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Kashyap S, AN I, KN S, R H. A mathematical model for thrombotic risk assessment in type 2 diabetes. Bioinformation 2023; 19:971-975. [PMID: 37928492 PMCID: PMC10625368 DOI: 10.6026/97320630019971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/30/2023] [Accepted: 09/30/2023] [Indexed: 11/07/2023] Open
Abstract
Hyperglycaemia is known to alter the circulating lipids in diabetics. Combinatorial effect of in vivo synthesis of lipids and dietary lipids leads to atherosclerosis. Uncontrolled diabetes is linked with the cardiovascular outcome. This data has correlated the Castelli's Risk Index (CRI-I and CRI-II), Atherogenic Index of Plasma and Atherogenic Coefficient with microvascular complications of T2DM. Etio-pathogenesis of cardiovascular risk factors and lipid biomarkers speaks of the thrombotic events of cerebrovascular accidents and also the reno-vascular mechanisms of renal arterial thrombotic events. Documentary evidence have proved that the micro albuminuria is a "cutting edge" to assess the microvascular complications of renal and retina. Uncontrolled diabetes is known to alter the triglycerides, lower HDL-cholesterol and elevate LDL-cholesterol. Alteration of lipid profile mimics a major link between diabetes and the increased cardiovascular risk in diabetic patients.
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Affiliation(s)
- Sahana Kashyap
- Department of Biochemistry, Sri Devaraj Urs Medical College, Constituent college of Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - Indumathi AN
- Department of Biochemistry, Sri Devaraj Urs Medical College, Constituent college of Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - Shashidhar KN
- Department of Biochemistry, Sri Devaraj Urs Medical College, Constituent college of Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
| | - Harish R
- Department of Biochemistry, Sri Devaraj Urs Medical College, Constituent college of Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, Karnataka, India
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Bage IJ, Kamalanathan S, Selvarajan S, Sahoo J, Jayanthi M, Naik D. The Association of Dyslipidemia and Atherogenic Indices With Glycemic Control in Diabetic Dyslipidemia Patients: A Real-World Landscape. Cureus 2023; 15:e45985. [PMID: 37900537 PMCID: PMC10601505 DOI: 10.7759/cureus.45985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Dyslipidemia is an important comorbid factor of type 2 diabetes mellitus (T2DM) that increases the risk of cardiovascular diseases. This study aimed to assess the pattern of dyslipidemia and atherogenic indices and determine its relation with glycemic control. METHODS A cross-sectional study enrolled 382 patients with diabetic dyslipidemia. The socio-demographics data, clinical features, and laboratory parameters were collected. The baseline lipid parameters such as total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and glycated hemoglobin (HbA1C) were measured. Atherogenic indices such as TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, non-HDL-C/HDL-C and atherogenic index of plasma (AIP) [log10 (TG/HDL-C)] were calculated. T2DM patients were classified into three groups based on the degree of glycemic control: Good glycemic control (HbA1C<7%), fair control (HbA1C 7-8%), and poor control (HbA1C>8%). RESULTS The population's mean age was 48.60±6.15 years, with 145 (38%) males. We found mixed dyslipidemia as the most prevalent (36.1%) form of dyslipidemia in our patients. The most common pattern in atherogenic indices was AIP (94.2%). HbA1c was positively correlated with duration of diabetes (r=0.253, p<0.001). In multivariate logistic regression analysis, duration of diabetes (>10 years) was significantly associated with poor glycemic control with an odds ratio (OR) of 2.31(95% CI; 1.25-4.24, p=0.007). CONCLUSION The present study indicated that neither the pattern of dyslipidemia nor the atherogenic indices were markers of poor glycemic control among South Indian patients attending our tertiary care institute. However, duration of diabetes was significantly associated with poor glycemic control.
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Affiliation(s)
- Isaac J Bage
- Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Sadishkumar Kamalanathan
- Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Sandhiya Selvarajan
- Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Jayaprakash Sahoo
- Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Mathaiyan Jayanthi
- Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Dukhabandhu Naik
- Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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Sobha SP, Kesavarao KE. Progonostic effect of GSTM1/GSTT1 polymorphism in determining cardiovascular diseases risk among type 2 diabetes patients in South Indian population. Mol Biol Rep 2023; 50:6415-6423. [PMID: 37326751 DOI: 10.1007/s11033-023-08514-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/10/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a significant complication of type 2 diabetes mellitus (T2DM), with oxidative stress playing a significant role. Glutathione S-transferase (GST) polymorphisms - GSTM1, GSTT1 - have been linked to CVD and T2DM. The role of GSTM1 and GSTT1 in CVD development among T2DM patients in the South Indian population is investigated in this study. MATERIALS AND METHODS The volunteers were grouped as Group 1: control, Group 2: T2DM, Group 3: CVD, and Group 4: T2DM with CVD (n = 100 each). Blood glucose, lipid profile, plasma GST, MDA, and total antioxidants were measured. GSTM1 and GSTT1 were genotyped using PCR. RESULTS GSTT1 plays a significant role in the development of T2DM and CVD [OR 2.96(1.64-5.33), < 0.001 and 3.05(1.67-5.58), < 0.001] while GSTM1 null genotype was not associated with disease development. Individuals with dual null GSTM1/GSTT1 genotype had the highest risk of developing CVD [3.70(1.50-9.11), 0.004]. Group 2 and 3 individuals showed higher lipid peroxidation and lower total antioxidant levels. Pathway analysis further indicated that GSTT1 significantly affects GST plasma levels. CONCLUSION GSTT1 null genotype may be considered a contributing factor that increases the susceptibility and risk of CVD and T2DM in the South Indian population.
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Affiliation(s)
- Santhi Priya Sobha
- Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chengalpattu Dt., TN, 603103, India
| | - Kumar Ebenezar Kesavarao
- Faculty of Allied Health Sciences, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chengalpattu Dt., TN, 603103, India.
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Rathi H, Kumar R, Goyal B, Kant R, Mirza AA, Rana S, Naithani M. Assessment of Dyslipidemia, Lipid Ratios, and Atherogenic Indices as Cardiovascular Risk Factors in Prediabetic and Diabetic Subjects. J Lab Physicians 2022; 14:420-426. [DOI: 10.1055/s-0042-1744240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Abstract
Background Uttarakhand is a small state in northern India that comprises mixed population with people dwelling in both hilly and plain areas. Globally, diabetes mellitus (DM) has already been considered to be a pandemic. Furthermore, cardiovascular diseases (CVD) significantly increase mortality and morbidity in patients suffering from DM. Additionally, dyslipidemia has been identified as an important marker in the development of atherosclerosis and ultimately CVD in patients of prediabetes and diabetes. Thus, the identification of subjects with dyslipidemia in prediabetes might be fruitful in lowering their progression to diabetes and ultimately in decreasing incidences of CVD. Hence, this study was undertaken to assess dyslipidemia via the calculation of atherogenic indices (AI) and lipid ratios in prediabetic and diabetic groups attending tertiary care hospital in Uttarakhand.
Materials and Methods This study reviewed retrospective biochemical data of 500 study subjects from e-hospital software of the All India Institute of Medical Sciences, Rishikesh. All study subjects were divided into three groups: 122 controls, 137 prediabetics, and 241 diabetics based on the American Diabetes Association criteria. Study subjects were evaluated for glycated hemoglobin (HbA1c), lipid profile, and AI (total cholesterol [TC]/high-density lipoprotein cholesterol [HDLc], low-density lipoprotein cholesterol [LDLc]/HDLc, TC-HDLc/HDLc, triglycerides [TG]/HDLc).
Results Results showed that TC, TG, LDLc, and AI were significantly higher, and HDLc was significantly decreased in prediabetic and diabetic groups compared with controls. Furthermore, HbA1c showed significant positive correlation with lipid profile and AI except atherogenic coefficient (TC-HDL/HDL).
Conclusion In conclusion, the current study showed the presence of dyslipidemia in both prediabetic and diabetic groups underlining their importance for screening at the prediabetic stage. Hence, we also recommend screening of the prediabetic group for dyslipidemia to arrest the development of early cardiovascular complications.
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Affiliation(s)
- Himani Rathi
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Raman Kumar
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bela Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Anissa Atif Mirza
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Satyavati Rana
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manisha Naithani
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Latif R, Rafique N. Prevalence and Risk Factors of Prediabetes in Young Saudi Females in a University Setting. Ethiop J Health Sci 2021; 30:929-940. [PMID: 33883838 PMCID: PMC8047230 DOI: 10.4314/ejhs.v30i6.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Studies reporting prediabetes prevalence in young Saudis are almost a decade old. The present study determined prediabetes prevalence and its associated risk factors (body composition, lipid profile, blood pressure and physical activity) in young Saudi females. Methods Three hundred Saudi females (18–20 years old), studying in year 2 and 3 at Imam Abdulrahman Bin Faisal University, were categorized as normoglycemic or prediabetic based on fasting plasma glucose criteria of World Health Organization (WHO) and American Diabetes Association (ADA). Anthropometric measurements, lipid profile, atherogenic indices, and physical activity data were compared. Association between fasting blood glucose and study variables was found by Bivariate analysis (Spearman Correlation for non-parametric variables and Pearson correlation for parametric) followed by Binary Logistic Regression analysis. Results Prevalence of prediabetes by WHO and ADA criteria were 11.3% and 18.7% respectively. Systolic, diastolic and mean arterial pressures, waist circumference, waist-hip and waist-stature-ratios were significantly raised in prediabetics compared to normoglycemic (WHO criteria p-values; 0.03, 0.003, 0.005, 0.01, 0.01, 0.04 respectively; ADA criteria 0.04, 0.001, 0.02, 0.02, 0.03, 0.01 respectively). For each unit increase in systolic, diastolic and mean arterial pressures, and waist circumference, the odds of becoming prediabetic increased by a factor of 1.02, 1.05, 1.04 and 1.03 respectively by WHO criteria: and 1.01, 1.03, 1.02, and 1.02 respectively by ADA criteria Conclusion Substantial numbers of young females in our university are suffering from prediabetes. An increase in systolic, diastolic, and mean arterial pressures and waist circumference are significant risk factors for prediabetes in young females.
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Affiliation(s)
- Rabia Latif
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University
| | - Nazish Rafique
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University
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Chakraborty M, Singh P, Dsouza JMP, Pethusamy K, Thatkar PV. Fasting and postprandial lipid parameters: A comparative evaluation of cardiovascular risk assessment in prediabetes and diabetes. J Family Med Prim Care 2020; 9:287-292. [PMID: 32110606 PMCID: PMC7014867 DOI: 10.4103/jfmpc.jfmpc_769_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/04/2019] [Accepted: 12/12/2019] [Indexed: 01/01/2023] Open
Abstract
Context: Dyslipidemia plays a crucial role in atherogenesis, in both prediabetes and diabetes. There persists a lacuna in the evaluation of postprandial lipid parameters in prediabetes. Aims: To comparatively evaluate fasting and postprandial blood lipid parameters and atherogenic lipid ratios for cardiovascular risk assessment, in prediabetes and diabetes. Materials and Methods: Fifty-one patients diagnosed with diabetes mellitus and thirty-two with prediabetes were selected for the study. Lipid profile and blood glucose were analyzed in fasting and postprandial blood samples. Statistical Analysis Used: Kolmogorov–Smirnov test, Shapiro–Wilk test, one-way ANOVA, and Pearson's regression analysis were applied. Results: Postprandially, triglycerides (TG) was increased significantly in diabetes compared to controls (P < 0.01) and prediabetics (P < 0.05). Among the lipid ratios, triglyceride/high density lipoprotein (TG/HDLc) was significantly increased postprandially in diabetes compared to controls (P < 0.05). A comparative analysis of fasting and postprandial parameters within each group showed a significant increase in postprandial TG/HDLc compared to the fasting state in prediabetes (P < 0.001) and diabetes (P < 0.001). Postprandial TG (P < 0.01) and TG/HDLc (P < 0.01) showed a stronger correlation with HbA1c compared to fasting TG (P < 0.05) and TG/HDLc (P > 0.05). The prevalence of dyslipidemia and insulin resistance was higher in postprandial state than the fasting state in prediabetes and diabetes. Conclusions: Postprandial TG and the TG/HDLc reflect lipid abnormalities than the corresponding fasting variables in diabetes and prediabetes. Postprandial TG and TG/HDLc are better reflectors of cardiovascular status in prediabetes and diabetes.
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Affiliation(s)
- Montosh Chakraborty
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India
| | - Prerna Singh
- Department of Biochemistry, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, India
| | - Jyothi M P Dsouza
- Department of Biochemistry, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, India
| | - Karthikeyan Pethusamy
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Pandurang V Thatkar
- Department of Community Medicine, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, India
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