Predictors of metabolic syndrome in Asian north Indians with newly detected type 2 diabetes.

Background & objectives: The identifi cation of metabolic syndrome (MS) among patients with type 2 diabetes (T2DM) is of great importance, since those with MS carry a cluster of cardiovascular risk factors. This study evaluates suitable criteria with high effi ciency in diagnosing MS and to identify the strongest predictors of MS in newly detected type 2 diabetes individuals. Methods: Newly detected type 2 diabetes (<6 months) patients were assessed. The MS was assessed by WHO, National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III), modifi ed NCEP-ATP-III and International Diabetes Federation (IDF) criteria. Receiver operating characteristics (ROC) curves of serum triglycerides, HDL, and waist circumference were created for the prediction of MS and the area under the corresponding curves (AUC) were used to evaluate the predictive effi ciency of each MS parameter. Different cut points in the selected variables and the corresponding sensitivity, specifi city, positive predictive value (PPV) and negative predictive value (NPV) were estimated. Results: Among the 563 newly detected T2DM individuals, the presence of MS ranged from 57 to 68 per cent according to the different criteria. The higher percentage of MS was observed in modifi ed NCEPATP III criteria. In comparison to men, presence of MS was higher in women in all the four criteria [198 (67%) vs. 165 (62%); 209 (70%) vs. 111 (42%); 231 (78%) vs. 151 (57%); 222 (75%) vs. 129 (49%)] by modifi ed WHO, NCEP-ATP III, modifi ed NCEP-ATP III, and IDF, respectively. The predictive ability to diagnose MS was highest with modifi ed NCEP-ATP III and lowest with IDF criteria. The optimal cut-off of waist circumference in men and women were 90 and 88 cm respectively. Serum triglyceride in men effectively indicated the presence of MS in newly detected T2DM individuals, whereas, in women the HDL-C was the stronger predictor of MS. Interpretation & conclusions: The study results show that modifi ed NCEP-ATP III criteria predict highest occurrence of MS in newly detected T2DM patients. Elevated serum triglyceride for men and decreased serum HDL-C in women were the strongest single predictors, effectively indicating presence of MS in newly detected T2DM.

Inhibition of sodium current by carbamazepine in dorsal root ganglion neurons in vitro.

Carbamazepine (CBZ), one of the most commonly prescribed antiepileptic drug, is proposed to inhibit Na+ channel. In this study, we have investigated the effects of CBZ on Na+ current, evoked in cultured dorsal root ganglion (DRG) neurons from neonatal rats using whole cell patch clamp technique. In small DRG neurons (20–25 μm), Na+ current was obtained by blocking K+ and Ca2+ currents with appropriate ion replacement and channel blockers. Separation of the Na+ current components was achieved on the basis of response to the conditioning voltage. The CBZ depressed Na+ current in a dose-dependent manner. The maximal Na+ current was depressed at 300 μM of CBZ, where 94±5.1% of depression was observed. The depression of normalized current amplitude was found to be 72±13.2%, 84±10%, 85±7.1% and 95±5.2% at 10, 30, 100 and 300 μM of CBZ concentrations, respectively, at –20 mV test pulse, when compared with control. The depression of current amplitude was observed as 48±12.3%, 42±15.2%, 71±17.7% and 90±5.8% at 10, 30, 100 and 300 μM of CBZ concentration, respectively, at 0 mV voltage pulse. The depression of Na+ currents was found to be dose-dependant at –20 and –10 mV but not at 0 mV. It is concluded that the depression of Na+ currents by CBZ may be responsible for inhibiting the neurotransmitter release.

Prevalence and predictors of metabolic syndrome in non-obese Asian Indians with newly detected type 2 diabetes mellitus.

We measured the prevalence and have evaluated the sensitivity, specificity, positive and negative predictive value of different predictors according to different standard criteria for metabolic syndrome in non-obese newly detected type 2 diabetes. Two hundred and fifteen patients of BMI <25 kg/m2 were studied. Metabolic syndrome prevalence was high in non-obese newly detected type 2 diabetes mellitus individuals. Greater prevalence of metabolic syndrome was observed in modified WHO (50.23%) and lesser in IDF (30.69%) classification. Non-obese metabolic syndrome individuals display significantly higher BMI, per cent body fat, waist circumference, hip circumference, waist hip ratio, blood pressure, triglyceride and a lower high density lipopratein than non-obese individuals without metabolic syndrome. The cut-off point for waist circumference in men was 86 cm and 79.7 cm for women (modified ATP III). Elevated serum triglyceride for men and low serum high density lipoprotein in women were the strongest predictors that effectively indicated the presence of metabolic syndrome in non-obese individuals.