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BACKGROUND: Obesity and type 2 diabetes mellitus are closely associated with each other and require careful management. This study aimed to assess the impact of sodium-glucose co-transporter 2 (SGLT2) inhibitors on glycemic control and body composition in diabetic patients, stratified by obesity status. METHODS: We enrolled patients diagnosed with type 2 diabetes mellitus, categorized as obese (BMI≥30) or non-obese (BMI<30), from our outpatient clinic. SGLT2 inhibitor therapy was added to their existing treatment regimen without altering dietary habits or exercise routines. Anthropometric measurements and laboratory parameters were compared between baseline and the third month of treatment. RESULTS: The study included 40 participants, evenly split between obese and non-obese groups. At the third-month follow-up, significant reductions were observed in BMI, weight, waist and hip circumference, and body fat percentage across both groups (p < 0.001). Conversely, muscle mass percentage significantly increased (p < 0.001). Additionally, there were statistically significant decreases in HbA1c, glucose, CRP, ALT, LDL, and total cholesterol levels from baseline to the third month of treatment (p < 0.001 for HbA1c and glucose; p = 0.009, p = 0.022, p = 0.003, and p = 0.021, respectively, for CRP, ALT, LDL, and total cholesterol). CONCLUSIONS: The findings of the present study suggest that SGLT2 inhibitors may offer substantial benefits, particularly in the management of obesity-related type 2 diabetes.
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Hypoglycaemia in individuals with diabetes is defined as the presence of signs or symptoms in addition to potentially occurring abnormal plasma glucose levels in the patient. Munchausen Syndrome (MS) is characterized by the deliberate induction of physical or psychological symptoms or the act of pretending to have symptoms. Patient reports of this factitious disease pattern are limited in the literature. The diagnosis and treatment of this syndrome, which is among factitious disorders, is very difficult. Endocrinological complaints are very common among those admitted to the hospitals. BACKGROUND: Unnecessary and numerous examinations cause financial losses and loss of time for both the individual and the healthcare system. In this case report, we aimed to discuss the management of a patient who tried to gain secondary gain by creating artificial hypoglycemia attacks. CASE REPORT: In this case report, the diagnosis of Munchausen syndrome given to a 28-year-old female patient who was diagnosed with type I diabetes and repeatedly admitted to the hospital due to hypoglycemia attacks is discussed. CONCLUSION: Munchausen syndrome is an important and often overlooked diagnosis that should be kept in mind due to the possibility of individuals harming themselves unpredictably, as well as causing disruptions in the healthcare system and wasting time due to numerous and unnecessary examinations and evaluations. For this reason, it is a diagnosis that should be kept in mind in cases of unexplained hypoglycemia attacks.
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OBJECTIVES: Type 2 diabetes mellitus (T2DM) and its microvascular complications are characterized by chronic inflammation. The Controlling Nutritional Status (CONUT) score is a tool used to assess nutritional status and is often associated indirectly with inflammatory processes. We aimed to compare the CONUT scores of T2DM patients with those of healthy volunteers and to compare T2DM patients with and without microvascular complications. METHODS: Patients diagnosed with T2DM and healthy volunteers (as controls) were included in the study. The CONUT score is calculated using the following formula: serum albumin score + total cholesterol score + total lymphocyte count score. CONUT scores of T2DM patients and healthy controls, as well as those of diabetics with and without microvascular complications, were compared. RESULTS: The CONUT scores of the T2DM and control groups were (1 [0-7]) and (0 [0-2]), respectively (p < 0.001). The sensitivity and specificity of the CONUT score (<1.5 threshold) in detecting T2DM were 43% and 90%, respectively (AUC: 0.67, p < 0.001, 95% CI: 0.64-0.71). Moreover, the CONUT score was an independent risk factor for T2DM (OR: 0.34, p < 0.001, 95% CI: 0.22-0.52). The CONUT score of T2DM patients with microvascular complications (2 [0-7]) was significantly higher than that of T2DM patients without microvascular complications (0 [0-4]) and control subjects (0 [0-2]) (p < 0.001). A CONUT score higher than 1.5 had 83% sensitivity and 92% specificity in detecting T2DM with microvascular complications (AUC: 0.91, p < 0.001, 95% CI: 0.89-0.93). CONCLUSION: The CONUT score could be useful in detecting diabetic microvascular complications in clinical practice, as it is an inexpensive and easy-to-assess marker.
Subject(s)
Biomarkers , Diabetes Mellitus, Type 2 , Diabetic Angiopathies , Nutritional Status , Humans , Diabetes Mellitus, Type 2/complications , Male , Female , Middle Aged , Diabetic Angiopathies/diagnosis , Biomarkers/blood , Adult , Cholesterol/blood , Serum Albumin/analysis , Serum Albumin/metabolism , Lymphocyte Count , Aged , Case-Control Studies , Risk Factors , Sensitivity and SpecificityABSTRACT
In various diseases characterized by inflammation, the C-reactive protein to albumin ratio (CAR) serves as a marker of inflammation. Type 2 diabetes mellitus (T2DM) is frequently complicated by diabetic neuropathy (DN) and timely diagnosis is crucial for treatment and potential reversal of this complication. Since both DN and T2DM are associated with chronic, low-grade inflammation, our study aimed to evaluate CAR levels in type 2 diabetic subjects with DN and compare them to those in subjects without DN. Patients presenting to our institutional outpatient clinics were divided into two groups based on the presence of DN. Data on characteristics and laboratory measures, including CAR, were compared between the DN and non-DN groups. The median CAR in the DN and non-DN group was 2.19% (range 0.2 - 49%) and 0.56% (range 0.02 - 5.8%), respectively (P < 0.001). CAR showed significant positive correlations with weight (r = 0.19, P = 0.01), body mass index (BMI) (r = 0.11, P = 0.03), waist circumference (r = 0.10, P = 0.046), fasting glucose (r = 0.14, P = 0.004), serum creatinine (r = 0.25, P < 0.001), triglyceride (r = 0.17, P < 0.001), and low density lipoprotein (LDL)-cholesterol (r = 0.13, P = 0.001) levels, and an inverse correlation with estimated glomerular filtration rate (eGFR) (r = -0.16, P <0.001). Additionally, CAR demonstrated a sensitivity of 78% and specificity of 73% for predicting DN at a threshold of 1.02% (area under curve [AUC] 0.84, 95% confidence interval [CI] 0.82 - 0.87, P < 0.001). High CAR levels were independently associated with an increased risk of DN (odds ratio [OR] 1.34, 95% CI 1.08 - 1.62, P < 0.001). Elevated CAR levels may thus be considered a potential marker for DN in T2DM patients.
Subject(s)
Malnutrition , Nutritional Status , Humans , Aged , Malnutrition/epidemiology , Geriatric Assessment , Nutrition Assessment , Risk Factors , Retrospective StudiesABSTRACT
INTRODUCTION: Insulin treatment is fundamental to diabetes management. Basal insulin therapy reduces intraday glycemic fluctuations upon reaching a steady state. Besides better blood glucose regulation and achieving target HbA1c values in patients, it also offers protection from diabetes complications. In this review, we aimed to compare basal-acting insulins in light of the literature. AREAS COVERED: We reviewed current evidence related to diabetes treatment with basal insulins. This includes discussions on clinical trials and meta-analyses concerning first and second-generation ultra-long-acting basal insulins. Treatment indications for long-acting basal insulins, which have shown benefits and are considered superior or comparable to others in the literature, are derived from current clinical studies and meta-analyses, which form the basis of the recommendations in this review. EXPERT OPINION: First and second-generation basal insulins do not show much superiority over each other in terms of blood glucose regulation and reaching the target HbA1c. However, second-generation basal insulins cause fewer hypoglycemic events. We recommend using the appropriate basal insulin in patient-based, individualized treatments. Basal insulin Icodec may become more widely used over time, owing to its association with less hypoglycemia and a reduction in the number of injections.
Subject(s)
Diabetes Mellitus, Type 2 , Humans , Diabetes Mellitus, Type 2/drug therapy , Blood Glucose , Insulin/therapeutic use , Glycated Hemoglobin , Insulin, Long-Acting/therapeutic use , Hypoglycemic Agents/adverse effectsABSTRACT
OBJECTIVES: The objective of this study was to identify a parameter that can facilitate the diagnosis of prediabetes and predict the likelihood of its development in individuals at high risk. METHODS: In this retrospective study, the study population was selected from Bolu Abant Izzet Baysal University Hospital's patients. Participants were divided into two groups, prediabetes and healthy group. We excluded individuals with certain conditions or taking certain medications. The study compared the ratios of uric acid to high-density lipoprotein (HDL) between the two groups and identified the optimal point of differentiation. RESULTS: The study analyzed data from 228 individuals, including 125 with prediabetes and 103 healthy controls. Those with prediabetes had a significantly higher median UHR (0.13 (0.07-0.24) %) compared to healthy individuals (0.09 (0.05-0.16) %) (p < 0.001). Higher UHR values were associated with a greater risk of prediabetes. A UHR cut-off points greater than 0.11 % had a sensitivity of 74 % and specificity of 69 % in detecting prediabetes. CONCLUSION: The study provides evidence that UHR can serve as a practical and valuable diagnostic and screening tool for prediabetes (Tab. 2, Fig. 1, Ref. 23). Text in PDF www.elis.sk Keywords: serum uric acid, HDL cholesterol, UHR, prediabetes.
Subject(s)
Prediabetic State , Humans , Prediabetic State/diagnosis , Cholesterol, HDL , Uric Acid , Retrospective Studies , Blood GlucoseABSTRACT
OBJECTIVE: Autoimmune hepatitis is a rare inflammatory disease of the liver that is characterized by elevated liver enzymes. The hemoglobin, albumin, lymphocyte, and platelet score, which is derived from hemoglobin, serum albumin, circulating lymphocyte count, and platelet count, is also associated with inflammatory conditions. The aim was to examine the hemoglobin, albumin, lymphocyte, and platelet score of patients with autoimmune hepatitis and to compare it to that of healthy individuals in this retrospective analysis. METHODS: Subjects diagnosed with autoimmune hepatitis were enrolled in the study, and healthy individuals were enrolled as controls. Moreover, autoimmune hepatitis subjects were grouped into mild or moderate/advanced fibrosis. Furthermore, aspartate to platelet ratio index, Fibrosis-4, and hemoglobin, albumin, lymphocyte, and platelet scores of the autoimmune hepatitis patients and controls were compared. In addition, the hemoglobin, albumin, lymphocyte, and platelet score of the autoimmune hepatitis patients with mild fibrosis is compared to that of those with moderate/advanced fibrosis. RESULTS: The mean hemoglobin, albumin, lymphocyte, and platelet score of the autoimmune hepatitis patients was 44.2±14.5 while this value was 76.8±15.5 in control subjects. The hemoglobin, albumin, lymphocyte, and platelet score was significantly reduced in autoimmune hepatitis patients than healthy controls (p<0.001). The hemoglobin, albumin, lymphocyte, and platelet score was significantly and negatively correlated with C-reactive protein, aspartate, alanine transaminase, gamma glutamyl transferase, aspartate to platelet ratio index, and Fibrosis-4 values. A hemoglobin, albumin, lymphocyte, and platelet score that was lower than 52.3 had 83% sensitivity and 73% specificity in predicting autoimmune hepatitis. The sensitivity and specificity of the hemoglobin, albumin, lymphocyte, and platelet score were higher than the Fibrosis-4 score in predicting moderate/advanced fibrosis in autoimmune hepatitis. CONCLUSION: We suggest that the hemoglobin, albumin, lymphocyte, and platelet score be used as an additional noninvasive diagnostic tool for autoimmune hepatitis and to predict moderate/advanced liver fibrosis in patients with autoimmune hepatitis.
Subject(s)
Hepatitis, Autoimmune , Humans , Hepatitis, Autoimmune/diagnosis , Retrospective Studies , Aspartic Acid , Liver Cirrhosis/diagnosis , Hemoglobins , Lymphocytes , Serum Albumin , Biomarkers , Severity of Illness Index , ROC CurveABSTRACT
SUMMARY OBJECTIVE: Autoimmune hepatitis is a rare inflammatory disease of the liver that is characterized by elevated liver enzymes. The hemoglobin, albumin, lymphocyte, and platelet score, which is derived from hemoglobin, serum albumin, circulating lymphocyte count, and platelet count, is also associated with inflammatory conditions. The aim was to examine the hemoglobin, albumin, lymphocyte, and platelet score of patients with autoimmune hepatitis and to compare it to that of healthy individuals in this retrospective analysis. METHODS: Subjects diagnosed with autoimmune hepatitis were enrolled in the study, and healthy individuals were enrolled as controls. Moreover, autoimmune hepatitis subjects were grouped into mild or moderate/advanced fibrosis. Furthermore, aspartate to platelet ratio index, Fibrosis-4, and hemoglobin, albumin, lymphocyte, and platelet scores of the autoimmune hepatitis patients and controls were compared. In addition, the hemoglobin, albumin, lymphocyte, and platelet score of the autoimmune hepatitis patients with mild fibrosis is compared to that of those with moderate/advanced fibrosis. RESULTS: The mean hemoglobin, albumin, lymphocyte, and platelet score of the autoimmune hepatitis patients was 44.2±14.5 while this value was 76.8±15.5 in control subjects. The hemoglobin, albumin, lymphocyte, and platelet score was significantly reduced in autoimmune hepatitis patients than healthy controls (p<0.001). The hemoglobin, albumin, lymphocyte, and platelet score was significantly and negatively correlated with C-reactive protein, aspartate, alanine transaminase, gamma glutamyl transferase, aspartate to platelet ratio index, and Fibrosis-4 values. A hemoglobin, albumin, lymphocyte, and platelet score that was lower than 52.3 had 83% sensitivity and 73% specificity in predicting autoimmune hepatitis. The sensitivity and specificity of the hemoglobin, albumin, lymphocyte, and platelet score were higher than the Fibrosis-4 score in predicting moderate/advanced fibrosis in autoimmune hepatitis. CONCLUSION: We suggest that the hemoglobin, albumin, lymphocyte, and platelet score be used as an additional noninvasive diagnostic tool for autoimmune hepatitis and to predict moderate/advanced liver fibrosis in patients with autoimmune hepatitis.
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Introduction: Prognostic nutritional index (PNI) is a novel inflammation marker that useful in predicting prognosis of certain conditions. We aimed to study PNI of the outpatient and inpatient subjects with established Covid-19 and also aimed to compare PNI of deceased and survived Covid-19 patients. Methods: The patients with Covid-19 whom presented to outpatient or inpatient clinics of Abant Izzet Baysal University Hospital were enrolled to the study. PNI levels of the inpatients and outpatients, deceased and survived were compared. PNI values of deceased and survived in inpatients were also compared. Results: Study population was consisted of 4419 subjects (2907 outpatients and 1512 inpatients). PNI of the inpatient (41.55 (36.42-47.1)) group was significantly lower than the PNI of the outpatient (51.95 (47.95-55.75)) subjects (p<0.001). The sensitivity and specificity of PNI (≤46.2 level) in determination of requirement inpatient treatment were 71.2% and 83.5%, respectively. PNI of the deceased patients (37(33.39-40.86)) was lower than the PNI of the survivors (50.45(45.6-54.65)), (p<0.001). The sensitivity and specificity of PNI at ≤44.55 level in determining mortality were 89.22% and 78.87%, respectively. Conclusion: We suggest that PNI could serve as a reliable prognostic index in covid-19 patients. Reduced level of PNI should alert physicians since it is associated with need for hospitalization and mortality in this population.
Subject(s)
COVID-19 , Nutrition Assessment , Humans , Prognosis , Nutritional Status , COVID-19/diagnosis , Retrospective Studies , HospitalizationABSTRACT
Comorbidity rates in the geriatric population have increased because of rising life expectancy; thus, patients have had to use more medications. Type 2 diabetes mellitus, one of the most common diseases, may influence the number of drugs used in geriatric patients. The present study was designed to investigate the association between the level of type 2 DM and polypharmacy. Fifty patients with type 2 diabetes over the age of 65 were included according to the inclusion criteria; 23 were well-controlled and 27 had poorly controlled diabetes. The groups were similar in terms of age, sex, WBC, Hb, Plt, AST, ALT, serum creatinine, fasting glucose, and eGFR levels. Patients with HbA1c values above 7.5 were classified as poorly controlled diabetes patients, and those below were considered well-controlled diabetes patients and were evaluated for inappropriate medication use. The number of medications used daily by the cases (p < 0.001), the number of concomitant diseases (p = 0.001), and the number of increased risks according to the Beers Criteria (p = 0.02) were observed to be high in poorly controlled type 2 diabetes mellitus subjects. HbA1c levels were related to the number of medications (r = 0.4, p = 0.004), comorbidities (r = 0.28, p = 0.04), and the number of increased risks according to the Beers Criteria (r = 0.31, p = 0.014). In conclusion, the number of medications used in patients with poorly controlled type 2 diabetes mellitus was found to be more elevated than in individuals with well-controlled type 2 diabetes mellitus. The HbA1c values varied among patients regarding polypharmacy, comorbidities, and increased risks according to the Beers Criteria.
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The prognostic nutritional index (PNI) is associated with inflammatory conditions. Since type 2 diabetes mellitus (T2DM) and its microvascular complications produce a significant inflammatory burden, we aimed to compare the PNI levels of the subjects with T2DM to those of healthy individuals. Furthermore, we aimed to compare the PNI levels of the diabetic subjects, with and without microvascular complications. The study cohort consisted of T2DM patients and healthy volunteers. The general characteristics, laboratory data, and PNI of the T2DM and control groups were compared. We further compared the PNI levels of the diabetic patients, with and without diabetic microvascular complications. The PNI levels of the T2DM patients and the control group were 51.6 (30.1-73.8)% and 64.8 (49.4-76)%, respectively (p < 0.001). Subgroup analyses revealed that the PNI was lower in the diabetic subjects with diabetic microvascular complications than in the diabetic patients without microvascular complications (p < 0.001), in patients with diabetic nephropathy compared to those without nephropathy (p < 0.001), in patients with diabetic retinopathy compared to those without retinopathy (p < 0.001), and in patients with diabetic neuropathy compared to those without neuropathy (p < 0.001). In conclusion, we assert that assessing the PNI may yield additional diagnostic value in regards to the timely determination of diabetic microvascular complications.
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OBJECTIVE: Accumulating evidence suggests the role of immune-inflammatory markers in early risk stratification and prognostication of COVID-19 patients. We aimed to evaluate their association with severity and the development of diagnostic scores with optimal thresholds in critical patients. SETTING AND PARTICIPANTS: This retrospective case study includes hospitalized COVID-19 patients from March 2019 to March, 2022, in the developing area teaching hospital in Pakistan. Polymerase chain reaction (PCR) positive patients, n = 467 were investigated for clinical outcomes, comorbidities and disease prognosis. The plasma levels of Interleukin-6 (IL-6), Lactate dehydrogenase (LDH), C-reactive protein (CRP), Procalcitonin (PCT), ferritin and Complete blood count markers were measured. RESULTS: Majority were males (58.8%) and patients with comorbidities had more severe disease. Hypertension and diabetes mellitus were the commonest comorbidities. Shortness of breath, myalgia and cough were the main symptoms. The hematological markers NLR, as well as the plasma levels of immune-inflammatory variables, IL-6, LDH, Procalcitonin, Erythrocyte sedimentation rate, Ferritin were markedly raised in severe and critical patients (p < 0.0001 for these markers). ROC analysis supports IL-6 as the most accurate marker with high prognostic relevance with proposed cut-off threshold (43 pg/ml), determining >90% of patients in terms of COVID-19 severity (AUC = 0.93, 91.7%, se; 90.3%sp). Furthermore, positive correlation with all other markers including NLR with cut-off = 2.99 (AUC = 0.87, se = 89.8%, sp = 88.4%), CRP with cut-offs at 42.9â mg/l, (AUC = 0.883, se = 89.3% and sp = 78.6%), LDH cut-off at 267µg/L, evidenced in >80% patients (AUC = 0.834 se = 84% and sp = 80%). Additionally, ESR and ferritin have the corresponding AUC 0.81 and 0.813 with cut-off at 55â mm/hr and 370, respectively. CONCLUSION: Investigating the immune-inflammatory markers can assist physicians in providing prompt treatment and ICU admission in terms of COVID-19 severity. As a result, which may reduce the overall mortality of COVID-19 patients.
Subject(s)
COVID-19 , SARS-CoV-2 , Male , Humans , Female , Retrospective Studies , Procalcitonin , Interleukin-6 , Pakistan/epidemiology , Biomarkers , C-Reactive Protein/analysis , FerritinsABSTRACT
OBJECTIVES: Diabetic kidney injury (DKI) is a serious microvascular complicationof type 2 diabetes mellitus (T2DM). Novel markers are being developedto make a timely diagnosis of this complication. Uric Acid to HDLratio (UHR) was reported to be associated with inflammatory andmetabolic diseases such as metabolic syndrome, type 2 diabetesmellitus, thyroiditis, and nonalcoholic hepatosteatosis, recently. Inthe present study, we aimed to show the diagnostic role of UHR indiabetic kidney injury (DKI), a condition characterized with chronicand low-grade inflammation. METHODS: We retrospectively analyzed data of 287 patients who already had T2D Min outpatient clinics of our institution. The study population was divided into two groups according to the presence of DKI. General characteristics and laboratory data, including UHR levels, of the diabetic subjects with DKI were compared to those of patients without DKI. RESULTS: The median UHR of the diabetic patients with DKI group (0,13 (0,06-0,33)) was significantly elevated compared to the UHR of diabetic patients without DKI (0,11 (0,04-0,34)) (p < 0.001). Median UHR was significantly and positively correlated with UACR (r=0.14, p=0.02), serum creatinine (r=0.18, p=0.002), and HbA1c (r=0.28, p<0.001) levels. There was also a significant inverse correlation between UHR and GFR (r=-0.19, p=0.001) values. Logistic regression analysis confirmed that a 0.1 point increase in UHR increases DKI odds by 2.3 times. UHR was also correlated with serum creatinine, GFR, and UACR, which are important signs for DKI. CONCLUSION: In conclusion, we think that UHR could be a diagnostic tool indiabetic kidney injury according to the preliminary results of the present study. UHR has an independent predictive role in DKI, and ithas significant correlation with other markers of kidney functions, therefore, we suggest routine evaluation of UHR in patients with DKIalong with other markers such as serum creatinine, GFR, and UACR.
Subject(s)
Diabetes Mellitus, Type 2 , Diabetic Nephropathies , Humans , Diabetes Mellitus, Type 2/complications , Uric Acid , Diabetic Nephropathies/diagnosis , Diabetic Nephropathies/etiology , Cholesterol, HDL , Retrospective Studies , Creatinine , KidneyABSTRACT
INTRODUCTION: While type 2 diabetes mellitus (T2DM) increases the risk of cardiac complications, diabetes treatment choices may increase or decrease the rates of cardiac events. In the present review, we comprehensively discussed the treatment options of diabetic subjects with cardiac conditions. AREAS COVERED: Current evidence related to diabetes treatment in cardiac situations has been reviewed. Clinical trials and meta-analyses on cardiac safety of anti-diabetic medicines are discussed. Treatment choices with proven benefits and those at least without associated increased cardiac risk were drawn from clinical trials; meta-analyses and cardiac safety studies in the recent medical literature were the basis of the suggestions in the present review. EXPERT OPINION: We can suggest that hypoglycemia and extreme hyperglycemia should be avoided in acute ischemic heart conditions. Certain diabetic treatment options, especially sodium-glucose cotransporter-2 (SGLT2) inhibitors, can reduce overall cardiovascular mortality and hospitalization due to heart failure. Therefore, we suggest that physicians should choose SGLT2 inhibitors as the first-line treatment option in diabetic patients with heart failure or those who have a high risk of heart failure development. T2DM increases the risk of atrial fibrillation (AF), and metformin and pioglitazone seem to reduce the risk of AF in diabetic population.
Subject(s)
Cardiovascular Diseases , Diabetes Mellitus, Type 2 , Heart Failure , Metformin , Sodium-Glucose Transporter 2 Inhibitors , Humans , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Cardiovascular Diseases/prevention & control , Cardiovascular Diseases/complications , Sodium-Glucose Transporter 2 Inhibitors/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors/pharmacology , Metformin/therapeutic use , Heart Failure/drug therapyABSTRACT
BACKGROUND: Hashimoto's thyroiditis (HT) is a chronic autoimmune thyroiditis that causes systemic inflammation in the body, leading to hypothyroidism and an enlargement of the thyroid gland. OBJECTIVES: This study aims to reveal whether there is a relationship between Hashimoto's thyroiditis and the platelet-count-to-lymphocyte-count ratio (PLR), which is used as a new inflammatory marker. METHODS: In this retrospective study, we compared the PLR of the euthyroid HT group and the hypothyroid-thyrotoxic HT group to the controls. We also evaluated the values of thyroid-stimulating hormone (TSH), free T4 (fT4), C-reactive protein (CRP), aspartate transaminase (AST), alanine transaminase (ALT), white blood cell count, lymphocyte count, hemoglobin, hematocrit, and platelet count in each group. RESULTS: The PLR of the subjects with Hashimoto's thyroiditis was found to be significantly different from the control group (p < 0.001), with the rankings as follows: hypothyroid-thyrotoxic HT 177% (72-417) > euthyroid HT 137% (69-272) > control group 103% (44-243). In addition to the increased PLR values, an increase in CRP values was also observed, revealing a strong positive correlation between the PLR and CRP in the HT patients. CONCLUSION: In this study, we found out that the PLR was higher in the hypothyroid-thyrotoxic HT and euthyroid HT patients than in a healthy control group.
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Since uric acid to HDL cholesterol ratio (UHR) is proposed as a novel predictor of metabolic and inflammatory disorders, we aimed to study UHR levels in patients with new onset type 2 diabetes mellitus (T2DM) and compare them to those in healthy controls. Patients with new onset T2DM were enrolled and control subjects were volunteers to participate without any established diseases. Laboratory data including UHR, fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) were compared. The mean UHR of the T2DM and control groups was 16±8% and 10±3%, respectively (p<0.001). Moreover, UHR was significantly and positively correlated with HbA1c (r=0.75, p<0.001), FBG (r=0.64, p<0.001), waist circumference (r=0.35, p<0.001), body mass index (r=0.20, p=0.002) and inversely correlated with glomerular filtration rate (r=-0.24, p<0.001). High levels of UHR might be associated with increased mean blood glucose levels for a long time, since UHR was correlated with both FBG and HbA1c in patients with new onset T2DM.
Subject(s)
Diabetes Mellitus, Type 2 , Humans , Diabetes Mellitus, Type 2/complications , Uric Acid , Glycated Hemoglobin , Cholesterol, HDL , Blood Glucose/metabolismABSTRACT
BACKGROUND: Nonvariceal upper gastrointestinal bleeding (UGB) has important morbidity and mortality. Predicting high-risk patients for mortality and rebleeding is necessary for a treatment plan. In the present study, we aimed to define the epidemiological and etiological characteristics of patients presenting with nonvariceal UGB and to observe mortality and morbidity rates. We also aimed to compare Rockall and Glasgow-Blatchford scoring systems in predicting rebleeding and mortality. METHODS: Subjects presenting with nonvariceal UGB over a 3-year period were included. Demographic characteristics, symptoms, and signs on physical examination, laboratory data, endoscopic signs and diagnosis, interventions during hospitalization and follow-up period were recorded. Glasgow-Blatchford and Rockall scores were calculated for every participant at the first day of the admission. RESULTS: A total of 709 patients were enrolled in the study. A total of 490 of them (69.1%) were men. The mean age of the women and men was 60.7±1.2 and 58.6± 0.7 years, respectively. Melena was the most common presenting symptom. Duodenal ulcer (31%), gastric ulcer (20.7%), and erosive disease (17.6%) were the most common causes of bleeding. History of use of aspirin and/or nonsteroidal anti-inflammatory drug use were present in 63.7% of the subjects. All patients were followed up for 30th-day mortality. Overall, rebleeding and mortality rates were 11% and 7%, respectively. A Rockall score greater than 6 was the most important predictor of mortality (odds ratio:39.1) and rebleeding (odds ratio:4.7). CONCLUSION: Nonvariceal UGB patients with a Rockall score greater than 6 should undergo aggressive endoscopic treatment and inpatient care.