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Fasoula NA, Xie Y, Katsouli N, Reidl M, Kallmayer MA, Eckstein HH, Ntziachristos V, Hadjileontiadis L, Avgerinos DV, Briasoulis A, Siasos G, Hosseini K, Doulamis I, Kampaktsis PN, Karlas A. Clinical and Translational Imaging and Sensing of Diabetic Microangiopathy: A Narrative Review. J Cardiovasc Dev Dis 2023; 10:383. [PMID: 37754812 PMCID: PMC10531807 DOI: 10.3390/jcdd10090383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Microvascular changes in diabetes affect the function of several critical organs, such as the kidneys, heart, brain, eye, and skin, among others. The possibility of detecting such changes early enough in order to take appropriate actions renders the development of appropriate tools and techniques an imperative need. To this end, several sensing and imaging techniques have been developed or employed in the assessment of microangiopathy in patients with diabetes. Herein, we present such techniques; we provide insights into their principles of operation while discussing the characteristics that make them appropriate for such use. Finally, apart from already established techniques, we present novel ones with great translational potential, such as optoacoustic technologies, which are expected to enter clinical practice in the foreseeable future.
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Affiliation(s)
- Nikolina-Alexia Fasoula
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Yi Xie
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Nikoletta Katsouli
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Mario Reidl
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Michael A. Kallmayer
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
| | - Hans-Henning Eckstein
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
| | - Vasilis Ntziachristos
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Leontios Hadjileontiadis
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center (HEIC), Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates;
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | - Alexandros Briasoulis
- Aleksandra Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece;
| | - Gerasimos Siasos
- Sotiria Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece;
| | - Kaveh Hosseini
- Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran;
| | - Ilias Doulamis
- Department of Surgery, The Johns Hopkins Hospital, School of Medicine, Baltimore, MD 21287, USA;
| | | | - Angelos Karlas
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
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Laursen JC, Jepsen R, Bruun-Rasmussen NE, Frimodt-Møller M, Jørgensen ME, Rossing P, Hansen CS. Blood oxygen saturation is lower in persons with pre-diabetes and screen-detected diabetes compared with non-diabetic individuals: A population-based study of the Lolland-Falster Health Study cohort. FRONTIERS IN EPIDEMIOLOGY 2022; 2:1022342. [PMID: 38455289 PMCID: PMC10910962 DOI: 10.3389/fepid.2022.1022342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/20/2022] [Indexed: 03/09/2024]
Abstract
Aims Low blood oxygen saturation is associated with increased mortality and persons with diabetes have sub-clinical hypoxemia. We aimed to confirm the presence of sub-clinical hypoxemia in pre-diabetes, screen-detected diabetes and known diabetes. Methods Pre-diabetes was defined as hemoglobin A1C (HbA1C) ≥ 42 mmol/mol and <48 mmol/mol; known diabetes as history or treatment of diabetes; screen-detected diabetes as no history or treatment of diabetes and HbA1C ≥ 48 mmol/mol. Blood oxygen saturation was measured with pulse oximetry. Urine albumin-to creatinine ratio (UACR) was measured on a single spot urine. Results The study included 829 adults (≥18 years) with diabetes (713 (86%) with known diabetes; 116 (14%) with screen-detected diabetes) and 12,747 without diabetes (11,981 (94%) healthy controls; 766 (6%) with pre-diabetes). Mean (95% CI) blood oxygen saturation was 96.3% (96.3% to 96.4%) in diabetes which was lower than in non-diabetes [97.3% (97.2-97.3%)] after adjustment for age, gender, and smoking (p < 0.001), but significance was lost after adjustment for BMI (p = 0.25). Sub-groups with pre-diabetes and screen-detected diabetes had lower blood oxygen saturations than healthy controls (p-values < 0.01). Lower blood oxygen saturation was associated with higher UACR. Conclusions Persons with pre-diabetes and screen-detected diabetes have sub-clinical hypoxemia, which is associated with albuminuria.
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Affiliation(s)
| | - Randi Jepsen
- Center for Epidemiological Research, Nykøbing Falster Hospital, Nykøbing Falster, Denmark
| | | | | | | | - Peter Rossing
- Complications Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Niu C, Liu L, Li Y, Li X. Impact of Diabetic Nephropathy on Pulmonary Function and Clinical Outcomes. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:8164034. [PMID: 36072729 PMCID: PMC9441358 DOI: 10.1155/2022/8164034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/27/2022]
Abstract
Objective The main objective is to study the effect of diabetic nephropathy on pulmonary function and clinical outcomes. Methods The method is to retrospectively analyze patients with diabetic nephropathy (DN) in our hospital from April 2018 to March 2022 as study subjects. The differences in baseline data, serum indicators, renal function indicators, and pulmonary function of patients at different clinical stages were analyzed and then explored. Finally, logistic regression was used to analyze the risk factors affecting patients' clinical outcomes and to evaluate the diagnostic effects. Results Baseline information (age, disease duration, BMI, and systolic and diastolic blood pressure), serum indicators (HbA1c, FBG, 2hPG, TG, TC, and LDLC), renal function indicators (CysC, BUN, and Scr), and pulmonary function (TLC, VC, FEV1, FEV1/FVC, MVV, MEF25, MEF50 MEF75, DLCO, and DLCO/VA) were significantly different (P < 0.01); multiple logistic regression analysis showed that SBP, HbA1c, FBG, 2hPG, BUN, Scr, TLC, VC, FEV1/FVC, MVV, DLCO, and DLCO/VA were all key factors in the development of clinical outcomes in DN (P < 0.05). ROC analysis showed that all of these important factors had an AUC greater than 0.75 for the diagnosis of DN with high sensitivity and specificity. Conclusion Serum and renal function indices of DN patients gradually increased with stage, accompanied by a decrease in pulmonary ventilation, and diffusion function; SBP, HbA1c, FBG, 2hPG, BUN, Scr, TLC, VC, FEV1/FVC, MVV, DLCO, and DLCO/VA were all key factors affecting the clinical outcome of DN; controlling blood glucose, lipids, improving pulmonary ventilation, and diffusion function can better prevent the occurrence and worsening of DN.
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Affiliation(s)
- Chunbo Niu
- First School of Clinical Medical to Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Lu Liu
- First School of Clinical Medical to Gansu University of Chinese Medicine, Lanzhou 730000, China
| | - Yang Li
- Department of Respiration and Critical Medicine in Cadre Ward, Gansu Provincial Hospital, Lanzhou 730000, China
| | - Xiaoqi Li
- Department of Respiration and Critical Medicine in Cadre Ward, Gansu Provincial Hospital, Lanzhou 730000, China
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