Anemia and type 2 diabetes mellitus associated with peripheral arterial disease progression in Chinese male patients

Serum Irisin as a Predictor for Peripheral Arterial Disease: Insights from a Clinical Study

OBJECTIVE

The purpose of this study was to investigate the correlation between serum irisin concentration and peripheral arterial disease (PAD), and to establish clinical prediction nomograms for PAD occurrence by comparing and analyzing clinical data from patients with PAD and healthy controls.

METHODS

A total of 112 patients with PAD and 90 healthy individuals were recruited for the study. Clinical data from both groups were collected and serum irisin concentration was measured using enzyme-linked immunosorbent assay (ELISA). Correlation analysis was conducted. Risk factors for PAD were identified through univariate and multivariate logistic regression. The clinical prediction nomograms were established and validated.

RESULTS

A total of 202 patients were enrolled in this study, with an average age of 63.98 ± 10.40 years. Of these, 123 were male (60.9%) and 79 were female (39.1%). Hypertension was present in 104 patients (51.5%), diabetes in 59 patients (29.2%), dyslipidemia in 94 patients (46.5%), and 105 patients (52.0%) were smokers. Among them, 112 patients were assigned to the PAD group, which included 78 males (69.6%) and 34 females (30.4%), with an average age of 67.54 ± 10.31 years. In this group, 62 patients (55.4%) had hypertension, 53 (47.3%) had diabetes, 62 (55.4%) had dyslipidemia, and 78 (69.6%) were smokers. The Rutherford classification of these patients showed that 64 (57.1%) were at stage I, 25 (22.3%) at stage II, 16 (14.3%) at stage III, and 7 (6.3%) at stage IV. Serum irisin concentration in patients with PAD showed a significant positive correlation with serum high-density lipoprotein (HDL) (r = 0.255) and a significant negative correlation with Rutherford classification (r = -0.374) and smoking status (r = -0.263). Univariate and multivariate logistic regression analyses identified irisin, age, diabetes, dyslipidemia, smoking, creatinine (CR), and neutrophil/lymphocyte ratio (NLR) as independent risk factors for the development of PAD (P < 0.05). Based on these findings, a clinical prediction nomogram was established. Internal validation of the nomogram demonstrated strong discriminatory ability, with an area under the curve (AUC) of 0.942, indicating the model's excellent performance. Calibration curves and decision curve analyses further confirmed the model's robust calibration and clinical applicability.

CONCLUSIONS

This study concluded that serum irisin concentrations were significantly lower in the PAD group compared to the healthy control group, and that serum irisin concentrations in the PAD group were significantly correlated with serum HDL, Rutherford classification, and smoking status. Additionally, Irisin level, age, diabetes, dyslipidemia, smoking, CR, and NLR were identified as independent risk factors for PAD development. The clinical prediction nomogram based on these factors may aid in accurately predicting the risk of PAD development.

Impaired Glucose Tolerance is Associated with Enhanced Platelet-Monocyte Aggregation in Short-Term High-Fat Diet-Fed Mice

High-fat diet (HFD) feeding is known to induce metabolic dysregulation, however, less is known on its impact in promoting the hypercoagulable state. This current study aimed to evaluate platelet-monocyte aggregate (PMA) formation following short-term HFD feeding. This is particularly important for understanding the link between inflammation and the hypercoagulable state during the early onset of metabolic dysregulation. To explore such a hypothesis, mice were fed a HFD for 8 weeks, with body weights as well as insulin and blood glucose levels monitored on a weekly basis during this period. Basal hematological measurements were determined and the levels of spontaneous peripheral blood PMAs were assessed using whole blood flow cytometry. The results showed that although there were no significant differences in body weights, mice on HFD displayed impaired glucose tolerance and markedly raised insulin levels. These metabolic abnormalities were accompanied by elevated baseline PMA levels as an indication of hypercoagulation. Importantly, it was evident that baseline levels of monocytes, measured using the CD14 monocyte marker, were significantly decreased in HFD-fed mice when compared to controls. In summary, the current evidence shows that in addition to causing glucose intolerance, such as that identified in a prediabetic state, HFD-feeding can promote undesirable hypercoagulation, the major consequence implicated in the development of cardiovascular complications.

Hematological profile associated with type 2 diabetes mellitus

BACKGROUND

Hematological changes affecting blood cells and the coagulation factors are shown to be associated with diabetes mellitus. We investigated some of the hematological risk factors implicated in the development of type 2 diabetes mellitus.

METHODS

The study conducted in western Algeria on a sample of 1852 subjects, 1059 with type 2 diabetes and 793 witnesses, were evaluated for peripheral blood parameters using hematology analyzer. All the informations related to the disease were collected from the patients and recorded using predesigned questionnaire.

RESULTS

The logistic model retained, the mean corpuscular hemoglobin concentration reveals that subjects with concentration over the normal ratio (>36 g/dl) have an exposure risk six and half times higher than subjects with normal concentration (OR = 6.59; 95% CI = 2.51-17.31, P = 0.000). As regards to the platelets blood ratio, subjects with a ratio lower are five times more exposed to type 2 diabetes compared to subjects with a normal ratio (OR = 5.01; 95% CI = 1.78-14.13, P < 0.002). Our logistic model also retained basophils ratio (OR = 2.18; 95% CI = 1.35-3.53, P < 0.001) and sedimentation rate at one hour (OR = 7.83; 95% CI = 3.39-18.06, P = 0.000).

CONCLUSIONS

Hematological profile associated with type 2 diabetes mellitus retained the mean corpuscular hemoglobin concentration over the normal ratio, lower platelets blood ratio, basophils ratio and sedimentation rate at one hour.

Anemia complicating type 2 diabetes: Prevalence, risk factors and prognosis

AIMS

To determine the prevalence, risk factors and prognosis of anemia in representative community-based patients with type 2 diabetes.

METHODS

Data from the Fremantle Diabetes Study Phase II (FDS2; n=1551, mean age 65.7years, 51.9% males) and Busselton Diabetes Study (BDS; n=186, mean age 70.2years, 50.0% males) cohorts, and from 186 matched BDS participants without diabetes, were analyzed. The prevalence of anemia (hemoglobin ≤130g/L males, ≤120g/L females) was determined in each sample. In FDS2, associates of anemia were assessed using multiple logistic regression and Cox proportional hazards modeling identified predictors of death during 4.3±1.2years post-recruitment.

RESULTS

The prevalence of anemia at baseline was 11.5% in FDS2 participants, 17.8% in BDS type 2 patients and 5.4% in BDS participants without diabetes. In FDS2, 163 of 178 patients with anemia (91.6%) had at least one other risk factor (serum vitamin B₁₂<140pmol/L, serum ferritin <30μg/L and/or transferrin saturation<20%, serum testosterone <10nmol/L (males), glitazone therapy, estimated glomerular filtration rate (eGFR) <60mL/min 1.73m², malignancy, hemoglobinopathy). More anemic than non-anemic FDS2 patients died (28.7% versus 8.0%; P<0.001). After adjustment for other independent predictors (age as time-scale, male sex, Aboriginality, marital status, smoking, eGFR), anemia was associated with a 57% increase in mortality (P=0.015).

CONCLUSIONS

Type 2 diabetes at least doubles the risk of anemia but other mostly modifiable risk factors are usually present. Anemia is associated with an increased risk of death after adjustment for other predictors.

Presence and characterisation of anaemia in diabetic foot ulceration

Introduction. Diabetic foot ulceration (DFU) is the commonest cause of severe limb ischaemia in the western world. In diabetes mellitus, anaemia is frequently unrecognized, yet studies have shown that it is twice as common in diabetics compared with nondiabetics. We aimed to assess the incidence of anaemia and further classify the iron deficiency seen in a high-risk DFU patient group. Methods. An observational study was undertaken in a multidisciplinary diabetic foot clinic setting. All patients with DFU attending over a four-month period were included. Anaemia was defined as haemoglobin (Hb) levels <12 g/dL. Iron deficiency was classified according to definitions of AID (absolute iron deficiency) and FID (functional iron deficiency). Results. 27 patients had DFU; 14 (51.9%) were anaemic; two (7.41%) had severe anaemia (Hb < 10 g/dL). No patient had B12 or Folate deficiency. In patients with anaemia, there was significant spread of indices. Only one patient had “textbook” absolute iron deficiency (AID) defined as low Hb, MCV, MCH, and ferritin. Functional iron deficiency (FID) was seen in a further seven patients (25.5%). Conclusion. Anaemia and iron deficiency are a common problem in patients with DFU. With current clinical markers, it is incredibly difficult to determine causal relationships and further in-depth scientific study is required.