Background:The objective of this study was to determine the levels of serum ischemia-modified albumin (IMA), fibrinogen (FIB) and high sensitivity C-reactive protein (hs-CRP) in type 2 diabetes mellitus (T2DM) patients with hypertension (HT) (DMT2HTN) and without HT (DMT2). Also, their association with certain biochemical and physical factors were studied to identify possible risk factors that lead to cardiovascular complications. Methods: Fasting blood samples were collected from 35 DMT2 or DMT2HTN patients each to analyze differences in serum and plasma levels of IMA, hs-CRP, FIB, total cholesterol (TC), high and low density lipoproteins (HDL and LDL), triglyceride (TG), hemoglobin A1c (HbA1C), glycated hemoglobin and creatinine. Results: In DMT2 and DMT2HTN patients, IMA, hs-CRP, FIB, TC, TG, HDL, LDL, glycated hemoglobin and creatinine levels, including body mass index (BMI) and waist-to-hip ratio (WHR), were significantly higher relative to healthy controls. In addition, the levels of IMA, hs-CRP and FIB levels showed a strong link to BMI, WHR, TC, TG, LDL and glycated hemoglobin. Lastly, both DMT2 and DMT2HTN patients demonstrated a significant reduction in HDL. Conclusions: DMT2 and DMT2HTN patients have a greater risk of developing cardiovascular related complications. This study suggests that quantifying hs-CRP, IMA and FIB levels can help diagnose the risk of developing complications during the early stages of metabolic and cardiovascular disease. Overall, the specific risk factors may be used for early identification of cardiovascular complications to decrease mortality and morbidity in T2DM patients.
Introduction: Diabetes mellitus cases are continually rising all over the world. Glycated haemoglobin (HbA1c) used as a diagnostic test to measure long-term average glycaemic control in diabetic patients. Aim: To assess the precision and reproducibility of the Ion Exchange Column Chromatography Resin (IECR) method and nephelometry in comparison to High-Performance Liquid Chromatography (HPLC) with respect to the estimation of HbA1c. Materials and Methods: A cross-sectional comparative study was conducted on 50 blood samples, collected from the diabetic subjects at the Department of Biochemistry and their HbA1c values were estimated by HPLC based BioRad D-10, nephelometry and IECR techniques. HPLC was used as a gold standard method, to evaluate the sensitivity and specificity of nephelometry and IECR techniques. Data were expressed as mean±standard deviation and intraclass Correlation Coefficient and Pearson correlation were calculated. Results: The mean age of the study subjects was 53.06±7.67 years. The mean plasma HbA1c levels were 8.16±2.9, 7.62±2.5 and 7.84±2.5 and mean estimated Average Glucose (eAG) was 187.00±84.4, 172.0±76.8, and 289.46±199.9 by HPLC, Nephelometry and IECR, respectively. Compared with HPLC, nephelometry had excellent correlation (r-value 0.925); p<0.001) and IECR (r-value 0.869; p<0.001). Conclusion: Nephelometry and IECR both had better performance and showed a greater concordance with gold standard HPLC. Therefore, nephelometry and IECR can be used as an alternative assay for HbA1c estimation.
Introduction: Menopause is an inevitable phase of a woman’s natural ageing process, marked by cessation of ovarian function. Hormonal changes during the phase causes derangement of lipid metabolism and thereby increasing cardiovascular risk in postmenopausal women. Diet plays a major role in influencing serum lipids. Aim: To determine and compare lipid profile, Atherogenic Index of Plasma (AIP) and non High-Density Lipoprotein-cholesterol (HDL-c) in pre and postmenopausal women based on vegetarian and non vegetarian diet. Materials and Methods: This cross-sectional study was comprised of 92 women (46 were premenopausal and 46 were postmenopausal) carried out at AJ Institute of Medical Sciences and Research Centre, Mangaluru, Karnataka, India between December 2019-May 2020. The groups were further divided into vegetarian and non vegetarians. Fasting lipid profile was determined by enzymatic methods. AIP and non HDL levels were calculated. Comparison of means between two groups was done using student t-test. Association between categorical variables was analysed using Chi-square test. Statistical significance was considered at p<0.05. Results: Serum Total Cholesterol (TC), Triglycerides (TG), Low-Density Lipoprotein-cholesterol (LDL-c), Very Low-Density Lipoprotein-cholesterol (VLDL-c), AIP and non HDL-c levels were LDL-c and HDL-c was high (184.09±17.49, 131.96±9.49, 106.00±20.92, 26.46±1.96, 0.05±0.07, 132.45±22.39 and 51.64±5.88, respectively) in vegetarians compared to non vegetarians in premenopausal women. In postmenopausal women, similar pattern was observed with regards to serum TC, TG, LDL-c, VLDL-c, AIP, non HDL-c and HDL-c in vegetarians and non vegetarians (p<0.05). An alarming proportion of non vegetarian postmenopausal women showed “very high” TC (91.3%), “low” HDL-c (56.5%), “very high” LDL-c (69.6%) and “high-risk” AIP (91.3%). Conclusion: The findings of this study indicated that all lipid parameters, AIP and non HDL-c were higher in non vegetarians except HDL-c in pre and postmenopausal women. Relevant dietary recommendations can be given to premenopausal women to promote positive health outcomes and alleviate cardiovascular risk.
BACKGROUND:Renal function is altered by thyroid status. Therefore, this study was done to determine the relationship between thyroid and renal parameters in overt type of thyroid dysfunction. AIM: The aims of this study were to correlate parameters of serum creatinine, creatinine clearance, with serum T3, T4 and TSH in overt hypothyroid cases. MATERIALS AND METHODS:This Case control study included fifty diagnosed cases of hypothyroidism in the department of Endocrinology, Medicine and Surgery of A J Institute of Medical Sciences & Research Centre, Mangaluru, of age group 15-75 years. Based on TSH levels, subjects were classified as subclinical hypothyroids and overt hypothyroids. Results were compared with age and sex matched twenty five euthyroids. Serum T3, T4 and TSH; Serum creatinine; and Creatinine clearance were estimated and analysed. RESULTS:The results of the present study were obtained from 75subjects out of whom 25 were controls, 22 were subclinical hypothyroids and 28 were overt hypothyroids. Age distribution of study subjects shows that the mean age was 39.56±13.019 for overt hypothyroids. Sex distribution of study subjects shows that majority of overt hypothyroids (78.6%) were females. Percentage of individuals with altered serum creatinine, and creatinine clearance among overt hypothyroids shows that there were more cases of overt hypothyroids with increased serum creatinine. Hypothyroid cases had decreased renal function. Overt hypothyroids showed statistically significant difference in the levels of serum creatinine, but they did not differ in the levels of creatinine clearance. CONCLUSION: Hypothyroidism is linked with considerable derangement in biochemical parameters of renal function, necessitating regularl monitoring of renal pararmeters in hypothyroid patients. HOW TO CITE THIS ARTICLE: INTRODUCTION:Long standing hypothyroidism causes significant reversible changes in renal function such as decrease in sodium resorption in the proximal tubules, impairment in the concentrating and diluting capacities of the distal tubules, a decrease in urate concentration, and a decrease in renal blood flow and GFR. This is because of hypodynamic state that occurs in hypothyroidism. The altered thyroid function induces a decrease in myocardial contractility and cardiac output. There is increase in peripheral resistance leading to systemic and renal vasoconstriction. This results in decreased renal blood flow causing decrease in GFR, increase in creatinine and a decrease in creatinine clearance.
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