Prevalence and clinical characteristics of carotid atherosclerosis in newly diagnosed patients with ketosis-onset diabetes: a cross-sectional study

Li, Lianxi; Zhao, Cheng; Ren, Ying; Tu, Ya; Lu, Junxi; Wu, Xing; Zhang, Weixing; Zhu, Jiaan; Yu, Libo; Bao, Yuqian; Jia, Weiping

doi:10.1186/1475-2840-12-18

Cited by 45 publications

(73 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to our previous and other studies [22,42-44], we found that older patients (age ≥ 65) had a higher mean CIMT and prevalence of carotid plaque compared with younger patients (age < 65) in each UACR tertile group. Gender difference in carotid atherosclerosis has been confirmed in general population and patients with diabetes [34,35,45], but in the present study, sex-related differences in the mean CIMT and in the prevalence of carotid plaque existed only in the highest UACR tertile group.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Low-grade albuminuria is associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes

Li¹,

Tu²,

Lu³

et al. 2013

Cardiovasc Diabetol

Self Cite

View full text Add to dashboard Cite

BackgroundLow-grade albuminuria is associated with cardiovascular risk factors and mortality. Our aim was to investigate the association between low-grade albuminuria and carotid atherosclerotic lesions in community-based patients with type 2 diabetes.MethodsA cross-sectional study was performed in 475 community-based patients with type 2 diabetes (190 males and 285 females) with normal urinary albumin-to-creatinine ratios (UACR) (< 3.5 mg/mmol) from Shanghai, China. The subjects were stratified into tertiles based on UACR levels (the lowest tertile was UACR ≤ 1.19 mg/mmol, and the highest tertile was UACR ≥ 2 mg/mmol). Carotid intima-media thickness (CIMT), carotid atherosclerotic plaque formation and stenosis were assessed and compared among the three groups based on ultrasonography. The urinary albumin excretion rate was determined as the mean of the values obtained from three separate early morning urine samples.ResultsCompared with the subjects with UACR in the lowest tertile, the subjects with UACR in the middle and highest tertiles had greater CIMT values (0.88 ± 0.35 mm, 0.99 ± 0.43 mm and 1.04 ± 0.35 mm, respectively; all p < 0.05) and a higher prevalence of carotid atherosclerotic plaques (25.3%, 39.0% and 46.2%, respectively; all p < 0.05) after adjusting for sex and age. Fully adjusted multiple linear regression and logistic regression analyses revealed that UACR tertiles were significantly associated with elevated CIMT (p = 0.007) and that, compared with the subjects in the first tertile of UACR, those in the second and third tertiles had 1.878- and 2.028-fold risk of carotid plaques, respectively. However, there was no statistical association between UACR tertile and the prevalence of carotid stenosis.ConclusionsHigher UACR within the normal range was independently associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes. Low-grade albuminuria contributes to the risk of carotid atherosclerosis and may be used as an early marker for the detection of atherosclerosis in patients with type 2 diabetes.

show abstract

Section: Discussionsupporting

confidence: 91%

“…Plaque within the carotid artery was defined as a localized protrusion of the internal part of the vessel wall into the lumen of 50% of the surrounding IMT value [21]. Carotid stenosis was defined as any degree of narrowing of the carotid arteries by carotid plaques [22]. …”

Section: Methodsmentioning

confidence: 99%

Low-grade albuminuria is associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes

Li¹,

Tu²,

Lu³

et al. 2013

Cardiovasc Diabetol

Self Cite

View full text Add to dashboard Cite

show abstract

“…This cross-sectional study was partly based on data used in our previous study15161718. Briefly, 3 598 inpatients with type 2 diabetes mellitus were consecutively observed.…”

Section: Methodsmentioning

confidence: 99%

“…All patients were interviewed to obtain their history of hypertension (HTN), cardio-cerebrovascular events (CCEs), medicine use including metformin, lipid-lowering drugs (LLDs), antihypertensive agents (AHAs) and insulin or insulin analogues (IIAs), alcohol consumption and smoking habits. The definitions of smoking, alcohol consumption, and HTN were based on our previous criteria1516. The definition of CCEs was also according to our previous study1518.…”

Section: Methodsmentioning

confidence: 99%

Serum uric acid levels are associated with obesity but not cardio-cerebrovascular events in Chinese inpatients with type 2 diabetes

Chen

Zhao

et al. 2017

Sci Rep

Self Cite

View full text Add to dashboard Cite

We aim to explore the associations between serum uric acid (SUA) and obesity and cardio-cerebrovascular events (CCEs) in Chinese inpatients with type 2 diabetes mellitus (T2DM). 2 962 inpatients with T2DM were stratified into quartile based on SUA concentrations. There were significant increases in the prevalence of both obesity (32.6%, 41.9%, 50.1%, and 62.8%, respectively, p < 0.001 for trend) and severe obesity (0.4%, 0.6%, 0.8%, and 1.3%, respectively, p < 0.001 for trend) across the SUA quartiles. A fully adjusted multiple logistic regression analysis revealed that SUA quartiles were independently associated with the presence of obesity (p < 0.001). The prevalence of CCEs was significantly higher in the obese diabetics than in the nonobese diabetics (16.8% vs. 13.2%, p = 0.027). After controlling for multiple confounding factors, BMI levels were also significantly correlated with the presence of CCEs (p = 0.020). However, there was no significant association of SUA quartiles/SUA levels with the presence of CCEs in T2DM. This study suggested that SUA levels were independently associated with obesity but not with CCEs in patients with T2DM. In selected populations such as subjects with T2DM, the role of uric acid in cardiovascular complications might be attributable to other cardiovascular risk factors, such as obesity.

show abstract

“…The role of ketones in contributing to the risk of development of cardiovascular disease (CVD) is not known. Nevertheless, there is some evidence that elevated ketone levels are associated with congestive heart failure and carotid atherosclerosis [12,13]. On the other hand elevated blood ketones are associated with the worsening of hyperglycemia, and patients with ketosis onset T2D showed much more severe insulin resistance compared to nonketotic onset T2D patients [14,15].…”

Section: Introductionmentioning

confidence: 99%

Hyperketonemia (Acetoacetate) Upregulates NADPH Oxidase 4 and Elevates Oxidative Stress, ICAM-1, and Monocyte Adhesivity in Endothelial Cells

Marie

Jain

2015

Cell Physiol Biochem

View full text Add to dashboard Cite

Background/Aims: The incidence of developing microvascular dysfunction is significantly higher in type 1 diabetic (T1D) patients. Hyperketonemia (acetoacetate, β-hydroxybutyrate) is frequently found along with hyperglycemia in T1D. Whether hyperketonemia per se contributes to the excess oxidative stress and cellular injury observed in T1D is not known. Methods: HUVEC were treated with ketones in the presence or absence of high glucose for 24 h. NOX4 siRNA was used to specifically knockdown NOX4 expression in HUVEC. Results: Ketones alone or in combination with high glucose treatment cause a significant increase in oxidative stress, ICAM-1, and monocyte adhesivity to HUVEC. Using an antisense approach, we show that ketone induced increases in ROS, ICAM-1 expression, and monocyte adhesion in endothelial cells were prevented in NOX4 knockdown cells. Conclusion: This study reports that elevated levels of ketones upregulate NOX, contributing to increased oxidative stress, ICAM-1 levels, and cellular dysfunction. This provides a novel biochemical mechanism that elucidates the role of hyperketonemia in the excess cellular injury in T1D. New drugs targeting inhibition of NOX seems promising in preventing higher risk of complications associated with T1D.

show abstract

Prevalence and clinical characteristics of carotid atherosclerosis in newly diagnosed patients with ketosis-onset diabetes: a cross-sectional study

Cited by 45 publications

References 46 publications

Low-grade albuminuria is associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes

Low-grade albuminuria is associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes

Serum uric acid levels are associated with obesity but not cardio-cerebrovascular events in Chinese inpatients with type 2 diabetes

Hyperketonemia (Acetoacetate) Upregulates NADPH Oxidase 4 and Elevates Oxidative Stress, ICAM-1, and Monocyte Adhesivity in Endothelial Cells

Contact Info

Product

Resources

About