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1.
Braz. j. biol ; 84: e250739, 2024. tab
Article in English | LILACS, VETINDEX | ID: biblio-1355896

ABSTRACT

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.


Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.


Subject(s)
Humans , Receptors, Calcitriol/genetics , Diabetes Mellitus, Type 2/genetics , Diabetes Mellitus, Type 2/epidemiology , Saudi Arabia , Case-Control Studies , Polymorphism, Single Nucleotide , Gene Frequency , Genotype
2.
Rev. latinoam. enferm. (Online) ; 31: e4088, Jan.-Dec. 2023. tab, graf
Article in Spanish | LILACS, BDENF | ID: biblio-1530190

ABSTRACT

Objetivo: analizar la correlación entre el tiempo en rango y la hemoglobina glicosilada de personas que viven con diabetes mellitus y realizan la monitorización continua de la glucemia o el automonitoreo de la glucemia capilar Método: revisión sistemática de etiología y riesgo basada en las directrices del JBI e informada según los Preferred Reporting Items for Systematic Reviews and Meta-Analyses, abarcando seis bases de datos y la literatura gris. La muestra incluyó 16 estudios y la calidad metodológica fue evaluada utilizando las herramientas del JBI. Protocolo registrado en Open Science Framework, disponible en https://doi.org/10.17605/OSF.IO/NKMZB. Resultados: tiempo en rango (70-180 mg/dl) mostró una correlación negativa con la hemoglobina glicosilada, mientras que el tiempo por encima del rango (>180 mg/dl) mostró una correlación positiva. Los coeficientes de correlación variaron entre -0,310 y -0,869 para el tiempo en rango, y entre 0,66 y 0,934 para el tiempo por encima del rango. Un estudio se realizó en una población que hacía el automonitoreo. Conclusión: hay una correlación estadísticamente significativa entre el tiempo en rango y el tiempo por encima del rango con la hemoglobina glicosilada. Cuanto mayor sea la proporción en el rango glucémico adecuado, más cerca o por debajo del 7% estará la hemoglobina glicosilada. Se necesitan más estudios que evalúen esta métrica con datos del automonitoreo de la glucemia.


Objective: to analyze the correlation between time on target and glycated hemoglobin in people living with diabetes mellitus and carrying out continuous blood glucose monitoring or self-monitoring of capillary blood glucose. Method: systematic review of etiology and risk based on JBI guidelines and reported according to Preferred Reporting Items for Systematic Reviews and Meta- Analyses, covering six databases and grey literature. The sample included 16 studies and methodological quality was assessed using JBI tools. Protocol registered in the Open Science Framework, available at https://doi.org/10.17605/OSF.IO/NKMZB. Results: time on target (70-180 mg/dl) showed a negative correlation with glycated hemoglobin, while time above target (>180 mg/dl) showed a positive correlation. Correlation coefficients ranged between -0.310 and -0.869 for time on target, and between 0.66 and 0.934 for time above target. A study was carried out on a population that performed self-monitoring. Conclusion: there is a statistically significant correlation between time on target and time above target with glycated hemoglobin. The higher the proportion in the adequate glycemic range, the closer to or less than 7% the glycated hemoglobin will be. More studies are needed to evaluate this metric with data from self-monitoring of blood glucose.


Objetivo: analisar a correlação entre o tempo no alvo e a hemoglobina glicada de pessoas que vivem com diabetes mellitus e realizam a monitorização contínua da glicemia ou a automonitorização da glicemia capilar. Método: revisão sistemática de etiologia e de risco pautada nas diretrizes do JBI e reportada conforme Preferred Reporting Items for Systematic Reviews and Meta-Analyses, abrangendo seis bases de dados e a literatura cinzenta. A amostra incluiu 16 estudos e a qualidade metodológica foi avaliada utilizando as ferramentas do JBI. Registrado protocolo no Open Science Framework, disponível em https://doi.org/10.17605/OSF.IO/NKMZB. Resultados: tempo no alvo (70-180 mg/dl) apresentou correlação negativa com a hemoglobina glicada, enquanto o tempo acima do alvo (>180 mg/dl) mostrou correlação positiva. Os coeficientes de correlação variaram entre -0,310 e -0,869 para o tempo no alvo, e entre 0,66 e 0,934 para o tempo acima do alvo. Um estudo foi efetuado com população que realizava a automonitorização. Conclusão: há correlação estatisticamente significativa entre o tempo no alvo e o tempo acima do alvo com a hemoglobina glicada. Quanto maior a proporção na faixa glicêmica adequada, mais próxima ou inferior a 7% estará a hemoglobina glicada. São necessários mais estudos que avaliem essa métrica com dados da automonitorização da glicemia.


Subject(s)
Humans , Blood Glucose , Glycated Hemoglobin , Blood Glucose Self-Monitoring , Diabetes Mellitus, Type 2
3.
Int. j. morphol ; 41(5): 1580-1586, oct. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1521044

ABSTRACT

SUMMARY: Middle cerebral artery (MCA), which has the largest irrigation area of the arteries that feed the brain, is an important artery whose microanatomy should be well known because of its vascular variation. In pathologies which are known to affect the cerebrovascular system such as type 2 diabetes mellitus (T2DM) and hypertension, morphometric characteristics of MCA gain importance. The aim of this study is to compare the morphometric characteristics of M1 segment of MCA in T2DM and hypertensive patients with those of healthy control group by using computed tomographic angiography (CTA). The study was carried out with retrospective morphometric analysis of CTA images of 200 individuals between 40 and 65 years of age. The individuals were grouped in four as hypertensive patients (group 1), patients with T2DM (group 2), patients with hypertension and T2DM (group 3) and healthy control group (group 4). Length and diameter measurements of M1 segment were performed and recorded by using 3D CTA images. While statistically significant difference was found between bilateral M1 segment diameters of both women and men (p0.05). As a result of the post hoc analysis performed, it was concluded that right and left M1 segment diameter of group 1, group 2 and group 3 was found to be different from group 4 in both sexes (p<0.05). We believe that this study will both be a guide in radio-anatomic assessments to be performed and also increase microanatomic level of information in the surgical treatment of the artery by showing the morphometric changes that occur in M1 segment of MCA in T2DM diseases.


La arteria cerebral media (ACM), que otorga la mayor área de irrigación de las arterias que alimentan el cerebro, es un vaso importante cuya microanatomía debe ser bien conocida por su variación vascular. En patologías que afectan al sistema cerebrovascular, como la diabetes mellitus tipo 2 (DM2) y la hipertensión, las características morfométricas de la ACM cobran importancia. El objetivo de este estudio fue comparar las características morfométricas del segmento M1 de la ACM en pacientes con DM2 e hipertensos con las del grupo control sano mediante el uso de angiografía por tomografía computada (TC). El estudio fue realizado através de análisis morfométrico retrospectivo de imágenes de TC de 200 individuos entre 40 y 65 años de edad. Los individuos fueron divididos en cuatro grupos, como pacientes hipertensos (grupo 1), pacientes con DM2 (grupo 2), pacientes con hipertensión y DM2 (grupo 3) y grupo control sano (grupo 4). Las mediciones de longitud y diámetro del segmento M1 se realizaron y registraron utilizando imágenes 3D TC. Si bien se encontraron diferencias estadísticamente significativas entre los diámetros bilaterales de los segmentos M1 de mujeres y hombres (p0,05). Como resultado del análisis post hoc realizado, se concluyó que el diámetro de los segmentos M1 derecho e izquierdo del grupo 1, grupo 2 y grupo 3 fue diferente del grupo 4 en ambos sexos (p<0.05). Creemos que este estudio será una guía en las evaluaciones anátomo-radiológicas y también mejorará el nivel de información microanatómica en el tratamiento quirúrgico al mostrar los cambios morfométricos que ocurren en el segmento M1 de la ACM en las enfermedades con DM2.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Middle Cerebral Artery/diagnostic imaging , Diabetes Mellitus, Type 2 , Computed Tomography Angiography , Hypertension
4.
Medicentro (Villa Clara) ; 27(3)sept. 2023.
Article in Spanish | LILACS | ID: biblio-1514498

ABSTRACT

Se presenta un paciente masculino de 60 años de edad, con antecedentes de padecer diabetes mellitus tipo II complicada con retinopatía diabética, así como glaucoma neovascular de tórpida evolución en el ojo izquierdo. Acude a consulta de glaucoma en el Centro Oftalmológico del Hospital Universitario Clínico- Quirúrgico «Arnaldo Milián Castro» de Villa Clara por presentar visión borrosa y molestias oculares en su ojo derecho. Al examen oftalmológico de dicho ojo se observa: disminución de la visión, sangramiento activo proveniente de vaso iridiano, edema corneal, rubeosis iridiana, hipertensión ocular y al fondo de ojo retinopatía diabética; se realizan complementarios hemáticos que muestran cifras de glicemia elevada (20 mmol/l). Se plantea el diagnóstico de glaucoma neovascular del ojo derecho en el curso de una diabetes mellitus tipo II descompensada. Se le indica tratamiento médico - quirúrgico y se logra una evolución favorable.


We present a 60-year-old male patient with a history of type II diabetes mellitus complicated by diabetic retinopathy, as well as neovascular glaucoma of torpid evolution in his left eye. He came to the glaucoma consultation in the Ophthalmological Center at "Arnaldo Milián Castro" Clinical and Surgical University Hospital in Villa Clara due to blurred vision and ocular discomfort in his right eye. Decreased vision, active bleeding from the iris vessel, corneal edema, iris rubeosis, ocular hypertension was observed in such eye at ophthalmological examination and diabetic retinopathy at eye fundus; blood tests were performed showing elevated glycemia figures (20 mmol /l). The diagnosis of neovascular glaucoma of the right eye is stated in the course of a decompensated type II diabetes mellitus. Medical and surgical treatment is indicated and a favourable evolution is achieved.


Subject(s)
Corneal Edema , Glaucoma, Neovascular , Diabetes Mellitus, Type 2 , Diabetic Retinopathy
5.
rev.cuid. (Bucaramanga. 2010) ; 14(3): 1-15, 20230901.
Article in Spanish | LILACS, BDENF, COLNAL | ID: biblio-1525797

ABSTRACT

Introducción: La diabetes mellitus tipo 2 es una de las principales causas de morbimortalidad en el mundo, su prevalencia es aún mayor en países de medianos y bajos ingresos. El automanejo es una estrategia que ha demostrado controlar las enfermedades crónicas. Objetivo: Determinar la factibilidad y eficacia preliminar de la intervención educativa AMAS + Vida enfocada en el automanejo de la salud dirigida a personas adultas con diabetes tipo 2 en una Institución de salud de primer nivel en Neiva, Colombia. Materiales y Métodos: Estudio de factibilidad, pre test ­ post test con un solo grupo, para establecer la eficacia preliminar de la intervención. Muestra intencional de 36 adultos con diabetes tipo 2. Los instrumentos empleados fueron ficha de caracterización y escala Partners in Health para medir automanejo. Resultados: 31 adultos con diabetes completaron el seguimiento de 3 meses, mayoría eran mujeres, con bajo nivel socioeconómico y educativo, hubo buena factibilidad de la intervención. Los participantes mejoraron significativamente los conocimientos de la enfermedad (p < 0,001); además hábitos alimenticios (p = 0,001), comportamientos de automanejo de la salud (p < 0,001) y disminución del índice de masa corporal (p = 0,01). No hubo cambios significativos en la actividad física (p = 0,125). Discusión: Las intervenciones basadas en el automanejo estructuradas bajo la teoría de adaptación a las enfermedades crónicas logran cambios en la promoción de la salud en personas con diabetes. Conclusiones: La intervención tuvo eficacia preliminar en el grupo estudiado con buena factibilidad. Se recomienda continuar desarrollando estudios de tipo experimental.


Introduction: Type 2 diabetes mellitus is a leading cause of morbidity and mortality worldwide, and its prevalence is even higher in middle- and low-income countries. Self-management is a strategy that has been shown to control chronic diseases. Objective: To determine the feasibility and preliminary efficacy of the AMAS + Vida educational intervention focused on health self-management in adults with type 2 diabetes in a primary health care facility in Neiva, Colombia. Materials and Methods: Feasibility study using a one-group pretest-posttest design to determine the preliminary efficacy of the intervention. Purposive sample of 36 adults with type 2 diabetes. The instruments used were a characterization form and the Partners in Health scale to measure self-management. Results: Thirty-one adults with diabetes completed the 3-month follow-up, most of whom were women with low socioeconomic and educational levels. The feasibility of the intervention was good. Participants significantly improved disease knowledge (p < 0.001), eating habits (p = 0.001), health self-management behaviors (p < 0.001), and decreased body mass index (p = 0.01). There were no significant changes in physical activity (p = 0.125). Discussion: Self-management-based interventions, structured according to the theory of adaptation to chronic illness, achieve health-promoting changes in people with diabetes. Conclusions: The intervention showed preliminary efficacy in the study group with good feasibility. Further experimental studies are recommended.


Introdução: O diabetes mellitus tipo 2 é uma das principais causas de morbidade e mortalidade no mundo; sua prevalência é ainda maior em países de baixa e média renda. A autogestão é uma estratégia que comprovadamente controla doenças crônicas. Objetivo: Determinar a viabilidade e eficácia preliminar da intervenção educativa AMAS + Vida focada na autogestão da saúde dirigida a adultos com diabetes tipo 2 em uma instituição de saúde de primeiro nível em Neiva, Colômbia. Materiais e Métodos: Estudo de viabilidade, pré-teste ­ pós-teste com grupo único, para estabelecer a eficácia preliminar da intervenção. Amostra intencional de 36 adultos com diabetes tipo 2. Os instrumentos utilizados foram uma ficha de caracterização e a escala Partners in Health para medir a autogestão. Resultados: 31 adultos com diabetes completaram o acompanhamento de 3 meses, a maioria eram mulheres, com baixo nível socioeconômico e educacional, houve boa viabilidade da intervenção. Os participantes melhoraram significativamente o conhecimento sobre a doença (p < 0,001); também hábitos alimentares (p = 0,001), comportamentos de autogestão da saúde (p < 0,001) e diminuição do índice de massa corporal (p = 0,01). Não houve alterações significativas na atividade física (p = 0,125). Discussão: Intervenções baseadas na autogestão estruturadas sob a teoria da adaptação às doenças crônicas alcançam mudanças na promoção da saúde das pessoas com diabetes. Conclusões: A intervenção teve eficácia preliminar no grupo estudado com boa viabilidade. Recomenda-se continuar desenvolvendo estudos experimentais.


Subject(s)
Feasibility Studies , Health Education , Nursing , Diabetes Mellitus, Type 2 , Self-Management
6.
Invest. educ. enferm ; 41(2): 187-201, junio 15 2023. ilus, tab
Article in English | LILACS, BDENF, COLNAL | ID: biblio-1438560

ABSTRACT

Objective. To synthesize the evidence of studies with educational interventions for adults with type-2 diabetes mellitus (DM2) in primary health care settings. Methods. A scoping review was conducted following the recommendations by the Joanna Briggs Institute and by the PRISMA declaration. The protocol was registered in INPLASY20215009. The search was carried out in: MEDLINE (via PubMed), EMBASE, Web of Science, LILACS, and grey literature. Results. Seventeen studies were included; most were randomized clinical trials of which 65% were conducted in high-income countries,and all the studies represented 5 656 participants. The results showed four big categories derived from educational interventions: therapeutic adherence (significant results on the satisfaction with the treatment); self-care and self-management in diabetes (improvement in self-efficacy, empowerment, and disease awareness); glycemic control in diabetes (significant results in reducing glycosylated hemoglobin); nursing and its role in the educational interventions on patients with DM2 (guidance in restructuring behaviors). Conclusion. The findings of this review suggest that educational interventions on patients with DM2 within the setting of primary health care can impact positively on therapeutic adherence, self-control, and knowledge of the disease. Moreover, it was possible to identify the influence of multidisciplinary health teams, where the relevance of nursing professionals in the construction and implementation of educational interventions is evidenced in obtaining better health results.


Objetivo. Sintetizar la evidencia de estudios con intervenciones educativas para adultos con diabetes mellitus tipo 2 (DM2) en la atención primaria de salud. Métodos. Se realizó una revisión de alcance siguiendo las recomendaciones del Instituto Joanna Briggs y de la declaración PRISMA. El protocolo se registró en INPLASY20215009. La búsqueda se realizó en: MEDLINE (vía PubMed), EMBASE, Web of Science, LILACS y literatura gris. Resultados. Diecisiete estudios fueron incluidos, la mayoría fueron ensayos clínicos aleatorizados, de estos 65% fueron conducidos en países de ingresos altos, y todos los estudios en total representaron 5656 participantes. Los resultados mostraron cuatro grandes categorías derivadas de las intervenciones educativas: adherencia terapéutica (resultados significativos en la satisfacción con el tratamiento); autocuidado y automanejo en diabetes (mejora en la autoeficacia, empoderamiento y conciencia de la enfermedad); control glucémico en diabetes (resultados significativos en la reducción de la hemoglobina glicosilada); enfermería y su papel en las intervenciones educativas en pacientes con DM2 (orientación en la reestructuración de comportamientos). Conclusión. Los hallazgos de esta revisión sugieren que las intervenciones educativas en pacientes con DM2 en el ámbito de la atención primaria de salud pueden impactar positivamente en la adherencia terapéutica, el autocontrol y el conocimiento de la enfermedad. Además, fue posible identificar la influencia de los equipos multidisciplinarios de salud, donde se evidencia la relevancia de los profesionales de enfermería en la construcción e implementación de intervenciones educativas para la obtención de mejores resultados de salud.


Objetivo. Sintetizar as evidências de estudos sobre intervenções educacionais para adultos com diabetes mellitus tipo 2 (DM2) na atenção primária à saúde. Métodos.Foi realizada uma revisão de escopo seguindo as recomendações do Joanna Briggs Institute e a declaração PRISMA. O protocolo foi registrado no INPLASY20215009. A pesquisa foi realizada em: MEDLINE (via PubMed), EMBASE, Web of Science, LILACS e literatura cinzenta. Resultados. Dezessete estudos foram incluídos, a maioria eram ensaios clínicos randomizados, 65% deles foram conduzidos em países de alta renda e todos os estudos, no total, contaram com 5656 participantes. Os resultados mostraram quatro grandes categorias derivadas das intervenções educacionais: adesão (resultados significativos na satisfação com o tratamento); autocuidado e autogestão da diabetes (melhoria na autoeficácia, fortalecimento e conscientização sobre a doença); controle glicêmico na diabetes (resultados significativos na redução da hemoglobina glicada); enfermagem e seu papel nas intervenções educacionais em pacientes com DM2 (orientação na reestruturação de comportamentos). Conclusão. Os achados desta revisão sugerem que as intervenções educacionais em pacientes com DM2 no ambiente da atenção primária à saúde podem impactar positivamente na adesão, no autogerenciamento e no conhecimento da doença. Além disso, foi possível identificar a influência das equipes multidisciplinares de saúde, onde fica evidente a relevância dos profissionais de enfermagem na construção e implementação de intervenções educacionais para obter melhores resultados de saúde.


Subject(s)
Humans , Male , Female , Self Care , Patient Education as Topic , Diabetes Mellitus, Type 2 , Primary Care Nursing
7.
Medicentro (Villa Clara) ; 27(2)jun. 2023.
Article in Spanish | LILACS | ID: biblio-1440526

ABSTRACT

Introducción: La enfermedad hepática grasa no alcohólica se caracteriza por: una acumulación de grasa en el hígado en forma de triacilglicéridos, ausencia de inflamación, fibrosis y un consumo de menos de 30 grados de alcohol al día. Esta afección se asocia a la diabetes mellitus (sobre todo tipo 2), y se observa un creciente aumento en el número de consultas hospitalarias por esta causa. Objetivo: Determinar la relación de los marcadores humorales y el estudio ultrasonográfico en pacientes diabéticos con enfermedad hepática grasa no alcohólica. Métodos: Se realizó una investigación descriptiva y transversal en la Consulta Provincial de Hepatología del Hospital Universitario Clínico-Quirúrgico «Arnaldo Milián Castro», en el período de marzo 2019 a diciembre 2020. El universo de estudio estuvo conformado por 89 pacientes (con edades mayores o iguales a 19 años, de ambos sexos); la muestra estuvo constituida por 66 pacientes que fueron seleccionados por muestreo no probabilístico. Resultados: Predominaron los pacientes con edades entre 40 y 59 años, masculinos, de piel blanca, y procedencia urbana. El grado de esteatosis predominante fue el grado 1 (leve). Los marcadores humorales (glicemia, gamma glutamil transpeptidasa, albúmina e índice de Ritis) fueron los más afectados patológicamente. Conclusiones: Los estudios ultrasonográficos mostraron una asociación estadísticamente significativa con alteración de los marcadores humorales de lesión hepática, lo cual puede alertar de una posible evolución desfavorable de esta enfermedad.


Introduction: non-alcoholic fatty liver disease is characterized by an accumulation of fat in the liver in the form of triacylglycerides, absence of inflammation, fibrosis and a consumption of less than 30 degrees of alcohol per day. This condition is associated with diabetes mellitus (especially type 2), and there is a growing increase in the number of hospital visits for this cause. Objective: to determine the relationship between humoral markers and ultrasonographic study in diabetic patients with non-alcoholic fatty liver disease. Methods: a descriptive and cross-sectional investigation was carried out in the provincial hepatology consultation at "Arnaldo Milián Castro" Clinical and Surgical University Hospital from March 2019 to December 2020. The study universe consisted of 89 patients (older than or equal to 19 years, of both genders); the sample consisted of 66 patients who were selected by non-probabilistic sampling. Results: white male patients aged between 40 and 59 years living in urban areas predominated. The predominant degree of steatosis was grade 1 (mild). Humoral markers (glycemia, gamma- glutamyl transpeptidase, albumin and De Ritis ratio) were the most pathologically affected. Conclusions: ultrasonographic studies showed a statistically significant association with changes in humoral markers of liver injury, which may alert to a possible unfavorable evolution of this disease.


Subject(s)
Blood Glucose , Diabetes Mellitus, Type 2 , Albumins , Non-alcoholic Fatty Liver Disease , Transaminases
8.
Article in Spanish | LILACS, CUMED | ID: biblio-1508251

ABSTRACT

Introducción: La retinopatía diabética es la principal causa de ceguera en personas diabéticas de 20 a 64 años de edad, e incrementa su aparición frente a un mal control de la enfermedad, que se expresa con valores altos de hemoglobina glucosilada (HbA1C). Objetivo: Establecer la relación entre los niveles de hemoglobina glucosilada y la presencia de retinopatía en los pacientes con diabetes mellitus tipo 2. Métodos: Se llevó a cabo un estudio descriptivo, prospectivo y transversal, en el que se obtuvieron, mediante ficha de observación, datos sociodemográficos, de evaluación oftalmológica y niveles de HbA1C, de los pacientes atendidos en consulta externa del Hospital General Isidro Ayora de la ciudad de Loja, Ecuador, en el período febrero-junio de 2018. Se aplicaron medidas de frecuencia y asociación para el análisis estadístico. Resultados: Se incluyeron 160 pacientes: 108 mujeres y 52 hombres, todos de raza mestiza. Se identificó retinopatía en 26,8 por ciento (N = 43) de los pacientes, de quienes 41 por ciento (N = 18) tenía más de 65 años de edad. La media de HbA1C en pacientes sin retinopatía fue de 7,4 por ciento, y en aquellos con retinopatía de 9,8 por ciento en mayor porcentaje de pacientes con valores de HbA1C de 7 por ciento o más presentaron retinopatía diabética, en comparación con aquellos de HbA1C menores a 7 por ciento (p < 0,0001), la retinopatía no proliferativa moderada fue el principal diagnóstico realizado. Conclusiones: El mal control glucémico en las personas con diabetes mellitus tipo 2 se asocia con mayor probabilidad de aparición de lesiones retinianas(AU)


Introduction: Diabetic retinopathy is the main cause of blindness in diabetic people aged 20 to 64 years; it increases its occurrence due to poor control of the disease, expressed by high values of glycosylated hemoglobin (HbA1c). Objective: To establish the relationship between glycosylated hemoglobin levels and the presence of retinopathy in patients with type 2 diabetes mellitus. Methods: A descriptive, prospective and cross-sectional study was carried out, in which sociodemographic data, others from an ophthalmologic evaluation and HbA1c levels were obtained, by means of an observation card, from patients seen in the outpatient clinic of Hospital General Isidro Ayoraof the city of Loja, Ecuador, in the period February-June 2018. Frequency and association measures were applied for statistical analysis. Results: The study included 160 patients: 108 women and 52 men, all of mixed race. Retinopathy was identified in 26.8percent (N=43) of patients, of whom 41percent (N=18) were over 65 years of age. The mean HbA1c in patients without retinopathy was 7.4percent, and 9.8percent in those with retinopathy. A higher percentage of patients with HbA1c values of 7percent more had diabetic retinopathy, compared to those with HbA1C under 7percent (p<0.0001). Moderate nonproliferative retinopathy was the main diagnosis. Conclusions: Poor glycemic control in persons with type 2 diabetes mellitus is associated with increased likelihood of retinal lesions(AU)


Subject(s)
Humans , Male , Female , Glycated Hemoglobin , Diabetes Mellitus, Type 2 , Diabetic Retinopathy/diagnosis , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective Studies
9.
Arq. bras. oftalmol ; 86(1): 27-32, Jan.-Feb. 2023. tab
Article in English | LILACS | ID: biblio-1403483

ABSTRACT

ABSTRACT Purpose: To evaluate the relationship between subfoveal choroidal thickness and plasma asymmetrical dimethylarginine level and the severity of diabetic retinopathy in patients with type 2 diabetes mellitus. Methods: A total of 68 cases, including 15 patients without diabetic retinopathy, 17 patients with nonproliferative diabetic retinopathy, 16 patients with type 2 diabetes mellitus and proliferative diabetic retinopathy, and 20 healthy patients (control group), were enrolled in this study. Subfoveal choroidal thickness was measured manually using the enhanced depth imaging optical coherence tomography scanning program, and plasma asymmetrical dimethylarginine level was measured using a commercial micro enzyme-linked immunosorbent assay kit. Results: The subfoveal choroidal thickness values and plasma asymmetrical dimethylarginine levels were significantly different between the four groups (p<0.001 and p<0.001). The subfoveal choroidal thickness values were significantly lower in the proliferative diabetic retinopathy group than in the other three groups (no diabetic retinopathy, nonproliferative diabetic retinopathy, and control groups; p<0.001, p=0.045, and p<0.001, respectively). The plasma asymmetrical dimethylarginine levels were significantly higher in the proliferative diabetic retinopathy group than in the other three groups (p<0.001, p<0.04, and p<0.001, respectively). In addition, a significant negative correlation was also found between plasma asymmetrical dimethylarginine level and subfoveal choroidal thickness (p<0.001, r=-0.479). Conclusion: Asymmetrical dimethylarginine is an important marker of endothelial dysfunction and endogenous endothelial nitric oxide synthase inhibitor. The severity of diabetic retinopathy was related to increased plasma asymmetrical dimethylarginine level and reduced subfoveal choroidal thickness in type 2 diabetic patients with diabetic retinopathy.


RESUMO Objetivo: Avaliar a relação da espessura subfoveal da coroide e dos níveis plasmáticos de dimetil-arginina assimétrica com a gravidade da retinopatia diabética em pacientes com diabetes mellitus tipo 2. Métodos: Foram incluídos 68 casos, compreendendo 15 pacientes sem retinopatia diabética, 17 pacientes com retinopatia diabética não proliferativa, 16 pacientes com retinopatia diabética proliferativa, e 20 casos saudáveis (grupo de controle). A espessura subfoveal da coroide foi medida manualmente, usando o programa de varredura com tomografia computadorizada óptica com imagem profunda aprimorada, e os níveis plasmáticos de dimetil-arginina assimétrica foram medidos usando um kit microELISA comercial. Resultados: Os valores da espessura subfoveal da coroide e os níveis plasmáticos de dimetil-arginina assimétrica foram significativamente diferentes nos quatro grupos (p<0,001 para ambos os parâmetros). Os valores da espessura subfoveal da coroide foram significativamente menores no grupo com retinopatia diabética proliferativa do que nos outros três grupos (sem retinopatia diabética, retinopatia diabética não proliferativa e grupo de controle, com p<0,001, p=0,045 e p<0,001, respectivamente). Já os níveis plasmáticos de dimetil-arginina assimétrica foram significativamente maiores no grupo com retinopatia diabética proliferativa do que nos outros três grupos (p<0,001, p=0,04 e p<0,001, respectivamente). Além disso, também foi encontrada uma correlação negativa significativa entre os níveis plasmáticos de dimetil-arginina assimétrica e a espessura subfoveal da coroide (p<0,001, r=-0,479). Conclusão: A dimetil-arginina assimétrica é um importante marcador de disfunção endotelial e um inibidor endógeno da óxido nítrico sintase. Foi encontrada uma relação da gravidade da retinopatia diabética e de níveis elevados de dimetil-arginina assimétrica no plasma com a redução da espessura subfoveal da coroide em pacientes diabéticos tipo 2 com retinopatia diabética.


Subject(s)
Humans , Arginine , Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Arginine/blood , Arginine/analogs & derivatives , Case-Control Studies , Diabetes Mellitus, Type 2/complications , Diabetic Retinopathy/diagnosis
10.
ABCS health sci ; 48: e023209, 14 fev. 2023. tab
Article in English | LILACS | ID: biblio-1438243

ABSTRACT

INTRODUCTION: Adherence to self-care has been identified as a means of preventing diabetic foot wounds, positively influencing the clinical outcomes and quality of life of patients. The adherence to this strategy is divergent in different populations. It is essential to determine the self-care practices that are associated with diabetic foot ulcers and the quality of life in adults with diabetes. OBJECTIVE: To understand self-care practices and explore their relationship with the foot wound risk and quality of life of persons with type 2 diabetes in a city in northeastern Brazil. METHODS: A descriptive exploratory study was conducted with a sample of 300 individuals with type 2 diabetes. Data were collected using a sociodemographic questionnaire, classification of foot wound risk, the Summary of Diabetes Self-Care Activities, and SF-36. RESULTS: Adherence to self-care was low for physical exercise, self-monitoring of blood glucose, and foot care. The diet and the use of medication had better adherence by the participants. Foot wound risk was related to no adherence to diet (OR 2.2 95% CI 1.32-3.38), physical activity (OR 0.49 95% CI 0.25-0.95), and blood glucose checking (OR 5.31 95% CI 1.58-17.78). Quality of life was associated with physical activity (OR 0.35 95% CI 0.16-0.74). CONCLUSION: It can be concluded that is a relationship between self-care practices adherence, risk of foot wounds, and quality of life.


INTRODUÇÃO: A adesão ao autocuidado tem sido apontado como meio de prevenção de feridas no pé diabético, influenciando positivamente nos desfechos clínicos e na qualidade de vida dos pacientes. A adesão a esta estratégia é divergente em diferentes populações. É essencial determinar as práticas de autocuidado que estão associadas às feridas do pé diabético e à qualidade de vida em adultos com diabetes. OBJETIVO: Conhecer as prática de autocuidado e explorar sua relação com o risco de feridas nos pés e a qualidade de vida de pessoas com diabetes tipo 2 em uma cidade do nordeste do Brasil. MÉTODOS: Foi realizado um estudo exploratório descritivo com uma amostra de 300 pessoas com diabetes tipo 2. Os dados foram coletados por meio de questionário sociodemográfico, classificação de risco de feridas nos pés, resumo das atividades de autocuidado com a diabetes e sf-36. RESULTADOS: A adesão ao autocuidado foi baixa para exercícios físicos, automonitorização da glicemia e cuidados com os pés. A dieta e o uso de medicamentos apresentaram melhor adesão pelos participantes. O risco de ferimento no pé foi relacionado à não adesão a dieta (OR 2,2 IC 95% 1,32-3,38), atividade física (OR 0,49 IC 95% 0,25-0,95) e verificação da glicemia (OR 5,31 IC 95% 1,58-17,78). A qualidade de vida foi associada à atividade física (OR 0,35 IC 95% 0,16-0,74). CONCLUSÃO: Pode-se concluir que existe relação entre a adesão ao autocuidado, risco de feridas nos pés e qualidade de vida.


Subject(s)
Humans , Male , Female , Middle Aged , Quality of Life , Self Care , Risk Factors , Diabetic Foot/prevention & control , Diabetes Mellitus, Type 2
11.
Rev. méd. Chile ; 151(1): 7-14, feb. 2023. ilus, tab
Article in Spanish | LILACS | ID: biblio-1515411

ABSTRACT

BACKGROUND: Diabetic retinopathy (DR) is an important cause of decreased visual acuity, whose prevalence has increased between 1990 and 2020. In Chile the prevalence of diabetic retinopathy was estimated at 24.8%. AIM: To assess the prevalence of DR in a southern Chilean city. MATERIAL AND METHODS: From a database of diabetic patients attending primary health care centers at Puerto Montt, Chile, 196 patients with DR and 392 patients without DR, matched by age and presence of chronic complications, were chosen for this case-control study. RESULTS: The prevalence of DR in the database of diabetic patients was 33.3%. glycated hemoglobin, the frequency insulin use, systolic blood pressure, HDL cholesterol, microalbuminuria, and proteinuria were significantly worse in cases. A multivariate analysis showed that retinopathy is much more likely to occur when the variables insulin use, neuropathy, and microalbuminuria concur. CONCLUSIONS: DR was associated with worse metabolic parameters and the presence of neuropathy in this case control study.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2 , Diabetic Retinopathy/epidemiology , Insulins , Case-Control Studies , Chile/epidemiology , Prevalence , Risk Factors
12.
Rev. méd. Chile ; 151(1): 72-80, feb. 2023. tab
Article in English | LILACS | ID: biblio-1515423

ABSTRACT

BACKGROUND: The prevention and control of SARS-CoV-2 infection in hemodialysis (HD) units is challenging. AIM: To describe the clinical characteristics and outcome of patients with chronic kidney disease (CKD) on HD with COVID-19, between March 2020 and January 28, 2021, attending a single HD unit in Bogotá, Colombia. MATERIAL AND METHODS: In this prospective observational study, incidence, prevalence, and case-fatality rate were estimated, including screening results with RT-PCR and anti-SARS-CoV-2 IgG and IgM antibodies in all patients and health personnel in the HD unit. RESULTS: Among patients and health workers, 55 and 9 cases of COVID-19 were identified, respectively. The median age of patients was 63 years (84% males). Fifty five percent of patients were symptomatic, with fever, cough and/or myalgia. The most common comorbidities were hypertension, type 2 diabetes mellitus, and coronary heart disease. The cumulative incidence of infection was 30.2%, population seroprevalence was 24.9%, and fatality was 9.1%. CONCLUSIONS: The incidence of SARS-CoV-2 infection in this HD unit was high. Strict biosafety protocols are required to prevent outbreaks.


INTRODUCCIÓN: La prevención y el control de la infección por SARS-CoV-2 en las unidades de hemodiálisis (HD) es un desafío. OBJETIVO: Describir las características clínicas y la evolución de los pacientes con enfermedad renal crónica (ERC) en HD con COVID-19, entre marzo de 2020 y el 28 de enero de 2021, que acudieron a una unidad de HD en Bogotá, Colombia. MATERIAL Y MÉTODOS: Estudio observacional prospectivo con estimación de incidencia, prevalencia y letalidad, incluyendo los resultados del cribado con RT-PCR y anticuerpos IgG e IgM anti-SARS-CoV-2 en todos los pacientes y personal sanitario de la unidad de HD. RESULTADOS: Se identificaron 55 casos de pacientes en HD y 9 casos de trabajadores de salud con COVID-19. La mediana de edad de los pacientes fue de 63 años y 84% eran hombres. Cincuenta y cinco por ciento de los pacientes eran sintomáticos, con fiebre, tos y/o mialgia. Las comorbilidades más frecuentes fueron hipertensión arterial, diabetes mellitus tipo 2 y enfermedad coronaria. La incidencia acumulada de infección fue del 30,2%, la seroprevalencia poblacional del 24,9% y la letalidad del 9,1%. CONCLUSIONES: La incidencia de infección por SARS-CoV-2 en esta unidad de HD fue alta. Se requieren de protocolos estrictos de bioseguridad para evitar brotes.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Renal Dialysis/methods , COVID-19/prevention & control , COVID-19/epidemiology , Seroepidemiologic Studies , Disease Outbreaks , Prospective Studies , Diabetes Mellitus, Type 2 , SARS-CoV-2
13.
Rev. cient. cienc. salud ; 5(1): 1-7, 26-01-2023.
Article in Spanish | LILACS, BDNPAR | ID: biblio-1512811

ABSTRACT

Introducción. La disminución del agua corporal es un proceso fisiológicamente natural vinculado al avance de la edad; la diabetes podría incrementar esta relación. Objetivo. Analizar el grado de correlación entre el porcentaje de agua corporal total con la edad en adultos con y sin diabetes mellitus tipo 2 de la población peruana. Material y Métodos. Estudio observacional, analítico, retrospectivo y transversal. Los datos provinieron de la encuesta nacional demográfica del año 2022. La población fue de 29 737 adultos, de los cuales 16 956 son mujeres y 12 781. La muestra fue el total de la población encuestada. Las variables fueron: diabetes mellitus tipo-2, agua corporal total (ACT), porcentaje de agua corporal, sexo, edad. Las pruebas empleadas fueron el chi-cuadrado de Pearson, V de Cramer y correlación de Spearman. Resultados. El porcentaje de adultos con bajos niveles porcentuales de agua corporal total fue más frecuente en diabéticos que en no diabéticos. En la prueba de asociación V de Cramer, se encontró asociaciones estadísticamente significativas, las cuales fueron de un efecto mayor en hombres que en mujeres con y sin diabetes. En hombres diabéticos, la edad y el ACT se correlacionan de forma moderada y negativa (Rho=-0,601), en no diabéticos, se correlacionó baja y negativamente (Rho=-0,237). En mujeres diabéticas, la correlación es baja y negativa (Rho=-0,308), mientras que, en no diabéticas, es muy baja (Rho=-0,056). Conclusión. Existe una mayor correlación negativa entre la edad y el agua corporal total en diabéticos que en no diabéticos de ambos sexos. Palabras Clave: agua corporal; diabetes mellitus tipo 2; correlación de datos; envejecimiento; Perú


Introduction. The decrease in body water is a physiologically natural process linked to the advancement of age; diabetes could increase this relationship. Objective.To analyze the degree of correlation between the percentage of total body water with age in adults with and without type 2 diabetes mellitus in the Peruvian population. Material and Methods. Observational, analytical, retrospective and cross-sectional study. The data came from the national demographic survey of the year 2022. The population was 29,737 adults, of which 16,956 are women and 12,781. The sample was the total population surveyed. The variables were: type-2 diabetes mellitus, total body water (ACT), percentage of body water, sex, age. The tests used were Pearson's chi-square, Cramer's V and Spearman's correlation. Results:The percentage of adults with low percentage levels of totalbody water was more frequent in diabetics than in non-diabetics. In Cramer's V association test, statistically significant associations were found, which were of a greater effect in men than in women with and without diabetes. In diabetic men, age and ACTcorrelated moderately and negatively (Rho=-0.601), in non-diabetics, it correlated low and negatively (Rho=-0.237). In diabetic women, the correlation is low and negative (Rho=-0.308), while in non-diabetics it is very low (Rho=-0.056). Conclusions. Thereis a greater negative correlation between age and total body water in diabetics than in non-diabetics of both sexes. Key words:body water; diabetes mellitus,type 2; correlation of data; aging; Peru


Subject(s)
Humans , Male , Female , Diabetes Mellitus, Type 2 , Peru , Body Water , Aging , Correlation of Data
14.
Rev. urug. enferm ; 18(1): 1-21, ene. 2023.
Article in Portuguese | LILACS, BDENF | ID: biblio-1424443

ABSTRACT

Introdução: O Diabetes Mellitus pode ocasionar inúmeras complicações crônicas ao longo do tempo. Dentre elas, destaca-se a neuropatia diabética que compreende um conjunto de doenças que atinge as fibras nervosas. Este estudo tem como objetivo descrever o grau de risco dos pés de pessoas com Diabetes Mellitus que utilizam insulina, residentes em um bairro da zona urbana de Pelotas, RS. Materiais e métodos: Trata-se de um estudo quantitativo descritivo. A coleta de dados ocorreu na zona norte da cidade de Pelotas, Rio Grande do Sul. A coleta de dados foi realizada na residência dos participantes, entre maio e junho de 2017, contou com a participação de 39 pessoas com pés com neuropatia por Diabetes Mellitus. Resultados: Os entrevistados tinham, predominantemente diabetes tipo 2, perfazendo 89,7%, sendo o tempo de diagnóstico, com o mínimo de 3 anos, até 40 anos de evolução da doença. Sobre a avaliação da neuropatia diabética, 43,6% apresentam dor ao caminhar. Dormência e perda de sensibilidade foi mencionado por 41%. Conclusão: Foi possível elencar o grau de risco para complicações nos pés de usuários com Diabetes Mellitus, esse achado demonstra a importância que as equipes de saúde têm na prevenção de doenças, assim como na promoção da saúde, evitando as ulcerações e posteriores, amputações.


Introduction: Diabetes Mellitus can cause numerous chronic complications over time. Among them, diabetic neuropathy stands out, which comprises a set of diseases that affect the nerve fibers. This study aims to describe the degree of risk of the feet of people with Diabetes Mellitus who use insulin, living in a neighborhood in the urban area of Pelotas, RS. Materials and methods: This is a descriptive quantitative study. Data collection took place in the northern part of the city of Pelotas, Rio Grande do Sul. Data collection was carried out at the participants' homes, between May and June 2017, with the participation of 39 people with feet with Diabetes Mellitus neuropathy. Results: Respondents had predominantly type 2 diabetes, accounting for 89.7%, with the time since diagnosis, with a minimum of 3 years, up to 40 years of disease evolution. Regarding the assessment of diabetic neuropathy, 43.6% present pain when walking. Numbness and loss of sensation was mentioned by 41%. Conclusions: It was possible to list the degree of risk for complications in the feet of users with Diabetes Mellitus, this finding demonstrates the importance that health teams have in preventing diseases, as well as in promoting health, avoiding ulcerations and subsequent amputations.


Introducción: La Diabetes Mellitus puede causar numerosas complicaciones crónicas con el tiempo. Entre ellas destaca la neuropatía diabética, que comprende un conjunto de enfermedades que afectan a las fibras nerviosas. Este estudio tiene como objetivo describir el grado de riesgo de los pies de personas con Diabetes Mellitus usuarias de insulina, residentes en un barrio del área urbana de Pelotas, RS. Materiales y Métodos: Se trata de un estudio cuantitativo descriptivo. La recolección de datos ocurrió en la zona norte de la ciudad de Pelotas, Rio Grande do Sul. La recolección de datos se realizó en los domicilios de los participantes, entre mayo y junio de 2017, con la participación de 39 personas con pies con neuropatía Diabética Mellitus. Resultados: Los encuestados tenían predominantemente diabetes tipo 2, representando el 89,7%, con el tiempo desde el diagnóstico, con un mínimo de 3 años, hasta los 40 años de evolución de la enfermedad. En cuanto a la valoración de la neuropatía diabética, el 43,6% presenta dolor al caminar. El 41% mencionó entumecimiento y pérdida de sensibilidad. Conclusiones: Se pudo enumerar el grado de riesgo de complicaciones en los pies de los usuarios con Diabetes Mellitus, este hallazgo demuestra la importancia que tienen los equipos de salud en la prevención de enfermedades, así como en la promoción de la salud, evitando ulceraciones y posteriores amputaciones.


Subject(s)
Humans , Diabetic Foot , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Diabetic Neuropathies , Disease Prevention , Brazil
15.
Chinese Journal of Internal Medicine ; (12): 891-895, 2023.
Article in Chinese | WPRIM | ID: wpr-986004

ABSTRACT

A 50-year-old man with a 15-year history of elevated blood glucose and an approximately 2-year history of diarrhea was admitted to the Peking Union Medical College Hospital. The initial diagnosis was type 2 diabetes. After repeated pancreatitis and pancreatoduodenectomy, severe pancreatic endocrine and exocrine dysfunction including alternating high and low blood glucose and fat diarrhea occurred. Tests for type 1 diabetes-related antibodies were all negative, C-peptide levels were substantially reduced, fat-soluble vitamin levels were reduced, and there was no obvious insulin resistance. Therefore, a diagnosis of pancreatic diabetes was clear. The patient was given small doses of insulin and supplementary pancreatin and micronutrients. Diarrhea was relieved and blood glucose was controlled. The purpose of this article is to raise clinicians' awareness of the possibility of pancreatic diabetes after pancreatitis or pancreatic surgery. Timely intervention and monitoring may reduce the occurrence of complications.


Subject(s)
Male , Humans , Middle Aged , Blood Glucose , Diabetes Mellitus, Type 2/complications , Pancreaticoduodenectomy/adverse effects , Pancreatitis, Chronic/complications , Malnutrition/complications
16.
Chinese Journal of Pathology ; (12): 486-491, 2023.
Article in Chinese | WPRIM | ID: wpr-985705

ABSTRACT

Objective: To investigate the clinical and pathologic characteristics of obese adults with nonalcoholic fatty liver disease (NAFLD) and to aid the diagnosis of nonalcoholic steatohepatitis (NASH). Methods: A total of 262 patients eligible for inclusion who received volume reduction metabolism surgery and liver biopsy in the First Affiliated Hospital of Nanjing Medical University from June 2018 to September 2019 were selected. HE staining, reticular fiber staining and Masson staining were performed. Statistical analysis was performed using SPSS 20.0. Results: The patients ranged in age from 18 to 66 years. Among the 262 cases, 65 cases (65/262, 24.8%) were male and 197 cases (197/262, 75.2%) were female. Sixty-one cases (61/262, 23.3%) were non-NAFLD, 201 cases (201/262, 76.7%) were NAFLD including 27 cases (27/201, 13.4%) of nonalcoholic fatty live (NAFL) and 174 cases (174/201, 86.6%) of NASH. The main lesions of NAFLD were in hepatic acinus zone 3. There were significant differences in age, alanine aminotransferase (ALT), glutamic oxaloacetic transaminase (AST), body mass index (BMI), fasting blood-glucose (FPG) and apolipoprotein A (APOA) levels among the non-NAFLD group, NAFL group and NASH group (P<0.05). Patients with BMI≥35 m/kg2 combined with type 2 diabetes had a higher prevalence of NASH. Multiple logistic regression showed that ALT and APOA were independent predictors of NASH (P<0.001, OR=1.05, 95%CI: 1.020-1.082; P=0.027, OR=0.916, 95%CI: 0.878-0.941). Total cholesterol (CHO) and high-density lipoprotein (HDL) were independent predictors of lobular inflammation (P=0.043, 95%CI: 0.010-0.634; P=0.024, 95%CI:-3.068--0.216). AST and HDL were independent predictors of fibrosis stage (P=0.029, 95%CI: 0.001-0.021; P<0.001, 95%CI:-2.670--0.645). Conclusions: Biochemical indicators of NAFLD are closely related to its pathology. The histological lesions of NAFLD are mainly present in hepatic acinar area 3. The diagnosis of NASH is supported by extensive steatosis and high levels of CHO, ALT, AST and BMI, low levels of HDL and ApoA in biochemical markers, but pathological examination is still the gold standard for it.


Subject(s)
Adult , Humans , Male , Female , Adolescent , Young Adult , Middle Aged , Aged , Non-alcoholic Fatty Liver Disease/pathology , Diabetes Mellitus, Type 2/pathology , Liver/pathology , Obesity/pathology , Apolipoproteins A
17.
Chinese Journal of Preventive Medicine ; (12): 614-625, 2023.
Article in Chinese | WPRIM | ID: wpr-985453

ABSTRACT

Objective: To investigate the distribution of blood pressure and analyze the associated factors of blood pressure of the elderly with type 2 diabetes in Jiangsu Province. Methods: The elderly over 60 years old participants with type 2 diabetes in the communities of Huai'an City and Changshu City, Jiangsu Province were selected in this study. They were divided into two groups: taking antihypertensive drugs and not taking antihypertensive drugs. The demographic characteristics, such as age and sex, and relevant factors were collected by questionnaire. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by physical examination. The percentile of SBP and DBP in each age group of men and women were described. The kernel density estimation curve was used to show the blood pressure distribution. The trend of blood pressure with age was fitted by locally weighted regression. The logistic regression model was used to analyze relevant factors of blood pressure. Results: A total of 12 949 participants were included in this study, including 7 775 patients in the antihypertensive drug group and 5 174 patients in the group without antihypertensive drugs. The SBP of participants was concentrated at 140-160 mmHg, and their DBP was concentrated at 75-85 mmHg. There were significant differences in the distribution of blood pressure among the subgroups of body mass index (BMI) and rural areas whether taking antihypertensive drugs and not. For participants aged under 80 years old, the SBP showed an increasing trend with age and the DBP showed a decreasing trend with age. Age, BMI ≥24 kg/m2, fasting blood glucose ≥7.0 mmol/L, living in rural areas and no smoking were influencing factors of the elevated SBP; BMI ≥24 kg/m2, male, living in rural areas, no smoking, drinking alcohol and not receiving drug hypoglycemic treatment were influencing factors of the elevated DBP. Conclusion: The SBP of older diabetic adults in Jiangsu Province is at a high level, and the distribution of blood pressure is significantly different between men and women in taking antihypertensive drugs group. The SBP presents a rising trend and the DBP is decreasing at the age of 60-80 years. The blood pressure level of this population are mainly affected by age, BMI, urban and rural areas, smoking.


Subject(s)
Adult , Aged , Humans , Male , Female , Middle Aged , Aged, 80 and over , Blood Pressure/physiology , Diabetes Mellitus, Type 2/epidemiology , Antihypertensive Agents/therapeutic use , Smoking , Body Mass Index , Hypertension/epidemiology
18.
Journal of Central South University(Medical Sciences) ; (12): 40-48, 2023.
Article in English | WPRIM | ID: wpr-971369

ABSTRACT

OBJECTIVES@#The excretion of urinary vitamin D-binding protein (uVDBP) is related to the occurrence and development of early-stage renal damage in patients with Type 2 diabetes (T2DM). This study aims to explore the significance of detecting uVDBP in T2DM patients and its relationship with renal tubules, and to provide a new direction for the early diagnosis of T2DM renal damage.@*METHODS@#A total of 105 patients with T2DM, who met the inclusion criteria, were included as a patient group, and recruited 30 individuals as a normal control group. The general information and blood and urine biochemical indicators of all subjects were collected; the levels of uVDBP, and a marker of tubular injury [urine kidney injury molecule 1 (uKIM-1), urine neutrophil gelatinase-associated lipocalin (uNGAL) and urine retinol-binding protein (uRBP)] were detected by enzyme-linked immunosorbent assay. The results were corrected by urinary creatinine (Cr) to uVDBP/Cr, uKIM-1/Cr, uNGAL/Cr and uRBP/Cr. The Pearson's and Spearman's correlation tests were used to analyze the correlation between uVDBP/Cr and urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR) and markers of tubular injury, and multivariate linear regression and receiver operating characteristic curve were used to analyze the correlation between uVDBP/Cr and UACR or eGFR.@*RESULTS@#Compared with the normal control group, the uVDBP/Cr level in the patient group was increased (P<0.05), and which was positively correlated with UACR (r=0.774, P<0.01), and negatively correlated with eGFR (r=-0.397, P<0.01). There were differences in the levels of uKIM-1/Cr, uNGAL/Cr, and uRBP/Cr between the 2 groups (all P<0.01). The uVDBP/Cr was positively correlated with uKIM-1/Cr (r=0.752, P<0.01), uNGAL/Cr (r=0.644, P<0.01) and uRBP/Cr (r=0.812, P<0.01). The sensitivity was 90.0% and the specificity was 82.9% (UACR>30 mg/g) for evaluation of uVDBP/Cr on T2DM patients with early-stage renal damage, while the sensitivity was 75.0% and the specificity was 72.6% for evaluation of eGFR on T2DM patients with early-stage renal damage.@*CONCLUSIONS@#The uVDBP/Cr can be used as a biomarker in early-stage renal damage in T2DM patients.


Subject(s)
Humans , Diabetes Mellitus, Type 2/complications , Creatinine , Vitamin D-Binding Protein/urine , Lipocalin-2/urine , Kidney/metabolism , Glomerular Filtration Rate , Biomarkers
19.
Environmental Health and Preventive Medicine ; : 20-20, 2023.
Article in English | WPRIM | ID: wpr-971210

ABSTRACT

BACKGROUND@#Alcohol consumption is a prevalent behavior that is bi-directionally related to the risk of type 2 diabetes. However, the effect of daily alcohol consumption on glucose levels in real-world situations in the general population has not been well elucidated. This study aimed to clarify the relationship between alcohol consumption and all-day and time-specific glucose levels among non-diabetic individuals.@*METHODS@#We investigated 913 non-diabetic males and females, aged 40-69 years, during 2018-2020 from four communities across Japan. The daily alcohol consumption was assessed using a self-report questionnaire. All-day and time-specific average glucose levels were estimated from the interstitial glucose concentrations measured using the Flash glucose monitoring system for a median duration of 13 days. Furthermore, we investigated the association between all-day and time-specific average glucose levels and habitual daily alcohol consumption levels, using never drinkers as the reference, and performed multiple linear regression analyses after adjusting for age, community, and other diabetes risk factors for males and females separately.@*RESULTS@#All-day average glucose levels did not vary according to alcohol consumption categories in both males and females. However, for males, the average glucose levels between 5:00 and 11:00 h and between 11:00 and 17:00 h were higher in moderate and heavy drinkers than in never drinkers, with the difference values of 4.6 and 4.7 mg/dL for moderate drinkers, and 5.7 and 6.8 mg/dL for heavy drinkers. Conversely, the average glucose levels between 17:00 and 24:00 h were lower in male moderate and heavy drinkers and female current drinkers than in never drinkers; the difference values of mean glucose levels were -5.8 for moderate drinkers, and -6.1 mg/dL for heavy drinkers in males and -2.7 mg/dL for female current drinkers.@*CONCLUSIONS@#Alcohol consumption was associated with glucose levels in a time-dependent biphasic pattern.


Subject(s)
Humans , Male , Female , Diabetes Mellitus, Type 2 , Blood Glucose Self-Monitoring , Blood Glucose , Alcohol Drinking/epidemiology , Risk Factors , Alcoholic Intoxication
20.
Acta Academiae Medicinae Sinicae ; (6): 264-272, 2023.
Article in Chinese | WPRIM | ID: wpr-981262

ABSTRACT

Objective To investigate the cardiac structural and functional characteristics in the patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM),and predict the factors influencing the characteristics. Methods A total of 783 HFpEF patients diagnosed in the Department of Geriatric Cardiology,the First Hospital of Lanzhou University from April 2009 to December 2020 were enrolled in this study.Echocardiography and tissue Doppler technique were employed to evaluate cardiac structure and function.According to the occurrence of T2DM,the patients were assigned into a HFpEF+T2DM group (n=332) and a HFpEF group (n=451).Propensity score matching (PSM)(in a 1∶1 ratio) was adopted to minimize confounding effect.According to urinary albumin excretion rate (UAER),the HFpEF+T2DM group was further divided into three subgroups with UAER<20 μg/min,of 20-200 μg/min,and>200 μg/min,respectively.The comorbidities,symptoms and signs,and cardiac structure and function were compared among the groups to clarify the features of diabetes related HFpEF.Multivariate linear regression was conducted to probe the relationship of systolic blood pressure,blood glucose,glycosylated hemoglobin,and UARE with cardiac structural and functional impairment. Results The HFpEF+T2DM group had higher prevalence of hypertension (P=0.001) and coronary heart disease (P=0.036),younger age (P=0.020),and larger body mass index (P=0.005) than the HFpEF group,with the median diabetic course of 10 (3,17) years.After PSM,the prevalence of hypertension and coronary heart disease,body mass index,and age had no significant differences between the two groups(all P>0.05).In addition,the HFpEF+T2DM group had higher interventricular septal thickness (P=0.015),left ventricular posterior wall thickness (P=0.040),and left ventricular mass (P=0.012) and lower early diastole velocity of mitral annular septum (P=0.030) and lateral wall (P=0.011) than the HFpEF group.Compared with the HFpEF group,the HFpEF+T2DM group showed increased ratio of early diastolic mitral filling velocity to early diastolic mitral annular velocity (E/e') (P=0.036).Glycosylated hemoglobin was correlated with left ventricular mass (P=0.011),and the natural logarithm of UAER with interventricular septal thickness (P=0.004),left ventricular posterior wall thickness (P=0.006),left ventricular mass (P<0.001),and E/e' ratio (P=0.049). Conclusion The patients with both T2DM and HFpEF have thicker left ventricular wall,larger left ventricular mass,more advanced left ventricular remodeling,severer impaired left ventricular diastolic function,and higher left ventricular filling pressure than the HFpEF patients without T2DM.Elevated blood glucose and diabetic microvascular diseases might play a role in the development of the detrimental structural and functional changes of the heart.


Subject(s)
Humans , Aged , Heart Failure/diagnosis , Diabetes Mellitus, Type 2 , Stroke Volume , Glycated Hemoglobin , Blood Glucose , Propensity Score , Ventricular Function, Left , Hypertension
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