Well-controlled Group Research Articles

Poorly controlled hypertension is associated with elevated serum Uric Acid to HDL-cholesterol ratio: A cross-sectional cohort study

ABSTRACT Objectives The diagnosis and follow-up of hypertension (HT) depend on the blood pressure measurements, which can be affected by several factors. In the present work, we aimed to explore the role of uric acid/HDL-cholesterol ratio (UHR) in HT and whether/or not it was associated with poor blood pressure control. Methods In this retrospective cross-sectional cohort study, all the participants treated for hypertension and then followed up in the internal medicine clinics of our institution were enrolled. Hypertensive patients were grouped as either poorly or well-controlled hypertension groups, according to the suggestions of Joint National Committee VIII criteria and healthy volunteers were enrolled as control group. UHR of the study groups was compared. Results Our study cohort consisted of 535 subjects; 258 in the well-controlled HT group, 186 in the poorly controlled HT group, and 91 in the control group. Median UHR levels of the poorly controlled HT group (13 (4–43) %) were significantly higher than well-controlled HT group 11 (4–22) %) and control group (8 (4–19) %) (p < 0.001). UHR was correlated with systolic (r = 0.33, p < 0.001) and diastolic (r = 0.28, p < 0.001) BP. UHR level greater than 11% has 70% sensitivity and 60% specificity in predicting poor BP control (AUC: 0.73, p < 0.001, 95%CI: 0.68–0.77). UHR was an independent risk factor for poor BP control in HT subjects and a unit elevation in UHR increased the risk of poorer BP control by 7.3 times (p < 0.001, 95%CI: 3.9–13.63). Conclusion Assessment of UHR may be useful in HT patients since elevated UHR levels could be associated with poor blood pressure control in this population.

Evaluation of patients with phenylalanine metabolism disorder: a single center experience.

The aim is to evaluate the clinical, demographic and laboratory data of the patients we followed up with phenylalanine metabolism disorder. In this study, patients with phenylalanine metabolism disorder who applied to Bursa Uludag University Faculty of Medicine, Department of Pediatrics, Pediatric Metabolism Department between 2011 and 2021 were retrospectively examined. The files of 397 patients who were followed up in our pediatric metabolism outpatient clinic and were found to have phenylalanine metabolism disorder by plasma phenylalanine level and molecular genetic analysis were evaluated. According to the highest plasma phenylalanine levels at admission, mild hyperphenylalaninemia phenotype constituted the largest group of 397 patients with 282 cases (71.1%), while the least common phenotype was malignant phenylketonuria (BH4 metabolism disorder) with four patients (1.0%). The number of patients with classical phenylketonuria was 90 (22.6%). 61 (62.8%) of 97 phenylalanine metabolism disorder cases who underwent BH4 loading test had a response. The mean phenylalanine level of the patients was 3.62±1.31mg/dL in mild hyperphenylalaninemia, 7.98±3.99mg/dL in mild phenylketonuria and 11.71±4.39mg/dL in classical phenylketonuria. While 241 (76%) of 317 patients younger than 8 years old were in the well-controlled group, 76 (24%) were in the poorly-controlled group. While 41 (53.9%) of 76 patients older than 8 years of age were in the well-controlled group, 35 (46.1%) were in the poorly-controlled group. In our study, the largest patient group consisted of patients with mild hyperphenylalaninemia, and the least common phenotype was mild phenylketonuria.

Uncontrolled type 1 diabetes among Egyptian adolescents; risk determinants and clinical outcomes

BackgroundAdolescents are exposed to multiple psychosocial, cognitive and emotional challenges. Those with type 1 diabetes (T1D) are additionally exposed to diabetes related social, dietary, emotional and clinical stressors. This can impair their glycemic control contributing to the development of diabetes complications. AimTo assess the risk determinants and clinical outcomes of uncontrolled diabetes among Egyptian adolescents with T1D. MethodsSix hundred adolescents with T1D were recruited from the Pediatric and Adolescents Diabetology Clinic, Ain-Shams University. Their mean age was 14.78 years and their mean HbA1C was 8.66% with 200 (33%) having HbA1C (>7%). From the studied cohort, 200 with good glycemic control (≤7%) and 200 with poor control (>7%) were assessed for diabetes-duration, insulin regimen, frequency of diabetic-ketoacidosis, clinically significant hypoglycemia and the Mini-International Neuropsychiatric-Interview for Children and Adolescents. Auxological assessment, fundus and clinical screening for complications were done. Neuropathy was confirmed by nerve conduction velocity. Thyroid profile, anti-tissue transglutaminase-IgG, fasting lipids and urinary albumin/excretion ratio (UAE) were measured. ResultsAdolescents having uncontrolled diabetes have significantly higher diabetes onset age (p = 0.037), diabetes-duration (p = 0.038), eating disorders (p = 0.027), sadness (p = 0.038), depression (p = 0.003), suicidal manifestations (p = 0.001) and anxiety (p<0.001) than the well-controlled group. Furthermore, they had significantly higher LDL(p<0.001), cholesterol(p = 0.002), triglycerides (p = 0.011), UAE (p = 0.007), neuropathy (p<0.001) and school absenteeism (p<0.001). Multivariate-regression showed that HbA1c is independently related to diabetes-duration (p = 0.005), depression (p<0.001), sadness (p = 0.004) and anxiety (p<0.001). ConclusionUncontrolled T1D among adolescents is associated with older age and psychiatric comorbidities. Furthermore, it is linked to school absenteeism, hyperlipidemia, diabetic nephropathy and neuropathy.

Clinical performance of hydrophilic, titanium‐zirconium dental implants in patients with well‐controlled and poorly controlled type 2 diabetes: One‐year results of a dual‐center cohort study

This study assessed the clinical performance of hydrophilic dental implants in a patient cohort with type 2 diabetes mellitus (T2DM). Subjects with T2DM of ≥2-years duration were allocated to either the well-controlled (WC; HbA1c ≤ 7.0%,) or poorly-controlled (PC; 7.5<HbA1c<10%) groups in a dual-center, prospective cohort study. Each subject received a single, titanium-zirconium (Ti-Zr) dental implant with a chemically-modified, hydrophilic (modSLA) surface in a posterior mandibular site. Postoperatively, subjects were followed at 1, 2, 4, 8, and 12-week intervals. Post-loading, subjects were followed at 3, 6, and 12-months. Clinical and radiographic parameters of implant success, and dental patient-reported outcomes were collected. Twenty-one dental patients (NWC =11; NPC =10; mean age: 66.8 ± 7.5 years) were enrolled and the 1-year implant success rate was 100%. Peri-implant bone levels were stable with 0.15 ± 0.06mm mean marginal loss at 1 year without significant inter-group differences (P=0.79). Postoperative pain was minimal at 1-week, and OHIP-5 scores decreased significantly over time as compared with preoperative levels (P<0.001) suggesting significant improvement in patient-perceived oral health following implant therapy. Elevated HbA1c levels>7.5% did not compromise 1-year success rates, or oral health-related quality of life in PC patients receiving modSLA, Ti-Zr implants. Given that implant placement up to 10% HbA1c significantly enhanced oral health-related quality of life without complications or morbidity, the safety and efficacy of implants to improve oral function in T2DM is supported, even without ideal glycemic control.

A Clinical Study to Assess the Severity of Periodontal Disease in Relation to Glycemic Status of Type II Diabetic Individuals.

Background:The study is done to find out the association between the glycemic status of Type II diabetic patients and the severity of periodontal disease (PD).Materials and Methods:Study groups included a total of 90 Type II diabetic individuals and were divided as Group I with well-controlled diabetics and Group II with poorly controlled diabetics based on glycosylated hemoglobin levels. The periodontal parameters of all patients, namely probing pocket depth, clinical attachment level, and bleeding on probing oral hygiene index-debris index score, were assessed. The collected data were subjected to statistical analysis.Results:The periodontal parameters of all patients with poor glycemic control were significantly higher than well-controlled group. There was a significant difference between all clinical parameters between groups with P < 0.001 indicating severe PD in poor glycemic status group.Conclusion:The severity of PD is related to glycemic status. The poorly controlled diabetic patients had severe periodontitis than well-controlled diabetic patients. Local factors such as dental plaque seem to have a major influence in disease progression.

Effect of SARS-CoV-2 on glycemic control in post-COVID-19 diabetic patients.

To study the clinicodemographic profile, outcomes, and post-COVID change in glycemic control among treated COVID-19-infected patients with poorly controlled or well-controlled diabetes mellitus (DM). Adult COVID-19-infected patients who tested positive with rapid antigen test or RT-PCR admitted were included in this prospective observational study. Patients were divided into well-controlled and poorly controlled diabetes group based on HbA1c values at admission. Telephonic follow-up and HbA1c estimation was done after three months. Clinical and laboratory investigations performed were compared between both groups. Hazard ratios (HRs) for mortality risk in both well-controlled and poorly controlled COVID-19 patients with DM was done by Cox proportional hazard models. Out of 260 patients, 140 (53.84%) and 120 (46.15%) were poorly and well-controlled diabetics respectively. One hundred sixty-three patients (62.69%) were male, and the mean age was 52.67 ± 15.69 years. Severity, duration of hospital stay, steroid duration, insulin requirement and mean HbA1C, both at admission and after three months, were significantly higher in poorly controlled group than the well-controlled group (P < 0.005). With increase in age, the HR for all-cause mortality increased by 1.15 times (95% CI, 1.05-1.25; P = 0.0025) in well-controlled than poorly controlled group, whereas with increase in FBS at admission, the HR for all-cause mortality increased by 1.03 times in poorly controlled than well-controlled group (95% CI, 1.01-1.06; P = 0.0044). Our results show that well-controlled blood glucose levels or improved glycemic control are associated with a better outcome in patients with COVID-19 and pre-existing type 2 diabetes mellitus.

Anaerobic Contributions Are Influenced by Active Muscle Mass and The Applied Methodology in Well-Controlled Muscle Group

Anaerobic Contributions Are Influenced by Active Muscle Mass and The Applied Methodology in Well-Controlled Muscle Group

Simple High-Performance Nonfused Ring Electron Acceptors With Well-Controlled Terminal Group Stacking

Simple High-Performance Nonfused Ring Electron Acceptors With Well-Controlled Terminal Group Stacking

Increases in serum carbonylated protein levels of dogs with hypercortisolism.

Protein carbonylation is an irreversible and degenerative modification that can be used to evaluate oxidative stress caused by glucocorticoids. In this study, we focused on protein carbonylation in dogs with hypercortisolism (HC). Sera samples were collected from 14 dogs diagnosed with HC and treated with trilostane, 12 dogs with inflammatory diseases (disease control group), and eight clinically healthy dogs. When the carbonylated protein levels were detected by the immunoblot analysis, one band of approximately 40 kDa was predominantly increased in the dogs with HC. The band was identified as haptoglobin using the liquid chromatography tandem mass spectrometry method. Furthermore, haptoglobin immune reactivity was higher in the dogs with HC. Although the average protein carbonylation level of the HC group was not significantly different from that of the other groups, the carbonylation level was significantly higher for the poorly controlled HC cases than for the well-controlled HC group. Additionally, the primary culture of canine hepatocytes was used to clarify the direct effect of glucocorticoids on protein carbonylation in dog livers. Both the carbonylated protein and haptoglobin clearly increased after 72 h. These findings suggest that haptoglobin and its carbonylated form are increased with canine HC, and that the protein carbonylation ratio and/or haptoglobin level could be related to disease management. These factors could be useful as biomarkers for an oxidative stress reaction, at least in the liver, and for treatment monitoring of HC.

A 4-hour Profile of 17-hydroxyprogesterone in Salt-wasting Congenital Adrenal Hyperplasia: Is the Serial Monitoring Strategy Worth the Effort?

Objective:Since there is no gold standard laboratory variable for adjustment of treatment in congenital adrenal hyperplasia (CAH), the aim was to assess the use of a 4-hour profile of serum 17-hydroxyprogesterone (17-OHP) to determine the most appropriate sample time and level of 17-OHP in predicting the metabolic control and evaluate the role of sex hormone-binding globulin (SHBG) in hyperandrogenemia.Methods:This study included children with salt-wasting CAH. Measurements for 17-OHP and cortisol were made from samples obtained before and 1, 2, and 4 hours after the morning dose of hydrocortisone. Patients were designated to have poor metabolic control when androstenedione levels according to age and sex-specific reference intervals were high and annual height standard deviation score (SDS) changes were ≥0.5.Results:The study cohort was 16 children (9 girls) with a median age of 7-years old. Premedication 17-OHP levels were strongly correlated with 17-OHP levels 1, 2, and 4 hours after the morning dose (rs=0.929, p<0.01; rs=0.943, p<0.01; rs=0.835, p<0.01, respectively). 17-OHP profiles (0, 1, 2, 4 hours) of poor (n=6) and good (n=10) metabolically controlled cases were similar. Among the patients with poor metabolic control, two cases had 17-OHP levels <2 ng/mL at all times. The remaining patients with poor metabolic control had median 17-OHP levels above 104 ng/mL, 82 ng/mL, 14 ng/mL, and 4 ng/mL, for baseline and 1, 2, and 4 hours, respectively. Differences between the poor and well-controlled group were androstenedione levels with respect to upper limit of normal [1.8 (1.5) and 0.5 (1.5) ng/mL, respectively p=0.03], annual change in height SDS [0.7 (0.2) and -0.03 (0.8) SDS, respectively, p=0.001], and daily hydrocortisone doses [7 (6) and 16 (8) mg/m2/day, respectively, p=0.02]. Androstenedione and SHBG levels were negatively correlated in the pubertal children (rs=-0.7, p=0.04).Conclusion:We conclude that: (i) a 4-hour 17-OHP profile is not useful in predicting hyperandrogenemia; (ii) suppressed levels of 17-OHP do not always indicate overtreatment; (iii) reference intervals of 17-OHP for different time periods might be of importance; (iv) low hydrocortisone doses should be avoided; and (v) SHBG could be used in pubertal children as an indicator of hyperandrogenemia.

Association of blood glucose level and prognosis of inpatients with coexistent diabetes and COVID-19.

Type 2 diabetes (T2D) increases the risk of coronavirus disease (COVID-19). This study investigates the association between glucose control of COVID-19 patients with T2D in first 7 days after hospital admission and prognosis. A total of 252 infected inpatients with T2D in China were included. Well-controlled blood glucose was defined as stable fasting blood glucose (FBG) levels in the range of 3.9–7.8 mmol/L during first 7 days using indicators of average (FBGA), maximum (FBGM) or first-time (FBG1) FBG levels. The primary endpoint was admission to intensive care unit or death. Hazard ratio (HR) of poorly controlled glucose level group compared with well-controlled group were 4.96 (P = 0.021) for FBGM and 5.55 (P = 0.014) for FBGA. Well-controlled blood glucose levels in first 7 days could improve the prognosis of COVID-19 inpatients with diabetes.

Fetal cardiac geometry and function in pregnancies with well-controlled gestational diabetes mellitus using Fetal HQ

Objective To determine whether abnormal cardiac shape and ventricular global, transverse, and longitudinal contractility are present in fetuses of women with well-controlled GDM. Methods A prospective observational study was performed on 80 fetuses of women with well-controlled GDM and 90 control fetuses. Using Fetal HQ, a new speckle-tracking technique, cardiac shape, global contractility, transverse contractility, and longitudinal contractility were calculated. The number and percentage of fetuses with z score values below 5th or above 95th were computed. Results Compared with controls, there were no significant differences in the frequency of cardiac geometric abnormalities in GDM fetuses. Despite good glycemic control, 60.0% of fetuses in the well-controlled GDM group had one or more types of global, longitudinal, and transverse contractility abnormalities of one or both ventricles, but more frequent on the right ventricle (RV, 50%). The most frequent abnormality of the RV occurred in the transverse contractility (35%), followed by abnormalities of global contractility (25%), and longitudinal contractility (21.3%), compared with controls. The left ventricle (LV) analysis demonstrated that the percentage of study fetuses with only transverse contractility abnormality (18.8%) was significantly higher. Conclusions Despite good glycemic control, abnormal ventricular contractility was present in fetuses of women with GDM, but more frequent in the RV. For both the RV and LV, transverse ventricular contractility abnormality were more prevalent than abnormal global and longitudinal contractility. Fetuses of women with GDM should be evaluated for ventricular contractility abnormality and have more follow-ups despite good glycemic control.

1452A Cohort Study of Comorbidities of Diabetes in Regional Australia

Abstract Background Epidemic of diabetes mellitus and its complications poses a major global threat and the burden of type 2 DM (T2DM) is also a worldwide phenomenon. However, data to rationalize continuous health promotion at local context such as regional New South Wales are lacking, and this underscores the need for continued epidemiological study. This study investigated if poorly controlled T2DM coexists with comorbidities more than those with good glycaemic control. Methods This was a cohort study at a private General Practice in Orange NSW, Australia. The study involved 137 de-identified adults living with T2DM. HbA1c and other biochemical and haematological records were reviewed. Other data included clinical notes including comorbidities, and complications. The cohort was separated into 2 groups: well-controlled versus poor glycaemic control. The resulting data were analysed for frequency, using the statistical software for Microsoft Excel. Results There were 37/137 of the T2DM cohort with baseline HbA1c of ≤ 6.5%, implying 73% poor glycaemic control in the region, at first time of testing. According to the clinical notes, the well-controlled group showed 29.7% comorbidities, including 2.7% queried infection. Among the 100 cases with abnormal HbA1c, comorbidities were observed in 22% including 4% who had infections. Conclusions Our observation implies no less comorbidities in well-controlled diabetes. However, the higher percentage of infection among the poorly controlled group is confirmation of need for continuous health promotion among people living with diabetes. Key messages This primary health statistic suggests the need to monitor for comorbidities equally, whether poor or well-controlled diabetes

Implant-supported mandibular overdentures: a retrospective case series study in a daily dental practice

BackgroundEvaluation of dental implant treatment is mostly based on studies with well-controlled study groups treated within a university-based setting. There are no long-term observational practice-based studies known on implant-supported overdentures. The present retrospective study deals with implant survival, peri-implant hard and soft tissue health, surgical and prosthetic aftercare, and satisfaction of patients treated with an implant-supported mandibular overdenture in a daily dental practice.Materials and methodsWithin the years 2006 till 2015, 295 patients were treated with two, three, or four implants for mandibular overdenture treatment in a daily dental practice in Zaandam, The Netherlands. Outcome parameters were scored at a routine yearly inspection including implant loss, plaque index, gingival index, bleeding index, presence of calculus, probing depth, and satisfaction with implant-supported overdenture. Radiographic analysis was performed to assess peri-implant bone changes. Surgical and prosthetic aftercare was obtained from the medical record.ResultsA total of 133 patients were seen for an evaluation visit (mean follow-up 51.2 months). Cumulative implant survival rate in the 2-implant group, 3-implant group, and 4-implant group was 100%, 99.1%, and 97.8% respectively, with a mean peri-implant bone loss of 0.53 mm, 0.61 mm, and 0.40 mm. Patients’ satisfaction was high in all groups.ConclusionIt was demonstrated, within the limitations of this study, that patients, who were treated with an implant-supported mandibular overdenture in a daily dental practice, experienced a high cumulative implant survival rate and a good peri-implant health, and were very satisfied.Trial registrationNetherlands Trial Register, NL8867. Registered 15 September 2020—retrospectively registered.

Prevalence of comorbidities and associated factors in acromegaly patients in the Turkish population

Background/aim The presence of comorbidities in patients with acromegaly causes an increase in morbidity and/or mortality and a decrease in quality of life. In this study, we aimed to investigate the demographic, clinical and laboratory features, prevalence of acromegaly-related comorbidities, and factors associated with these comorbidities in patients with acromegaly.Materials and methods In the study, 96 patients who were followed up with the diagnosis of acromegaly were included. Clinical, laboratory and imaging features, and accompanying comorbidities of the patients were recorded from the patient files.Results Of the patients included in the study, 63 (65.6%) were female and 33 (34.4%) were male. The mean age of diagnosis was 42.61± 12.08, and the mean follow-up period was 9.97 ± 7.26 years. Median insulin-like growth factor 1 level was 238.16 ng/mL (30.5–820), median growth hormone level was 2.05 ug/L (0.1–29.4). A total of 60 (62.5%) of the patients were in the well-controlled group, and 36 (37.5%) had active disease at the time of inclusion. Diabetes mellitus (DM) was detected in 30 (31.3%) patients, prediabetes in 19 (28.8%) patients, hypertriglyceridemia in 38 (42.2%) patients, hypertension (HT) in 41 (42.7%) patients, cardiovascular disease in 5 (5.2%) patients, malignancy in 9 (9.4%) patients, obstructive sleep apnea syndrome in 8 (8.3%) patients, carpal tunnel syndrome in 11 (11.5%) patients, arthropathy in 5 (5.2%) patients, hearing loss in 7 (7.3%) patients, thyroid nodule in 56 (67.5%) patients, thyroid cancer in 4 (4.2%) patients, colonic polyp in 19 (38.8%) patients.Conclusion In this study, we revealed that the most common comorbidities in acromegaly patients in the Turkish population are thyroid nodules, low high-density lipoprotein (HDL cholesterol (HDL-C) level, hypertriglyceridemia, HT, colonic polyps, DM, and prediabetes, and female sex and age at diagnosis are the most important factors associated with comorbidities.

Evaluation of blood and tooth element status in asthma cases: a preliminary case\u2013control study

BackgroundAsthma is a common respiratory disorder; some data were present on the correlation between increased levels of some elements and the risk of asthma development. It was aimed to evaluate the levels of 13 selected blood and tooth elements (magnesium, phosphorus, calcium, chromium, manganese, iron, copper, zinc, strontium, molybdenum, cadmium, lead, mercury) in a well-controlled asthma group and the control group.MethodsDuring the study period, 17 asthma patients and 26 age and gender-matched healthy children donated shed deciduous teeth having neither decay nor filling and enrolled for the study. The element levels in blood and teeth matrixes were analyzed with inductively coupled plasma mass spectrometry. Differences in blood and tooth elements in groups were evaluated with generalized linear models after adjusting confounding factors.ResultsAfter adjusting the child’s “z scores of body mass index for age”, history of iron deficiency anemia, and status of parental smoking, the generalized linear model revealed significantly lower tooth magnesium levels, lower blood zinc levels, and lower blood zinc/copper ratio in the asthma group than the control group (p = 0.042, p = 0.034, p = 0.002, respectively). Other studied elements for tooth and blood matrixes were similar in groups.ConclusionOur study revealed some differences in tooth and blood element levels in the asthma group. Further studies on zinc and magnesium levels of severe asthma cases are necessary for the interpretation of the results.

Effects of Glycemic Control on Hearing Outcomes in Diabetes Patients With Idiopathic Sudden Sensorineural Hearing Loss.

Objective: This study aimed to analyze the effects of glycemic control on the hearing outcomes of type 2 diabetes patients with idiopathic sudden sensorineural hearing loss (ISSHL).Methods: Type 2 diabetes patients with ISSHL were enrolled. All patients were admitted for 5 days and received systemic corticosteroid treatment. Patients were divided into groups according to their degree of glycemic control pre- (glycosylated hemoglobin) and post- (mean blood glucose) onset of ISSHL. Demographic, audiometric, and hearing outcome data were analyzed. Furthermore, a multivariate analysis was performed to determine the prognostic factors affecting the hearing outcomes in these patients.Results: One hundred forty-four patients were enrolled. The hearing recovery rates were as follows: complete recovery, 19%; partial recovery, 15%; slight improvement, 22%; and no improvement, 44%. Initial hearing levels and diabetes duration were significantly higher in the pre-onset poor-controlled group (glycosylated hemoglobin ≥ 7.0%) than those in the well-controlled group. The hearing recovery rates did not differ significantly pre- or post-onset. In a multivariate analysis, duration from hearing loss onset to treatment, presence of vertigo, and initial hearing level were negative prognostic factors that affected hearing recovery.Conclusion: The degree of pre- or post-onset glycemic control did not affect hearing outcomes in patients with ISSHL and type 2 diabetes. Therefore, the administration of systemic corticosteroid is required for diabetes patients with ISSHL within allowable blood glucose levels.

Study of Subclinical Atherosclerosis in Patients with Type 2 Diabetes Mellitus

Background: Patients with type 2 diabetes mellitus (T2DM) are at increased risk of atherosclerosis. The early recognition of atherosclerosis at its subclinical stages can slow or prevent progression to atherosclerotic diseases, including coronary artery disease, cerebrovascular disease, and peripheral arterial disease. Objective: Identification of the relationship between T2DM and subclinical atherosclerosis and to explore factors that can be associated with a high risk of subclinical atherosclerosis. Patients and Methods: We recruited 75 participants among whom 50 T2DM while 25 were controls. Patients with T2DM were subdivided into two equal groups, well-controlled and uncontrolled. After complete history and examination, investigations including fasting and 2-hour postprandial blood glucose, high sensitive C–reactive protein (hs-CRP), and serum triglyceride (TG) levels were obtained. All participants underwent duplex ultrasound that was used to measure carotid intima-media thickness (cIMT) as a biomarker of subclinical atherosclerosis. Results: Uncontrolled diabetics had increased cIMT than well-controlled diabetics and well-controlled diabetics had increased cIMT than non-diabetics. There was a highly significant positive correlation between cIMT and duration of diabetes in both well-controlled and uncontrolled diabetic groups. In the uncontrolled diabetic group only, there was a highly significant positive correlation between cIMT and each of hs-CRP and TG levels. Conclusion: The risk of subclinical atherosclerosis is higher in type 2 diabetic patients especially in those with uncontrolled diabetes. In uncontrolled diabetics, subclinical atherosclerosis is associated with hypertriglyceridemia and elevated hs-CRP level.

Effect of diabetes control status on the progression of Parkinson's disease: A prospective study.

ObjectiveTo evaluate whether the control status of type 2 diabetes mellitus (DM) influences the progression of Parkinson’s disease (PD).MethodsWe conducted a prospective cohort study from March 2009 to August 2020. Patients at baseline were categorized into DM and non‐DM groups, and those with DM were further classified into the well and poorly controlled DM groups based on the 7.0% of glycated hemoglobin (HbA1C) levels. Multivariate Cox proportional hazards regression models were used to explore the predictors for PD‐related outcomes by hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsOf the 379 patients enrolled, 49 (12.9%) had DM, and 22 of DM (44.9%) were poorly controlled. The adjusted HRs were 2.060 (95% CI 1.165‐3.641) for United Rating Scale (UPDRS) III score increased ≥14 in the poorly controlled‐DM group, and 1.066 (95% CI 0.572‐1.986) in the well‐controlled DM group, relative to the non‐DM group (p trend = 0.025), after adjusting for sex, age, age of onset, body mass index, and UPDRS III and Montreal Cognitive Assessment (MoCA) scores at baseline. The adjusted HRs were 2.079 (95% CI 1.212‐3.566) for reaching Hoehn & Yahr stage ≥3 in the poorly controlled DM group, and 0.879 (95% CI 0.413‐1.871) in the well‐controlled DM group, compared with the non‐DM group (p trend = 0.021). Time to death or time to MoCA 3‐point decrease were not significantly different among the three groups.InterpretationPoorly controlled DM is an independent risk factor contributing to motor progression in PD. Our study highlights the importance of adequate control of diabetes in PD.

Quantitative evaluation of computed tomography findings in patients with bronchial asthma: prediction of therapeutic response.

To compare pretreatment quantitative CT parameters between patients with well-controlled and those with poorly controlled bronchial asthma after treatment. We retrospectively reviewed 785 patients with clinical diagnosis of bronchial asthma from January 2009 to April 2015. Of these, 43 patients underwent high-resolution CT and pulmonary function tests at initial diagnosis. According to the Global Initiative for Asthma (GINA) 2015 guidelines, the patients were classified into two groups (well-controlled (GINA1), n=18; poorly controlled (GINA2 and GINA3), n=25). Quantitative measurements for airways (total cross-sectional area (TA), lumen area (LA), wall area (WA) and wall area percentage (WA%)), air trapping and emphysema were performed on initial pretreatment CT scans. We compared CT measurements for airways between well-controlled and poorly controlled groups and also compared those between ever-smokers and never-smokers. The significant quantitative CT parameters were evaluated with multiple regression analysis. The TA and the WA demonstrated significantly higher values in the poorly controlled than in the well-controlled patient group (TA in RB1 and LB1, each P<0.05; WA in RB1 and RB8, each P<0.05). Quantitative parameters for air trapping and emphysema did not show significant differences between the two patient groups. On multiple regression analysis, the TA and the WA were statistically significant in comparison of two patient groups with an adjustment for age, sex, body mass index and smoking history (each P<0.05). Significantly higher values of the WA and the WA% were revealed in the asthmatics with smoking history comparing to non-smokers (P<0.05). Most of the quantitative CT measurements did not correlate significantly with clinical outcomes in patients with bronchial asthma. And, further research that supplements the limitations of this study is needed to support and validate the association between CT parameters and therapeutic response. This can be justified by the fact that a trend of higher values in airway measurements on initial pretreatment HRCT scan in the poorly controlled than in the well-controlled patient group.