目的探讨ABCD2评分对眩晕患者脑梗死事件的预测价值。方法收集2010年1月至2012年10月解放军第252医院收治的眩晕患者268例,根据有无脑梗死分为脑梗死组和无脑梗死组,对患者行ABCD2评分,分析组间年龄、血压、临床特征、症状持续时间和糖...目的探讨ABCD2评分对眩晕患者脑梗死事件的预测价值。方法收集2010年1月至2012年10月解放军第252医院收治的眩晕患者268例,根据有无脑梗死分为脑梗死组和无脑梗死组,对患者行ABCD2评分,分析组间年龄、血压、临床特征、症状持续时间和糖尿病史的差异,绘制ROC曲线。结果脑梗死组就诊时血压≥140/90 mm Hg、肢体无力比例显著高于无脑梗死组(P<0.05),脑梗死组ABCD2评分显著高于无脑梗死组(P<0.05)。利用ROC曲线,以ABCD2评分来预测脑梗死情况,曲线下面积为0.90,P=0.000,95%CI为0.835~0.966,Cutoff值为4.5分。结论ABCD2评分可对眩晕后脑梗死风险进行预测,对预防脑卒中的发生、改善预后至关重要。展开更多
BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients,particularly in the primary care setting.AIM To assess the diabetes empowerment scores and its correlated factors among type ...BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients,particularly in the primary care setting.AIM To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.METHODS This is a cross sectional study involving 322 patients with type 2 diabetes mellitus(DM)followed up in a primary care clinic.Systematic sampling method was used for patient recruitment.The Diabetes Empowerment Scale(DES)questionnaire was used to measure patient empowerment.It consists of three domains:(1)Managing the psychosocial aspect of diabetes(9 items);(2)Assessing dissatisfaction and readiness to change(9 items);and(3)Setting and achieving diabetes goal(10 items).A score was considered high if it ranged from 100 to 140.Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.RESULTS The median age of the study population was 55 years old.56%were male and the mean duration of diabetes was 4 years.The total median score of the DES was 110[interquartile range(IQR)=10].The median scores of the three subscales were 40 with(IQR=4)for"Managing the psychosocial aspect of diabetes";36 with(IQR=3)for"Assessing dissatisfaction and readiness to change";and 34 with(IQR=5)for"Setting and achieving diabetes goal".According to multiple linear regressions,factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level(P<0.001),diabetes education exposure(P=0.003),lack of ischemic heart disease(P=0.017),and lower glycated hemoglobin(HbA1c)levels(P<0.001).CONCLUSION Diabetes empowerment scores were high among type 2 diabetes patients in this study population.Predictors for high empowerment scores included above secondary education level,diabetes education exposure,lack of ischemic heart disease status and lower HbA1c.展开更多
AIM: To assess the performance of the Finnish Diabetes Risk Score(FINDRISC) questionnaire for detecting and predicting type 2 diabetes mellitus(DM2) in a Colombian population.METHODS: This is a longitudinal observatio...AIM: To assess the performance of the Finnish Diabetes Risk Score(FINDRISC) questionnaire for detecting and predicting type 2 diabetes mellitus(DM2) in a Colombian population.METHODS: This is a longitudinal observational study conducted in Floridablanca, Colombia. Adult subjects(age ≥ 35 years) without known diabetes, were included. A modified version of FINDRISC was completed, and the glycemia values from all the subjects were collected from the hospital's database. Firstly, a cross-sectional analysis was performed and then, the subsample of prediabetic participants was followed for diabetes incidence. RESULTS: A total of 772 subjects were suitable for the study. The overall prevalence of undiagnosed DM2 was 2.59%, and the incidence of DM2 among the prediabetic participants was 7.5 per 100 person-years after a total of 265257 person-years follow-up. The FINDRISC at baseline was significantly associated with undiagnosed and incident DM2. The area under receiver operating characteristics curve of the FINDRISC score for detecting undiagnosed DM2 in both men and women was 0.7477 and 0.7175, respectively; and for predicting the incidence of DM2 among prediabetics was 71.99% in men and 67.74% in women. CONCLUSION: The FINDRISC questionnaire is a useful screening tool to identify cross-sectionally unknown DM2 and to predict the incidence of DM2 among prediabetics in the Colombian population.展开更多
Background Previous studies have demonstrated that micro RNA-204(mi R-204) is involved in atherosclerosis and vascular calcification. However, the value of mi R-204 as the predictive biomarker for cardiovascular disea...Background Previous studies have demonstrated that micro RNA-204(mi R-204) is involved in atherosclerosis and vascular calcification. However, the value of mi R-204 as the predictive biomarker for cardiovascular disease(CVD) remains unclear. We aimed to evaluate the association between the circulating mi R-204 level and ten-year CVD risk based on the Framingham risk score(FRS). Methods In this retrospective study, we enrolled 194 consecutive patients with type 2 diabetes mellitus(T2DM) without CVD in Beijing Anzhen Hospital between January 2015 and September 2016. We used the FRS to evaluate the risk of CVD for each patient. Circulating mi R-204 levels were measured by quantitative real-time polymerase chain reaction. Results Circulating mi R-204 levels were significantly lower in the group of patients(0.49 ± 0.13) at high risk of CVD(FRS > 20%) than in the low(FRS < 10%) and intermediate(FRS: 10%–20%) risk groups(0.87 ± 0.19 and 0.75 ± 0.25, respectively;P < 0.001). FRS was negatively correlated with mi R-204 levels(r =-0.421, P < 0.001). According to multivariate logistic analyses, reduced mi R-204 level was independently associated with an increased risk of CVD after adjusting for conventional risk factors(OR = 0.876, 95% CI: 0.807–0.950, P = 0.001). Receiver-operating characteristic curve analysis showed that the circulating mi R-204 level can predict the high risk of CVD with higher specificity than the traditional risk factor of high systolic blood pressure or the protective factor of high-density lipoprotein cholesterol. Conclusions Our study demonstrated that patients with lower circulating mi R-204 levels were at high risk for CVD. After adjustment for potential confounders, mi R-204 was independently associated with CVD in patients with T2DM.展开更多
AIM: To study clinical and histopathological features of nonalcoholic fatty liver disease(NAFLD) in patients with and without type 2 diabetes mellitus(T2DM) using updated nonalcoholic steatohepatitis clinical research...AIM: To study clinical and histopathological features of nonalcoholic fatty liver disease(NAFLD) in patients with and without type 2 diabetes mellitus(T2DM) using updated nonalcoholic steatohepatitis clinical research network(NASH-CRN) grading system.METHODS: We retrospectively analyzed data of 235 patients with biopsy proven NAFLD with and without T2 DM.This database was utilized in the previously published study comparing ethnicity outcomes in NAFLD by the same corresponding author.The pathology database from University of Chicago was utilized for enrolling consecutive patients who met the criteria for NAFLD and their detailed clinical and histopathology findings were obtained for comparison.The relevant clinical profile of patients was collected from the Electronic Medical Records around the time of liver biopsy and the histology was read by a single well-trained histopathologist.The updated criteria for type 2 diabetes have been utilized for analysis.Background data of patients with NASH and NAFLD has been included.The mean differences were compared using χ2 and t-test along with regression analysis to evaluate the predictors of NASH and advanced fibrosis.RESULTS: Patients with NAFLD and T2 DM were significantly older(49.9 vs 43.0,P < 0.01),predominantly female(71.4 vs 56.3,P < 0.02),had higher rate of metabolic syndrome(88.7 vs 36.4,P < 0.01),had significantly higher aspartate transaminase(AST)/alanine transaminase(ALT) ratio(0.94 vs 0.78,P < 0.01) and Fib-4 index(1.65 vs 1.06,P < 0.01) as markers of NASH,showed higher mean NAFLD activity score(3.5 vs 3.0,P = 0.03) and higher mean fibrosis score(1.2 vs 0.52,P < 0.01) compared to patients with NAFLD without T2 DM.Furthermore,advanced fibrosis(32.5 vs 12.0,P < 0.01) and ballooning(27.3 vs 13.3,P < 0.01) was significantly higher among patients with NAFLD and T2 DM compared to patients with NAFLD without T2 DM.On multivariate analysis,T2 DM was independently associated with NASH(OR = 3.27,95%CI: 1.43-7.50,P < 0.01) and advanced fibrosis(OR = 3.45,95%CI: 1.53-7.77,P < 0.01) in all patients with NAFLD.There was a higher rate of T2DM(38.1 vs 19.4,P < 0.01) and cirrhosis(8.3 vs 0.0,P = 0.01) along with significantly higher mean Bilirubin(0.71 vs 0.56,P = 0.01) and AST(54.2 vs 38.3,P < 0.01) and ALT(78.7 vs 57.0,P = 0.01) level among patients with NASH when compared to patients with steatosis alone.The mean platelet count(247 vs 283,P < 0.01) and high-density lipoprotein cholesterol level(42.7 vs 48.1,P = 0.01) was lower among patients with NASH compared to patients with steatosis.CONCLUSION: Patients with NAFLD and T2 DM tend to have more advanced stages of NAFLD,particularly advanced fibrosis and higher rate of ballooning than patients with NAFLD without T2 DM.展开更多
文摘目的探讨ABCD2评分对眩晕患者脑梗死事件的预测价值。方法收集2010年1月至2012年10月解放军第252医院收治的眩晕患者268例,根据有无脑梗死分为脑梗死组和无脑梗死组,对患者行ABCD2评分,分析组间年龄、血压、临床特征、症状持续时间和糖尿病史的差异,绘制ROC曲线。结果脑梗死组就诊时血压≥140/90 mm Hg、肢体无力比例显著高于无脑梗死组(P<0.05),脑梗死组ABCD2评分显著高于无脑梗死组(P<0.05)。利用ROC曲线,以ABCD2评分来预测脑梗死情况,曲线下面积为0.90,P=0.000,95%CI为0.835~0.966,Cutoff值为4.5分。结论ABCD2评分可对眩晕后脑梗死风险进行预测,对预防脑卒中的发生、改善预后至关重要。
基金Supported by research grant from University Putra Malaysia,No.GPIPS/2018/9612600
文摘BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients,particularly in the primary care setting.AIM To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.METHODS This is a cross sectional study involving 322 patients with type 2 diabetes mellitus(DM)followed up in a primary care clinic.Systematic sampling method was used for patient recruitment.The Diabetes Empowerment Scale(DES)questionnaire was used to measure patient empowerment.It consists of three domains:(1)Managing the psychosocial aspect of diabetes(9 items);(2)Assessing dissatisfaction and readiness to change(9 items);and(3)Setting and achieving diabetes goal(10 items).A score was considered high if it ranged from 100 to 140.Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.RESULTS The median age of the study population was 55 years old.56%were male and the mean duration of diabetes was 4 years.The total median score of the DES was 110[interquartile range(IQR)=10].The median scores of the three subscales were 40 with(IQR=4)for"Managing the psychosocial aspect of diabetes";36 with(IQR=3)for"Assessing dissatisfaction and readiness to change";and 34 with(IQR=5)for"Setting and achieving diabetes goal".According to multiple linear regressions,factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level(P<0.001),diabetes education exposure(P=0.003),lack of ischemic heart disease(P=0.017),and lower glycated hemoglobin(HbA1c)levels(P<0.001).CONCLUSION Diabetes empowerment scores were high among type 2 diabetes patients in this study population.Predictors for high empowerment scores included above secondary education level,diabetes education exposure,lack of ischemic heart disease status and lower HbA1c.
基金Supported by The Ophthalmological Foundation of Santander-FOSCAL
文摘AIM: To assess the performance of the Finnish Diabetes Risk Score(FINDRISC) questionnaire for detecting and predicting type 2 diabetes mellitus(DM2) in a Colombian population.METHODS: This is a longitudinal observational study conducted in Floridablanca, Colombia. Adult subjects(age ≥ 35 years) without known diabetes, were included. A modified version of FINDRISC was completed, and the glycemia values from all the subjects were collected from the hospital's database. Firstly, a cross-sectional analysis was performed and then, the subsample of prediabetic participants was followed for diabetes incidence. RESULTS: A total of 772 subjects were suitable for the study. The overall prevalence of undiagnosed DM2 was 2.59%, and the incidence of DM2 among the prediabetic participants was 7.5 per 100 person-years after a total of 265257 person-years follow-up. The FINDRISC at baseline was significantly associated with undiagnosed and incident DM2. The area under receiver operating characteristics curve of the FINDRISC score for detecting undiagnosed DM2 in both men and women was 0.7477 and 0.7175, respectively; and for predicting the incidence of DM2 among prediabetics was 71.99% in men and 67.74% in women. CONCLUSION: The FINDRISC questionnaire is a useful screening tool to identify cross-sectionally unknown DM2 and to predict the incidence of DM2 among prediabetics in the Colombian population.
基金the National Natural Scientific Foundation of China (No. 81573744 & No. 81973841)。
文摘Background Previous studies have demonstrated that micro RNA-204(mi R-204) is involved in atherosclerosis and vascular calcification. However, the value of mi R-204 as the predictive biomarker for cardiovascular disease(CVD) remains unclear. We aimed to evaluate the association between the circulating mi R-204 level and ten-year CVD risk based on the Framingham risk score(FRS). Methods In this retrospective study, we enrolled 194 consecutive patients with type 2 diabetes mellitus(T2DM) without CVD in Beijing Anzhen Hospital between January 2015 and September 2016. We used the FRS to evaluate the risk of CVD for each patient. Circulating mi R-204 levels were measured by quantitative real-time polymerase chain reaction. Results Circulating mi R-204 levels were significantly lower in the group of patients(0.49 ± 0.13) at high risk of CVD(FRS > 20%) than in the low(FRS < 10%) and intermediate(FRS: 10%–20%) risk groups(0.87 ± 0.19 and 0.75 ± 0.25, respectively;P < 0.001). FRS was negatively correlated with mi R-204 levels(r =-0.421, P < 0.001). According to multivariate logistic analyses, reduced mi R-204 level was independently associated with an increased risk of CVD after adjusting for conventional risk factors(OR = 0.876, 95% CI: 0.807–0.950, P = 0.001). Receiver-operating characteristic curve analysis showed that the circulating mi R-204 level can predict the high risk of CVD with higher specificity than the traditional risk factor of high systolic blood pressure or the protective factor of high-density lipoprotein cholesterol. Conclusions Our study demonstrated that patients with lower circulating mi R-204 levels were at high risk for CVD. After adjustment for potential confounders, mi R-204 was independently associated with CVD in patients with T2DM.
文摘AIM: To study clinical and histopathological features of nonalcoholic fatty liver disease(NAFLD) in patients with and without type 2 diabetes mellitus(T2DM) using updated nonalcoholic steatohepatitis clinical research network(NASH-CRN) grading system.METHODS: We retrospectively analyzed data of 235 patients with biopsy proven NAFLD with and without T2 DM.This database was utilized in the previously published study comparing ethnicity outcomes in NAFLD by the same corresponding author.The pathology database from University of Chicago was utilized for enrolling consecutive patients who met the criteria for NAFLD and their detailed clinical and histopathology findings were obtained for comparison.The relevant clinical profile of patients was collected from the Electronic Medical Records around the time of liver biopsy and the histology was read by a single well-trained histopathologist.The updated criteria for type 2 diabetes have been utilized for analysis.Background data of patients with NASH and NAFLD has been included.The mean differences were compared using χ2 and t-test along with regression analysis to evaluate the predictors of NASH and advanced fibrosis.RESULTS: Patients with NAFLD and T2 DM were significantly older(49.9 vs 43.0,P < 0.01),predominantly female(71.4 vs 56.3,P < 0.02),had higher rate of metabolic syndrome(88.7 vs 36.4,P < 0.01),had significantly higher aspartate transaminase(AST)/alanine transaminase(ALT) ratio(0.94 vs 0.78,P < 0.01) and Fib-4 index(1.65 vs 1.06,P < 0.01) as markers of NASH,showed higher mean NAFLD activity score(3.5 vs 3.0,P = 0.03) and higher mean fibrosis score(1.2 vs 0.52,P < 0.01) compared to patients with NAFLD without T2 DM.Furthermore,advanced fibrosis(32.5 vs 12.0,P < 0.01) and ballooning(27.3 vs 13.3,P < 0.01) was significantly higher among patients with NAFLD and T2 DM compared to patients with NAFLD without T2 DM.On multivariate analysis,T2 DM was independently associated with NASH(OR = 3.27,95%CI: 1.43-7.50,P < 0.01) and advanced fibrosis(OR = 3.45,95%CI: 1.53-7.77,P < 0.01) in all patients with NAFLD.There was a higher rate of T2DM(38.1 vs 19.4,P < 0.01) and cirrhosis(8.3 vs 0.0,P = 0.01) along with significantly higher mean Bilirubin(0.71 vs 0.56,P = 0.01) and AST(54.2 vs 38.3,P < 0.01) and ALT(78.7 vs 57.0,P = 0.01) level among patients with NASH when compared to patients with steatosis alone.The mean platelet count(247 vs 283,P < 0.01) and high-density lipoprotein cholesterol level(42.7 vs 48.1,P = 0.01) was lower among patients with NASH compared to patients with steatosis.CONCLUSION: Patients with NAFLD and T2 DM tend to have more advanced stages of NAFLD,particularly advanced fibrosis and higher rate of ballooning than patients with NAFLD without T2 DM.
