Risk Factors For Diabetes Mellitus Research Articles

Assessment of glucocorticoid and antibiotic exposure as risk factors for diabetes mellitus in selected dog breeds attending UK primary-care clinics.

Diabetes mellitus (DM) is an important endocrine disorder in dogs. This study explored prior exposure to glucocorticoids or antibiotic treatment as risk factors for developing DM in dogs attending primary-care VetCompass clinics in the UK. A breed frequency matched case-control study nested in a cohort of dogs (n = 480,469) aged 3 years or over was used to explore associations between glucocorticoid and antibiotic exposure and the odds of developing DM. A total of 565 cases and 2179 controls were included. Dogs with DM had over four times the odds of exposure to glucocorticoids within 6 weeks prior to diagnosis (odds ratio [OR] 4.07, 95% confidence interval [CI] 2.41-6.89, p < 0.001) compared to controls within 6 weeks prior to a randomly selected quasi-date of diagnosis. Dogs that had only one unique documented antibiotic course had a decreased odds of developing DM (OR 0.65, 95% CI 0.46-0.91, p = 0.012) compared to dogs that had no documented courses of antibiotics. This study only included selected breeds, so the results may not be generalisable to all dog breeds. Exposure to glucocorticoids is associated with a substantial increase in the risk of developing DM for the dog breeds included in this analysis.

PD11-04 EFFECT OF HEALTH AND AGE ON TOTAL TESTOSTERONE: HEALTHY MEN HAVE HIGHER TESTOSTERONE REGARDLESS OF AGE

You have accessJournal of UrologyCME1 Apr 2023PD11-04 EFFECT OF HEALTH AND AGE ON TOTAL TESTOSTERONE: HEALTHY MEN HAVE HIGHER TESTOSTERONE REGARDLESS OF AGE William Shyr, Jonathan Davilla, Darius Paduch, and Great Neck William ShyrWilliam Shyr More articles by this author , Jonathan DavillaJonathan Davilla More articles by this author , Darius PaduchDarius Paduch More articles by this author , and Great NeckGreat Neck More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003251.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The arbitrary cut-off total testosterone (TT) level of 300 ng/dL is used to diagnose hypogonadism in men of all ages, although intuitively, younger men should have higher TT levels. There is growing evidence that TT level is a proxy of men’s overall health. This study aimed to analyze the effects of age, common comorbidities, and body mass index (BMI) on TT. METHODS: Data from the 2013-2016 NHANES survey were analyzed. TT was measured using liquid chromatography-mass spectrometry certified by the CDC. Only men 18-79 years old were evaluated in the study. Men taking testosterone and aromatase inhibitors were excluded. We conducted a multivariate analysis of the following risk factors for low TT: age, BMI, diabetes mellitus (DM), hypertension (HTN), hypercholesterolemia, and coronary artery disease (CAD). DM was defined as HgA1c ≥ 6.5% or diagnosis by a physician, and hypercholesterolemia as cholesterol above 240 mg/dL or diagnosis by a physician. Healthy men were defined as men with BMI <24.9 without any of the above risk factors. Linear and local polynomial regression models were used for fitting TT. The t-test was used to compare mean TT between groups. Statistical significance (SS) was set at p<0.05. RESULTS: The study consisted of 4,615 men with a median age of 46 years. Multivariate analysis showed that hypercholesterolemia (p<0.001), DM (p=0.03), and elevated BMI (p<0.001) were predictors of low TT. Neither age nor HTN was SS for TT in the multivariate analysis. With age, TT level slightly decreased, especially from 18 to 34. There were twice as many hypogonadal (TT < 300 ng/dL) men at the age of 34 than at the age of 18 (25% v 12.5%; p<0.001). The overall mean TT level for healthy men was higher at 522 ng/dL (95%CI: 506-538) than unhealthy men at 390 ng/dL (95%CI: 382-398) (p<0.001) (Figure 1). Mean values of TT in both healthy men and men with comorbidities are higher than the cutoff value of 300 ng/dL. CONCLUSIONS: Obesity, even being overweight, and poor cardiovascular health, but not age, are strongly associated with lower TT. Healthy men, regardless of age, typically have TT levels above 500 ng/dL. Our study suggests that weight loss, controlling DM and cardiovascular risk factors likely increase TT, and such interventions should be discussed with patients in addition to testosterone therapy. Source of Funding: Fracchia Research Scholarship © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e333 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information William Shyr More articles by this author Jonathan Davilla More articles by this author Darius Paduch More articles by this author Great Neck More articles by this author Expand All Advertisement PDF downloadLoading ...

PROGNOSTIC IMPLICATION OF HIGH SENSITIVITY C-REACTIVE PROTEIN IN ACUTE CORONARY SYNDROME PATIENTS

Aim: An observational cross sectional study for assessing the levels of High sensitivity creactive protein in patients with acute coronary syndrome and study its prognostic implication. Methods: All the patients presenting with clinical,ECG and 2D – echocardiographic evidence of acute myocardial infarction admitted in department of medicine. Results: A study of 48 patients with acute coronary syndrome of both sex were taken as sample.36 patients were diagnosed as ST elevation MI(STEMI) and 12 patients were diagnosed as Non-ST elevation MI(NSTEMI).Out of 36 STEMI patients,20 patients were male and 16 were female.Out of 12 NSTEMI patients,6 were male and 6 were female.Among male patients with STEMI ,85% had risk factor of smoking,alcohol,diabetes mellitus or systemic hypertension,whereas in females it was 81%.Among NSTEMI males had risk of 83% and females it was 60%.In patients with STEMI,8% had normal EF,25% had Moderate EF and 50% had low EF.The correlation between the prognosis and values of HS-CRP of patients with extensive AWMI is found to be statistically significant.(ppatients with extensive AWMI is found to be statistically significant.(p&lt;0.05). Conclusion: The levels of HS-CRP correlate with several cardiovascular risk factors such as smoking,diabetes mellitus and hypertension.Elevated levels of hs-CRP is related to the presence of plaque rupture ,which provokes acute coronary syndrome.Therefore, in a resource limited country like India, evaluation of hs-CRP would be considered as the best modality over optical coherence tomography and intravascular ultrasound.This suggests that the assessment of HS-CRP levels may enable the physician in detecting the prognosis of acute coronary syndrome patients,plan effective reperfusion therapy and also assess long term complications.

Unmasking a silent killer: Prevalence of diagnosed and undiagnosed Diabetes Mellitus among people living with HIV in rural South Africa.

To document the prevalence of Impaired Glucose Tolerance (IGT) and undiagnosed Diabetes Mellitus (DM) and to identify factors associated with undiagnosed DM in People Living With HIV (PLWH). Cross-sectional study performed at Ndlovu Medical Center, Limpopo, South Africa including PLWH aged ≥18 years. Between August and November 2017, 356 HIV-positive participants were included. Information was collected on socio-demographics, DM symptoms and risk factors for DM. IGT and DM were diagnosed using random plasma glucose and/or HbA1c. Factors associated with undiagnosed DM were assessed by comparing participants with newly diagnosed DM to participants without DM. IGT was diagnosed in 172 (48.3%) participants. Twenty-nine (8.1%) participants met the definition of DM, of whom 17 (58.6%) were newly diagnosed. Compared to participants without DM, participants with DM were on average five years older, were more likely to have a positive family history for DM, were less physically active and had higher systolic blood pressure, body mass index and waist circumference. Factors associated with undiagnosed DM included age ≥45 years (OR=3.59) and physical inactivity (OR=3.17). The prevalence of IGT and DM among PLWH is high and more than half of DM cases were undiagnosed. Regular screening for DM in PLWH is recommended, especially in an aging population with additional cardiovascular disease risk factors. This article is protected by copyright. All rights reserved.

Feeding Habits, Nutritional Condition, Fecal Intestinal Metabolites, and Risk of Developing Diabetes Mellitus II in the Mexican Population: A Cross-Sectional Study

Early identification of type 2 diabetes mellitus (T2DM) risk factors prevents its consequences. Fecal volatile organic compounds (FVOCs) can serve as disease biomarkers. The objective was to compare nutritional condition, feeding habits, and FVOCs into low-risk and high-risk (HR) T2DM developed in the Mexican population. A cross-sectional study was conducted in healthy adult volunteers between 18 and 59 years of age from Tepic, Nayarit, México. The FVOCs p-cresol and acetic, propionic, butyric, and valeric acids were evaluated. The values of body mass index (BMI), body fat, visceral fat index, metabolic age, and basal metabolic rate were higher in the HR group. In addition, high total calorie intakes and high macronutrient calorie intakes were found in the HR group. Both groups showed the same values for the evaluated FVOCs. Through principal component analysis, it was found that when BMI, metabolic age, weight, and visceral fat index increase, adults will be more likely to be at high risk for developing T2DM.

Investigation of risk factors associated with impaired glucose regulation: Using the momentum equation to assess the impact of risk factors on community residents.

To identify risk factors for impaired glucose regulation (IGR) and assess their impact on community residents, this study used a questionnaire to conduct cross-sectional surveys and analysis. Overall, 774 residents of an urban community in northern China (Jian city) participated in this study. Trained investigators conducted surveys using questionnaires. Based on their medical history, respondents were divided into three glucose status groups as follows: normal (NGT), IGR, and diabetes mellitus (DM). Statistical analysis of survey data was performed using SPSS v. 22.0. Age, hypertension, family history of diabetes (FHD), dyslipidemia, obesity, and cardiovascular and cerebral disease (CVD) were positively correlated with IGR in men and women. IGR was negatively correlated with a sedentary lifestyle in men and positively correlated with being overweight in women. The number of type 2 diabetes mellitus (T2D) risk factors per subject was positively correlated with age in the NGT group. Glucose status deteriorated with increasing age and the number of risk factors. FHD was the strongest risk factor in both men and women. Prevention of IGR includes weight control, physical activity, and prevention of hypertension and dyslipidemia, especially in subjects with FHD.

Correlation of asprosin and Nrg-4 with type 2 diabetes Mellitus Complicated with Coronary Heart Disease and the Diagnostic Value

PurposeAsprosin is a newly discovered adipose factor secreted by white fat, which is involved in glucose metabolism and inflammation. Neuregulin-4 (Nrg-4) is a new adipose factor released from brown adipose tissue and is considered to play an important role in metabolism. This study aims to explore the association between serum Asprosin, Nrg-4 level and coronary heart disease(CHD) in patients with type 2 diabetes mellitus(T2DM) and the diagnostic value.Patients and methods157 patients with T2DM were enrolled from Affiliated Hospital of Chengde Medical University between December 2020 to July 2021. These patients were divided into T2DM without CHD group (T2DM-0, n = 80) and T2DM with CHD (T2DM-CHD, n = 77). Serum Asprosin and Nrg-4 expression was detected by enzyme-linked immunosorbent assay, and the correlations between Asprosin or Nrg-4 and clinical and biochemical indicators were analyzed. A receiver operating characteristics curve analysis and area under the curve (AUC) were used to evaluate diagnostic accuracy.ResultsSerum Asprosin level of the T2DM-CHD group were significantly higher and Nrg-4 level significantly lower than those of the T2DM-0 group.Spearman correlation analysis showed that serum Asprosin levels were significantly positively correlated with diabetes course,history of hypertension, fasting plasma glucose(FPG), glycosylated hemoglobin A1c(HbA1C), triglycerides(TG),triglyceride glucose index(TyG index) and urea, and negatively correlated with ALT (all p < 0.05). Nrg-4 was negatively correlated with history of hypertension, body mass index(BMI), FPG, HbA1C, TG, and TyG indexes (all p < 0.05), and positively correlated with high-density lipoprotein cholesterol(HDL-C)(p < 0.05).Logistic regression analysis showed that after adjusting potential confounders, Asprosin was a risk factor for diabetes mellitus, Nrg-4 was a protective factor.The AUC of Asprosin for diagnosing T2DM-CHD was 0.671 (95% confidence interval [CI] 0.584–0.759), and the AUC of the Nrg4 index for diagnosing T2DM-CHD was 0.772 (95% CI 0.700-0.844). The AUC of Asprosin and Nrg-4 for the combined diagnosis of T2DM-CHD was 0.796 (95% CI 0.726–0.864).ConclusionAsprosin and Nrg-4 may be novel diagnostic biomarkers for T2DM with CHD, as they effectively improved the diagnostic accuracy for T2DM-CHD.

The Prevalence and Associated Predictors for Diabetes Mellitus in Adult Patients With Thyroid Nodules.

Diabetes mellitus (DM) and thyroid nodules (TNs) with the risk of malignancy are increasing globally. Hence, we conducted this study to evaluate the prevalence and the associated predictors for DM among adult patients with TNs in Royal Commission Hospital, Kingdom of Saudi Arabia (KSA). A retrospective study was conducted between January 1, 2015 and December 31, 2021. Patients with documented TNs based on the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) were recruited. Then the prevalence and associated risk factors for DM were assessed. Three hundred ninety-one patients who had TNs were recruited. The median (interquartile range (IQR)) age was 46.00 (20.0) years, and 332 (84.9%) of the patients were females. There was a high prevalence of DM (24.0%) among adult patients with TNs. In the univariate analysis, there were significant associations between diagnosed DM among adult patients with TNs and age, gender, 25-hydroxyvitamin D (25(OH)D) level, hypertension, bronchial asthma, free triiodothyronine (FT3), white blood cell count, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides. In the multivariate analysis, there were significant associations between diagnosed DM among adult patients with TNs and age (odds ratio (OR) 1.037 (95% confidence interval (CI) 1.012 - 1.062)), hypertension (OR 0.374 (95% CI 0.203 - 0.689)), FT3 level (OR 0.635 (95% CI 0.412 - 0.980)), LDL (OR 0.643 (95% CI 0.456 - 0.907)) and HDL (OR 0.654 (95% CI 0.465 - 0.919)). There was a high prevalence of DM among patients with TNs. Age, hypertension, FT3, LDL and HDL were significantly associated with DM and TNs.

Abstract 68: Interleukin-6, Diabetes and Metabolic Syndrome in a Biracial Cohort: The Reasons for Geographic and Racial Differences in Stroke (REGARDS)

Background: Type 2 diabetes mellitus (DM) is more common in Black than White adults in the US. The inflammatory cytokine interleukin-6 (IL-6) is implicated in DM pathogenesis and circulates at higher levels in Black people. Metabolic syndrome (MetS), a group of conditions related to insulin resistance, often precedes or coexists with DM. Little evidence is available on associations of IL-6 with these disorders in Black people. Methods: REGARDS enrolled 30,239 Black and White adults in 2003-07 and conducted a follow up visit 9.5 years later. Baseline IL-6 was measured in a sample of 4,400 participants (equal by race/sex groups) attending both visits. Modified Poisson regression estimated relative risk (RR) by level of baseline IL-6 for incident DM among those without prevalent DM; similar analyses were conducted for MetS. Inverse odds weighting estimated the percent mediation of the racial disparity in incident DM by IL-6. Results: Incident DM occurred in 460/3,399 (14%) at risk, and there were 384/1,957 (20%) cases of incident MetS. As shown in the Figure , DM and MetS incidence increased across baseline IL-6 quartiles overall, with a steeper rise and higher incidence among Black than White adults. Adjusting for confounders, the RR of DM for IL-6 in the 4 th vs 1 st quartile was 1.91 (95% CI 1.38-2.65). Higher IL-6 was also associated with MetS (RR 1.65 (95% CI 1.22-2.22)). In adjusted models there were no material differences in these associations by race. The RR of DM in Black compared with White people was 1.90 (95% CI 1.59-2.27); there was no association of race with MetS. IL-6 significantly mediated 13.4% of the racial disparity in DM adjusting for demographic factors. Conclusions: Higher IL-6 is a risk factor for incident DM and MetS in Black and White adults. The race disparity in DM was partly mediated by IL-6. Interventions to reduce IL-6 may lower risk of DM and MetS and lessen the racial disparity in DM. Figure: Diabetes and Metabolic Syndrome Incidence (bars) and Relative Risk (95% CI) by Baseline IL-6 Quartile

Prevalence of and factors associated with diabetes mellitus among people living with HIV in Vietnam.

Studies have shown that people living with HIV (PLWH) have a higher risk of having non-communicable diseases (NCDs) than do people without HIV. In Vietnam, HIV remains a major public health concern, and with recent rapid economic growth, NCDs such as diabetes mellitus (DM) have become a significant disease burden. This cross-sectional study was conducted to examine the prevalence of DM and the factors associated with DM among PLWH on antiretroviral therapy (ART). In total, 1,212 PLWH were included in the study. The age-standardized prevalence of DM and pre-diabetes were 9.29% and 10.32%, respectively. In the multivariate logistic regression analysis, male sex, age above 50 years, and body mass index ≥ 25 kg/m2 were associated with DM, and borderline p-value was found for associations with current smoking and years on ART. The results suggest higher DM prevalence among PLWH and that longer time on ART could be an important risk factor for DM among PLWH. These findings also suggest that interventions such as weight control and smoking cessation support could be provided at outpatient clinics. Integration of HIV/AIDS and NCDs services is essential to address health needs comprehensively and enhance health-related quality of life for PLWH.

Dyslipidemia Treatment and Lipid Control in US Adults with Diabetes by Sociodemographic and Cardiovascular Risk Groups in the NIH Precision Medicine Initiative All of Us Research Program.

Real-world data on lipid levels and treatment among adults with diabetes mellitus (DM) are relatively limited. We studied lipid levels and treatment status in patients with DM across cardiovascular disease (CVD) risk groups and sociodemographic factors. In the All of Us Research Program, we categorized DM as (1) moderate risk (≤1 CVD risk factor), (2) high risk (≥2 CVD risk factors), and (3) DM with atherosclerotic CVD (ASCVD). We examined the use of statin and non-statin therapy as well as LDL-C and triglyceride levels. We studied 81,332 participants with DM, which included 22.3% non-Hispanic Black and 17.2% Hispanic. A total of 31.1% had ≤1 DM risk factor, 30.3% had ≥2 DM risk factors, and 38.6% of participants had DM with ASCVD. Only 18.2% of those with DM and ASCVD were on high-intensity statins. Overall, 5.1% were using ezetimibe and 0.6% PCSK9 inhibitors. Among those with DM and ASCVD, only 21.1% had LDL-C < 70 mg/dL. Overall, 1.9% of participants with triglycerides ≥ 150 mg/dL were on icosapent ethyl. Those with DM and ASCVD were more likely to be on high-intensity statins, ezetimibe, and icosapent ethyl. Guideline-recommended use of high-intensity statins and non-statin therapy among our higher risk DM patients is lacking, with LDL-C inadequately controlled.

The first experience of using a comprehensive detailed ultrasound examination of the foot in patients with diabetes mellitus

IntroductionAssessment of amputation risk has been discussed more than once in the management of patients with diabetes. Systemic inflammatory symptoms can serve as signs of an infectious process. However, not all patients show exhibit these symptoms in a timely manner. At the same time, a decrease in pain, tactile and temperature sensitivity fails as a part of the main assessment of risk factors in diabetes mellitus. MethodsUsing examination methods and comparing with clinical experience and the results of other researchers, a pilot study was carried out to diagnose structural changes in the foot in patients with diabetes. Nested examinations were carried out in several stages, on the expert class medical ultrasonographic apparatus Siemens Acuson NX3. The methods of ultrasound diagnostics in the diabetic foot can be significantly helpful when using a scale of criteria and guidelines for the examination. ConclusionThe main diagnostic criterion for determining the risks of developing a diabetic foot condition, could be a gradual transition from the phase of compaction of hyaline cartilage to the phase of synovitis, and then to the phase of development of bone tissue necrosis related to a part of the Charcot’s foot. It leads to disruption of the musculoskeletal system of the foot, and atherosclerotic plaques and stenosis of the dorsalis pedis artery and first toe, which form a deterioration in the nutrition of the soft tissues of the foot with their necrosis.

Association among Cases of Women with first degree Family History of Diabetes Mellitus, Previous Macrosomia and Preterm Births, and Pregnancy Weight Gain at Mama Lucy Kibaki Hospital, Nairobi City

Background: Weight gain during pregnancy is of great concern for most women and obstetricians because of its possible consequences. This concern exists because gestational weight gain that exceeds what is recommended by the Institute of Medicine is associated with many maternal and fetal complications. While excessive gestational weight gain (GWG) is associated with modifiable risk factors for Gestational Diabetes Mellitus (GDM) notably, obesity and overweight conditions, there is a paucity of information on the association of cases of excessive GWG with non-modifiable risk factors (NMRF) for GDM namely history of diabetes mellitus in the first-degree family members as well as previous macrosomia and preterm deliveries. Method: The study prospectively monitored GWG in 337 women with a history of diabetes mellitus in first-degree family members as well as previous macrosomia and preterm deliveries. Data collected was analysed through bivariate regression to determine the odds of excessive GWG in the presence and absence of each of the three non-modifiable risk factors. Results: The non-modifiable risk factors of women of all BMIs were not found to be significantly associated with excessive GWG. For instance, a family history of DM in obese women was not associated with excessive GWG (P = 0.254; AOR = 0.715; 95%CI: 0.401-1.272). History of macrosomia in obese women was also not statistically significant (P = 0.973; AOR = 1.015; 95% CI: 0.429-2.402). Similarly, history of preterm births in obese women was not significantly associated with excessive GWG (P = 0.778; AOR = 0.902; 95%CI: 0.441-1.847). Conclusion: History of macrosomia and preterm births as well as family history of Diabetes mellitus cannot serve as predictors for excessive GWG because there is no association among them and excessive GWG by women of all BMIs

Gaining metabolic insight in older men undergoing androgen deprivation therapy for prostate cancer (the ADT & Metabolism Study): Protocol of a longitudinal, observational, cohort study.

Androgen deprivation therapy (ADT), a cornerstone of treatment for patients with locally advanced and metastatic prostate cancer, is associated with many adverse effects, including osteoporosis, sexual dysfunction, fatigue, and vasomotor symptoms. It is also associated with loss of muscle mass and increased adiposity. This change in body composition is likely the inciting event in the development of insulin resistance, an independent risk factor for diabetes mellitus and cardiovascular disease. Although the occurrence of insulin resistance during ADT has been reported, it remains unclear whether this insulin resistance is primarily hepatic or muscular. Similarly, the mechanisms that lead to insulin resistance also remain unknown. The ADT & Metabolism Study was designed to address these knowledge gaps, as the elucidation of the predominant site of insulin resistance will allow prevention strategies and the use of targeted, tissue-specific insulin-sensitizing agents in patients undergoing ADT. This prospective, mechanistic, single-center, 24-week, observational cohort study will enroll treatment-naïve adult men with prostate cancer about to undergo surgical or medical ADT for at least 24 weeks (ADT group; n = 50) and a control group of men who had undergone radical prostatectomy and are in remission (non-ADT group, n = 25). The primary outcome is to determine the site of insulin resistance (skeletal muscle or liver) using frequent sampling oral glucose tolerance test at baseline and 12 and 24 weeks after commencement of ADT (ADT group) or after enrollment in the study (non-ADT group). Secondary outcomes will assess changes in hepatic and intramyocellular fat (using magnetic resonance spectroscopy), inflammatory markers, adipokines, free fatty acids, and changes in body composition (assessed using dual-energy x-ray absorptiometry) and their correlation with the development of insulin resistance. Exploratory outcomes will include changes in muscle performance, physical function, physical activity, vitality, and sexual drive.

The relationship between the two endocrine pathologies: subclinical gestational hypothyroidism and gestational diabetes mellitus

BACKGROUND: Over the past decade, gestational diabetes mellitus has become of increasing medical and social importance. It happens due to its increased prevalence and due to its negative impact on pregnancy and long-term metabolic disorders in the mother and fetus.&#x0D; AIM: The aim of this study was to assess the relationship between subclinical gestational hypothyroidism and gestational diabetes mellitus, the two most common endocrine pathologies in pregnancy.&#x0D; MATERIALS AND METHODS: We studied 200 medical records of pregnant women. The main group included 133 patients with subclinical gestational hypothyroidism, and the control group consisted of 67 women without endocrine pathology. The diagnosis of gestational diabetes mellitus was made based on the Ministry of Health of the Russian Federation clinical guidelines criteria. The diagnosis of subclinical hypothyroidism was made based on the thyroid-stimulating hormone level above 2.5 IU/ml in combination with an increased titer of antithyroid antibodies or above 4.0 IU/ml in the absence of any thyroid disorder. Statistical analysis was carried out using the StatTech v.2.1.0 program (Stattech Ltd, Russia).&#x0D; RESULTS: The prevalence of hypothyroidism was higher among women with family history of diabetes mellitus. The chances of developing gestational diabetes mellitus increased by 9.706 times in the presence of hypothyroidism, by 1.077 times with an increase in age by one full year at the time of seeing the doctor, and by 1.023 times with an increase in weight before pregnancy by one kilogram. The thyroid-stimulating hormone level of more than 2.7 IU/ml predicted the development of gestational diabetes mellitus with a sensitivity of 71.4% and a specificity of 63.1%.&#x0D; CONCLUSIONS: Subclinical gestational hypothyroidism and gestational diabetes mellitus are interrelated endocrine disorders with common pathophysiological predictors. Among women with a normal body mass index, subclinical gestational hypothyroidism is a more significant risk factor for gestational diabetes mellitus than an increase in age or body weight. A certain threshold level of thyroid-stimulating hormone (more than 2.7 IU/ml) in the first trimester increases the chances of developing gestational diabetes mellitus and should be considered as a signal for timely prevention and detection of gestational diabetes mellitus.

Serum Ferritin Levels and Other Associated Parameters with Diabetes Mellitus in Adult Patients Suffering from Beta Thalassemia Major.

Although beta thalassemia major (BTM) patients are properly treated with blood transfusions in accompany with iron chelation therapy, they suffer from complications, such as diabetes mellitus (DM). The purpose was to detect the critical serum ferritin level and other parameters correlated with DM among adult BTM patients. Also, it was to study whether each of these parameters is associated with a certain period of age. This study included 200 adult BTM patients. A cross-sectional study was carried out. Patients clinical and laboratory variables, such as ferritin levels, and fasting blood glucose (FBS) were extracted from medical records at Zagazig University Hospital, Egypt. Liver and cardiac iron contents were assessed using MRI T2* methods. Statistical analysis was performed using IBM SPSS V26.0 software package. The overall frequency of DM over the total sample equals 6.5%. There were no impaired fasting glucose (IFG) in the medical records. Statistical significance between serum ferritin and DM was (P = 0.014). The serum ferritin 2500 ng/mL with age group (27-<32) years-old were risk factors. The distributions of DM according to BMI were (3.5%) of class overweight. Significant association between DM and BMI was (r = 0.357, P < 0.001). Liver MRI T2* has significant correlation with serum ferritin, but cardiac MRI T2* was poorly correlated. Association between liver and cardiac MRI T2* was not found. Age group (27-<32) years-old and ferritin >2500 ng/mL should be properly treated immediately. The serum ferritin and BMI of class "overweight" were risk factors for DM. Factors such as diet should be followed. Serum ferritin can be used for estimating liver iron content for economic factors. But cardiac MRI T2* must be performed for evaluating cardiac iron accurately.

From cause to consequence: Insights into incident diabetes mellitus after hepatic steatosis

From cause to consequence: Insights into incident diabetes mellitus after hepatic steatosis

Research progress on risk factors of post-pancreatitis diabetes mellitus after acute pancreatitis

胰腺炎后糖尿病（PPDM）常于胰腺急性或慢性炎症后发生，这是一种典型的继发性糖尿病，其中急性胰腺炎后糖尿病（PPDM-A）是主要疾病之一。急性胰腺炎（AP）时胰腺局部炎症反应，严重损伤散布在胰腺组织中的胰岛α细胞、β细胞，使胰高血糖素分泌增加和胰岛素分泌减少，最终引起机体血糖升高。PPDM-A血糖控制差，使用胰岛素较早，胰腺导管腺癌发病率高，病死率高。识别危险因素对早期有效预防PPDM-A具有重要的临床意义，目前应激性高血糖，慢性持续低度炎症，脂质代谢障碍，胰腺细胞坏死和损伤被认为是PPDM-A的危险因素，因此本文围绕以上几个方面进行论述。.

Cardiovascular Outcomes according to Comorbidities and Low-Density Lipoprotein Cholesterol in Korean People with Type 2 Diabetes Mellitus.

There are no clear data to support the cardiovascular (CV) risk categories and low-density lipoprotein cholesterol (LDL-C) treatment goals in Korean people with type 2 diabetes mellitus (T2DM). We evaluated the incidence of cardiovascular disease (CVD) according to comorbidities and suggested LDL-C treatment goals in Korean people with T2DM in nationwide cohort data. Using the Korean National Health Insurance Service database, 248,002 people aged 30 to 90 years with T2DM who underwent routine health check-ups during 2009 were included. Subjects with previous CVD were excluded from the study. The primary outcome was incident CVD, defined as a composite of myocardial infarction and ischemic stroke during the follow-up period from 2009 to 2018. The mean age of the study participants was 59.6±10.9 years, and median follow-up period was 9.3 years. CVD incidence increased in the order of DM duration of 5 years or more (12.04/1,000 person-years), hypertension (HT) (12.27/1,000 personyears), three or more CV risk factors (14.10/1,000 person-years), and chronic kidney disease (18.28/1,000 person-years). The risk of incident CVD increased linearly from an LDL-C level of ≥70 mg/dL in most patients with T2DM. In T2DM patients without HT or with a DM duration of less than 5 years, the CVD incidence increased from LDL-C level of ≥100 mg/dL. For primary prevention of CVD in Korean adults with T2DM, it can be helpful to lower LDL-C targets when there are chronic kidney disease, HT, a long duration of diabetes mellitus, or three or more CV risk factors.

HYPERLIPIDEMIA IS A DOMINANT RISK FACTOR FOR CORONARY HEART DISEASE

Background: Coronary heart disease (CHD) is a major health problem in developed and developing countries. Until now, the death rate due to CHD is the highest in the world. Its risk factors include major modifiable risk factors, such as hyperlipidemia, hypertension, diabetes mellitus, obesity, smoking, and non-modifiable risk factors. Purpose: This study aimed to determine the major risk factors for the incidence of CHD. Methods: This study employed an unmatched case-control design, with a total sample of 43 cases and 86 controls recruited by a purposive sampling technique. Case samples were CHD patients diagnosed by a cardiologist and control samples were non-CHD patients who visited the cardiac polyclinic, with similar variables of age, sex, and residence. The samples were taken at the integrated heart center of Sanglah Hospital, Denpasar, based on the patient medical records. Data analysis was performed using the Chi-square test and logistic regression. Results: The results showed three risk factors that statistically and significantly increased the incidence of CHD, namely history of total cholesterol of ≥240mg/dl with adjusted OR=4.64 (95% CI: 1.60-13.49), type-2 diabetes mellitus with adjusted OR=2.85 (95% CI: 1.16-6.99), and smoking with adjusted OR=2.54 (95% CI: 1.01-6.46). Conclusion: The history of high total cholesterol is statistically the most dominant risk factor for the incidence of CHD.