Evaluation of Glucose Tolerance Status in Patients with Asthma Bronchiale

Gülcan, Erim; Bulut, İsmet; Toker, Aysun; Gülcan, Aynur

doi:10.1080/02770900802627302

Cited by 31 publications

(28 citation statements)

References 18 publications

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“…Several other studies have also demonstrated these effects triggered by the use of corticosteroids. 30,31 Duration of surgery was also correlated with a higher risk of hyperglycemia in PACU. This fact may be justified by the sympathetic response associated with surgical stress and the release of counterregulatory hormones, which determine lower insulin secretion and peripheral tissue resistance to the action of insulin and produce hyperglycemia.…”

Section: Discussionmentioning

confidence: 92%

Hyperglycemia assessment in the post-anesthesia care unit

Pereira

Azuma

Gatto

et al. 2017

Brazilian Journal of Anesthesiology (English Edition)

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Background and objectives: Hyperglycemia in surgical patients may cause serious problems. Analyzing this complication in this scenario contributes to improve the management of these patients. The aim of this study was to evaluate the prevalence of hyperglycemia in the postanesthetic care unit (PACU) in non-diabetic patients undergoing elective surgery and analyze the possible risk factors associated with this complication. Methods: We evaluated non-diabetic patients undergoing elective surgeries and admitted in the PACU. Data were collected from medical records through precoded questionnaire. Hyperglycemia was considered when blood glucose was >120 mg.dL −1 . Patients with hyperglycemia were compared to normoglycemic ones to assess factors associated with the problem. We excluded patients with endocrine-metabolic disorders, diabetes, children under 18 years, body mass index (BMI) below 18 or above 35, pregnancy, postpartum or breastfeeding, history of drug use, and emergency surgeries. Results: We evaluated 837 patients. The mean age was 47.8 ± 16.1 years. The prevalence of hyperglycemia in the postoperative period was 26.4%. In multivariate analysis, age (OR = 1.031, 95% CI 1.017---1.045); BMI (OR = 1.052, 95% CI 1.005---1.101); duration of surgery (OR = 1.011, 95% CI 1.008---1.014), history of hypertension (OR = 1.620, 95% CI 1.053---2.493), and intraoperative use of corticosteroids (OR = 5.465, 95% CI 3.421---8.731) were independent risk factors for postoperative hyperglycemia. Conclusion: The prevalence of hyperglycemia was high in the PACU, and factors such as age, BMI, corticosteroids, blood pressure, and duration of surgery are strongly related to this complication. PALAVRAS-CHAVECirurgia eletiva; Hiperglicemia; Prevalência; Fatores de risco; Sala de recuperação anestésica Avaliação de hiperglicemia na sala de recuperação pós-anestésicaResumo Justificativa e objetivos: Hiperglicemia em pacientes cirúrgicos pode ocasionar graves problemas. Nesse contexto, analisar essa complicação contribui para o melhor manejo desses pacientes. O objetivo do estudo foi avaliar a prevalência de hiperglicemia na sala de recuperação pós-anestésica (SRPA) em pacientes não diabéticos submetidos a cirurgias eletivas e analisar os possíveis fatores de risco associados a essa complicação. Métodos: Foram avaliados pacientes não diabéticos submetidos a cirurgias eletivas e admitidos na SRPA. Os dados foram coletados dos prontuários por meio de questionário pré-codificado. Foi considerada hiperglicemia quando a glicemia era > 120 mg.dL −1 . Pacientes com hiperglicemia foram comparados com os normoglicêmicos para avaliar fatores associados ao problema. Foram excluídos os pacientes com distúrbios endócrino-metabólicos, diabéticos, menores de 18 anos, índice de massa corpórea (IMC) menor do que 18 ou maior do que 35, gestação, puerpério ou aleitamento materno, antecedente de uso de drogas e cirurgias de urgência. Resultados: Foram avaliados 837 pacientes. A média de idade foi 47,8 ± 16,1 anos. A prevalên-cia de hiperglicemia n...

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Section: Discussionmentioning

confidence: 92%

Hyperglycemia assessment in the post-anesthesia care unit

Pereira

Azuma

Gatto

et al. 2017

Brazilian Journal of Anesthesiology (English Edition)

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“…Like PM 2.5 exposure, other insults that cause pulmonary oxidative stress, such as exposure to tobacco smoke or ozone, have also been associated with the development of systemic insulin resistance (Bass et al 2013; Henkin et al 1999; Vella et al 2015). Similarly, pulmonary diseases such as microbial infections (Wang et al 2009) and asthma (Gulcan et al 2009) are also associated with insulin resistance and an increased risk for diabetes. Although it remains to be seen whether an increase in pulmonary oxidative stress induced by various toxicological or pathological insults is a general cause of insulin resistance and diabetes, it is tempting to speculate that the vascular endothelium is particularly sensitive to oxidants generated in the lung and that there is an underappreciated link between pulmonary oxidative stress and the onset and precipitation of metabolic disease.…”

Section: Discussionmentioning

confidence: 99%

Exposure to Fine Particulate Air Pollution Causes Vascular Insulin Resistance by Inducing Pulmonary Oxidative Stress

Haberzettl

O’Toole

Bhatnagar

et al. 2016

Environ Health Perspect

201

113

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Background:Epidemiological evidence suggests that exposure to ambient air fine particulate matter (PM2.5) increases the risk of developing type 2 diabetes and cardiovascular disease. However, the mechanisms underlying these effects of PM2.5 remain unclear.Objectives:We tested the hypothesis that PM2.5 exposure decreases vascular insulin sensitivity by inducing pulmonary oxidative stress.Methods:Mice fed control (10–13% kcal fat) and high-fat (60% kcal fat, HFD) diets, treated with 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPOL) or mice overexpressing lung-specific extracellular superoxide dismutase (ecSOD) were exposed to HEPA-filtered air or to concentrated PM2.5 (CAP) for 9 or 30 days, and changes in systemic and organ-specific insulin sensitivity and inflammation were measured.Results:In control diet–fed mice, exposure to CAP for 30 days decreased insulin-stimulated Akt phosphorylation in lung, heart, and aorta but not in skeletal muscle, adipose tissue, and liver and did not affect adiposity or systemic glucose tolerance. In HFD-fed mice, 30-day CAP exposure suppressed insulin-stimulated endothelial nitric oxide synthase (eNOS) phosphorylation in skeletal muscle and increased adipose tissue inflammation and systemic glucose intolerance. In control diet–fed mice, a 9-day CAP exposure was sufficient to suppress insulin-stimulated Akt and eNOS phosphorylation and to decrease IκBα (inhibitor of the transcription factor NF-κB levels in the aorta. Treatment with the antioxidant TEMPOL or lung-specific overexpression of ecSOD prevented CAP-induced vascular insulin resistance and inflammation.Conclusions:Short-term exposure to PM2.5 induces vascular insulin resistance and inflammation triggered by a mechanism involving pulmonary oxidative stress. Suppression of vascular insulin signaling by PM2.5 may accelerate the progression to systemic insulin resistance, particularly in the context of diet-induced obesity.Citation:Haberzettl P, O’Toole TE, Bhatnagar A, Conklin DJ. 2016. Exposure to fine particulate air pollution causes vascular insulin resistance by inducing pulmonary oxidative stress. Environ Health Perspect 124:1830–1839; http://dx.doi.org/10.1289/EHP212

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“…Another independent study reported that active asthma contributed to the risk of myocardial infarction (aOR, 2.33; 95% CI, 1.12–4.82)34. Other independent studies corroborate the associations between asthma and risk of both DM3536 and CHD3738. The associations of asthma with other chronic inflammatory diseases including acute coronary syndrome 39, irritable bowel disease40, chronic kidney disease41, and cancer42 have also been reported.…”

Section: Introductionmentioning

confidence: 80%

“…Nonetheless, the main conceptual limitation of the current literature is a failure to recognize asthma “as a chronic inflammatory disease with systemic inflammatory features that go beyond the airway.” Emerging evidence suggests that asthma poses a significant impact on immune dysfunction and dysregulation at a systemic level in both adults and children in a way that poses them at risk for significantly higher morbidity and mortality from ARC23242526272829323334353637383940414247484950515253545657585960616263136137. In this regard, the current literature suggests that asthma poses a significantly increased risk of RA in subjects with asthma.…”

Section: Discussionmentioning

confidence: 99%

Asthma and the Risk of Rheumatoid Arthritis: An Insight into the Heterogeneity and Phenotypes of Asthma

Rolfes

Juhn

et al. 2017

Tuberc Respir Dis

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Asthma is traditionally regarded as a chronic airway disease, and recent literature proves its heterogeneity, based on distinctive clusters or phenotypes of asthma. In defining such asthma clusters, the nature of comorbidity among patients with asthma is poorly understood, by assuming no causal relationship between asthma and other comorbid conditions, including both communicable and noncommunicable diseases. However, emerging evidence suggests that the status of asthma significantly affects the increased susceptibility of the patient to both communicable and noncommunicable diseases. Specifically, the impact of asthma on susceptibility to noncommunicable diseases such as chronic systemic inflammatory diseases (e.g., rheumatoid arthritis), may provide an important insight into asthma as a disease with systemic inflammatory features, a conceptual understanding between asthma and asthma-related comorbidity, and the potential implications on the therapeutic and preventive interventions for patients with asthma. This review discusses the currently under-recognized clinical and immunological phenotypes of asthma; specifically, a higher risk of developing a systemic inflammatory disease such as rheumatoid arthritis and their implications, on the conceptual understanding and management of asthma. Our discussion is divided into three parts: literature summary on the relationship between asthma and the risk of rheumatoid arthritis; potential mechanisms underlying the association; and implications on asthma management and research.

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Evaluation of Glucose Tolerance Status in Patients with Asthma Bronchiale

Abstract: Our results suggest that disturbance of the glucose metabolism caused by inflammation-induced insulin resistance may occur in asthmatic patients and that this phenomenon may increase the risk of diabetes mellitus in these individuals.

Cited by 31 publications

References 18 publications

Hyperglycemia assessment in the post-anesthesia care unit

Hyperglycemia assessment in the post-anesthesia care unit

Exposure to Fine Particulate Air Pollution Causes Vascular Insulin Resistance by Inducing Pulmonary Oxidative Stress

Asthma and the Risk of Rheumatoid Arthritis: An Insight into the Heterogeneity and Phenotypes of Asthma

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