Subclinical impairment of left ventricular myocardium function in type 2 diabetes mellitus patients with or without hypertension

BACKGROUND Cardiovascular disease has been the leading cause of morbidity and mortality for type 2 diabetes mellitus(T2DM)patients over the last decade.AIM To determine whether layer-specific global longitudinal strain(GLS)combined with peak strain dispersion(PSD)can be used to assess left ventricle(LV)myocardium systolic dysfunction in T2DM patients or without hypertension(HP).METHODS We enrolled 97 T2DM patients,70 T2DM+HP patients and 101 healthy subjects.Layer-specific GLS and PSD were calculated by EchoPAC software in apical three-,four-and two-chamber views.GLS of the epimyocardial,middle-layer and endomyocardial(GLSepi,GLSmid,and GLSendo)were measured and recorded.Receiver operating characteristic analysis was performed to detect LV myocardium systolic dysfunction in T2DM patients.RESULTS There were significant differences in GLSepi,GLSmid,GLSendo,and PSD between healthy subjects,T2DM patients and T2DM patients with HP(P<0.001).Trend tests yielded the ranking of healthy subjects>T2DM patients>T2DM with HP patients in the absolute values of GLSepi,GLSmid and GLSendo(P<0.001),while PSD was ranked healthy subjects<T2DM<T2DM with HP(P<0.001).Layer-specific GLS and PSD had high diagnostic efficiency for detecting LV myocardium systolic dysfunction in T2DM patients,however,the area under the curve(AUC)for layer-specific GLS and PSD combined was significantly higher than the AUCs for the individual indices(P<0.05).CONCLUSION Layer-specific GLS and PSD were associated with LV myocardium systolic dysfunction in T2DM patients,T2DM patients with HP.T2DM patients with HP have more severe LV myocardium systolic dysfunction than T2DM patients without HP and normal control patients.The combination of layer-specific GLS and PSD may provide additional prognostic information for T2DM patients with or without HP.

Meta-analysis of Integrated Traditional Chinese and Western Medicine in Treating H Type Hypertension

Objective: The aim of this study was to compare the clinical emcacy of integration of traditional Chinese medicine (TCM) and we stern medicine, and the western medicine therapy for H type hypertension. Methods: The randomized contmlled trials were collected via searching the internet. The literatures were screened according to inclusion and exclusion criteria. All the assignments were performed by two researchers. If there was disagreement between the two researchers, we would ask evidence based medicine expert for advice, to get an optimal result. The database included the ChianInfo (1978—2015), the Superstar database (1955—2017), the CBM(1985—2017), CNKI(1984—2017), PubMed(1966—2017). Accordingto Meta analysis, the RevMan 5.2 software was used to recover and analyze the literatures, and make the assessment of the integration of TCM and westem medicine in treating H Type Hypertension. Results: In the study, 12 trials were included. The total number of cases is 1139. The Meta analysis results showed that: Compared with western medicine the integration of TCM and western medicine would improve the antihypertensive efficacy [OR=0.39, 95%CI (0.25, 0.59), Z=4.38(P< 0.0001)],lower Hcy levels [WMD=-1.93, 95%CI (-2.27, 0.21), Z=4.38 (P< 0.0001)]. Conclusion: The combination therapy can effectively reduce Hcy levels, control blood pressure, better than Western medicine.

Clinical Study on Treatment of Vascular Aging in Patients with Type 2 Diabetes Complicated by Hypertension with Combination of Traditional Chinese Medicine and Western Medicine

Objective:To explore the clinical effect of combination of traditional Chinese medicine and western medicine in treatment of vascular aging in patients with type 2 diabetes complicated by hypertension.Methods:Ninety patients with type 2 diabetes complicated by hypertension admitted to our hospital from May 2016 to August 2019 were selected as research objects.They were randomly divided into control group and observational group,with 45 cases each.Control group was given amlodipine besylate combined with metformin hydrochloride.On the basis of control group,observational group was given combination of TCM syndrome differentiation.Blood glucose,blood pressure and blood lipids before and after 14 days of treatment were compared between two groups.Results:Blood glucose,blood pressure and lipid indexes after treatment were lower than before treatment in both groups;observational group was lower than control group and the difference was statistically significant(P<0.05).Conclusion:Combination of traditional Chinese medicine and Western medicine could lower blood glucose and blood pressure indexes,control blood lipids and delay blood vessel aging in patients with type 2 diabetes complicated by hypertension,it is worthy of clinical popularization.

Drug Therapy Monitoring in Patients with Type 2 Diabetes and Hypertension

The aim of this paper is to detect, prevent and resolve DRP （drug-related problems） and NOM （negative outcomes associated with medication） in hospitalized patients with DM2 （type 2 diabetes） with HTN （hypertension） in a tertiary care clinic. Descriptive cross-sectional interventional study is used. DTM （drug therapy monitoring） was conducted in 73 patients using data obtained from clinical histories and interviews. NOM were detected based on symptoms and laboratory test results. The statistical significance was 0.05. It can be found that 23 DRP were detected, primarily in the category ＂likelihood of adverse effects＂ （30.43%） causing NOM in the ＂non-quantitative safety problem＂ category. The NOM detected were related to safety （62%）, effectiveness （24.5%） and necessity （13.5%）. Of the 68.57% of pharmacist interventions accepted, 48.57% were resolved and 20% were not resolved. A simple linear correlation （r = -0.34） analysis indicated a weak association between patient age and severity ofNOM. DTM made it＇possible to detect suspected DRP and NOM, which were then prevented or resolved, improving the control of HTN and DM2 and helping ensure better drug therapy outcomes for patients.

AGTR1 A1166C gene polymorphism is associated with the effectiveness of valsartan monotherapy in Chinese patients with essential hypertension:A retrospective analysis

Objective:To investigate whether angiotensinⅡtype 1 receptor(AGTR1 A1166C)gene polymorphism was associated with the effectiveness of valsartan monotherapy in Chinese patients with essential hypertension.Methods:This retrospective analysis included 198 patients(≥18 years of age)who received valsartan monotherapy(80 mg/day)for newly developed essential hypertension at the authors’center between January 1,2020 and December 31,2023.Genotyping for AGTR1 A1166C gene polymorphism was done by polymerase chain reaction(PCR)-melting curve analysis of genomic DNA from peripheral blood samples.A dominant genetic model for AGTR1 A1166C(AA genotype versus AC+CC genotype)was used.Multivariate regression analysis of baseline variables and AGTR1 polymorphism was conducted to identify predictors of target blood pressure attainment(<140/90 mmHg)at the 4-week follow-up.Results:The median age of the 198 patients was(53.7±13.5)years,and 58%were men.Genotyping assays showed that 164 patients had the AA genotype,and 34 patients were of the AC/CC genotype,including 30 with the AC genotype and 4 with the CC genotype.Allele distribution was consistent with Hardy Weinberg equilibrium.109 Patients(55.1%)attained the blood pressure target.Multivariate analysis showed that smoking(versus no smoking,HR 0.314,95%CI 0.159-0.619,P=0.001)and AGTR1 A1166C AA genotype(versus AC/CC,HR 2.927,95%CI 1.296-6.611,P=0.023)were significant and independent predictors of target attainment.25 Patients(73.5%)with AGTR1 A1166C AC/CC genotype attained the target versus 51.2%(51/164)of patients with AGTR1 A1166C AA genotype(P=0.017).Patients with AGTR1 A1166C AC/CC genotype had a significantly greater reduction in systolic blood pressure[(33.1±10.8)mmHg versus(29.2±11.7)mmHg in AA carriers;(P=0.029)].Conclusions:Hypertensive patients carrying one or two C alleles of the AGTR1 A1166C gene were more responsive to valsartan treatment.

Association of Low Serum Magnesium Levels in Type 2 Diabetes Mellitus with &without Hypertension

Background: Diabetes Mellitus is a widespread metabolic abnormality that constitutes a most important physical dilemma in the world. Hypomagnesaemia accelerates the rate of diabetic complications. Objective: To analyze the association of magnesium levels in DM (Type 2 Diabetes Mellitus) with and without complication of Hypertension. Design: It was a comparative analytical study. Setting: This research was carried out in medicine department, Peoples Medical College Hospital, Nawabshah from March 2016 to February 2017. Samples: 245 patients with Type 2 DM after fulfilling the selection criteria were included, out of them 123 with hypertension and 122 without hypertension. Methods: After a short-lived consultation, all the subjects were categorized for variable analyses like age, gender, Type 2 DM with and without hypertension, duration of diabetes and presence of hypomagnesaemia. Joint National Committee (JNC 8) classification of Hypertension was applied to collect data. Blood samples were drawn for research purpose in fasting state for serum magnesium level analyses on the basis of hypertension and without hypertension. Results: In 245 diagnosed Type 2 diabetic patients, 160 were males and 85 were females. Out of them, 123 were hypertensive while 122 were non hypertensive. Normal magnesium was present in 120 (48.97%) and low magnesium was present in 125 (51.02%) patients overall. A decreased serum level of magnesium was observed in 52.04% hypertensive subjects with diabetes and 50% non-hypertensive subjects with diabetes. Conclusion: Frequency of decreased serum magnesium is widespread in T2DM with and without hypertension.

Association of obesity with hypertension and type 2 diabetes mellitus in India:A meta-analysis of observational studies

AIM To perform a meta-analysis of the association of obesity with hypertension and type 2 diabetes mellitus(T2DM) in India among adults. METHODS To conduct meta-analysis, we performed comprehensive, electronic literature search in the PubM ed, CINAHL Plus, and Google Scholar. We restricted the analysis to studies with documentation of some measure of obesity namely; body mass index, waist-hip ratio, waist circumference and diagnosis of hypertension or diagnosis of T2DM. By obtaining summary estimates of all included studies, the meta-analysis was performed using both RevM an version 5 and "metan" command STATA version 11. Heterogeneity was measured by I^2 statistic. Funnel plot analysis has been done to assess the study publication bias.RESULTS Of the 956 studies screened, 18 met the eligibility criteria. The pooled odds ratio between obesity and hypertension was 3.82(95%CI: 3.39 to 4.25). The heterogeneity around this estimate(I^2 statistic) was 0%, indicating low variability. The pooled odds ratio from the included studies showed a statistically significant association between obesity and T2DM(OR = 1.14, 95%CI: 1.04 to 1.24) with a high degree of variability.CONCLUSION Despite methodological differences, obesity showed significant, potentially plausible association with hypertension and T2DM in studies conducted in India. Being a modifiable risk factor, our study informs setting policy priority and intervention efforts to prevent debilitating complications.

Effect of oncometabolic surgery on gastric cancer:The remission of hypertension,type 2 diabetes mellitus,and beyond

This review summarizes the definition and surgical methods of oncometabolic surgery according to previous studies.Then,the authors discuss the beneficial effects observed after gastrectomy in gastric cancer(GC)patients with concurrent hypertension or type 2 diabetes mellitus(T2DM).The authors summarize the current studies analyzing the remission rate and the hypotheses of the mechanisms underlying these effects.The remission rate ranged from 42.5%-65.4%in T2DM patients and from 11.1%-57.6%among those with hypertension.Furthermore,the remission of T2DM could have an impact on overall survival rates as well.The mechanisms underlying the remission of hypertension and T2DM is unclear in current studies,but oncometabolic surgery is expected to be applied in clinical practice.In addition,the effect of oncometabolic surgery on other chronic metabolic comorbidities is expected to be proven in further studies.Therefore,the purpose of this review is to discuss the effects of oncometabolic surgery reported in current studies with a primary focus on the remission of hypertension and T2DM after gastrectomy in GC patients.The possibility of the remission of other metabolic comorbidities in GC patients who undergo oncometabolic surgery is also discussed.

Drug-related problems among type II diabetes mellitus patients with hypertension: a cross-sectional study

Patients with type II diabetes mellitus(T2DM)and hypertension(HTN)are at increased threat for long experiencing various problems related to medicine as they frequently received different medications for managing their condition.Recently,there were no studies done locally on drug-related problems(DRPs)among T2DM patients with HTN.Thus,this study aims to assess the DRPs among T2DM patients with HTN admitted at Kibuye Referral Hospital(KRH).DRPs were drug safety problems,drug effectiveness problems and other drug problems.Methods:A retrospective cross-sectional study involved patients'files with T2DM and HTN,who were admitted at KRH from January 2013 to December 2017.The identification and classification of DRPs were based on pharmaceutical care network Europe(PCNE)classification system version 8.02.A simple random sampling technique was used to choose study participants from the target population.Data that met inclusion and exclusion criteria were analyzed using STATA version 13.The Fisher exact test(bivariate analysis)and logistic regression(multivariate)were used to test association and p-value≤0.05 was considered as statistically significant.An adjusted odd ratio(AOR)with a confidence interval(CI)of 95% was determined using binary logistic regression.Results:Findings revealed that the prevalence of DRPs was 81.29%(313/385)and most of them each patient had at least two DRPs(69.05%).The patients aged above 55 years old were more likely to develop DRPs than those with age below 35 years(AOR=1.2;P=0.02;95%CI:0.2-2.3).Nevertheless,there was no significant association between DRPs and middle age(between 35 and 54 age of old).The patients who consumed more than or equal to 5 drugs were 2.4 times more likely to develop DRPs than those who took the number of medicines less than 5(AOR=15.4;P<0.001;95%CI:8.8-26.8).Also,traditional medicines use(AOR=1.9;P=0.016;95%CI:1.1-3.5)and having drug-related complication(AOR=2.4;P<0.001;95%CI:1.9-3)had shown significant associations.The total causes of DRPs identified were 1626 and most causes of DRPs were arisen from drug use(45.01%)and prescribing(37.83%).The drug/dose selections were the most frequent causes of DRPs(36.97%).Conclusion:Since the prevalence of DRPs were relatively high,various factors influencing DRPs were established and most causes of DRPs were arising from drug use&drug prescribing among T2DM patients with HTN.Early detection needed to enhance patient’s life quality.Conducting studies in other hospitals needed to establish the national planning of DRPs to eradicate DRPs among patients T2DM with HTN.

Influence of folic acid and vitamin B12 combined therapy on plasma Hcy, inflammatory factor levels and blood vessels endothelial function in patients with vascular dementia and type H hypertension

Objective:To investigate influence of folic acid and vitamin B12 combined therapy on plasma homocysteine (Hcy) level, blood vessels endothelial function and inflammatory factors in patients with vascular dementia and type H hypertension.Methods:100 cases of patients with vascular dementia and type H hypertension accorded with the inclusion criteria were selected as research objects. They were randomly divided as the control group and the therapeutic group, 50 cases each. For control group, Enalapril tablets were administered by mouth for treatment. For therapeutic group, folic acid and vitamin B12 treatment were provided on the basis of treatment for control group. Treatments were continued for 12 weeks. Plasma Hcy levels, inflammatory factors [(interleukin-6 (IL-6), interleukin-8 (IL-8) and hypersensitive C reaction protein (hs-CRP)], blood vessels endothelial function indexes variation in patients before and after treatment were observed and detected.Results:Plasma Hcy, IL-6, IL-8 and hs-CRP levels in two groups of patients after treatment were significantly decreased comparing with the same group before treatment, and the above index levels in therapeutic group after treatment were significantly lower than control group (P<0.05);For comparison of blood vessels endothelial function indexes in the patients, NO levels in two groups after treatment were increased in various degrees, and endothelin-1 (ET-1) were decreased. The differences between levels of the two indexes in therapeutic group before and after treatment were significant, and levels after treatment in therapeutic group were significantly better than in control group (P<0.05). While variations of the differences in control group before and after treatment were not significant (P>0.05);After treatment, diastolic pressure and systolic pressure in the two groups of patients were significantly improved comparing with before treatment (P<0.05). However, after treatment, the differences of levels between therapeutic group and control group were not significant (P>0.05). MMSE score in therapeutic group after treatment was significantly higher than before treatment, and significantly higher than in control group (P<0.05).Conclusions: Combined therapy of folic acid and vitamin B12 for treating vascular dementia with type H hypertension could effectively decrease plasma Hcy and inflammatory factor levels, and improve blood vessels endothelial function and dementia degree on patients. It has certain clinical value which deserves to be promoted.

Impact of Hypertension on Type 2 Diabetes in Mysore Population of South India

Objective: The study aims to explore the prevalence of hypertension and its impact on Type 2 diabetes in a Mysore population of the Indian subcontinent. Methods: 636 participants volunteered for the study. Anthropometric measurements and blood pressure were recorded while plasma was analyzed for biochemical markers. The IDF and JNC 7 diagnostic criteria were followed to define diabetes and hypertension. Statistical Analyses: One-way analysis of variance, χ2-test and Logistic regression analysis were performed to assess differences of the mean, proportion and the independent effect of hypertension on the development of type 2 diabetes. Results: Hypertension was observed to be prevalent in 37.1% of the studied population with an insignificant gender difference. Rate of occurrence of hypertensives was found to be significantly higher in type 2 diabetes (51.9%), obese subjects (45.2%), long-term smokers (49%) and alcohol addicts (48%) than control groups. The risk of development of diabetes was significantly higher in hypertensives than normotensive. However, when creatinine and blood urea nitrogen were included in the model, the significance was nullified. Conclusions: The prevalence of type 2 diabetes and hypertension is increasing at an alarming rate. This study reveals that the significance of hypertension as a parameter in predicting the risk of type 2 diabetes was influenced by the renal function and lipid profile.

Hypertension, type Ⅳ cardiorenal syndrome and chronic kidney disease: Pathophysiological and therapeutical approach

Hypertension represent one of the most important comorbid factors in chronic kidney disease(CKD) patients and its prevalence increases from 65% to 95% according to glomerular filtration rate decline. CKD patients need to maintain their blood pressure levels into 130/80 mm Hg according to most recent guidelines. Despite of many therapeutic agents, achievement of ideal blood pressure levels remains so far from the ideal ones. Hypertensive disease represent most important risk factor to develop a type Ⅳ cardiorenal syndrome, while prevalence of end stage renal disease is still raising and it represents worldwide epidemiological challenge. Correct management of hypertensive disease can obtain better control on CKD progression.

Association of rs1137101 with hypertension and type 2 diabetes mellitus of Mongolian and Han Chinese

BACKGROUND Hypertension(HTN)and type 2 diabetes mellitus(T2DM)are often coincident,and each condition is considered a risk factor for the other.Both occur frequently in the Inner Mongolia region of China.The reasons for differences in risk between Han and Mongolian ethnic groups are not known.The LEPR gene and its polymorphism,rs1137101(Gln223Arg),are both considered risk factors for HTN and T2DM,but any role of rs1137101 in the occurrence of HTN+T2DM remains unclear for Mongolian and Han populations in the Inner Mongolia region.AIM To investigate the relationship between rs1137101 and the occurrence of HTN with T2DM in Mongolian and Han populations in Inner Mongolia METHODS A total of 2652 subjects of Han and Mongolian ethnic origins were enrolled in the current study,including 908 healthy controls,1061 HTN patients and 683 HTN patients with T2DM.RESULTS The association between the rs1137101 polymorphism and HTN with T2DM was analyzed,and differences between Han and Mongolian individuals assessed.There was a significant correlation between rs1137101 and HTN(co-dominant,dominant,over-dominant and log-additive models)and HTN+T2DM(co-dominant,dominant,over-dominant and log-additive models)after adjustment for sex and age in individuals of Mongolian origin.rs1137101 was significantly associated with HTN(co-dominant,recessive and log-additive models)and HTN+T2DM(codominant,dominant,over-dominant and log-additive models)in the Han Chinese population.CONCLUSION Mongolian and Han subjects from Inner Mongolia with HTN who had rs1137101 were protected against the development of T2DM.Allele A has the opposite impact on the occurrence of HTN in Mongolian and Han Chinese populations.

Relation between the Severity of Obstructive Sleep Apnea and the Severity of Type 2 Diabetes Mellitus and Hypertension

Background: Obstructive sleep apnea syndrome (OSAS) may promote hyperglycemia, insulin resistance, and hypertension (HTN). Purpose: To evaluate if there is a relationship between the severity of OSA and the severity of type 2 diabetes mellitus (T2DM) and HTN in our patients, aiming to understand and optimize the control for comorbidities. Materials and Methods: Patients referred for polysomnography (PSG) were retrospectively recruited during the period from October 2017 to August 2020. A STOP-BANG questionnaire formed eight questions was used to assess the risk of OSAS. We divided the patients into two groups;group 1, who have snoring without T2DM, and group 2, who have snoring with T2DM. PSG was completed for all subjects and data were collected for each patient including apnoea hypopnea index (AHI), mean arterial oxygen saturation (SaO2), and Nadir SaO2 recorded during PSG. Anthropometric data, medical history, and medications for T2DM (for group 2) and HTN and HbA1c were collected (for group 2). AHI was used to evaluate the severity of OSA and its relation to T2DM and HTN. Results: The study included 300 patients who met the inclusion criteria with mean age of 49.9 ± 13.6 years. The majority of subjects (56.3%) were males and the mean body mass index (BMI) was 38.0 ± 8.4 kg/m2. Forty-two percent had HTN and 32.7% had T2DM. OSA was diagnosed in 209 patients (69.7%). OSA was more detected among those with increased age, increased BMI, and those with HTN and T2DM. The severity of both HTN and T2DM was significantly higher among patients with OSA. Conclusions: There is a relation between OSA and T2DM and HTN. The risk of OSA is higher among patients with uncontrolled T2DM and HTN. OSA should be suspected in subjects with obesity, especially with uncontrolled HTN and T2DM.

The correlation of deceleration capacity of rate with the cardiac function and micro-inflammatory state in patients with both primary hypertension and type 2 diabetes mellitus

Objective:To study the correlation of deceleration capacity of rate with the cardiac function and micro-inflammatory state in patients with both primary hypertension and type 2 diabetes mellitus.Methods: A total of 60 patients with both primary hypertension and type 2 diabetes mellitus who were treated in our hospital between May 2012 and February 2016 were collected as the observation group, and 50 patients with primary hypertension who were treated in our hospital during the same period were selected as the control group. According to the median of deceleration capacity of rate (DC), the observation group of patients were further divided into high DC group and low DC group (n=30). The 24 h dynamic electrocardiogram of the included patients were obtained to calculate the DC value;color Doppler diasonograph was used to measure the echocardiogram of the two groups, and obtain the left cardiac function indexes and strain rate indexes;enzyme-linked immunosorbent assay (ELISA) was used to detect the contents of serum pro-inflammatory factors and anti-inflammatory factors.Results: The DC value of observation group was lower than that of control group;left cardiac function indexes IVSTd, LVIDd and LVIDs levels of low DC group and high DC group were higher than those of control group, strain rate indexes SRs, SRe and Sra levels were lower than those of control group, and serum pro-inflammatory factors CRP, IL-6, IL-18 and PCT contents were higher than those of control group while anti-inflammatory factors IL-10 and IL-13 contents were lower than those of control group;IVSTd, LVIDd and LVIDs levels of low DC group were higher than those of high DC group, SRs, SRe and Sra levels were lower than those of high DC group, and serum CRP, IL-6, IL-18 and PCT contents were higher than those of high DC group while IL-10 and IL-13 contents were lower than those of high DC group.Conclusion:DC value is lower in patients with both primary hypertension and type 2 diabetes mellitus, and can intuitively reflect the cardiac function and systemic micro-inflammatory state.

Ventricular Repolarization: Epidemiology and Clinical Correlates among Type-2 Diabetics with Uncontrolled Arterial Hypertension in Western Region of the Republic of Macedonia

This study aimed to describe the epidemiology of repolarization dispersion (QT dispersion and Tpeak-Tend dispersion) and further describe their associated clinical correlates among uncontrolled arterial hypertension in type-2 Diabetics patient, in western region of the Republic of Macedonia. Abnormal ventricular repolarization is associated with increased cardiovascular risk. Data relating to the frequency of increased repolarization dispersion, among uncontrolled arterial hypertension in type-2 Diabetics patient in western region of the Republic of Macedonia, are scarce. A total of 600 patients were enrolled into this observation study. Study participans were selected among primary care patient, who were receiving ongoing care for diabetes mellitus and hypertension during 1 calendar year. Twelve lead resting electrocardiography, QT, QTc, Tpeak-Tend-intervals and dispersions, were determined manually, and were compared between groups. Patients with uncontrolled BP have greater frequency of: prolonged QTc.max.interval, (61.3% vs.33.6%;p = 0.0005), prolonged Tpeak-Tend interval (65.3% vs. 34.7%;p = 0.005), increased dispersion of QTc. interval (65.9% vs. 34.1%;p = 0.00), increased disperion of Tpeak-Tend interval (65.5% vs. 34.5%;p = 0.002). Females with uncontrolled BP have greater frequency of: increased dispersion of QTc. interval (61.2% vs. 38%;p = 0.02), increased dispersion of Tpeak-Tend interval (63.1% vs. 31.5%;p = 0.008). Hypertensive diabetic patients with uncontrolled BP and abnormal ventricular repolarization have greater BMI (p = 0.000;95%CI 3.849 - 7.871), longer duration of D.M (p = 0.000;95%CI 1.600 - 1.981), longer duration of arterial hypertension (p = 0.000;95%CI 1.468 - 1.850) and less controlled glycemia (p = 0.000;95%CI 1.556 - 3.004). Frequency of increased set of electrophysiological parameters that indicate a prolonged and more heterogeneous repolarization among diabetic patients with uncontrolled BP, is considerable high and seems to be significantly associated with demographic and clinical parameters: gender, BMI, duration of diabetes, duration of BP and glycemic control.

AN ASSOCIATION STUDY BETWEEN ESSENTIAL HYPERTENSION AND HLA-DRB1 ALLELES

It is well established that genetic and environmental factors are involved in the etiology of essential hypertension(EH). Previous studies have suggested that at least one of the HLA genes is responsible for the genetic susceptibility to EH. Our aim in the present study was to investigate this issue in China by the PCR-SSP HLA-DRB1 typing method. The results showed an increased frequency of HLA-DR2 and a decreased frequency of HLA-DR7 with EH patients compared with controls. We consider that HLA-DR2 may represent a marker for susceptibility to FH in the North Chinese population.

Dyslipidemia and cardiovascular disease risk factors in patients with type 1 diabetes:A single-center experience

BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.

High adiponectin levels fail to protect against the risk of hypertension and,in women,against coronary disease:involvement in autoimmunity?

AIM:To investigate whether serum adiponectin protects against cardiometabolic risk in a population sample with prevailing metabolic syndrome.METHODS:Middle-aged adults representative of a general population with baseline circulating adiponectin measurements(n=1224)were analyzed prospectively at a mean of 3.8 years’follow-up,using continuous values or sex-specific tertiles.Total adiponectin was assayed by an ELISA kit.Type-2 diabetes was identified by criteria of the American Diabetes Association.Hypertension was defined as a blood pressure≥140 mmHg and/or≥90 mmHg and/or use of antihypertensive medication.Outcomes were predicted using Cox proportional hazards regression analysis in models that were controlled for potential confounders.RESULTS:In models of multiple linear regression,sex hormone-binding globulin,fasting insulin(inverse)and,in men,age were significant independent covariates of serum adiponectin which further tended in women to be positively associated with serum creatinine.Cox regression analyses for incident coronary heart disease(CHD),adjusted for sex,age,non-HDL cholesterol,waist circumference and C-reactive protein,revealed significant inverse association with adiponectin tertiles in men but not women(HR=0.66;95%CI:0.32-1.38 for highest tertile).Cox regression for type-2 diabetes in a similar model(wherein glucose replaced non-HDL cholesterol),adiponectin tertiles appeared to protect in each gender.HR for incident hypertension roughly displayed unity in each of the adiponectin tertiles(P-trend=0.67).CONCLUSION:High adiponectin levels failed to protect against the development of hypertension and,in women,against CHD,presumably paralleling impairment in renal function as well.Involvement of adiponectin in autoimmune complex with loss of antioxidative-antiatherogenic properties may be underlying.

RELATION OF HYPERTENSION TO DIABETIC NEPHROPATHY IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES MELLITUS—A PAIR-MATCHED CASE-CONTROL STUDY

To assess the role of hypertension and family history of hypertensio n in the development of nephropathy in patients with non insulin dependent dia betes mellitus (NIDDM).Methods. A retrospective analysis was done on 2 groups of NIDDM patients, one g roup without proteinuria (urine protein< 300mg/24h, n=106) and the other group w ith proteinuria (urine protein≥500mg/24h, n=106). The 2 groups were matched by age(≤±3yrs), sex, ethnic and resident place. Some information of these subject s including demographic; history of disease, family history of diseases, lifesty le and behavior style variables was obtained by questionnaire; some variables w ere measured, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), quantity of protein in 24h urine. Then condi tional logistic regression analysis was performed.Results. Some factors, including history of hypertension, longer duration of hy pertension, higher levels of the past highest SBP and DBP, were independently as sociated with the occurrence risk of diabetic nephropathy (DN). Their correspond ing odd ratios (OR) with 95% confidence intervals (CI) were 2.00(1.17～3.43), 1 .25(1.08～1.46), 1.38(1.15～1.66), and 1.33(1.09～1.62) respectively, but family history of hypertension was not significantly associated with the development o f DN. When the above mentioned relations were respectively adjusted by some pos sible confounding factors, they still existed.Conclusions. History of hypertension, longer duration of hypertension, higher l evels of the past highest SBP and DBP are independent risk factors for DN in Chi nese NIDDM patients.