Assessment of Mortality Rate, Need for ICU Admission and Ventilation in COVID-19 Patients with Diabetes Mellitus.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has become a threat to public health. People with chronic diseases, such as diabetes, are at a greater risk of severe diseases and death upon contracting this new disease. Due to the novelty of COVID-19, no specific information is available about the degree of its mortality and risk factors among diabetic patients. Therefore, this study aims to compare diabetic and nondiabetic COVID-19 patients regarding mortality rate, the need for intensive care unit (ICU) admission, invasive and noninvasive ventilation, and the associated risk factors. METHODS: This was a cross-sectional study performed on the medical records of 650 adult COVID-19 patients (325 diabetics and 325 nondiabetics) admitted to Razi Hospital in Ahvaz from March 2020 to September 2020. RESULTS: The mean age of the patients was 61.3 years in the diabetic group and 52.3 years in the nondiabetic group. Men comprised 48.3% of the diabetic group and 59.7% of the nondiabetic group. Diabetic patients suffered from significantly more underlying diseases, such as ischemic heart disease (IHD), hypertension (HTN), chronic kidney disease (CKD), and acute renal failure (ARF) compared to the nondiabetic group (p < 0.0001). Also, when compared with the nondiabetic group, the diabetic group had a significantly higher mortality rate (17.5% vs. 12%; p = 0.047, respectively), more ICU admissions (35.4% vs. 27.7%; p = 0.035, respectively), and a greater need for invasive ventilation (17.5% vs. 11.4%; p = 0.026, respectively). CONCLUSION: In diabetic patients, the mortality rate, need for ICU admission, and need for invasive ventilation were significantly higher than nondiabetic patients. Our logistic regression analysis in diabetic patients with COVID-19 showed that age, CKD, and ARF were the risk factors affecting mortality. In contrast, age and CKD were the risk factors affecting the rate of ICU admission, and CKD and ARF were the risk factors affecting the need for invasive ventilation.

Association between heavy metals and metabolic syndrome in drinking water and surface soil: case-control study in Iran.

Although obesity is a major risk factor for metabolic syndrome (MetS), not all obese people develop MetS that is directly related to obesity. This suggests that the risk of MetS is influenced by other genetic or environmental agents such as heavy metals. The aim of this study was to investigate the relationship between heavy metals in drinking water and surface soil, and its relationship with the incidence of MetS. To determine the sampling points of drinking water and surface soil, from the location of 150 people selected for inclusion in the study, 16 points were selected randomly for heavy metal concentration analysis. Results were indicated that mean concentrations of V, Mn, Ni, As, Cd, and Sr in drinking water of MetS group were higher than control group. The concentration of heavy metals in drinking water, except for Mn and Sr, did not show a significant difference between case and control groups. The results of this study showed that concentration of heavy metals in drinking water and surface soil was positively associated with the incidence of MetS.

Association between the rs615563 variant of PCSK9 gene and circulating lipids and Type 2 diabetes.

OBJECTIVE: Many different genetic variants of proprotein convertase subtilisin kexin 9 (PCSK9) are related to the serum levels of cholesterol and LDL cholesterol (LDL-C). The rs615563 variant of PCSK9 (a gain-of-function mutation) is associated with increased triglycerides and cholesterol levels, but its association with the incidence of diabetes is not well defined. This study aimed to investigate the relationship between the PCSK9 rs615563 variant with the incidence of type 2 diabetes. The data reported in this study are based on subsamples from a 5-year (2009-2014) cohort study of the adult population (590 subjects) aged 20 years and older. The rs615563 polymorphism was genotyped using polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP) analysis. RESULTS: The distribution of PCSK9 rs615563 genotypes was not significantly different between the diabetic and non-diabetic individuals. The incidence of diabetes after five-years of follow-up was not different between the genotypes. Our findings also showed no significant relationship between this polymorphism and serum lipid parameters. The data extracted from our cohort study do not support the findings that the gain-of-function mutations of PCSK9 predispose to the incidence of type 2 diabetes.

Relationship between urinary heavy metals with metabolic syndrome and its components in population from Hoveyzeh cohort study: A case-control study in Iran.

BACKGROUND: The incidence of Metabolic Syndrome (MetS) has been growing rapidly and is rising to pandemic proportions. Although obesity is a primary risk factor for the enhancement of these conditions, not all obese individuals develop metabolic syndrome, indicating that the risk for developing MetS is impacted by other genetic and/or environmental factors such as heavy metals. Therefore, the present study focused on the association between exposures to heavy metal and MetS. METHODS: Urine samples were collected from 150 participants (75 patients with MetS and 75 healthy participants), which were used from Hoveyzeh Cohort center. To make a quantitative comparison between the two groups, Man-Whitney nonparametric test was used. The logistic regression was performed adjusted for age, demographic, lifestyle factor, physical activity, occupational history and urine creatinine. RESULTS: The results of logistic regression showed that OR and 95 % CI for Cd, Pb, Sr, As and Fe concentration were still significant after adjusting for urine creatinine. Moreover, there was a relationship between Cd and Pb levels and waist circumstance (WC). After adjusting for urine creatinine, age, sex, occupation, smoking status, education and place of residence, only Pb concentration was showed a significant association with systolic blood pressure (SBP). The subjects with high urine level of Cd had the high odds (OR: 6.273; 95 % Cl: 1.783-22.070) of MetS and low high-density lipoprotein (HDL-C). The relationship between As concentration and high fasting blood sugars confirmed the previous evidence suggesting that high As level can cause diabetes. CONCLUSION: These results indicated that outbreak of MetS and its component are associated with heavy metal concentrations in urine.

Albuminuria and its correlates in type 2 diabetic patients.

INTRODUCTION: The aim of this study was to determine the prevalence of albuminuria and its correlates and investigate disease management for patients with type 2 diabetes mellitus in Ahvaz. MATERIALS AND METHODS: This was a cross-sectional study on the 350 patients with type 2 diabetes mellitus attending the Diabetes Clinic at Golestan Hospital, from October 2010 to September 2011. Demographic characteristics were recorded and height, weight, and blood pressure were measured. Blood urea nitrogen and serum levels of creatinine, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, and glycosylated hemoglobin A were measured in fasting blood samples. Spot urine and 24-hour urine collection were tested for albumin and kidney ultrasonography was done. RESULTS: A total of 72 of 350 patients (20.6%) had microalbuminuria and 18 (5.1%) had macroalbuminuria. Elevated serum creatinine was seen in 6.9% and azotemia in 6.0%. In multivariable analysis, blood urea nitrogen level, glycosylated hemoglobin A, and duration of diabetes mellitus were associated with urinary albumin excretion (P = .04). A small proportion of the participants achieved optimal treatment goals for modifiable risk factors. CONCLUSIONS: Abnormal urinary albumin excretion is seen in one-quarter of type 2 diabetic patients and a small but important number of them have azotemia. Albuminuria was found to be associated with long-term duration of diabetes mellitus, poor glucose control (revealed by high glycosylated hemoglobin A levels), and high blood urea nitrogen. Poor glycemic control may have a significant role in the progression of diabetic nephropathy in these patients.