 228 consecutive DM patients aged from 18 to 75 years, aimed at detection of current mental disorders. Part 2 was a cross-sectional study in 72 consecutive T1DM patients with in-depth assessment of signs of organic brain involvement. All patients underwent cognitive function tests. Mental disorders were diagnosed by a psychiatrist according to ICD-10 diagnostic criteria. Results: Mental disorders were found in 80.3% of patients, being significantly more prevalent in patients with T2DM (87.9%) than in T1DM patients (57.4%, р<0.0001). Anxiety disorders as a whole were diagnosed as frequently as depressive ones (39.5% and 40.0%, respectively), being the most prevalent both in T1DM (35%) and T2DM (60%). Within the class of anxiety disorders, diabetes-specific phobias of injections and hypoglycemia were noted 8-fold more often (р<0.01) in T1DM than in T2DM patients. Generalized (22.4 versus 9.3%) and organic (18 versus 0%) anxiety disorders as well as unipolar depressive episodes and dysthymia (40.2 versus 25.9%, р<0.05) occurred considerably more often in T2DM than in T1DM patients. In total, signs of organic brain involvement were found in 37% of T1DM patients. Possible etiologic factors of organic brain disorders were as follows: craniocerebral injury including concussion of the brain, severe hypoglycemia, and diabetic ketoacidosis – in 40.7% of patients each; alcohol abuse – 30.7%; arterial hypertension – 22.2%; ante- and intranatal factors – 11.1%; neuroinfections/intoxications and occupational neurotropic factors – in 7.4% each; electric trauma, general malnutrition, stroke, and brain tumor – in 3.7% each. None of the listed potential causes could be found only in one patient with organic brain involvement (3.7%). In T1DM patients, organic brain involvement was nonspecific, and there was no evidence of its association with the level of glycated hemoglobin, acute and chronic vascular diabetic complications. Conclusion: The present investigation revealed a high prevalence of non-severe mental disorders with predominance of generalized anxiety disorders and unipolar protracted depressions in T2DM in-patients and specific phobias in T1DM patients. Organic brain involvement (encephalopathy) occurs in every third young T1DM patient; however, in the majority of cases, its potential etiology is linked with factors unrelated to DM or non-specific for DM (for example, hypoglycemia). In routine medical practice, diagnostics and treatment of mental disorders in DM patients are close to non-existent.

Single Nucleotide Polymorphism of TCF7L2 and Adiponectin Genes for Type 2 Diabetes Mellitus in Taiwan

Introduction Uncontrolled blood pressure and poor glycaemic control may lead to increased morbidity and mortality (1). A systematic review of 40 studies reported beneficial effects of interventions conducted in community pharmacies in the management of diabetes and cardiovascular diseases (2). Aim To evaluate the impact of a tailored intervention on clinical outcomes in the management of hypertensive and/or type 2 diabetes mellitus (T2DM) patients in community pharmacies in a pilot implementation study. Methods The study (April to July 2019) utilized a mixed-method design. This included a cross-sectional survey among 133 consented community pharmacists and 390 T2DM and/or hypertensive patients at the pharmacies. Thirty-one item (pharmacists) and 29-item (patients) semi-structured questionnaires were used to gather information on their perception of pharmacists’ roles in the management of T2DM and/or hypertension. Barriers to implement identified roles by the pharmacists were documented. Thereafter, a prospective before- and after-intervention study was conducted in four consented pharmacies to address the barriers. Two pharmacists per pharmacy and 34 consented T2DM and/or hypertensive adult patients who had been on medications for ≥3 months participated. Pharmacists were provided with 2-hr one-on-one training on the management of T2DM and hypertension based on standard guidelines pre-intervention and at 4 weeks. Components of the pharmacist’s intervention included patient’s education, medication counselling , lifestyle modifications and self-care use of point of care devices. Systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose (FBG) and body mass index (BMI) of all patients were measured at baseline, 4- and 8-week post-intervention. Weekly patient follow-up visits to the pharmacies were mandatory. Telephone calls and referral were incorporated, when necessary. Failure to show up for two consecutive visits disqualified patients from completing the study. Descriptive statistics (to summarise data), and paired t-test to compare mean differences in the measured parameters at α=0.05. Results Hypertensive and/or T2DM patients (374) and 71 pharmacists participated in the survey. The patients expected pharmacists to provide medication counselling (81;27.1%), education (47;12.6%), follow-up (18;4.8%), health outcomes monitoring (17;4.5%), and collaboration with physicians (12;3.2%). Sixty-nine (97.2%) pharmacists agreed that patients’ follow-up, patient counselling (71;100.0%), therapeutic plan design to achieve goals (67;94.4%) and collaboration with physicians (61;85.9%) were important. Barriers to providing adequate counsel to these patients were time constraints (23;32.4%), unconducive environment (7;9.9%) and patient’s impatience (33;46.5%). For the intervention component, 16 of the 34 patients enrolled were lost to follow-up (one hospitalized, seven failed two consecutive visits, and eight lost to referral). Effects of the tailored intervention on the parameters are in Table 1. Conclusion The patients’ and pharmacists’ perceived roles of the pharmacist in the management of hypertension and T2DM were in tandem. The 8-week tailored pharmacists’ intervention resulted in better control of blood pressure but increased FBG. This pilot study is limited by the small sample size of patients and pharmacists, as well as the lack of appropriate comparator. Future large-scale multi-site study with relevant comparator is required for a far-reaching conclusion on the impact of the tailored pharmacist intervention in the management of diabetes and hypertension.

Introduction: Diabetes is the second most prevalent comorbidity of coronavirus disease 2019 (COVID-19) cases in Indonesia. Type 2 diabetes mellitus (T2DM) patients experience increased blood vessel remodeling, resulting in elevated peripheral arterial resistance. In addition to exacerbating the severity of T2DM, COVID-19 also increases hypertension risk. This study aimed to elucidate the effect of COVID-19 on hypertension prevalence among T2DM patients. Methods: This research employed an analytical observational design, specifically the case-control study design. A total of 200 datasets were extracted from medical records covering the period from May 2020 to April 2022 at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. The inclusion criteria for the study samples were T2DM patients diagnosed by a doctor, as documented in their medical records, with no previous history of hypertension. The data were analyzed using the Chi-square test at a significance level of p&lt;0.05 to determine the effect of COVID-19 on hypertension prevalence in T2DM patients. Results: There were 100 T2DM patients without COVID-19 (30 with hypertension and 70 without hypertension) and 100 T2DM patients with COVID-19 (45 with hypertension and 55 without hypertension). The Chi-square test indicated an effect associated with COVID-19 on hypertension prevalence in T2DM patients, with p=0.028 and an odds ratio (OR) of 1.909. Conclusion: The study suggests that COVID-19 infection increases the risk of hypertension in T2DM patients. Raising awareness of the complications of hypertension is important, particularly for high-risk individuals, such as T2DM patients who have a history of COVID-19. Highlights: There has been no research examining the relationship between coronavirus disease 2019 (COVID-19) and the prevalence of hypertension complications, especially in type 2 diabetes mellitus (T2DM) patients. This study highlights the importance of raising awareness regarding the finding that the incidence of COVID-19 increases the prevalence of hypertension in T2DM patients.

Objective To investigate the levels of serum retinol-binding protein 4 (RBP4) and high sensitive C reactive protein (hs-CRP) in type 2 diabetic mellitus (T2DM) patients with macrovascular complications. Methods All of 115 subjects were divided into 3 groups: normal control group (35subjects), T2DM patients with macrovascular complications group (40 subjects) and simple T2DM patients group (40 subjects). Serum RBP4 and hs-CRP was detected and fasting blood glucose(FBG), glycosylated hemoglobin A1c (HbA1c), triacylglycerol (TG), total cholesterol (TC), high density lipopretein cholesferel (HDL-C), low density lipoprotein cholesferol(LDL-C) and fasting insulin(FINS) were measured. Body mass index (BMI) and HOMA-IR was calculated. The correlation of RBP4 and other factors were analyzed.Results The concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group and simple T2DM patients group compared with those in normal control group [hs-CRP:(9.12±4.21),(2.01±1.96), (0.98±0.36)mg/L; RBP4:(30.70 ± 5.45), (20.02±5.32),(12.02±3.45)mg/L] (P<0.01). Also,the concentrations of RBP4 and hs-CRP were significantly increased in T2DM patients with macrovascular complications group compared with those in simple T2DM patients group (P<0.01). Univariate analysis showed that serum RBP4 was positively associated with LDL-C,BMI,FBG,hs-CRP,FINS,HOMA-IR (r=0.325, 0.597, 0.323, 0.571, 0.275, 0.463,P<0.05 or <0.01).Conclusions The concentrations of RBP4 and hs-CRP are significantly higher in T2DM patients. The changes of RBP4 and hs-CRP are closely related to the occurrence and development of diabetic macrovascular complications. Key words: Diabetes mellitus; Retinol-binding proteins; C-reactive protein

Objective To explore the distribution characteristics of islet autoantibodies and other organ-specific autoantibodies in type 1 diabetes mellitus (T1DM) patients, and the correlation between organ-specific autoantibodies and clinical features. Methods A total of 205 newly diagnosed T1DM patients and 170 healthy controls were recruited in this study from the Second Xiangya Hospital of Central South University between Jan. 2015 and Dec. 2017. Glutamic acid decarboxylase antibody (GADA), insulinoma antigen 2 antibody (IA-2A), zinc transporter 8 antibody (ZnT8A) and other organ-specific autoantibodies, including thyroid peroxidase antibody (TPOA), thyroglobulin antibody (TGA), tissue transglutaminase antibody (tTGA) and 21-hydroxylase antibody (21-OHA) were detected by radioligand assay. In antibody-positive patients the function of thyroid and adrenal cortex was further examined; the coexistence of islet antibodies with other organ-specific autoantibodies, and the correlation between organ-specific antibodies and clinical characteristics were analyzed. Chi-square test, one-way analysis of variance and non-parametric test were used for statistical analysis. Results (1) The positive rates of GADA, IA-2A and ZnT8A in patients with T1DM were significantly higher than those in healthy controls [70.2% (144/205) vs 0.6%(1/170), 42.9%(88/205) vs 0 and 30.7%(63/205) vs 0 (0/170), χ2=190.131, 95.357, 62.792, respectively, all P 0.05). (3) In T1DM patients the detections of combining various islet autoantibodies (GADA+IA-2A+ZnT8A) could increase the positive rate to 82.9%. (4) T1DM patients with positive GADA and IA-2A were more likely to have positive TPOA and TGA antibodies, patients with positive IA-2A were more likely to have positive tTGA antibodies, and patients with two or more islet autoantibodies were more likely to have positive TPOA and TGA antibodies. (5) The proportion of T1DM patients with Graves′ disease was higher than that of healthy controls (4.4% vs 0.6%, P<0.05). Conclusions T1DM patients are prone to merge other organ-specific autoantibodies. It is of great clinical significance to screen other organ specific autoantibodies, especially in T1DM patients with positive polyantibodies. Key words: Diabetes mellitus, type 1; Islet autoantibody; Organ-specific autoantibody

BackgroundCoronary artery disease (CAD) confers considerable morbidity and mortality in diabetes. However, the role of CAD in additive effect of left ventricular (LV) function has rarely been explored in type 2 diabetes mellitus (T2DM) patients. This study aimed to investigate how CAD affect LV systolic and diastolic function in T2DM patients.Materials and methodsA total of 282 T2DM patients {104 patients with CAD [T2DM (CAD +)] and 178 without [T2DM (CAD −)]} and 83 sex- and age- matched healthy controls underwent cardiac magnetic resonance scanning. LV structure, function, global strains [including systolic peak strain (PS), peak systolic (PSSR) and diastolic strain rate (PDSR) in radial, circumferential and longitudinal directions] and late gadolinium enhancement (LGE) parameters were measured. T2DM (CAD +) patients were divided into two subgroups based on the median of Gensini score (60) which was calculated to assess the severity of CAD. Multivariable linear regression analyses were constructed to investigate the determinants of reduced LV function.ResultsCompared with normal controls, T2DM (CAD −) patients exhibited increased LV end-diastolic and end-systolic volume index and decreased LV global strains, while T2DM(CAD +) patients showed more marked increase and decrease than T2DM(CAD-) and healthy controls, except for longitudinal PDSR (PDSR-L) (all P < 0.017). All of LV global strains demonstrated a progressive decrease from normal controls, through Gensini score ≤ 60, to Gensini score > 60 group, except for PDSR-L (all P < 0.017). CAD was an independent predictor of reduced LV global circumferential PS (GCPS, β = 0.22, p < 0.001), PSSR (PSSR-C, β = 0.17, p = 0.005), PDSR (PDSR-C, β = 0.22, p < 0.001), global radial PS (GRPS, β = 0.19, p = 0.001), and global longitudinal PS (GLPS, β = 0.18, p = 0.003) in T2DM. The Gensini score was associated with decreased GCPS, PSSR-C, PDSR-C, GRPS, and GLPS in T2DM (CAD +) (all p < 0.05).ConclusionCAD has an additive deleterious effect on LV systolic and diastolic function in T2DM patients. Among T2DM (CAD +) patients, the Gensini score is associated with reduced LV contractile and diastolic function.Trial registration Retrospectively registered

High sensitivity C-reactive protein (Hs-CRP) is a sensitive marker of subclinical inflammation associated with atherosclerosis. Uncontrolled diabetes mellitus (DM) is one of the important risk factors of coronary heart disease (CHD). The aim of this study was to evaluate the association between Hs-CRP levels and both glycaemic control and CHD in Syrian type 2 diabetes mellitus (T2DM) patients. A random sample of 108 subjects was selected from T2DM and/or CHD patients seen in the National Centre for Diabetes, and the outpatient clinic of cardiology department at Tishreen University Hospital in Latakia. Four groups were formed: Group 1 [T2DM (+) CHD (-), N=29], Group 2 [T2DM (-) CHD (+), N=25], Group 3 [T2DM (+) CHD (+), N=29], and Group 4 (T2DM (-) CHD (-), N=25). Serum Hs-CRP and glycated haemoglobin (HBA1C) were determined. The SPSS 25.0 program was used for the statistical analysis. Probability (P) value less than 0.05 was considered statistically significant. Mean Hs-CRP level was higher in T2DM subjects with (5.23±1.56mg/l) or without (2.29±0.78mg/l) CHD compared to T2DM (-) CHD (-) patients (0.16±0.04mg/l), (p&lt;0.0001 for both). Mean Hs-CRP level in T2DM with CHD was not only higher than T2DM patients without CHD (p&lt;0.0001), but also than non-diabetic subjects with CHD (2.56±0.45mg/l) (p&lt;0.0001). There was a positive correlation between serum Hs-CRP and HBA1C in T2DM patients with CHD (r=0.781, P&lt;0.0001), Similarly, Hs-CRP levels were positively and significantly correlated with HBA1C in T2DM patients without CHD (r=0.800, p&lt;0.0001). We also noticed that for every 1.0% increase in HbA1c there was an 77% increase in the likelihood of having an elevated Hs-CRP. We concluded that Hs-CRP was strongly correlated with glycaemic control in T2DM patients. The highest Hs-CRP level was observed in T2DM with CHD patients. Hs-CRP could predict the incidence of coronary heart disease in T2DM patients.

Objective To compare the characteristics of food and nutrition intake in type 2 diabetes mellitus (T2DM) patients with or without carotid atherosclerosis and analyze the relationship between diets/C-reactive protein (CRP) and carotid intima-media thickness (C-IMT). Methods Sixty patients with T2DM were enrolled and divided into two groups based on C-IMT: group A (C-IMT ＜ 1 mm, n=30) and group B (C-IMT≥1 mm, n=30). All subjects were investigated with questionnaires including 3-day food recall They all took somatometric measurement. Blood and urine samples were collected in all subjects to examine the levels of high sensitive-CRP,C-peptide, blood glucose, glycosylated hemoglobin, blood lipid, renal function, urine microalbumin, and other indicators. Results The intakes of vegetables, fruits, and aquatic products were significantly higher in group A than in group B ( P ＜ 0. 05 ). The intake of vitamin C in group A was significantly higher than that in group B ( P ＜0. 05 ). The levels of CRP in group B was significant higher than that in group A (P = 0. 000). Positive correlation was found between CRP level and C-IMT in T2DM patients ( r = 0. 36, P = 0. 004). Furthermore, CRP was negatively correlated with the intakes of vegetables and fruits ( r = - 0. 334, P = 0. 01 ), aquatic products ( r = -0. 315, P = 0. 016), and vitamin C ( r = - 0. 2786, P = 0. 038 ), respectively. The intake of fruits was negatively correlated with C-IMT (r, = -0. 33, P = 0. 01 ). Conclusions T2DM patients without carotid atherosclerosis intake more vegetables, fruits, aquatic products and vitamin C than those with atherosclerosis. Vegetables, fruits,sea foods and vitamin C may be the protective factors against atherosclerosis in T2DM patients. CRP is associated with the development of atherosclerosis in T2DM patients. Key words: Diet; C-reactive protein; Type 2 diabetes mellitus; Atherosclerosis