Comparative evaluation of LDL-CT, non-HDL/HDL ratio, and ApoB/ApoA1 in assessing CHD risk among patients with type 2 diabetes mellitus.

BACKGROUND: Research proved the importance of dosing apolipoprotein B (ApoB) over LDL cholesterol as a predictor of cardiovascular events. In this study, we aimed to observe the input apolipoprotein A1 (ApoA1) and ApoB, primarily if its ratio could provide in patients with type 2 diabetes mellitus (T2DM) without known atherosclerotic events regarding the coronary heart disease (CHD) risk. METHODS: We enrolled 83 patients with T2DM who attended the National Institute of Diabetes (Bucharest) between March 2022 and December 2022. A blood sample was taken from all patients to measure the different lipid parameters, including ApoA1 and ApoB. Spearman's correlation test for correlation between variables was used, and a multivariate regression analysis was performed to determine whether there are associations between CHD and the ApoB/ApoA1 and non-HDL-cholesterol/HDL-cholesterol ratios. Values of p < 0.05 were considered significant. RESULTS: Correlation analyses revealed that LDL-C was moderately associated with CHD (r = 0.199, p = 0.067). The non-HDL-C/HDL-C ratio exhibited a stronger, significant correlation with CHD (r = 0.366, p = 0.001). Evaluating apolipoproteins, ApoA1 levels negatively correlated with CHD (r = -0.233, p = 0.035), whereas ApoB levels showed a positive association (r = 0.292, p = 0.008). Notably, the severity of CHD risk increased with the ApoB/ApoA1 ratio (r = 0.530, p < 0.001). Similar trends in correlation coefficients were observed for fatal CHD and ASCVD, albeit with varied significance levels. CONCLUSIONS: Among patients with T2DM, the ApoB/ApoA1 ratio exhibited the strongest correlation with CHD risk, surpassing traditional LDL-C and even the non-HDL-C/HDL-C ratio, suggesting its potential utility as a more reliable marker for cardiovascular risk assessment in this population.

Kidney aging process and the management of the elderly patient with renal impairment (Review).

As life expectancy increases, a rise in the number of chronically ill patients is observed due to the aging population. Among the various diseases, chronic kidney disease is at present one of the main causes of morbidity and, due to its typical complications, it is also one of the most important causes of mortality in the general population. For these reasons, the understanding of the kidney aging process, its consequences and its adequate management are essential. The judicious use of certain types of drugs, the prevention of episodes of renal injury either by toxic mechanisms or by dehydration are important aspects and are part of the apropriate approach for elderly patients. The most effective treatment of various types of conditions with a negative impact on renal function and for which an increased incidence is known as we age should also be considered. Thus, in the case of elderly patients, in order to protect the kidneys, an integrative approach is recommended, one that includes both elements of prevention and the appropriate treatment of existing diseases.

Management of acute intradialytic cardiovascular complications: Updated overview (Review).

An increasing number of patients require renal replacement therapy through dialysis and renal transplantation. Chronic kidney disease (CKD) affects a large percentage of the world's population and has evolved into a major public health concern. Diabetes mellitus, high blood pressure and a family history of kidney failure are all major risk factors for CKD. Patients in advanced stages of CKD have varying degrees of cardiovascular damage. Comorbidities of these patients, include, on the one hand, hypertension, hyperlipidemia, hyperglycemia, hyperuricemia and, on the other hand, the presence of mineral-bone disorders associated with CKD and chronic inflammation, which contribute to cardiovascular involvement. Acute complications occur quite frequently during dialysis. Among these, the most important are cardiovascular complications, which influence the morbidity and mortality rates of this group of patients. Chronic hemodialysis patients manifest acute cardiovascular complications such as intradialytic hypotension, intradialytic hypertension, arrhythmias, acute coronary syndromes and sudden death. Thus, proper management is extremely important.

Dyselectrolytemia-management and implications in hemodialysis (Review).

Hemodialysis is a method for the renal replacement therapy followed by series of acute and chronic complications. Dyselectrolytemia appears in patients undergoing dialysis through mechanisms related to the chronic kidney disease and/or to the dialysis therapy and for this group of patients it is associated with an increase of morbidity and mortality. The dialysate has a standard composition, which can be modified according to the patient's characteristics. During hemodialysis patients are exposed to 18,000-36.000 litres of water/year, and the water purity along with the biochemical composition of the dialysate are essential. The individualization of the dialysis prescription is recommended for each patient and it has an important role in preventing the occurrence of dyselectrolyemia. The individualization of the treatment prescription according to the blood constants of each patient is the prerogative of the nephrologist and the association of the electrolyte imbalances with the patients cardiovascular mortality explains the importance of paying special attention to them.

Detection of possible restriction sites for type II restriction enzymes in DNA sequences.

In order to make a step forward in the knowledge of the mechanism operating in complex polygenic disorders such as diabetes and obesity, this paper proposes a new algorithm (PRSD -possible restriction site detection) and its implementation in Applied Genetics software. This software can be used for in silico detection of potential (hidden) recognition sites for endonucleases and for nucleotide repeats identification. The recognition sites for endonucleases may result from hidden sequences through deletion or insertion of a specific number of nucleotides. Tests were conducted on DNA sequences downloaded from NCBI servers using specific recognition sites for common type II restriction enzymes introduced in the software database (n = 126). Each possible recognition site indicated by the PRSD algorithm implemented in Applied Genetics was checked and confirmed by NEBcutter V2.0 and Webcutter 2.0 software. In the sequence NG_008724.1 (which includes 63632 nucleotides) we found a high number of potential restriction sites for ECO R1 that may be produced by deletion (n = 43 sites) or insertion (n = 591 sites) of one nucleotide. The second module of Applied Genetics has been designed to find simple repeats sizes with a real future in understanding the role of SNPs (Single Nucleotide Polymorphisms) in the pathogenesis of the complex metabolic disorders. We have tested the presence of simple repetitive sequences in five DNA sequence. The software indicated exact position of each repeats detected in the tested sequences. Future development of Applied Genetics can provide an alternative for powerful tools used to search for restriction sites or repetitive sequences or to improve genotyping methods.

A pathophysiological approach to metabolic syndrome using factor analysis in an adult Romanian population.

The aim of the study was to examine the role of insulin resistance in etiopathogenesis of metabolic syndrome in an adult Romanian population using exploratory factor analysis. We analyzed 228 non-diabetic subjects randomized in respect to the age and sex distribution of the general population. For each patient, age, sex, body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), HDL-cholesterol (HDL), plasma triglycerides (TG), fasting plasma glucose (FPG) and fasting insulin were obtained. Factor analysis was performed using principal component analysis, with Varimax rotation of the major determinants of metabolic syndrome. Mean age was 48.9 +/- 12.7 years; 107 (46.9%) were men and 121 (53.1%) women. We found three major factors, which are correlated with metabolic syndrome and may explain its variance. Factor 1 comprises SBP and DBP in men and SBP, DBP and BMI in women. Factor 2 comprises BMI, HDL, TG and FPG in men and BMI, TG and FPG in women. Factor 3 comprises fasting insulin in men and fasting insulin, TG and HDL in women. The finding of more than one factor suggests that insulin resistance is not the only pathophysiological mechanism involved. These factors appear to work independently of each other in men, but they intersect in women, suggesting that the pathophysiology of metabolic syndrome may be different in women compared with men.