Background Lipoprotein ratios are indicators of atherosclerosis and related diseases such as cardiovascular diseases (CVDs). Early and accurate diagnosis of atherosclerotic disease in patients with diabetic foot ulceration (DFU) is required urgently and remains fundamental to assess the risk of CVDs. This study aimed to determine whether lipoprotein ratios can predict atherosclerosis in type 1 diabetic patients with DFU. Methodology This was a cross-sectional study including 255 patients with confirmed type 1 diabetes with a male-tofemale ratio of 1.19. Patients admitted to the hospital due to diabetes-related complications were divided into the following groups: patients without DFU (n = 153) and patients with DFU (n = 102). Clinical, biological, and pathophysiological features of patients were compared. Results Our study reported a distinct predominance of males (54.50%), with a mean age of 28.64 ± 10.92 years and duration of diabetes of 10.40 ± 9.25 years. The prevalence of DFU was 40.0%. The receiver operator characteristic curve was applied to define the best cutoff lipid ratios to detect atherosclerosis. Total cholesterol (TC)/high-density lipoprotein (HDL) ratio was a valid marker for atherosclerosis with a sensitivity of 86.3%, specificity of 71.4%, and diagnostic accuracy of 0.836%. The findings showed that the fourth quartiles (odds ratio [OR] = 83.02 [22.18-310.75]; p = <10-3) of TC/HDL ratio was significantly higher in patients with DFU. Similarly, the last quartiles (fourth) of low-density lipoprotein (LDL)/HDL and triglyceride (TG)/HDL ratio were higher in DFU group (OR = 33.71 [12.04-94.38], p = <10-3 ; OR = 9.60 [4.27-21.58], p = <10-3 ; respectively). In the DFU group, conventional lipid profiles and lipid ratios were markedly higher in males compared to females patients (TG = 1.
Coronavirus disease 2019 (COVID-19) increases the risk of several cardiovascular diseases (CVDs) such as acute myocardial injury. Vascular dysfunctions are important drivers of CVDs. A variety of risk factors promotes the development and progression of CVDs including, overweight and obesity, arterial hypertension, physical inactivity, smoking, unhealthy diet, overconsumption of alcohol, dyslipidemia, atherosclerosis and diabetes mellitus. However, nearly all of these risk factors are modifiable by antihypertensive, antidiabetic, or lipid-lowering medication and lifestyle changes. Other factors such as age or genetic factors cannot be modified. Moreover, infection and inflammation have been shown to increase the risk of CVDs. The COVID-19 pandemic yielded a new perspective to this field. Cardiometabolic events, diseases, risk factors and COVID-19 are strongly intertwined. An increased CVDs risk through multifactorial mechanisms has been observed in COVID-19 patients. Furthermore, a higher rate of infection with COVID-19, severe COVID-19, and bad outcome has been demonstrated in patients with established cardiometabolic disorders and vascular risk factors. Summary at present, we suggest that regular interactions between healthcare professionals and patients should include education on COVID-19 and on primary and secondary vascular prevention in order to minimize the burden of the virus in our susceptible populations. Keywords: Cardiometabolic disorders, cardiovascular diseases, inflammation, atherosclerosis, COVID-19.
Objective: To investigate the relationship between Lipid ratios and asymptomatic peripheral artery disease (aPAD) in type 1 diabetic patients. Materials and Methods: This cross-sectional study was performed among 223 diabetics. Patients were segregated with aPAD when their ankle-brachial index (ABI) was abnormal (ABI ≤ 0.90, or ABI > 1.20). Patients were segregated into the following groups (patients with normal ABI vs. patients with arterial stiffness). The association between lipid ratios and aPAD was analyzed using multivariate logistic regression analysis and the receiver operator characteristic curve. Results: Our study reported a slight preponderance of females (108 males vs. 115 females), with a mean age of 30.70±9.69 years and a diabetes duration of 11.13±8.95 years. The prevalence of arterial stiffness was 38.11%. TC/HDL-C ratio was a significant predictor for atherosclerosis with a sensitivity of 77.3%, specificity of 62.5%, and diagnostic accuracy of 0.758%. The results revealed that the 4th quartile (odds ratio [OR]=12.52 [5.06-31.00], p=<0.001) of TC/HDL-C ratio was statistically higher in patients with arterial stiffness. Similarly, the last quartiles of LDL-C/HDL-C and TG/HDL-C ratio were higher in the arterial stiffness group (OR=3.70 [1.68-8.11], p=0.001; OR=4.74 [2.12-10.59], p=<0.001; respectively). In the arterial stiffness group, non-traditional lipid values were significantly higher in males compared to females. Conclusion: Lipid ratios are correlated with aPAD in type 1 diabetic patients, and should thus be assessed in clinical decision-making and risk stratification on atherosclerotic cardiovascular disease.
Background and Objectives: Epidemiological inquiries on the subclinical atherosclerotic disease in type 1 diabetes associated with autoimmune thyroid disease are scarce. Our aim was to evaluate the risk of developing atherosclerosis via lipid ratios by comparing two groups of patients according to their TSH (Thyroid-stimulating hormone) status. Methods: A retrospective study including 190 patients (13-74 years) with confirmed type 1 diabetes divided into the following groups (patients with serum TSH < 2.5 μIU/mL vs. patients with serum TSH ≥ 2.5 μIU/mL). Autoimmune thyroid disease was classified according to clinical, biological, and follow up data. Results: Our study showed a slight predominance of females (50.50%), with an average age of 29.25±11.39 years. The prevalence of hypothyroidism was 14.7%, hyperthyroidism 6.3%, and anti-TPO 16.31%. Significant differences were observed between lipid profiles such as HDL and TG (p= 0.008; p=0.04, respectively). The results showed that the 3rd (OR= 2.28 [0.72-7.20]; p=0.15) and the fourth quartiles (OR= 1.9 [0.61-5.83]; p=0.26) of TC/HDL ratio were higher in patients with serum TSH ≥ 2.5 μIU/mL group. Similarly, we noticed higher concordant values on the last quartile (4th) of LDL/HDL ratio with p values of 0.06 as well as the two quartiles (2ndand 4th) of TG/HDL ratio with p values of 0.03 and 0.04, respectively. In both groups, lipid ratios were slightly higher in males compared to females’ patients. Conclusion: The risk of atherosclerosis was higher in patients with elevated TSH concentrations. Therefore, early detection of thyroid dysfunction and associated dyslipidemia is essential for effective prevention of premature cardiovascular morbidity and mortality. Keywords: Subclinical atherosclerotic disease, autoimmune thyroid disease, TSH, type 1 diabetes
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