Value Of Fasting Blood Glucose Research Articles

Effect and Predictive Value of Blood HbA1c, FBG, 2hPBG, and FINS on the Pregnancy Outcome in Patients with Gestational Diabetes Mellitus.

This study aimed to investigate the effects of hemoglobin A1c (HbA1c), fasting blood glucose (FBG), 2-hours postprandial blood glucose (2hPBG), and fasting insulin (FINS) levels on pregnancy outcomes and their predictive value in patients with gestational diabetes mellitus (GDM). A total of 109 pregnant women with GDM (GDM group) were included and assayed for serum FBG, 2hPBG, HbA1c, and FINS levels. The incidence of adverse pregnancy outcomes was recorded. GDM patients were divided into the poor pregnancy outcome group and the favorable pregnancy outcome group and analyzed for HbA1c, FBG, 2hPBG, and FINS. The predictive value of serum index combined detection on GDM pregnancy outcome was assessed, and the effect of serum indices on pregnancy outcome was evaluated in GDM patients with logistic regression. In the GDM group, there were 8 cases of premature membranes breaking (7.34%), 6 cases of premature delivery (5.50%), 3 cases of hyperamniotic fluid (2.75%), 2 cases of neonatal asphyxia (1.83%), 5 cases of fetal growth restriction (4.59%), and 3 cases of low-birth-weight infants (2.75%). The total incidence of adverse preg-nancy outcomes was 24.77% (27/109). HbA1c, FBG, 2hPBG, and FINS in the poor pregnancy outcome group were higher than those in the favorable pregnancy outcome group. The AUC value of blood biochemical indicators combined detection in predicting pregnancy outcome in GDM patients was higher than of HbA1c, FBG, 2hPBG, and FINS alone detection. HbA1c ≥ 6.94%, FBG ≥ 7.18 mmol/L, 2hPBG ≥ 9.36 mmol/L, and FINS ≥ 13.07 U/L were the risk factors affecting pregnancy outcomes in GDM patients. The changes of HbA1c, FBG, 2hPBG, and FINS levels in GDM patients are associated with adverse pregnancy outcomes, and the combined detection of serum indicators has predictive value for pregnancy outcomes in GDM patients.

Impact of SGLT-2 inhibitors on modifiable cardiovascular risk factors in Romanian patients with type 2 diabetes mellitus.

Modifiable cardiovascular risk factors are high blood pressure, smoking, diabetes, sedentary lifestyle, obesity, and hypercholesterolemia. To investigate the impact of sodium-glucose 2 co-transporter inhibitors (SGLT-2i) on modifiable cardiovascular risk factors in Romanian patients diagnosed with type 2 diabetes mellitus (T2DM). A retrospective study was conducted on 200 Romanian patients with T2DM who were being treated with SGLT-2i, either Dapagliflozin or Empagliflozin. Collected data included demographic characteristics, such as weight, body mass index (BMI), fasting blood glucose (FBG), creatinine, glycated hemoglobin (HbA1c), abdominal circumference (AC), urine albumin-to-creatinine ratio (UACR), systolic blood pressure (SBP), diastolic blood pressure (DBP), C-reactive protein (CRP) and N-terminal pro b-type natriuretic peptide (NT-proBNP). The patients were observed for one year after being treated with SGLT-2i. The mean value of FBG decreased from 180.00mg% (IQR: 154.50-207.00) to 130.00mg% (IQR: 117.50-150.00) (p < 0.001), and the mean of HbA1c values decreased from 8.40% (IQR: 7.98-9.15%) to 7.30% (IQR: 6.90-7.95%) (p < 0.001). We also obtained significant positive effects on body weight, i.e., the weight decreased from 90.50kg (82.00-106.50) to 89.00kg (77.50-100.00) (p = 0.018), BMI from 32.87kg/m2 (29.24-36.45) to 31.00kg/m2 (27.74-34.71) (p < 0.001) and AC from 107.05 (± 16.39) to 102.50 (± 15.11) (p = 0.042). The UACR decreased from 23.98mg/g (19.76-36.85) to 19.39mg/g (1.30-24.29) (p < 0.001). Initially, the median value for SBP was 140.00mmgHg (130.00-160.00), and for DBP was 80.00 mmgHg (72.00-90.00), and one year after treatment, the medium value was 120.00 mmgHg (115.50-130.00) for SBP (p < 0.001), and 72.00 mmgHg (70.00-78.00) for DBP (p < 0.001) The mean CRP values decreased from 68.00mg/dL (56.25-80.25) to 34.00mg/dL (28.12-40.12) (p < 0.001), and the mean NT-proBNP decreased from 146.00pg/mL (122.50-170.50) to 136.00 pg/mL (112.50-160.50) (p = 0.005). Treatment with SGLT-2i in Romanian patients with T2DM has beneficial effects on modifiable cardiovascular risk factors.

Biochemical profile of patients in ketosis-prone diabetes state in Côte d’Ivoire

: Diabetes keto-acidosis is the most serious hyperglycemic emergency in patients with diabetes. DKA has long been considered a key clinical feature of T1D. In this study, we assessed biochemical disorders focused on lipid and renal parameters in KPD.: We carried out a case-controls study for one year, encompassing 200 participants in total. Patients were outpatients newly diagnosed diabetics attending for the first time hospitals, controls were no-ketosis participants. Blood samples were taken, after 10 to 12 hours of fasting from the day before, in different tubes for each intended analyses according to instructor’s recommendation. The increased mean value of fasting blood glucose together with HbA1c are corrolated with ketonuria. As regard to cardio-metabolic risk, ketosis-prone patients were at greater risk than no-ketosis controls The mean AIP value was higher in KPD women than in men, with no significant statistical correlation. Uremia and creatininemia, two kidney parameters commonly prescribed to explore glomerular filtration, were correlated with some social indicators. The mean values of these both parameters increased significantly with age in KPD group. Creatinine increased significantly with age in patients, in line with glomerular filtration rate (GFR). The older the participants, the higher the mean values of these parameters. : These biochemical parameters, high atherogenic index and lower glomerular filtration rate, documented in our study, must be sought out when inaugural ketosis is suspected for improving the clinical prognosis of patients in the initial step of management.

Correlation of Fructosamine and HbA1c (Glycosylated Haemoglobin) in Type 2 Diabetes Mellitus Patients with Chronic Kidney Disease

Background: In 2015, India had 69.2 million diabetes and 36.5 million impaired Glucose Tolerance (IGT) people (20-79yrs) which are expected to rise to 123.5 million and 63.6 million by 2040 respectively. Therefore need for assessing correct glycemic status of patients of Diabetes Mellitus as well as Diabetes Mellitus patients with CKD at correct time becomes necessary. Use of Fructosamine for the analysis of blood glucose levels might give better, comparatively fast results in these patients. Aims: The purpose of this study was to find out the correlation between Fasting Blood sugar, Fructosamine and HbA1c( Glycosylated haemoglobin) in patients of Type 2 Diabetes Mellitus with and without kidney disease Method: A total of 100 patients were taken and divided into 2 groups: Group A (n=50) – Patients with Diabetes Mellitus and Group B (n=50)- Patients with Diabetes Mellitus and Chronic Kidney Disease. 50 healthy controls (without DM and CKD) were taken. Result: Mean value of Fasting blood glucose in Group A – 186mg/dL SD- 52.2; Group B-182mg/dL, SD - 49.4. (t=0.781, p=0.437).The patients with DM and CKD (Group B) had lower levels of mean HbA1c (6.93%) as compared to Group A (DM), mean HbA1c -8.4%.There was significant difference between the groups (t=5.396, p&lt;0.001). The mean of Fructosamine in Group A-439, SD-127 , Group B-421,SD-112.(t=0.757,p=0.451).Our study also showed that in different stages of CKD ,there was no statistical difference between Fructosamine and HbA1c (HbA1c Vs GFR: r= - 0, 038, p=0.817, Fructosamine Vs GFR :r= -0.057, p=0.726). Conclusion: Serum Fructosamine is superior to HbA1c in assessing blood glucose control in Diabetes Mellitus patients with CKD.

Fasting blood glucose as a predictor of progressive infarction in men with acute ischemic stroke

ObjectiveBlood glucose is related to early neurological deterioration in acute ischemic stroke, but multiple mechanisms are involved in early neurological deterioration, such as progressive infarction. This study aimed to determine whether fasting blood glucose (FBG) is an independent predictor of progressive infarction.MethodsFrom April 2017 to December 2020, we retrospectively enrolled 477 patients with acute ischemic stroke within 48 hours of onset. Demographic characteristics, clinical information, neuroimaging characteristics, and laboratory data were collected after admission.ResultsWe found that 147 (30.8%) patients had progressive infarction. Multiple regression analysis showed that high FBG concentrations (>7.66 mmol/L) were independently associated with progressive infarction. Sex subgroup analysis showed that high FBG concentrations were an independent predictor of progressive infarction in male patients (odds ratio, 2.559; 95% confidence interval, 1.279–5.121). In a receiver operating characteristic curve analysis, FBG concentrations were a predictor of progressive infarction in all cases, especially in male patients. The cutoff value of FBG in all patients and men was 7.155 mmol/L.ConclusionsFBG is an independent predictor of progressive infarction in patients with acute ischemic stroke within 48 hours of onset, especially in men. Patients with FBG concentrations ≥7.155 mmol/L are more likely to develop progressive infarction.

Metabolic syndrome prevalence and patterns among rural women: a community-based study in Cilongok, Central Java, Indonesia

MetS (MetS) is a predictor of cardiovascular disease and type 2 Diabetes mellitus. The prevalence of MetS increases not only in the urban area but also in the rural area. Women have a greater risk of MetS than men in some studies. This study was purposed to describe MetS prevalence and pattern of rural area women in the Integrated Development Post of Non-communicable Disease (Posbindu PTM) in Cilongok Rural Area. A population-based cross-sectional study was conducted in Cilongok, Banyumas rural area of Central Java among 63 rural women. Data were collected by interviews; measurement of fasting blood glucose, high-density lipoprotein, and triacylglycerol; measurement of blood pressure and abdominal circumference. Food consumption data were collected by multiply 24-hours food recalls. MetS were categorized by NCEP ATP III 2001 criteria. The prevalence of MetS in rural area women was 31.75%. Age was associated with MetS (p-value 0.038 ;95% CI : 0.983-23.63). Women with MetS have significant differences with women without MetS in the value of fasting blood glucose, high-density lipoprotein, triacylglycerol, blood pressure, and abdominal circumference (p-value &lt;0.05). About 95% of MetS women have a high waist circumference and 80% have a low high-density lipoprotein. MetS women consumed higher energy than women without MetS (p-value &lt;0.05). Conclusion: Prevalence of MetS in Cilongok rural area women was high. High in fasting blood glucose, high-density lipoprotein, triacylglycerol, blood pressure, and abdominal circumference were found to be a predictor of MetS. High energy consumption becomes a risk factor for MetS.&#x0D; &#x0D;

Metformin Downregulates the Expression of Epidermal Growth Factor Receptor Independent of Lowering Blood Glucose in Oral Squamous Cell Carcinoma.

PurposeType 2 diabetes mellitus (T2DM) is among the risk factors for the occurrence and development of cancer. Metformin is a potential anticancer drug. Epidermal growth factor receptor (EGFR) plays an important role in the progression of oral squamous cell carcinoma(OSCC), but the relationship between metformin and EGFR expression in OSCC remains unclear.MethodsThis study involved the immunohistochemical detection of EGFR expression in cancer tissues of patients with T2DM and OSCC. The patients were divided into groups according to whether they were taking metformin for the treatment of T2DM, and the expression of EGFR in different groups was compared. Correlation analysis between the expression of EGFR and the fluctuation value of fasting blood glucose (FBG) was carried out. Immunohistochemistry was used to detect the expression of EGFR in cancer tissues of patients with recurrent OSCC. These patients had normal blood glucose and took metformin for a long time after the first operation.ResultsEGFR expression in T2DM patients with OSCC taking metformin was significantly lower than that in the non-metformin group. FBG fluctuations were positively correlated with the expression of EGFR in the OSCC tissues of the non-metformin group of T2DM patients. In patients with recurrent OSCC with normal blood glucose, metformin remarkably reduced the expression of EGFR in recurrent OSCC tissues.ConclusionMetformin may regulate the expression of EGFR in a way that does not rely on lowering blood glucose. These results may provide further evidence for metformin in the treatment of OSCC.

The role of first-trimester HbA1c in the early detection of gestational diabetes

BackgroundWe aimed to assess the utility of HbA1c in the early detection of gestational diabetes (GDM) in the first trimester.MethodsThis prospective study was performed on 700 pregnant women in the perinatology clinic at a tertiary university hospital from March 2018 to March 2020. For all pregnant women, HbA1c and fasting blood glucose (FBG) levels were examined during the first trimester. Then, a GDM screening test was done within 24–28 weeks of pregnancy using a 100 g oral glucose tolerance test (OGTT) as the gold standard test. The GDM diagnosis was made according to the American Diabetes Association (ADA) criteria. Sensitivity, specificity, positive (PPV), and negative predictive value (NPV) of HbA1c and FBG were calculated using the receiver operating characteristic (ROC) curve.ResultsOf 700 participants, one hundred and fifteen (16.4%) women had GDM. The GDM patients were significantly older and had a higher pre-gestational body mass index and pregnancy weight gain compared to the non-GDM participants. The sensitivity and specificity for ruling out GDM at an HbA1c cut-off value of 4.85% was 92.2 and 32.8%, respectively, with a 95.5% NPV and a 21.2% PPV. Furthermore, sensitivity and specificity for diagnosing GDM at an HbA1c cut-off value of 5.45% was 54.8 and 96.8%, respectively, with a 91.5% NPV and a 76.8% PPV. Using HbA1c could decline OGTT in 40.4% of the pregnant women (28.7% with HbA1c < 4.85 and 11.7% with HbA1c ≥ 5.45%).ConclusionIt seems that the first-trimester HbA1c cannot replace OGTT for the diagnosis of GDM because of its insufficient sensitivity and specificity. However, women with higher first-trimester HbA1c had a high risk for GDM incidence.

Level of glycosylated haemoglobin in the first trimester in cases of gestational diabetes mellitus

Background: Glycosylated haemoglobin (HbA1c) level during early pregnancy has been proposed as a predictor of gestational diabetes mellitus (GDM). Objectives: To determine the mean value of first trimester’s glycosylated haemoglobin (HbA1c) in gestational diabetes mellitus cases. Methods: An analytical cross-sectional study was conducted among GDM cases at the Obstetrics and Gynaecology Department of Kathmandu Medical College after ethical clearance. Purposive sampling was done to enrol 102 cases that presented over a period of August 2020 to January 2021. First trimester HbA1c levels were recorded. The HbA1c values were grouped into two taking 5.7% as a cut-off which is an established threshold for prediabetes in a normal population. Results: The mean age of participants was 28.74 ± 4.1 years and mean body mass index was 29.13 ± 2.73 kg/m2. Mean value of HbA1c was 5.52 ± 0.44%. Mean value of fasting blood glucose and postprandial glucose after oral glucose tolerance test (OGTT) was 102.25 ± 7.36 mg/dl and 167.55 ± 10.91 mg/dl respectively. Out of total participants, only 40 (39.21%) had HbA1c value more than 5.7% while 62 (60.78%) had HbA1c value less than 5.7%. There was weak positive correlation between HbA1c and Fasting Blood Glucose (Pearson’s correlation coefficient r = 0.13). Similarly, correlation between HbA1c and blood sugar after OGTT (r = 0.17) was also insignificant. Conclusion: This study concluded that the HbA1c value of first trimester is not very different than normal population. Hence, diabetic range of HbA1c value in first trimester is useful in diagnosing overt diabetes.

Effect of Diabetes Self Management Education on Fasting Blood Glucose on Type 2 Diabetes

Diabetes Mellitus is a metabolic disease that can increase mortality and morbidity rates. Indonesia ranks 4th in the world with the most Type 2 DM, which is 21.3 million. Education of patients with Type 2 DM is a treatment that aims to make patients behave in a healthy manner so that good glycemic control is achieved. The purpose of the study was to a.nalyze the effect of Diabetes Self Management Education on the value of fasting blood glucose in Type 2 DM patients at Telaga Murni Health Center, West Cikarang. Quasy Experiment research method with pre-experimental one group Pretest-Posttest design. Sample 44, selected using purposive sampling. Respondents were given an intervention for 4 weeks by checking blood glucose before and after the intervention. The results of the analysis showed that there was a decrease in the average blood glucose before and after the intervention, which was 27.8 mg/dl. The Wilcoxon test analysis revealed that the p value was 0.000 (<0.05), which means that there was an effect of giving DSME on the fasting blood glucose value. It is hoped that there will be maximization of education for Type 2 DM patients to increase awareness, knowledge and skills in managing their disease.

Kualitas diet dan kontrol glikemik pada orang dewasa dengan diabetes melitus tipe dua

Diet quality and glycemic control in adults with type two diabetes mellitusBackground: As assessed by Alternate Healthy Eating Index (AHEI), diet quality is correlated with glycemic control through its effect on glucose-insulin homeostasis. Studies are evaluating the diet quality index in Indonesia, especially its relation to glycemic control in those with type 2 diabetes mellitus (T2DM), are lacking. Objective: To analyze the association between diet quality and glycemic control T2DM in adults. Methods: This research was a cross-sectional study using data from "Cohort study of non-communicable disease risk factors" in 2016 by the Indonesia Ministry of Health. Hundred and five (105) subjects diagnosed with T2DM, aged 25-65, were recruited in this study. A 24-hour dietary recall was collected, and a diet quality index referred to the USA adapted AHEI-2010 was assessed. The portion of food components was modified based on the Indonesian Dietary Guidelines. Glycemic control was evaluated according to fasting blood glucose (FBG) and 2-hours-post-75-g glucose load (2h-PG). Spearman correlation test was applied in this analysis. Results: A mean age of subjects was 51 years, and 77.1% out of 105 subjects were women. Mean value of FBG 123.5 and 2h-PG 228.9 mg/dL. The total score of AHEI was 53.8. There was not a significant correlation between the total score of AHEI with FBG (r= -0.079) and 2h-PG (r= -0.069) (p&gt;0.05). However, there was a significant association between the fruits score and 2h-PG (r= -0.224) (p&lt;0.05). Most of the subjects consumed fruits containing low-moderate fructose, such as bananas, oranges, papayas. Conclusions: In T2DM, there was no significant association between the total score of current diet quality and poor glycemic control, except for the fruits component.

Evaluation of efficacy and safety of a polyherbal Unani formulation in diabetes mellitus type 2 (Zayābīṭus Sukkari Qism Sāni) - a randomised controlled clinical study

Diabetes mellitus type 2 (Zayābīṭus Sukkari Qism Sāni) is a major health concern in 21st century. Despite tremendousadvances in modern sciences, there is a lack of relatively safe and effective drug for its management.The primary objective of this study was to evaluate the efficacy and safety of a polyherbal Unani formulation containingGurmar booti (Gymnema sylvestre), Gilo (Tinospora cordifolia) and Jamun (Syzygium cumini) in the management of DiabetesMellitus Type 2 (DMT2). It was a randomised controlled clinical study conducted on 60 participants of DMT2 inadequatelycontrolled by diet and exercise. The test drug was given to group-A participants (n=30) 6 g twice daily orally for 12 weeks andthe standard drug metformin (500 mg) was given twice daily orally to group-B participants (n=30).It was observed that the difference between the Mean (± SD) value of fasting blood glucose (FBG), postprandial bloodglucose (PPBG) and glycosylated haemoglobin (HbA1c) in Test and Control groups at the end of the study in comparison tobaseline was significant (p<0.05). This study concludes that the test drug was effective in reducing FBG and PPBG significantlyin diabetic participants’ at 12 weeks of treatment.

Kudzu Resistant Starch: An Effective Regulator of Type 2 Diabetes Mellitus.

Kudzu is a traditional medicinal dietary supplement, and recent research has shown its significant benefits in the prevention/treatment of type 2 diabetes mellitus (T2DM). Starch is one of the main substances in Kudzu that contribute decisively to the treatment of T2DM. However, the underlying mechanism of the hypoglycemic activity is not clear. In this study, the effect of Kudzu resistant starch supplementation on the insulin resistance, gut physical barrier, and gut microbiota was investigated in T2DM mice. The result showed that Kudzu resistant starch could significantly decrease the value of fasting blood glucose and the levels of total cholesterol, total triglyceride, and high-density lipoprotein, as well as low-density lipoprotein, in the blood of T2DM mice. The insulin signaling sensitivity in liver tissue was analyzed; the result indicated that intake of different doses of Kudzu resistant starch can help restore the expression of IRS-1, p-PI3K, p-Akt, and Glut4 and thus enhance the efficiency of insulin synthesis. Furthermore, the intestinal microorganism changes before and after ingestion of Kudzu resistant starch were also analyzed; the result revealed that supplementation of KRS helps to alleviate and improve the dysbiosis of the gut microbiota caused by T2DM. These results validated that Kudzu resistant starch could improve the glucose sensitivity of T2DM mice by modulating IRS-1/PI3K/AKT/Glut4 signaling transduction. Kudzu resistant starch can be used as a promising prebiotic, and it also has beneficial effects on the gut microbiota structure of T2DM mice.

Metabolic Derangements in Patients of Psoriasis and their Association with Psoriasis Area Severity Index Score: A Cross-sectional Study

Introduction: Psoriasis is a chronic inflammatory disease of skin associated with various metabolic derangements. These metabolic derangements increases the risk of cardiovascular diseases in psoriatic patients. Aim: To study the metabolic parameters- Fasting Blood Glucose (FBS), serum lipid profile, serum uric acid, C-Reactive Protein (CRP) in psoriatic patients in relation to clinical disease severity- Psoriasis Area Severity Index (PASI) score. Materials and Methods: The study was a hospital based cross-sectional observational study carried out over a period of 18 months in Department of Dermatology at Government Medical College and Rajindra Hospital, Patiala that included 250 psoriatic patients. Their percentage Body Surface Area (BSA) involved and PASI score were calculated as per the standard guidelines. The severity of psoriasis was divided into mild (PASI&lt;7), moderate (PASI 7-12) and severe (PASI &gt;12) disease based on PASI score. Serum lipid profile was measured by enzymatic method, blood glucose by glucose oxidase method, serum uric acid by uricase method and CRP by latex slide agglutination method and the values obtained were compared with severity of psoriasis. Results: There was a rise in the value of FBS, serum lipid profile, serum uric acid and CRP as PASI score increased and the difference between these values was statistically highly significant (p-value &lt;0.001). Conclusion: There was a significantly higher derangement of metabolic parameters in patients with higher PASI scores. So, patients with severe psoriasis have a higher risk of metabolic complications and cardiovascular diseases as compared to patients with mild disease. These patients should be advised lifestyle modifications and should be regularly monitored so that the metabolic derangements can be detected earlier and metabolic complications can be avoided.

The impact of intra gastric balloon as a treatment of obesity on pre-diabetes in obese persons

ABSTRACT Introduction: Obesity is arising health problem that is linked to many pathological conditions. Treatment of obesity has a beneficial effect on many health problems. Little data available about effect of weight loss on prediabetes. Object: To evaluate the effect of intra gastric balloon (IGB) as obesity treatment on prediabetes. Method: In a prospective study we have followed 42 obese prediabetic patients who used IGB as obesity treatment. All patients were evaluated for anthropometric measures, lipid profile, fasting blood glucose (FBG), postprandial blood glucose (PPBG) and glycosylated hemoglobin HbA1c before and 6 months after IGB insertion. Results: There was a significant reduction in body weight, waist–hip ratio and also body mass index (BMI), as by time of balloon removal mean body weight was 86.62 ± 7.84 Kg, and mean BMI at time of removal was 29.48 ± 2.31 kg/m2 compared to 99.10 ± 7.34 Kg and 33.61 ± 2.18 Kg/m2 before balloon insertion (p < 0.05). Also, significant improvement of FBG and PPBG with mean value of FBG 93.00 ± 9.12 mg% and mean level of PPBG 133.31 ± 11.68 mg% compared to FBG 110.71 ± 12.10 mg% and PPBG 166.81 ± 18.82 mg% before balloon insertion (p < 0.05), likewise there was a significant reduction in HbA1c as its mean value has become 5.48 ± 0.35 compared to 6.01 ± 0.21 before balloon insertion (p < 0.05). Conclusions: six months treatment with IGB for obesity improved the prediabetic condition that may prevent or at least delay type II diabetes mellitus, which needs longer follow-up.

Fasting blood glucose to HDL-C ratio as a novel predictor of clinical outcomes in non-diabetic patients after PCI.

Background The present study was to assess the prognostic value of fasting blood glucose to high-density lipoprotein cholesterol ratio (GHR) in non-diabetic patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).Methods and results A total of 6645 non-diabetic patients from two independent cohorts, the CORFCHD-PCI study (n=4282) and the CORFCHD-ZZ (n=2363) study, were enrolled in Clinical Outcomes and Risk Factors of Patients with Coronary Heart Disease after PCI. Patients were divided into two groups according to the GHR value. The primary outcome included all-cause mortality (ACM) and cardiac mortality (CM). The average follow-up time was 36.51 ± 22.50 months. We found that there were significant differences between the two groups in the incidences of ACM (P=0.013) and CM (P=0.038). Multivariate Cox regression analysis revealed GHR as an independent prognostic factor for ACM. The incidence of ACM increased 1.284-times in patients in the higher GHR group (hazard ratio [HR]: 1.284 [95% confidence interval [CI]: 1.010–1.631], P<0.05). Kaplan–Meier survival analysis suggested that patients with high GHR value tended to have an increased accumulated risk of ACM. However, we did not find significant differences in the incidence of major adverse cardiac events, main/major adverse cardiovascular and cerebrovascular events (MACCE), stroke, recurrent myocardial infarction (MI) and bleeding events.Conclusions The present study indicates that GHR index is an independent and novel predictor of ACM in non-diabetic CAD patients who underwent PCI.

Predictive Value of Fasting Blood Glucose for Microvascular Obstruction in Nondiabetic Patients with ST-Segment Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention.

Background The relationship between fasting blood glucose (FBG) and microvascular obstruction (MVO) after primary percutaneous coronary intervention (PCI) remains unclear in nondiabetic patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to determine the predictive value of FBG in MVO in nondiabetic STEMI patients. Methods A total of 108 nondiabetic STEMI patients undergoing primary PCI were enrolled in this study. The patients were classified into either the MVO group or non-MVO group based on cardiac magnetic resonance imaging (CMR). Results FBG in the MVO group was higher than in the non-MVO group. Univariate analysis showed that FBG, peak high-sensitive troponin T (TnT), pre-PCI thrombolysis in myocardial infarction (pre-PCI TIMI) flow, left ventricular ejection fraction (LVEF), infarction size, left ventricular end-diastolic diameter (LVEDd), left ventricular end-diastolic volume (LVEDV), and global longitudinal strain (GLS) were likely predictive factors of MVO. After adjustment for other parameters, FBG, peak TnT, LVEF, and LVEDV remained independent predictors for MVO. Conclusion FBG was independently associated with MVO in nondiabetic STEMI patients.

A novel method for controlling unobserved confounding using double confounders

BackgroundControlling unobserved confounding still remains a great challenge in observational studies, and a series of strict assumptions of the existing methods usually may be violated in practice. Therefore, it is urgent to put forward a novel method.MethodsWe are interested in the causal effect of an exposure on the outcome, which is always confounded by unobserved confounding. We show that, the causal effect of an exposure on a continuous or categorical outcome is nonparametrically identified through only two independent or correlated available confounders satisfying a non-linear condition on the exposure. Asymptotic theory and variance estimators are developed for each case. We also discuss an extension for more than two binary confounders.ResultsThe simulations show better estimation performance by our approach in contrast to the traditional regression approach adjusting for observed confounders. A real application is separately applied to assess the effects of Body Mass Index (BMI) on Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Fasting Blood Glucose (FBG), Triglyceride (TG), Total Cholesterol (TC), High Density Lipoprotein (HDL) and Low Density Lipoprotein (LDL) with individuals in Shandong Province, China. Our results suggest that SBP increased 1.60 (95% CI: 0.99–2.93) mmol/L with per 1- kg/m2 higher BMI and DBP increased 0.37 (95% CI: 0.03–0.76) mmol/L with per 1- kg/m2 higher BMI. Moreover, 1- kg/m2 increase in BMI was causally associated with a 1.61 (95% CI: 0.96–2.97) mmol/L increase in TC, a 1.66 (95% CI: 0.91–55.30) mmol/L increase in TG and a 2.01 (95% CI: 1.09–4.31) mmol/L increase in LDL. However, BMI was not causally associated with HDL with effect value − 0.20 (95% CI: − 1.71–1.44). And, the effect value of FBG per 1- kg/m2 higher BMI was 0.56 (95% CI: − 0.24–2.18).ConclusionsWe propose a novel method to control unobserved confounders through double binary confounders satisfying a non-linear condition on the exposure which is easy to access.

Association between fasting blood glucose and outcomes and mortality in acute ischaemic stroke patients with diabetes mellitus: a retrospective observational study in Wuhan, China.

ObjectiveTo evaluate the predictive value of fasting blood glucose (FBG) on unfavourable outcomes and mortality in diabetes mellitus (DM) patients after acute ischaemic stroke (AIS).Study designA hospital-based observational cohort study was conducted. Clinical data, including sex, age, body mass index, vascular risk factors and systolic/diastolic blood pressure, were routinely collected. National Institutes of Health Stroke Scale score was used to assess stroke severity on admission. FBG was determined on the first day after fasting for at least 8 hours. The modified Rankin Scale was used to assess functional outcome at 90 days: 3–6, unfavourable outcome and 6, death.SettingRenmin Hospital of Wuhan University, Wuhan, China.ParticipantsPatients who had AIS with DM, who were consecutively admitted within 24 hours of onset from January 2018 to June 2019.ResultsFor the 568 patients, the median age was 65 years (IQR, 55–74 years). There were 377 (66.4%) men. The median FBG values were 7.37 mmol/L (IQR, 5.99–10.10 mmol/L), and the median glycated haemoglobin (HbA1c) values were 6.6 (IQR, 5.8–8.3). Multivariable logistic and Cox regression analysis of confounding factors showed that FBG at the time of admission was an independent predictor of unfavourable outcome (OR, 1.25 (1.14–1.37); p<0.0001) and mortality (HR, 1.10 (1.03–1.15); p<0.05) at 90 days after onset. Time to death was analysed by Kaplan-Meier curves based on FBG quartiles. The risk of death in the two highest quartile groups (FBG, 7.38–10.10 mmol/L; FBG, ≥10.11 mmol/L) was significantly higher than that in the two lowest quartile groups (FBG, ≤6.00 mmol/L; FBG, 6.01–7.37 mmol/L; p<0.0001).ConclusionsHigher FBG levels are associated with unfavourable outcomes and mortality in Chinese patients who had AIS with DM. Our data contribute to the knowledge regarding the relationship between FBG and prognosis in patients with DM who had AIS.

171-LB: Evaluation of Universal Diabetes Diagnostic Testing at First Prenatal Visit

Diabetes mellitus (DM) in pregnancy is not routinely screened for in Haiti. If done, screening relies on OGTT at 24-28 weeks (w) of gestation. It is unclear whether this is an optimal approach in Haiti. We aimed to evaluate the implications of a universal DM diagnostic testing before 24 w. All consecutive pregnant women aged ≥18 y without known DM attending their first pregnancy visit in 4 prenatal clinics of Port-au-Prince and surroundings were invited to participate. Using a Contour NextR glucometer, eligible subjects underwent: Fasting blood glucose (FBG) test at 1-23 w and ≥36 w, 75g 2-h OGTT at 24-28 w for FBG &amp;lt;126 mg/dL before 24 w or at 24-35 w-first visit. We used WHO/IADPSG diagnostic criteria for DM in pregnancy (DIP) (FBG ≥126 mg/dL and/or 2h ≥200 mg/dL) and for gestational DM (GDM) (1 or more: FBG 92-125 mg/dL, 1-h BG ≥180 mg/dL, 2-h BG 153-199 mg/dL). A total of 945 women (mean age 29.78 ± 5.77 y, parity 2.04 ± 1.29, pre-eclampsia: 3.80%, caesarian section: 18.75%, preterm birth: 7.13%, single or living alone: 10.13%, family history of DM: 10.11%) were studied. Women with first visit at &amp;lt; and ≥24 w were 332 and 613, respectively. Prevalence of DIP and GDM by first screening period was: 7.20% and 13.02% overall, 12.35% and 13.86% at &amp;lt;24 w, and 4.40% and 12.56% at ≥24 w. Median FBG progressively decreased from 83 mg/dL at ≤5 w to 73 mg/dL at ≥36 w, p=0.0000. Of the 40 women with GDM at &amp;lt;24 w, 20 had GDM confirmed and 20 were normal on OGTT. A cut-off value of FBG &amp;gt;100 mg/dL at &amp;lt;24 w for DM (DIP and GDM) diagnosis on OGTT had: specificity (SP) 98.8%, sensitivity (SE) 19.3%, and positive predictive value (PPV) 78.6%. A cut-off value of FBG &amp;lt;72 mg/dL at &amp;lt;24 w to rule out DM on OGTT had: SP 12.2%, SE 98.3%, and NPV 96.8%. Women with these cut-offs represented 14.9% of those undergoing OGTT after the &amp;lt;24 w screening. Our findings suggest that universal screening for DM before 24 w of gestation leads to diagnosis of DM in about 20% of pregnant women. A rule in/rule out approach using FBG &amp;lt;72 mg/dL and &amp;gt;100 mg/dL values at &amp;lt;24 w can help reduce the number of OGTT at ≥24 w. Disclosure P. Larco: None. E. Jean Baptiste: None. K. Moise: None. M. Charles Larco: None. B.S. Jerome: None. J.E. von Oettingen: None. R. Charles: None.