62 research outputs found
Supplemental Material - Utility of bioelectrical phase angle for cardiovascular risk assessment among individuals with and without diabetes mellitus
No full textSupplemental Material for Utility of bioelectrical phase angle for cardiovascular risk assessment among individuals with and without diabetes mellitus by Dimitrios Tsilingiris, Lukas Schimpfle, Ζoltan Κender, Alba Sulaj, Ekaterina von Rauchhaupt, Stephan Herzig, Julia Szendroedi, and Stefan Kopf in Diabetes & Vascular Disease Research</p
Use of adenovirus type-5 vector vaccines in COVID-19: potential implications for metabolic health?
No full textMacroglossia in endocrine and metabolic disorders: current evidence, perspectives and challenges
No full text: Macroglossia is an uncommon condition characterized by chronic, painless and abnormal enlargement of the tongue. A multitude of medical conditions can cause macroglossia. Major endocrine and metabolic disorders associated with macroglossia include genetic, congenital and acquired conditions, such as mucopolysaccharidoses; acquired and congenital hypothyroidism and myxedema; transient neonatal diabetes mellitus; acromegaly and amyloidosis. Macroglossia is often associated (~57-60%) with all types of mucopolysaccharidoses, particularly type I (Hurler syndrome) and type II (Hunter syndrome), being a prominent feature of the disorder. It may also occur in patients with acquired and congenital hypothyroidism and myxedema, being a common sign of congenital hypothyroidism with an approximate prevalence of 12-25% at the time of diagnosis. Macroglossia is a predominant oral finding in subjects with transient neonatal diabetes mellitus (~44%), acromegaly (54-69%) and amyloidosis (10-25%), particularly AL amyloidosis (20-40%) whereas is considered a hallmark of the disease. Secondary to macroglossia various disturbances may occur, such as difficulty in speech or eating, orthodontic anomalies or even more serious conditions including upper airway obstruction or obstructive sleep apnea. Until now, no comprehensive review has been conducted focusing on macroglossia in endocrine and metabolic disorders. The objective of this review is to summarize literature on the etiology and epidemiology of macroglossia in major endocrine and metabolic disorders. It highlights key aspects such as pathophysiology, clinical presentation, diagnostic evaluation, management and prognosis of macroglossia in the context of endocrine and metabolic disorders
Διερεύνηση της επίδρασης της ετεροζύγου β-μεσογειακής αναιμίας στα επίπεδα της HbA1c σε άτομα με και χωρίς σακχαρώδη διαβήτη
No full textΣτόχοι: Η παρούσα διατριβή αποσκοπεί στη διερεύνηση της επίδρασης της ετεροζύγου β-θαλασσαιμίας (εβΜΑ) στα επίπεδα της γλυκοζυλιωμένης αιμοσφαιρίνης (HbA1c) μεταξύ ατόμων με και χωρίς σακχαρώδη διαβήτη. Υλικά και Μέθοδοι: Η HbA1c μελετήθηκε συγχρονικά σε δύο ξεχωριστούς πληθυσμούς ως ακολούθως: (α) μεταξύ δύο υποομάδων χωρίς ΣΔ (100 άτομα με εβΜΑ και 100 αιματολογικώς υγιή άτομα-ομάδα ελέγχου), σταθμισμένων ως προς ηλικία, φύλο και δείκτη μάζας σώματος (ΔΜΣ), λαμβάνοντας υπ’ όψη τις τιμές γλυκόζης νηστείας και φρουκτοζαμίνης ορού. Eξετάστηκε επιπλέον η επίδραση της συγκέντρωσης αιμοσφαιρίνης και του ποσοστού HbF. (β) μεταξύ δύο υποομάδων ατόμων με ΣΔ (77 άτομα με εβΜΑ και 71 αιματολογικώς υγιή άτομα-ομάδα ελέγχου) σταθμισμένων ως προς ηλικία, φύλο, ΔΜΣ, τύπο και διάρκεια ΣΔ, και παρουσία επιπλοκών, λαμβάνοντας υπ’ όψη τις τιμές γλυκόζης νηστείας και φρουκτοζαμίνης ορού. Συνεκρίθη επιπλέον το χάσμα γλυκοζυλίωσης (GG) μεταξύ των δύο υποομάδων. Eξετάστηκε επιπλέον η επίδραση της συγκέντρωσης αιμοσφαιρίνης και χολερυθρίνης, του ποσοστού δικτυοερυθροκυττάρων και του ποσοστού HbF. Αποτελέσματα: Στον πληθυσμό (α) η μέση τιμή της HbA1c ήταν πανομιότυπη μεταξύ των δύο υποομάδων. Μεταξύ των συμμετεχόντων με εβΜΑ και μόνον, διαπιστώθηκe σημαντική θετική συσχέτιση της HbA1c με τη συγκέντρωση αιμοσφαιρίνης (r=0.455, p<0.001). Υψηλότερες τιμές HbA1c διαπιστώθηκαν μεταξύ ατόμων με εβΜΑ χωρίς αναιμία σε σχέση με αυτά με αναιμία (5.35% vs. 5.12% p<0.001, απόλυτη διαφορά 0.23%). Σε πολυπαραγοντική ανάλυση η HbA1c φάνηκε να σχετίζεται με το θετικό οικογενειακό ιστορικό ΣΔ, το ΔΜΣ και τη συγκέντρωση αιμοσφαιρίνης. H συσχέτιση με την εβΜΑ ήταν μη σημαντική (p=0.07), όμως μετά από διόρθωση ως προς το ποσοστό της HbF, αποκαλύφθηκε μια ανεξάρτητη σημαντική θετική συσχέτιση μεταξύ εβΜΑ και HbA1c. Στον πληθυσμό (β), ουδεμία σημαντική επίδραση της εβΜΑ στα επίπεδα της HbA1c ή στο GG διαπιστώθηκε, παρά την υπολογίσιμη επίδραση των παραμέτρων που σχετίζονται με το ρυθμό ανακύκλωσης των ερυθροκυττάρων. Συμπέρασμα: H εβΜΑ και η σχετιζόμενη με αυτήν αναιμία έχουν μικρή από κλινικής σκοπιάς επίδραση στις τιμές της HbA1c ενώ μεταξύ ατόμων με ΣΔ ουδεμία επίδραση στα επίπεδα της HbA1c παρατηρείται. Τα ευρήματα αυτά συνηγορούν υπέρ της χρήσης της HbA1c για τη διάγνωση και θεραπευτική παρακολούθηση του ΣΔ.Background and Aims: To investigate the effect of heterozygous β-thalassemia on glycated hemoglobin (HbA1c) among individuals with and without diabetes mellitus (DM). Μaterials and Methods: Using a cross-sectional design, HbA1c levels were studied in two populations as follows: (a) between two subgroups of individuals without DM (100 consecutive carriers of β-thalassemia trait and 100 healthy controls) matched for age, gender and BMI, taking into account fasting serum glucose and fructosamine levels. The effect of hemoglobin concentration and HbF% on HbA1c was also examined. (b) between two subgroups of individuals with DM (77 consecutive carriers of β-thalassemia trait and 71 healthy controls) matched for age, gender, BMI, diabetes type and duration, and presence of complications, considering fasting serum glucose and fructosamine levels. The glycation gap (GG) was calculated. The effect of hemoglobin and bilirubin concentration, HbF(%) and relative reticulocyte count was examined. Results: In population (a), mean HbA1c level was almost identical in the two groups. Within the group of β-thalassemia, there was a positive correlation between HbA1c and hemoglobin concentration (r=0.455, p<0.001), which was not observed in controls. β-thalassemia carriers without anemia had slightly higher HbA1c levels compared to those with anemia (5.35% vs. 5.12% p<0.001, absolute difference (0.23%). In multivariable analysis, hemoglobin concentration, BMI and 1st degree family history of T2DM were significant predictors of HbA1c, while β-thalassemia carrier state was non-significant (p=0.07) but a positive correlation became significant after adjustment for HbF(%). In population (b) no significant effects of β-thalassemia carrier state was ascertained on either HbA1c level or GG despite the considerable effects of erythrocyte turnover-related parameters. Conclusions: The effect of heterozygous β-thalassemia and β-thalassemia trait-associated anemia on HbA1c among individuals without DM is of negligible clinical significance while no effect of heterozygous β-thalassemia on HbA1c values is observed among individuals with DM. These findings advocate for the clinical use of HbA1c as a diagnostic criterion for diabetes mellitus and for long-tern therapeutic monitoring among β-thalassemia carriers
Effect of heterozygous beta thalassemia on HbA1c levels among individuals with and without diabetes mellitus
No full textBackground and Aims: To investigate the effect of heterozygous β-thalassemia on glycated hemoglobin (HbA1c) among individuals with and without diabetes mellitus (DM). Μaterials and Methods: Using a cross-sectional design, HbA1c levels were studied in two populations as follows: (a) between two subgroups of individuals without DM (100 consecutive carriers of β-thalassemia trait and 100 healthy controls) matched for age, gender and BMI, taking into account fasting serum glucose and fructosamine levels. The effect of hemoglobin concentration and HbF% on HbA1c was also examined. (b) between two subgroups of individuals with DM (77 consecutive carriers of β-thalassemia trait and 71 healthy controls) matched for age, gender, BMI, diabetes type and duration, and presence of complications, considering fasting serum glucose and fructosamine levels. The glycation gap (GG) was calculated. The effect of hemoglobin and bilirubin concentration, HbF(%) and relative reticulocyte count was examined. Results: In population (a), mean HbA1c level was almost identical in the two groups. Within the group of β-thalassemia, there was a positive correlation between HbA1c and hemoglobin concentration (r=0.455, p<0.001), which was not observed in controls. β-thalassemia carriers without anemia had slightly higher HbA1c levels compared to those with anemia (5.35% vs. 5.12% p<0.001, absolute difference (0.23%). In multivariable analysis, hemoglobin concentration, BMI and 1st degree family history of T2DM were significant predictors of HbA1c, while β-thalassemia carrier state was non-significant (p=0.07) but a positive correlation became significant after adjustment for HbF(%). In population (b) no significant effects of β-thalassemia carrier state was ascertained on either HbA1c level or GG despite the considerable effects of erythrocyte turnover-related parameters. Conclusions: The effect of heterozygous β-thalassemia and β-thalassemia trait-associated anemia on HbA1c among individuals without DM is of negligible clinical significance while no effect of heterozygous β-thalassemia on HbA1c values is observed among individuals with DM. These findings advocate for the clinical use of HbA1c as a diagnostic criterion for diabetes mellitus and for long-tern therapeutic monitoring among β-thalassemia carriers.Στόχοι: Η παρούσα διατριβή αποσκοπεί στη διερεύνηση της επίδρασης της ετεροζύγου β-θαλασσαιμίας (εβΜΑ) στα επίπεδα της γλυκοζυλιωμένης αιμοσφαιρίνης (HbA1c) μεταξύ ατόμων με και χωρίς σακχαρώδη διαβήτη. Υλικά και Μέθοδοι: Η HbA1c μελετήθηκε συγχρονικά σε δύο ξεχωριστούς πληθυσμούς ως ακολούθως: (α) μεταξύ δύο υποομάδων χωρίς ΣΔ (100 άτομα με εβΜΑ και 100 αιματολογικώς υγιή άτομα-ομάδα ελέγχου), σταθμισμένων ως προς ηλικία, φύλο και δείκτη μάζας σώματος (ΔΜΣ), λαμβάνοντας υπ’ όψη τις τιμές γλυκόζης νηστείας και φρουκτοζαμίνης ορού. Eξετάστηκε επιπλέον η επίδραση της συγκέντρωσης αιμοσφαιρίνης και του ποσοστού HbF. (β) μεταξύ δύο υποομάδων ατόμων με ΣΔ (77 άτομα με εβΜΑ και 71 αιματολογικώς υγιή άτομα-ομάδα ελέγχου) σταθμισμένων ως προς ηλικία, φύλο, ΔΜΣ, τύπο και διάρκεια ΣΔ, και παρουσία επιπλοκών, λαμβάνοντας υπ’ όψη τις τιμές γλυκόζης νηστείας και φρουκτοζαμίνης ορού. Συνεκρίθη επιπλέον το χάσμα γλυκοζυλίωσης (GG) μεταξύ των δύο υποομάδων. Eξετάστηκε επιπλέον η επίδραση της συγκέντρωσης αιμοσφαιρίνης και χολερυθρίνης, του ποσοστού δικτυοερυθροκυττάρων και του ποσοστού HbF. Αποτελέσματα: Στον πληθυσμό (α) η μέση τιμή της HbA1c ήταν πανομιότυπη μεταξύ των δύο υποομάδων. Μεταξύ των συμμετεχόντων με εβΜΑ και μόνον, διαπιστώθηκe σημαντική θετική συσχέτιση της HbA1c με τη συγκέντρωση αιμοσφαιρίνης (r=0.455, p<0.001). Υψηλότερες τιμές HbA1c διαπιστώθηκαν μεταξύ ατόμων με εβΜΑ χωρίς αναιμία σε σχέση με αυτά με αναιμία (5.35% vs. 5.12% p<0.001, απόλυτη διαφορά 0.23%). Σε πολυπαραγοντική ανάλυση η HbA1c φάνηκε να σχετίζεται με το θετικό οικογενειακό ιστορικό ΣΔ, το ΔΜΣ και τη συγκέντρωση αιμοσφαιρίνης. H συσχέτιση με την εβΜΑ ήταν μη σημαντική (p=0.07), όμως μετά από διόρθωση ως προς το ποσοστό της HbF, αποκαλύφθηκε μια ανεξάρτητη σημαντική θετική συσχέτιση μεταξύ εβΜΑ και HbA1c. Στον πληθυσμό (β), ουδεμία σημαντική επίδραση της εβΜΑ στα επίπεδα της HbA1c ή στο GG διαπιστώθηκε, παρά την υπολογίσιμη επίδραση των παραμέτρων που σχετίζονται με το ρυθμό ανακύκλωσης των ερυθροκυττάρων. Συμπέρασμα: H εβΜΑ και η σχετιζόμενη με αυτήν αναιμία έχουν μικρή από κλινικής σκοπιάς επίδραση στις τιμές της HbA1c ενώ μεταξύ ατόμων με ΣΔ ουδεμία επίδραση στα επίπεδα της HbA1c παρατηρείται. Τα ευρήματα αυτά συνηγορούν υπέρ της χρήσης της HbA1c για τη διάγνωση και θεραπευτική παρακολούθηση του ΣΔ
Could inhaled corticosteroids be the game changers in the prevention of severe COVID-19? A review of current evidence
No full textAs the coronavirus 2019 disease (COVID-19) pandemic is going through its second year, the world is counting more than 4.9 million lives lost. Many repurposed immunomodulatory drugs have been tried and failed to treat COVID-19. The only successful treatments that improve survival are systemic corticosteroids and tocilizumab, by targeting the systemic inflammatory cascade. An intriguing observation that patients with chronic respiratory disease seem to be less prone to COVID-19 gave ground to the hypothesis that inhaled corticosteroids (ICS) may protect them from SARS-CoV-2 infection. In this review, we summarize current evidence regarding the therapeutic role of inhaled and systemic corticosteroids in COVID-19, and we present experimental data on the potential actions of ICS against SARS-CoV-2 infection. We also discuss safety issues as well as therapeutic considerations and clinical implications of the use of ICS in COVID-19. Four randomized controlled trials (RCT) with more than 3,000 participants suggest that ICS may lead to earlier clinical improvement and lower rate of hospitalization in patients with mild COVID-19, while 9 ongoing RCTs are anticipated to provide more evidence for the use of ICS in COVID-19. Recent evidence has shown promise that ICS could provide tangible benefits to patients suffering from COVID-19
Screening tools for diabetic foot ulcers: a narrative review
No full textThe prevalence of diabetic foot ulcers (DFUs) is 4 to 10% among people with diabetes mellitus. DFUs are associated with increased morbidity and mortality as well as reduced quality of life and have a significant impact on overall healthcare expenditure. The main predisposing factors for DFU are diabetic neuropathy, peripheral arterial disease, and trauma. The fact that a range of tests can be used to identify patients at risk for DFU often causes confusion among practitioners regarding which screening tests should be implemented in clinical practice. Herein we sought to determine whether tests of somatic nerve function, such as pinprick sensation, thermal (cold/hot) test, ankle reflexes, vibration perception, 10-g monofilament, Ipswich touch test, neuropathy disability score, and nerve conduction studies, predict the development of DFUs. In addition, we examined whether sudomotor function screening tests, such as Neuropad, sympathetic skin response, and other tests, such as elevated plantar pressure or temperature measurements, can be used for DFU screening. If not treated properly, DFUs can have serious consequences, including amputation, early detection and treatment are vital for patient outcomes. © The Author(s), under exclusive licence to Hellenic Endocrine Society 2024
Lower circulating omentin-1 is independently linked to subclinical hypothyroidism reflecting cardiometabolic risk: an observational case-control and interventional, longitudinal study
No full textOmentin-1, a newly discovered adipokine, is implicated in the modulation of the adipose phenotype, ameliorating systemic metabolism and exhibiting anti-atherogenic, antioxidative, cardioprotective, anti-inflammatory and insulin-sensitizing properties. Our goal was to explore circulating omentin-1 in subclinical hypothyroidism (SH) and determine its correlations with cardiometabolic risk factors
The non-linear relationship between muscle mass and BMI calls into question the use of BMI as a major criterion for eligibility for bariatric surgery.
No full textSARS-CoV-2 adipose tissue infection and hyperglycemia: A further step towards the understanding of severe COVID-19.
No full textNumerous studies have highlighted the prognostic significance of hyperglycemia in the outcomes of SARS-CoV-2 infection. A number of mechanisms have been proposed as potential drivers of this association, which were, however, up until recently based rather on speculation than on investigational evidence. It has been recently come to light that the development of insulin resistance in the frame of COVID-19 is likely the driving force behind the development of overt hyperglycemia. This results through the infectious insult of the adipose tissue, and is observed in conjunction with aberrant adipokine secretion by host adipocytes, such as decreased adiponectin, as well as a switch towards an antiviral immune secretory profile. These data could have a considerable relevance not only for the management of hyperglycemia in the course of the infection but also for the overall understanding of the pathogenesis of severe COVID-19
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