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Turk Kardiyoloji Dernegi Arsivi : Turk... Apr 2024This research aims to identify the association between the nine polymorphic variants (rs4961, rs699, rs4762, rs5186, rs1403543, rs1799998, rs5443, rs2070744, rs1799983)...
OBJECTIVE
This research aims to identify the association between the nine polymorphic variants (rs4961, rs699, rs4762, rs5186, rs1403543, rs1799998, rs5443, rs2070744, rs1799983) and the occurrence of hypertension and its clinical manifestations in the Uzbek population.
METHODS
The study included 227 individuals, comprising 179 patients with hypertension and 48 controls. Clinical parameters such as age, weight, blood glucose, triglycerides, total cholesterol, low-density lipoprotein and high-density lipoprotein, blood urea nitrogen, creatinine, pulse wave velocity, left ventricular mass, and microalbuminuria levels were identified. We assessed the distribution of allele frequencies of these polymorphic variants in the Uzbek population to establish their association with cardiovascular diseases and their clinical manifestations.
RESULTS
Genetic analysis of the polymorphic variants demonstrated a significant association of the AGT 521 C>T variant with arterial hypertension [P ≤ 0.01; Odds Ratio (OR) = 2.91]. The NOS3 -786 T>C variant correlated with left ventricular hypertrophy (P ≤ 0.05; OR = 0.35) and increased pulse wave velocity (P ≤ 0.01; OR = 0.21). The correlations of the AGTR2 1675 G>A variant with left ventricular hypertrophy (P ≤ 0.01; OR = 1.59) and increased pulse wave velocity (P ≤ 0.01; OR = 0.33) were identified. The AGT 704 T>C variant showed a significant association with increased pulse wave velocity (P ≤ 0.05; OR = 2.73).
CONCLUSION
Four of the nine studied polymorphic variants were associated with clinical manifestations of hypertension in the Uzbek population. These variants can be used as genetic biomarkers to identify the risks of developing cardiovascular diseases and hypertension in the Uzbek population.
Topics: Humans; Cardiovascular Diseases; Polymorphism, Single Nucleotide; Renin-Angiotensin System; Hypertrophy, Left Ventricular; Pulse Wave Analysis; Hypertension
PubMed: 38573093
DOI: 10.5543/tkda.2023.67866 -
International Journal of Medical... 2023Micro RNAs (miRs) expression is involved in the pathogenesis of type 2 diabetes mellitus (T2DM). This study investigates the expression levels of plasma miR-29a,...
Micro RNAs (miRs) expression is involved in the pathogenesis of type 2 diabetes mellitus (T2DM). This study investigates the expression levels of plasma miR-29a, miR-146a, and miR-147b and their correlations with clinical parameters in patients with T2DM. 105 patients with T2DM who categorized either as newly diagnosed T2DM (n=52) or treated T2DM (n=53) and 93 healthy individuals were included in this study. The expression levels of miR-29a, miR-146a, and miR-147b were quantified by real-time PCR and analyzed for possible association with T2DM. The expressions of miR-29a and miR-147b were significantly increased in T2DM patients compared with healthy controls (<0.0001). The expression levels of miR-29a in newly diagnosed T2DM patients were higher than that in the group of treated T2DM (=0.002). The expression of studied miRs was correlated with several clinical parameters such as blood glucose levels, HbA1C, microalbuminuria, C-peptide, triglyceride levels as well as the HOMA-β index. The expression levels of miR-29a and miR-147b show a potential diagnostic performance to discriminate newly diagnostic T2DM (AUCs=0.77 and 0.84, respectively) and beta-cell dysfunction (AUCs= 0.62 and 0.75, respectively). The plasma miR-29a and miR-147b expression levels in T2DM patients are significantly associated with T2DM while miR-146a shows poor evidence in relation to T2DM. miR-147b shows potential as a biomarker for the diagnosis of T2DM and pancreatic beta cell dysfunction.
Topics: Humans; MicroRNAs; Diabetes Mellitus, Type 2; Biomarkers
PubMed: 37786444
DOI: 10.7150/ijms.84899 -
Cureus Feb 2024Worldwide, diabetic nephropathy (DN) is a significant contributor to end-stage renal failure and chronic kidney disease. Probiotic supplementation has recently gained... (Review)
Review
Worldwide, diabetic nephropathy (DN) is a significant contributor to end-stage renal failure and chronic kidney disease. Probiotic supplementation has recently gained popularity as a potential nutritional therapy in several clinical trials aimed at improving renal function, inflammation, oxidative stress, dyslipidemia, glycemic control, and inflammation. However, they still need to undergo a thorough assessment of DN. It is crucial that the optimal dosage, duration, and combination of probiotic strains administered for the purpose of slowing down the advancement of DN be assessed. Based on the available publications, including relevant randomized controlled trials, systematic reviews, and meta-analysis from 2013-2023 from search engines like MEDLINE (PubMed), Scopus, and Web of Science, a literature review was generated using the keywords "gut microbiota," "gut microbiome," "diabetic kidney disease," "diabetic nephropathy," "probiotic," and "prebiotic." Multiple clinical trials focusing on probiotic administration techniques revealed changes in renal, glucose, and lipid biomarkers. Probiotic supplementation using , and for 12 weeks indicated a reduction in glycosylated hemoglobin, fasting blood glucose, and the microalbuminuria/creatinine ratio. Multispecies as well as single-species probiotic administration containing and greater than 4*10 colony forming units (CFU)/day for 8-12 weeks in DN patients improves renal metabolic markers and reduces the progression of disease patterns. Optimal supplementation techniques of probiotics in conjunction with prebiotics and synbiotics in DN benefit glycaemic control, renal function, blood lipid profile, inflammation, and oxidative stress. Future randomized controlled trials supplementing specific probiotics coupled with prebiotics and synbiotics, with larger sample sizes and longer follow-up times, will generate more reliable findings for the impact of probiotic supplementation on DN.
PubMed: 38558739
DOI: 10.7759/cureus.55149 -
Alternative Therapies in Health and... Sep 2023The treatment of diabetic nephropathy (DN) is still quite limited. DN remains poorly understood due to the complexity of and differences in its etiology. Therefore,...
CONTEXT
The treatment of diabetic nephropathy (DN) is still quite limited. DN remains poorly understood due to the complexity of and differences in its etiology. Therefore, potential biomarkers for diagnosis and targeted treatments are urgently needed.
OBJECTIVE
The study aimed to analyze the associations between circulating total bile acid (TBA) levels and the risk of DN in Chinese patients with type 2 diabetes mellitus (T2DM) and to determine the differences in the TBA levels of males and females, including pre- and postmenopausal women, to find clues for the screening of DN.
DESIGN
The research team performed a retrospective study.
SETTING
The study took place at the Second Affiliated Hospital at the School of Medicine of Zhejiang University in Zhejiang, China.
PARTICIPANTS
Participants were 1785 T2DM patients admitted to the hospital between April 2008 and November 2013.
GROUPS
The research team separated participants into three groups: (1) the normoalbuminuria or normal group, with a UACR <30 mg/g·Cr (2) the microalbuminuria (MAU) group, with a UACR of 30-299 mg/g·Cr; and (3) the macroalbuminuria (MAC) group, with a UACR of ≥300 mg/g·Cr.
OUTCOME MEASURES
Between the three groups, the research team compared: (1) the demographic and clinic characteristics of the normal, MAU, and MAC groups; (2) TBA distribution by age; (3) TBA distribution by gender; and (4) TBA quartiles. The team also examined the associations between TBA and albuminuria, identifying the odds ratios (OR) and relevant 95% confidence intervals (CI) using multiple logistic regression.
RESULTS
The study found that: (1) the MAC group's TBA was significantly lower than those of the normal and MAU groups; (2) the TBA of postmenopausal women was significantly higher than that of premenopausal women; (3) the incidence of MAC was obviously increased with TBA levels; (4) the risks for MAU group didn't change significantly with increasing TBA levels; (5) the MAC group's odds ratios (ORs) were 0.61 between Q2 and Q1, 0.44 between Q3 and Q1, and 0.38 between Q4 and Q1; and (6) for men and postmenopausal women, the TBA levels of those in Q3 and Q4 might decrease the risk of MAC, whereas no such correlation existed for MAU.
CONCLUSIONS
An independent negative association exists between TBA levels and MAC in T2DM. The decrease of circulating TBA might be a prospective clinical factor for determining established DN, especially for males and postmenopausal females.
PubMed: 37384402
DOI: No ID Found -
Clinical and Experimental Nephrology Dec 2023The National Kidney Foundation recently proposed a ≥ 30% decrease in urinary albumin-to-creatinine ratio (UACR) over 0.5-2 years as a surrogate endpoint for...
BACKGROUND
The National Kidney Foundation recently proposed a ≥ 30% decrease in urinary albumin-to-creatinine ratio (UACR) over 0.5-2 years as a surrogate endpoint for chronic kidney disease (CKD) progression in individuals with baseline UACR > 30 mg/g. This historical cohort study aimed to determine the applicability of a decrease in UACR, within as little as 1 year, as a surrogate endpoint for Japanese individuals with type 2 diabetes mellitus (T2D).
METHODS
A total of 5067 individuals with T2D were divided into three groups based on 1-year change in UACR: ≥ 30% decrease (UACR decreased group), < 30% decrease and < 30% increase (UACR unchanged group), or ≥ 30% increase (UACR increased group). The primary endpoint was a composite of a ≥ 30% decline in estimated glomerular filtration rate (eGFR) or the initiation of kidney replacement therapy, whichever occurred first.
RESULTS
At baseline, the proportions of individuals with normoalbuminuria, microalbuminuria, and eGFR ≥ 60 mL/min/1.73 m were 68.1%, 22.1%, and 75.5%, respectively. During a median follow-up of 6.8 years, 926 individuals (18.3%) reached the composite endpoint. Adjusted hazard ratios (vs. the UACR unchanged group) for the UACR decreased and increased groups were 0.758 (95% confidence interval [CI], 0.636-0.905; P = 0.002) and 1.304 (95% CI, 1.108-1.536; P = 0.001), respectively.
CONCLUSIONS
These findings support the use of 1-year changes in UACR as a surrogate endpoint for the progression of CKD and the implementation of a ≥ 30% decrease in UACR as a positive efficacy endpoint in Japanese individuals with T2D and early-stage kidney disease.
Topics: Humans; Diabetes Mellitus, Type 2; Creatinine; Cohort Studies; East Asian People; Kidney; Renal Insufficiency, Chronic; Glomerular Filtration Rate; Biomarkers; Disease Progression; Albumins; Albuminuria
PubMed: 37606804
DOI: 10.1007/s10157-023-02380-8 -
Cureus Apr 2024Background Ischemic stroke is a major health crisis with significant consequences. Microalbuminuria, a sign of endothelial dysfunction, has been linked to adverse...
Background Ischemic stroke is a major health crisis with significant consequences. Microalbuminuria, a sign of endothelial dysfunction, has been linked to adverse outcomes in ischemic stroke. Early neurological deterioration (END) is a critical factor influencing the patient's prognosis. This study aimed to determine the prevalence of microalbuminuria, its predictive value in assessing END, and its prognostic implications in acute ischemic stroke (AIS). Methodology This study conducted at Pradyumna Bal Memorial Hospital, Kalinga Institute of Medical Sciences Bhubaneswar (November 2020-April 2022) included 114 AIS patients over 18 years who presented within 24 hours of stroke onset. Demographics, vascular risk factors, National Institutes of Health Stroke Scale (NIHSS) scores (admission and day three), modified Rankin scores (day 10), urinary albumin-to-creatinine ratios, and carotid artery Doppler studies were collected. Results The mean age of the patients was 61.87 years, with males constituting 72.8% of the population. Hypertension (50.9%) and diabetes mellitus (28.9%) were the most common comorbid conditions. The mean NIHSS stroke severity at presentation was 11.30. END occurred in 38.6% of patients. Overall, 43.9% of cases showed carotid stenosis, and the mean carotid intimal media thickness was 1.08 mm. Notably, the presence of microalbuminuria significantly increased the chances of both END (39.45 times higher risk) and worse functional outcomes (odds ratio = 19.147, p = 0.001). Conclusions Microalbuminuria emerges as a robust independent predictor of END and a poor prognosis in AIS. These findings highlight the importance of early microalbuminuria identification and intervention to reduce END risk and potentially improve outcomes in AIS patients.
PubMed: 38752035
DOI: 10.7759/cureus.58311 -
Molecular Biology Reports Dec 2023Diabetic nephropathy (DN), which is a chronic outcome of diabetes mellitus (DM), usually progresses to end-stage renal disease (ESRD). The DN pathophysiology,...
BACKGROUND
Diabetic nephropathy (DN), which is a chronic outcome of diabetes mellitus (DM), usually progresses to end-stage renal disease (ESRD). The DN pathophysiology, nevertheless, is not well-defined. Several miRNAs were reported to be either risk or protective factors in DN.
METHODS, AND RESULTS
The present study sought to inspect the potential diagnostic and prognostic value of hsa-miR-221 in DN. The study included 200 participants divided into four groups: Group 1 (50 patients with DN), Group 2 (50 diabetic patients without nephropathy), Group 3 (50 nondiabetic patients with CKD), and Group 4 (50 healthy subjects as a control group). Patients in groups 1 and 3 were further classified based on the presence of macroalbuminuria and microalbuminuria. Hsa-miR-221 expression was measured by RT- qRT-PCR. DN patients had significantly elevated serum hsa-miR-221 levels than the other groups, while diabetic patients without nephropathy exhibited elevated levels compared to both nondiabetic patients with CKD, and the control group. The DN patients with macroalbuminuria revealed significantly higher mean values of hsa-miR-221 relative to the patients with microalbuminuria. Significant positive associations were observed in the DN group between serum hsa-miR-221 and fasting insulin, fasting glucose, HOMA IR, ACR, and BMI. The ROC curve analysis of serum hsa-miR-221 in the initial diagnosis of DN in DM revealed high specificity and sensitivity.
CONCLUSIONS
It is concluded that hsa-miR-221 has the potential to be a useful biomarker for prognostic and diagnostic purposes in DN.
Topics: Humans; Diabetic Nephropathies; Prognosis; Diabetes Mellitus, Type 2; MicroRNAs; Biomarkers; Albuminuria; Renal Insufficiency, Chronic
PubMed: 37831346
DOI: 10.1007/s11033-023-08846-y -
Pakistan Journal of Medical Sciences 2024To find the correlation of serum uric acid with microalbuminuria in Type-2 diabetic patients with normal creatinine.
OBJECTIVE
To find the correlation of serum uric acid with microalbuminuria in Type-2 diabetic patients with normal creatinine.
METHODS
This cross-sectional study was conducted in the Department of Diabetes, Endocrinology and Metabolic diseases, Hayatabad Medical Complex, Peshawar, Pakistan from 1 April, 2022 to 30 September, 2022. Total 160 diabetic patients between the age of 30 and 65 years were enrolled in the study. Type-2 diabetic patients with microalbuminuria between 2.5 and 30 mg/mmol were included. The demographic details of patients were recorded in the questionnaire after taking consent. Fasting Uric acid, lipid profile and glucose along with creatinine and HbA1C were estimated from patient's venous blood samples. Ratio of albumin to creatinine (ACR) in the random spot urine sample was used to detect microalbuminuria.
RESULTS
Out of 160 participants enrolled in the study there were 86 (54%) males and 74 (46%) females with the mean age of 50.15 ± 11.1 years and BMI of 20.93 kg/m. Ninety six (60%) of the patients had Type-2 DM for less than five years, while remaining 64 (40%) were more than five years diabetic. Mean serum uric acid calculated was 6.85±2.06(mg/dl), while microalbuminuria was calculated as 8.02±0.78 (mg/mmol). The Pearson correlation of serum uric acid and microalbuminuria based on sex and age was statistically significant(p<0.05).
CONCLUSION
We found that uric acid level was significantly associated with microalbuminuria in people with Type-2 diabetes with normal serum creatinine. Uric acid level can be a potential screening tool for early detection of DKD.
PubMed: 38827879
DOI: 10.12669/pjms.40.5.8208 -
BMC Research Notes Jul 2023Diabetes is the most common metabolic disorder that leads to various complications, and among these complications, disruption in the lipid profile and serum uric acid...
OBJECTIVE
Diabetes is the most common metabolic disorder that leads to various complications, and among these complications, disruption in the lipid profile and serum uric acid (SUA) is one of the significant cases that can lead to the deterioration of the health status of patients with diabetes. So, we aimed to evaluate the level of SUA and lipid profiles in patients with diabetes. A total of 230 patients with diabetes who were admitted to Razi Hospital, Rasht, Iran, were enrolled in this study. Demographical data and clinical characteristics of the patients include gender, body mass index (BMI), duration of diabetes, history of smoking, FBS, HbA1c, SUA, Creatinine (Cr), Cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), retinopathy, hypertension, ischemic heart disease (IHD), and microalbuminuria were recorded. All data were analyzed using the SPSS version 21 by a significant level < 0.05.
RESULT
According to our results, 70 were male, and 160 were female, with a mean age of 57.36 ± 8.05 years and a mean BMI of 28.10 ± 4.62. The most frequent comorbidities were hypertension, 67%. The serum level of FBS, HBA1c, SUA, Cr, Chol, LDL, HDL, and TG were 191.47 ± 71.66 mg/dL, 7.94 ± 1.21 mg/dL, 5.65 ± 1.95 mg/dL, 0.94 ± 0.16 mg/dL, 167.28 ± 45.22 mg/dL, 95.91 ± 37.03 mg/dL, 39.78 ± 10.44 mg/dL, and 186.75 ± 76.65 mg/dL, respectively. Only UA had a significant relationship with TG level (P < 0.05).
Topics: Uric Acid; Lipids; Diabetes Mellitus, Type 2; Humans; Male; Female; Adult; Middle Aged; Aged; Triglycerides
PubMed: 37488643
DOI: 10.1186/s13104-023-06429-5 -
Cureus Aug 2023Background Microalbuminuria (MA) is an important clinical marker for the early detection of kidney damage in patients with type 2 diabetes (T2DM). Urine...
Background Microalbuminuria (MA) is an important clinical marker for the early detection of kidney damage in patients with type 2 diabetes (T2DM). Urine albumin-to-creatinine ratio (ACR), also known as urine microalbumin, is a sign of diabetic nephropathy (DN), which is a prevalent complication of diabetes and can result in end-stage renal disease (ESRD) if not managed. The prevalence of MA in T2DM has been steadily increasing worldwide, making it a significant public health concern. The goal of this study was to estimate the prevalence of MA and its relationship to hypertension and other diabetic complications among people with T2DM. Methodology This descriptive cross-sectional study was conducted from February 5, 2022, to February 10, 2023, to analyse data from T2DM patients who visited the outpatient diabetic clinic of Sheikh Zayed Medical College and Hospital, Rahim Yar Khan, Pakistan. This study included a total of 640 patients, aged 35-60 years, who had been diagnosed with T2DM for at least five years and fulfilled the inclusion criteria. Data on demographic and clinical characteristics, blood pressure (BP) measurements, and laboratory investigations were collected. MA was assessed based on the ACR in a spot urine sample of more than 30 mg/l. Blood pressure greater than 140/90 or already taking anti-hypertensives was taken to constitute hypertension. Factors associated with MA like hypertension, gender, mode of diabetes treatment, duration of diabetes, glycosylated haemoglobin (HbA1c), dyslipidemia, and other diabetic complications such as retinopathy and neuropathy were also recorded. Results The prevalence of MA in this study of T2DM patients study was 39.1%. The mean age of the participants with MA was 53.9 with a standard deviation (SD) of 6.1 years, and the mean duration of diabetes was 10.1 years (SD 6.2 years); 101 (33.4%) males (n=302) and 103 (30.5%) females (n=338) had MA. There was a statistically significant correlation between MA > 30mg/d and hypertension (p = <0.001), diabetes duration since diagnosis (p=0.04), HbA1C level (p = <0.001), dyslipidemia (p=0.001), therapy type (p = <0.001), triglyceridemia (p = 0.03), history of diabetes retinopathy (p= <0.002), and peripheral neuropathy (p= <0.001). However, there was no statistically significant correlation between MA and age (p = 0.56), female gender (p = 0.08), low- and high-density lipids, or statin use (p = 0.06). Conclusion The prevalence of microalbuminuria among T2DM patients is significantly high (39.1%) and is positively correlated with various factors such as male gender, hypertension, suboptimal control of diabetes mellitus, high HbA1c levels, longer disease duration, dyslipidemia with high triglycerides, treatment modalities of T2DM, and other diabetic complications like neuropathy and retinopathy. As diabetes is very prevalent in our country, the number of patients with diabetic kidney disease will rise significantly in the near future, leading to ESRD and other diabetic complications, and immediate intervention is needed to prevent this. Further research is warranted to explore potential interventions and evaluate their impact on patient outcomes.
PubMed: 37692611
DOI: 10.7759/cureus.43190