RESUMO
This study aimed to determine whether urinary creatinine excretion rate (CER), a marker of muscle mass, is associated with diabetic retinopathy in individuals with type 2 diabetes and to ascertain whether this putative association depends on body mass index (BMI). This cross sectional study evaluated 2035 individuals with type 2 diabetes. Twenty-four-hour urine was collected. Individuals with diabetic retinopathy had lower CER and BMI values than those without. Patients in higher CER quartiles had higher BMI values and a lower prevalence of diabetic retinopathy. A significant relationship between CER and diabetic retinopathy persisted, even after adjusting for traditional risk factors, including glycated hemoglobin, diabetes duration, and hypertension, in multivariable analysis. Further adjustment for BMI did not significantly alter the association between CER and diabetic retinopathy. This study suggests that CER is inversely associated with diabetic retinopathy in individuals with type 2 diabetes, and this association is independent of BMI.
Assuntos
Índice de Massa Corporal , Creatinina , Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Humanos , Diabetes Mellitus Tipo 2/urina , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/urina , Retinopatia Diabética/etiologia , Masculino , Feminino , Pessoa de Meia-Idade , Creatinina/urina , Estudos Transversais , Idoso , Fatores de Risco , Biomarcadores/urinaRESUMO
Aims: To explore the relationship between plasma leucine-rich α-2-glycoprotein 1 (LRG1) level and the degree of urinary albumin excretion in patients with type 2 diabetes. Methods: We evaluated 332 patients with type 2 diabetes in a cross-sectional study. Result: The plasma LRG1 level differed significantly according to the quartiles of urinary albumin excretion (Q1 [<7.7 mg/g], 17.1 µg/mL; Q2 [7.7-15.0 mg/g], 17.5 µg/mL; Q3 [15.1-61.4 mg/g], 18.6 µg/mL; Q4 [≥61.5 mg/g], 22.3 µg/mL; p for trend = 0.003) under adjustment with other covariates. A positive correlation was found between plasma LRG1 level and urinary albumin excretion (ρ = 0.256, p <0.001). According to a multivariate model, the association between LRG1 and urinary albumin excretion remained significant, under adjustment for confounding factors (ß = 0.285, p <0.001). Conclusion: Plasma LRG1 level was independently associated with urinary albumin excretion in patients with type 2 diabetes. This study suggests that LRG1 may be associated with increased excretion of urinary albumin in the early stages of diabetic nephropathy.
Assuntos
Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Humanos , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Glicoproteínas , LeucinaRESUMO
This study aimed to investigate the association between galectin-3 concentration and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus (T2DM) with and without albuminuria. In this cross-sectional study, we examined 334 patients with T2DM. The eGFR was calculated using a creatinine-based formula (eGFRcrea) and a combined creatinine-cystatin C equation (eGFRcrea-cyst). The participants were categorized into two groups based on the urinary albumin-to-creatinine ratio (UACR): patients without albuminuria (UACR < 30 mg/g) and those with albuminuria (UACR ≥ 30 mg/g). Greater concentrations of plasma galectin-3 were associated with lower eGFRcrea-cyst and eGFRcrea levels in patients with and without albuminuria. Plasma galectin-3 concentrations were negatively correlated with eGFRcrea-cyst in patients with normoalbuminuria and albuminuria (γ = - 0.405, P < 0.001; γ = - 0.525, P < 0.001, respectively). Galectin-3 concentrations were significantly associated with eGFRcrea-cyst after adjusting for sex, age, and other confounding factors, including UACR as a categorical or continuous variable in multiple regression analyses (ß = - 0.294, 95% CI - 70.804 to - 41.768, P < 0.001; ß = - 0.265, 95% CI - 65.192 to - 36.550, P < 0.001, respectively). Likewise, when eGFRcrea-cyst was treated in place of eGFRcrea, this result was replicated in the correlation and regression analyses. Galectin-3 concentration was negatively associated with eGFR in patients with T2DM, independent of albuminuria status.
Assuntos
Cistos , Diabetes Mellitus Tipo 2 , Albuminas , Albuminúria , Creatinina , Estudos Transversais , Cistatina C , Diabetes Mellitus Tipo 2/complicações , Galectina 3 , Taxa de Filtração Glomerular , HumanosRESUMO
AIMS/INTRODUCTION: We investigated the classification of diabetic peripheral neuropathy (DPN) patients by subjective symptoms, and identification of the relationship between the patterns and intensities of symptoms and the clustered groups of DPN patients. MATERIALS AND METHODS: This multicenter study analyzed epidemiological data and sensory symptoms of 649 patients with DPN. Cluster analysis was carried out to identify subgroups of patients with characteristic symptom profiles. Factor analysis was carried out to investigate the symptom patterns of the clustered groups of DPN patients. RESULTS: Three clusters of patients with DPN were identified: severe symptoms with decreased quality of life (cluster 1, n = 119, 18.3%), predominantly insensate symptoms with relatively good quality of life (cluster 2, n = 318, 49.0%), and moderate pain intensity and decreased quality of life (cluster 3, n = 204, 31.4%). The frequency of symptoms on each item of the Michigan Neuropathy Screening Instrument questionnaire showed a similar distribution according to pain intensities along with the three clusters. CONCLUSIONS: Our study supports the hypothesis that diversity in sensory symptoms exists in patients with DPN. Heterogeneity in DPN patients should be taken into account for a more stratified or individualized treatment approach. Based on a multicenter study, we identified three clusters of patients with DPN. Our research supports the hypothesis that diversity in sensory symptoms exists in patients with DPN. Heterogeneity in DPN patients should be taken into account for a more stratified or individualized treatment approach.
Assuntos
Diabetes Mellitus Tipo 2 , Neuropatias Diabéticas , Humanos , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/epidemiologia , Dor , Fenótipo , Qualidade de VidaRESUMO
AIM: This study aimed to evaluate whether fibroblast growth factor 19 (FGF19) is associated with the risk of diabetic retinopathy in patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 357 patients with T2DM were investigated in this cross-sectional study. Logistic regression analysis was performed to assess the association between FGF19 level and diabetic retinopathy. RESULTS: Serum FGF19 level was significantly lower in patients with diabetic retinopathy in those without diabetic retinopathy. The multivariable analysis revealed a significant association between serum FGF19 level and diabetic retinopathy (odds ratio for every 1 standard deviation increase in logarithmic value = 0.69, 95% confidence interval 0.51-0.94, p = 0.019). CONCLUSION: Serum FGF19 level was negatively associated with diabetic retinopathy in patients with T2DM.
RESUMO
Peroxisome proliferator-activated receptor gamma (PPARγ) is a master transcription factor in adipocyte differentiation, while distal-less homeobox 5 (Dlx5) is essential for initiating osteoblast differentiation by driving Runt-related transcription factor 2 expression. Considering that adipocytes and osteoblasts share common progenitors, there is a reciprocal correlation between bone and fat formation. However, the mechanism by which Dlx5 controls PPARγ remains unclear. We elucidated that Dlx5 physically binds to PPARγ during immunoprecipitation; in particular, the ligand-binding and DNA-binding domains of PPARγ were involved in the interaction. Transcriptional activity of PPARγ was significantly decreased by Dlx5 overexpression, whereas the opposite results were detected with Dlx5 knockdown. Rosiglitazone, a PPARγ agonist, further enhanced the PPARγ-induced transcriptional activity; however, Dlx5 overexpression effectively repressed the rosiglitazone-mediated increase in activity. Finally, DNA-binding affinity assay revealed that Dlx5 interrupts the interaction of PPARγ with the PPARγ response element promoter. In conclusion, our findings indicate that Dlx5 impedes PPARγ-induced activity, and it may be useful for managing diabetes drug-mediated obesity.
Assuntos
Proteínas de Homeodomínio/metabolismo , PPAR gama/metabolismo , Células 3T3-L1 , Adipócitos/fisiologia , Animais , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/genética , Camundongos , PPAR gama/agonistas , Regiões Promotoras Genéticas , Domínios Proteicos , Rosiglitazona/farmacologia , Ativação TranscricionalRESUMO
AIM: To assess the relationship between growth differentiation factor-15 (GDF-15) levels and estimated glomerular filtration rate (eGFR) in type 2 diabetes mellitus (DM) patients with and without albuminuria. METHODS: We examined 324 patients with type 2 DM in a cross-sectional study. eGFR was determined using equations from creatinine (eGFRcr) and the combination of creatinine and cystatin C (eGFRcr-cys). The patients were classified into two groups based on urinary albumin: creatinine ratio (ACR): the normoalbuminuria group (urinary ACRâ¯<â¯30â¯mg/g) and the albuminuria group (urinary ACRâ¯≥â¯30â¯mg/g). RESULTS: In individuals both with and without albuminuria, higher GDF-15 levels were associated with lower eGFRcr and eGFRcr-cys. Plasma GDF-15 levels were inversely correlated with eGFRcr in individuals both with and without albuminuria (γâ¯=â¯-0.624, pâ¯<â¯0.001 and γâ¯=â¯-0.509, pâ¯<â¯0.001, respectively). A multiple regression analysis showed that GDF-15 levels were significantly associated with eGFRcr after adjusting for age, sex and other confounders, including urinary ACR as a continuous or categorical variable (ßâ¯=â¯-0.309, pâ¯<â¯0.001 and ßâ¯=â¯-0.318, pâ¯<â¯0.001, respectively). Similarly, these results were replicated when eGFRcr-cys was considered instead of eGFRcr in correlation and regression analyses. CONCLUSION: GDF-15 levels were inversely associated with eGFR in patients with type 2 DM. This relationship was independent of albuminuria status.
Assuntos
Diabetes Mellitus Tipo 2 , Insuficiência Renal Crônica , Albuminúria/complicações , Albuminúria/diagnóstico , Creatinina , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Taxa de Filtração Glomerular , Fator 15 de Diferenciação de Crescimento , HumanosRESUMO
BACKGROUND: Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). METHODS: From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. RESULTS: In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9±14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, -1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy. CONCLUSION: This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.
Assuntos
Diabetes Mellitus Tipo 2 , Glicemia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes/efeitos adversos , Estudos RetrospectivosRESUMO
The purpose of our study was to investigate the relationship between plasma growth differentiation factor-15 (GDF-15) concentrations and diabetic retinopathy in patients with type 2 diabetes mellitus (DM). We evaluated 235 patients with type 2 DM in a cross-sectional study. Significantly increased levels of the plasma GDF-15 were found in individuals with diabetic retinopathy versus those without. According to the degree of diabetic retinopathy, there was a significant difference in the average plasma GDF-15 levels (no diabetic retinopathy, 1114 ng/L; nonproliferative diabetic retinopathy, 1327 ng/L; proliferative diabetic retinopathy, 1445 ng/L; p for trend = 0.035) after adjustments for confounders. Logistic regression analyses indicated that plasma GDF-15 concentrations were significantly associated with diabetic retinopathy (odds ratio per 1 standard deviation increment in the log-transformed value, 1.78; 95% confidence interval, 1.05-3.03, p = 0.032). Our study showed a significant positive relationship between plasma GDF-15 concentrations and diabetic retinopathy in type 2 DM patients.
Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Retinopatia Diabética/metabolismo , Fator 15 de Diferenciação de Crescimento/metabolismo , Adulto , Idoso , Estudos Transversais , Feminino , Fator 15 de Diferenciação de Crescimento/sangue , Fatores de Diferenciação de Crescimento/sangue , Fatores de Diferenciação de Crescimento/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Índice de Gravidade de DoençaRESUMO
The aim of this study was to test the hypothesis that plasma sphingosine 1-phosphate (S1P) levels are associated with the risk of cardiovascular autonomic neuropathy (CAN) in type 2 diabetes patients. This cross-sectional study included 287 individuals with type 2 diabetes. CAN was evaluated using cardiovascular reflex tests. Logistic regression analyses were conducted to assess the relationship between plasma S1P levels and CAN. Plasma S1P concentrations were significantly lower in individuals with CAN than in those without CAN. There was a significant interaction between plasma S1P levels and sex with respect to CAN (p for interaction = 0.003). When stratified by sex, the association between plasma S1P levels and CAN exhibited a sex difference; in multivariable analysis, plasma S1P levels were significantly associated with CAN in women (odds ratio per standard deviation increase in the log-transformed value, 0.40; 95% confidence interval, 0.23-0.70, p = 0.001). However, there was no significant association between plasma S1P and CAN in men. Plasma S1P concentrations were inversely associated with CAN only in women with type 2 diabetes.
Assuntos
Diabetes Mellitus Tipo 2/sangue , Lisofosfolipídeos/sangue , Doenças do Sistema Nervoso/sangue , Esfingosina/análogos & derivados , Adulto , Idoso , Sistema Nervoso Autônomo , Sistema Cardiovascular/inervação , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Análise de Regressão , Fatores de Risco , Esfingosina/sangueRESUMO
BACKGROUND: Adequate suppression of bone turnover rate is important to decrease fracture risk without mineralization defect due to oversuppression. This study was performed to determine reference intervals (RIs) for 2 bone turnover markers, serum C-terminal telopeptide of type I collagen (CTX) and osteocalcin, in Korean women. METHODS: A total of 461 Korean women (287 premenopausal and 174 postmenopausal) without any disease or drug history affecting bone metabolism was included. Serum CTX and osteocalcin were measured after overnight fasting. Bone mineral density (BMD) was measured at the 1st to 4th lumbar vertebra using dual energy X-ray absorptiometry. Subjects with normal spinal BMD (T-score ≥-1.0) were included in this study. RESULTS: After stable concentrations were maintained, both CTX and osteocalcin were abruptly increased in 50 to 59 years, and then decreased with increasing age. Median levels and interquartile range of serum CTX and osteocalcin in all subjects were 0.322 (0.212-0.461) ng/mL and 15.68 (11.38-19.91) ng/mL. RIs for serum CTX and osteocalcin in all subjects were 0.115 to 0.861 ng/mL and 6.46 to 36.76 ng/mL. Those were higher in postmenopausal women (CTX, 0.124-1.020 ng/mL, osteocalcin, 5.42-41.57 ng/mL) than in premenopausal women (CTX, 0.101-0.632 ng/mL, osteocalcin, 6.73-24.27 ng/mL). If we use target reference levels as lower half of premenopausal 30 to 45 years in patients with antiresorptive drugs, those were 0.101 to 0.251 ng/mL and 6.40 to 13.36 ng/mL. CONCLUSIONS: We established RIs for serum CTX and osteocalcin in healthy Korean women with normal lumbar spine BMD. Premenopausal RIs for serum CTX and osteocalcin would be useful to monitor patients with low bone mass using osteoporosis drugs.
RESUMO
BACKGROUND: Diabetes mellitus (DM) is the most common chronic metabolic disorder with an increasing prevalence worldwide. According to a previous study, physicians' treatment patterns or patients' behaviors change when they become aware of the risk for cardiovascular (CV) disease in patients with DM. However, there exist controversial reports from previous studies in the impact of physicians' behaviors on the patients' quality of life (QoL) improvements. So we investigate the changes in QoL according to physicians and patients' behavioral changes after the awareness of CV risks in patients with type 2 DM. METHODS: Data were obtained from a prospective, observational study where 799 patients aged ≥40 years with type 2 DM were recruited at 24 tertiary hospitals in Korea. Changes in physicians' behaviors were defined as changes in the dose/type of antihypertensive, lipid-lowering, and anti-platelet therapies within 6-month after the awareness of CV risks in patients. Changes in patients' behaviors were based on lifestyle modifications. Audit of Diabetes Dependent Quality of Life comprising 19-life-domains was used. RESULTS: The weighted impact score change for local or long-distance journey (P=0.0049), holidays (P=0.0364), and physical health (P=0.0451) domains significantly differed between the two groups; patients whose physician's behaviors changed showed greater improvement than those whose physician's behaviors did not change. CONCLUSION: This study demonstrates that changes in physicians' behaviors, as a result of perceiving CV risks, improve QoL in some domains of life in DM patients. Physicians should recognize the importance of understanding CV risks and implement appropriate management.
Assuntos
Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/complicações , Padrões de Prática Médica , Qualidade de Vida , Idoso , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/terapia , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
OBJECTIVE: To investigate the association between serum C-peptide level and cardiovascular autonomic neuropathy (CAN) in individuals with type 2 diabetes mellitus (DM) according to estimated glomerular filtration rate (eGFR) METHODS: In a cross-sectional study, we examined 939 individuals with type 2 DM. We measured fasting C-peptide, 2-hour postprandial C-peptide, and ΔC-peptide (postprandial C-peptide minus fasting C-peptide) levels. The individuals were classified into 2 groups based on eGFR: individuals without impaired renal function (eGFR ≥60 mlâmin-1 1.73m-2) and those with impaired renal function (eGFR <60 mlâmin-1 1.73m-2). RESULTS: Individuals with CAN had lower fasting C-peptide, postprandial C-peptide, and ΔC-peptide levels in patients both with and without impaired renal function. Multivariate logistic regression analyses adjusted for gender, age, and other confounders, including eGFR, showed that serum C-peptide level was significantly associated with CAN (odds ratio [OR] per standard deviation increase in the log-transformed value, 0.67; 95% confidence interval [CI], 0.52-0.87 for fasting C-peptide, P < 0.01; OR, 0.62; 95% CI, 0.47-0.83 for postprandial C-peptide, P < 0.01; OR, 0.71; 95% CI, 0.54-0.93 for ΔC-peptide, P < 0.05). CONCLUSIONS: Serum C-peptide level was negatively associated with CAN in individuals with type 2 DM independent of eGFR.
Assuntos
Peptídeo C/sangue , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/sangue , Adulto , Idoso , Sistema Nervoso Autônomo/fisiopatologia , Doenças do Sistema Nervoso Autônomo/sangue , Doenças do Sistema Nervoso Autônomo/etiologia , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas/sangue , Angiopatias Diabéticas/etiologia , Angiopatias Diabéticas/fisiopatologia , Nefropatias Diabéticas/sangue , Nefropatias Diabéticas/etiologia , Nefropatias Diabéticas/fisiopatologia , Neuropatias Diabéticas/etiologia , Neuropatias Diabéticas/fisiopatologia , Feminino , Taxa de Filtração Glomerular/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
The published data regarding the role of serum apolipoprotein (apo) A-I, apoB, and the apoB/A-I ratio in the risk of diabetic retinopathy remain inconsistent, and there is limited information about the effect of renal status on their associations in individuals with type 2 diabetes. The aim of this study was to investigate whether serum apoA-I, apoB, and the apoB/A-I ratio are associated with the presence of diabetic retinopathy in type 2 diabetes and to explore whether the relationships between these apolipoproteins and diabetic retinopathy are modified by urinary albumin excretion rate (UACR) and estimated glomerular filtration rate (eGFR).In total, 1215 individuals with type 2 diabetes were included in this cross-sectional study. Serum levels of apoA-I and apoB and the apoB/apoA-I ratio were measured. A logistic regression model was performed to explore associations of apolipoproteins with retinopathy.Individuals with diabetic retinopathy had significantly lower levels of serum apoA-I and higher apoB/apoA-I ratio than those without diabetic retinopathy. In the multivariable analyses, the associations between apoA-I and diabetic retinopathy and between the apoB/apoA-I ratio and diabetic retinopathy were statistically significant after adjustment for the traditional risk factors (odds ratio [OR] per standard deviation [SD] increase in the log-transformed value; 0.55, 95% confidence interval (CI); 0.32 to 0.97, Pâ=â.038; OR per SD increase in the log-transformed value; 2.83, 95% CI; 1.18 to 6.76, Pâ=â.019; respectively). Additional adjustments for UACR or eGFR removed the significant associations.In individuals with type 2 diabetes, serum apoA-I and the apoB/apoA-I ratio are associated with presence of diabetic retinopathy, which might be attributable to the correlated changes in UACR and eGFR.
Assuntos
Albuminúria/urina , Apolipoproteínas/sangue , Diabetes Mellitus Tipo 2/sangue , Retinopatia Diabética/sangue , Taxa de Filtração Glomerular/fisiologia , Adulto , Idoso , Apolipoproteína A-I , Apolipoproteína B-100 , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Retinopatia Diabética/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
F-18 fluorodeoxyglucose (FDG)-avid metastatic lesions are associated with a poor response to radioiodine ablation therapy (RIT) in papillary thyroid cancer (PTC). This study evaluated the significance of preablative FDG positron emission tomography (PET) for the assessment of risk factors and frequency of malignant FDG-avid lymph nodes in patients with PTC undergoing RIT.The study included 339 consecutive patients (mean age 46.3â±â12.5 y; 260 females) with PTC referred for the first RIT and who underwent routine preablative FDG PET between April 2011 and February 2013. FDG-avid lymph nodes (FALNs) were identified using retrospective image reviews. The frequency of malignant FALN (mFALN), its contribution to persistent or recurrent PTC, and its risk factors were analyzed.Among the patients, 112 had FALNs (33.0%): 11 mFALNs (3.2%) and 101 benign FALNs (bFALNs, 29.8%). mFALN contributed to 55% of persistent or recurrent PTC after RIT, which was observed in 20 of 339 patients (5.9%) during the post-RIT follow-up. Among preoperative risk factors, suspicious extrathyroidal extension and lateral neck lymph node metastasis on imaging studies were associated with mFALN. Among postoperative risk factors, T3/T4 and N1b stages, higher stimulated thyroglobulin, and higher numbers of metastatic lymph nodes and dissected lymph nodes, were associated with mFALN.mFALNs were observed in a small number of patients with PTC undergoing RIT, but it contributed 55% of total recurrent or persistent disease. Increased frequency of mFALNs is associated with more advanced PTC. Preablative FDG PET has value in evaluation of patients with RIT-resistant lesions and may help determine further treatment strategies.
Assuntos
Fluordesoxiglucose F18 , Metástase Linfática/diagnóstico por imagem , Recidiva Local de Neoplasia/tratamento farmacológico , Tomografia por Emissão de Pósitrons/métodos , Câncer Papilífero da Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Feminino , Humanos , Radioisótopos do Iodo , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/radioterapia , Prognóstico , Compostos Radiofarmacêuticos , República da Coreia , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Câncer Papilífero da Tireoide/mortalidade , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/radioterapia , Neoplasias da Glândula Tireoide/mortalidade , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/radioterapiaRESUMO
The purpose of the study was to test the hypothesis that anemia is related with serum C-peptide concentrations in individuals with type 2 diabetes mellitus (DM).This cross-sectional study was carried out in 1300 individuals with type 2 DM. We measured fasting C-peptide, 2-hour postprandial C-peptide, and postprandial C-peptide minus fasting C-peptide (ΔC-peptide) concentrations. Anemia was defined as hemoglobin (Hb) concentrations <130âg/L in men and <120âg/L in women. Anemia was graded into 2 groups: grade I anemia of Hb concentrations ≥110âg/L and grade II anemia of Hb concentrations <110âg/L.Fasting C-peptide, postprandial C-peptide, and ΔC-peptide concentrations were lower in individuals with anemia. According to the grade of anemia, the average C-peptide concentrations differed significantly after adjusting for other covariates. In the multivariable model, the statistically significant relation between anemia and serum C-peptide concentrations remained after adjusting for confounders, including age, gender, family history of diabetes, body mass index, duration of diabetes, glycated Hb, free fatty acids, hypertension, and hyperlipidemia (fasting C-peptide concentration: ßâ=â-0.057, Pâ=â.032; postprandial C-peptide concentration: ßâ=â-0.098, Pâ<â.001; ΔC-peptide concentration: ßâ=â-0.095, Pâ<â.001).Anemia was inversely associated with serum C-peptide concentrations in individuals with type 2 DM.
Assuntos
Anemia/sangue , Anemia/epidemiologia , Peptídeo C/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Adulto , Idoso , Peptídeo C/metabolismo , Estudos Transversais , Jejum/metabolismo , Feminino , Hemoglobinas Glicadas , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial/fisiologiaRESUMO
OBJECTIVE: To evaluate the relationship between levels of serum apolipoproteins and the prevalence of cardiovascular autonomic neuropathy (CAN) in type 2 diabetes. METHODS: In total, 3199 individuals with type 2 diabetes were investigated in a cross-sectional study. The diagnosis of CAN was made based on the results of a cardiovascular reflex test. Serum apolipoprotein A-I (apoA-I) and apolipoprotein B (apoB) levels were measured. RESULTS: Serum apoA-1 levels were significantly low in individuals with CAN, but there was no significant association between serum apoB levels and CAN. According to the degree of cardiovascular autonomic dysfunction, the average apoA-I levels were significantly different after adjusting for other covariates (normal, 1.32â¯g/l, 95% confidence interval [CI] 1.30-1.35; early, 1.29â¯g/l, 95% CI 1.27-1.31; definite, 1.27â¯g/l, 95% CI 1.25-1.30; P for trendâ¯=â¯0.010). In the multivariable analysis, the statistically significant association between apoA-I and CAN remained after adjusting for the risk factors (odds ratio per standard deviation increase in the log-transformed value, 0.65; 95% CI, 0.43-0.97, Pâ¯=â¯0.036). Additional adjustments for serum high-sensitivity C-reactive protein (or fibrinogen) concentrations eliminated this relationship. CONCLUSIONS: Serum apoA-I levels are inversely associated with the prevalence of CAN in individuals with type 2 diabetes. Our data also suggest that a putatively increased risk of CAN associated with decreased apoA-I levels might be mediated by correlated increases in the levels of inflammatory markers.
Assuntos
Apolipoproteína A-I/sangue , Doenças Cardiovasculares/sangue , Diabetes Mellitus Tipo 2/sangue , Neuropatias Diabéticas/sangue , Idoso , Apolipoproteínas B/sangue , Doenças Cardiovasculares/etiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Neuropatias Diabéticas/etiologia , Feminino , Coração/inervação , Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição AleatóriaRESUMO
BACKGROUND: The aim of this study is to determine the proportion of cancers presenting with parathyroid hormone (PTH) related protein (PTHrP)-mediated hypercalcemia, examine the clinical and biochemical characteristics, identify predictive factors for survival. And we also compared those characteristics between solid organ and hematologic malignancy groups. METHODS: Cancer patients with PTHrP-mediated hypercalcemia who were treated at Chonnam National University Hospital in Korea from January 2005 to January 2015 were retrospectively reviewed. RESULTS: Of all 115 patients, solid organ malignancies were the most common etiology (98 cases, 85.2%), with squamous cell carcinoma (50 cases, 43.4%), adenocarcinoma (27 cases, 23.4%). Interestingly, hepatocellular carcinoma (HCC; 18 cases, 15.7%) and cholangiocarcinoma (11 cases, 9.6%) were much more common causes than other previous reports. Hematologic malignancy was less common (17 cases, 14.8%), with multiple myeloma (9 cases, 7.8%) and non-Hodgkin's lymphoma (5 cases, 4.3%). Overall median survival was only 37 days. There was significant difference in median survival between two groups (35 days for solid organ malignancy and 72 days for hematologic malignancy; P=0.015). Cox regression analysis identified age, the type of malignancy and the time interval of developing hypercalcemia after cancer diagnosis as independent predictive factors for survival time. CONCLUSIONS: PTHrP-mediated hypercalcemia was most frequently caused by solid organ malignancy. However, HCC and cholangiocarcinoma were important causes of PTHrP-mediated hypercalcemia may be due to geographic differences in cancer incidence in Korean population. Age, the type of malignancy and the time interval of developing hypercalcemia after cancer diagnosis were independent poor predictive factors for survival time.
RESUMO
BACKGROUND: Although previous studies have established a close relationship between caloric intake and metabolic syndrome, there is limited research exploring the impact of meal frequency adjusted by caloric intake on metabolic syndrome (MetS). OBJECTIVE: To evaluate the association of meal frequency and MetS after adjusting for confounding factors including caloric intake in Korean men and women. METHODS: We analyzed the national representative data of a total 12,389 adults (5171 men, 7218 women) from the Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2012. Subjects were categorized as eating 3 meals/day (MF3) or 2 or fewer meals/day (MF ≤ 2). Daily caloric intake was calculated using CAN-Pro 4.0 (The Korean Nutrition Society, Seoul, Korea). RESULTS: The prevalence of components of MetS differed significantly according to meal frequency in both men and women. In an unadjusted analysis, the prevalence of MetS in women was significantly higher in the MF3 group than the MF ≤ 2 group (27.5% vs. 17.8%, P < 0.001), whereas the prevalence of MetS in men did not differ between the MF3 and MF ≤ 2 groups (24.6% vs. 22.7%, P = 0.281). However, after adjusting for age, caloric intake, smoking status, alcohol consumption, physical activity, income, and education level, men in the MF ≤ 2 group had an increased risk of metabolic syndrome compared to men in the MF3 group (OR = 1.37, 95%, CI = 1.12-1.67). On the other hand, meal frequency did not affect the risk of metabolic syndrome in women after adjusting for confounding factors including caloric intake (OR = 1.09, 95%, CI = 0.90-1.31). CONCLUSIONS: This study suggests that lower meal frequency adjusted for caloric intake, physical activity, age, smoking, alcohol, income, and education may be associated with increased risk of MetS in Korean men.
RESUMO
To investigate the relationship among anemia, physiological serum bilirubin levels, and cardiovascular autonomic neuropathy (CAN) in subjects with type 2 diabetes. In total, 2230 subjects with type 2 diabetes were evaluated in this cross-sectional study. CAN was diagnosed with a cardiovascular reflex test. The prevalence of anemia was greater in subjects with CAN. In multivariable analysis, the relationship between anemia and CAN remained statistically significant after adjusting for the risk factors (odds ratio [OR] 1.39; 95% confidence interval [CI] 1.07-1.80, Pâ=â.015). Additional adjustment for serum bilirubin concentrations abolished this relationship (OR 1.20, 95% CI 0.91-1.58, Pâ=â.189). Anemia is positively associated with the prevalence of CAN in subjects with type 2 diabetes. In addition, our results suggest that the putative increased CAN risk associated with anemia might be mediated by a correlated decrease in serum bilirubin levels.