ABSTRACT
Background: Hypertension is turned into a leading cause of non-communicable disease associated mortality and morbidity in both developing as well as developed world. Hypertension is reported to be the fourth contributor to premature death in developed countries and the seventh in developing countries. In the regard of early diagnosis and better prognosis, the concept of pre-hypertension, defined as a systolic blood pressure of 120-139 mmHg and/or a diastolic blood pressure of 80-89 mmHg was introduced as the new guideline for the management of blood pressure by the seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC-7). Among various other factors inflammation may be a causative factor for development of Hypertension But the association is not very clear. Accordingly, we have designed our study to find any association of hsCRP with pre-hypertension and hypertension so that early prevention and control can help to avoid or delay the grave outcome and complications of hypertension. Methods: A total of 37 hypertensives, 30 pre-hypertensives and 31 age and sex matched healthy control subjects were selected for the study, with consent. Two BP readings were taken five minutes apart, on both arms, with a mercury sphygmomanometer. The estimation of serum hsCRP was done on XL-600 automatic analyzer with the kit (Erba Mannheim) based on the measurement of antigen-antibody reaction by the end-point method. Results: There is significant difference in systemic and diastolic blood pressure and hsCRP in between group study. In pre-hypertensive group hsCRP is correlated with diastolic blood pressure. Conclusion: Our results suggest a correlation exists between hsCRP and hypertension more significantly with pre-hypertension. So estimation of serum hsCRP can be a good diagnostic as well as prognostic marker in diagnosing pre-hypertensives and prevent the occurance of hypertension and cardio vascular disorders thereby.
ABSTRACT
Background: Type 2 diabetes is associated with significant cardiovascular morbidity and mortality. Dyslipidemia, which affects almost 50% of patients with type 2 diabetes, is a cardiovascular risk factor characterized by elevated triglyceride levels, low high-density lipoprotein (HDL) cholesterol levels, and a preponderance of small, dense, low-density lipoprotein (LDL) particles. In addition to their glucose-lowering properties, oral anti-diabetic agents may have effects on lipid levels, especially triglycerides (TGs), HDL-C, LDL-C and total cholesterol levels. Methods: A prospective, open-labeled, randomized, parallel-group study was carried out in sizable number of patients (n=40) of established type 2 diabetes on combined oral anti-diabetic drugs, to investigate the effects of combined oral anti-diabetic on lipid parameters who was not receiving any hypolipidemic agent in addition. Results: Statistically significant mean reduction of triglycerides (TGs) of 25.1mg/dl (a 15.30% reduction from baseline value) and by 13.5 mg/dl (a 8.94% reduction from baseline value) in the SU (sulfonylurea) plus PIO (pioglitazone) and SU plus MET (metformin) group respectively. Present study also shows improvement in HDL cholesterol with SU plus PIO group by 13.18% which is almost twice that observed in SU plus MET group (8.06%). Present study also shows increase in LDL cholesterol with SU plus PIO group by 2.10%, is just opposite to SU plus MET group (4.92 % decrease). With SU plus PIO group, a statistically significant mean reduction of total cholesterol (TC) of 8.33mg/dl (5.14 % decrease) and by 7.62 mg/dl (4.28% decrease) in the SU plus MET group. Conclusions: Pioglitazone, a thiazolidinedione, has been shown to improve the lipid profile in patients with type 2 diabetes by increasing HDL-C levels and by decreasing triglyceride and total cholesterol levels in monotherapy or combination regimens with sulfonylurea. Metformin also has been shown to reduce LDL-C, TC, and TG levels and increase HDL-C levels in monotherapy and in combination regimens with sulfonylurea. In contrast, LDL cholesterol levels mild increase with pioglitazone monotherapy or with SU combination therapy. Thus the results of this study have demonstrated that SU plus pioglitazone is an effective combination regimen for patients insufficiently treated with SU monotherapy and may provide possible positive effects on other coronary risk factors/ dyslipidemias associated with the type 2 diabetes.
ABSTRACT
Emerging datas have shown a high failure rate of longterm monotherapy in preventing the vascular complications of DM II. It establishes the significance of meal time hyperglycemia and the role of post-prandial glucose excursions in the development and progression of vascular complications. This prospective, randomized, open parallel group study was conducted on patients selected from those who were attending O.P.D. of Department of Endocrinology and Human Metabolism of SVBP Hospital, L.L.R.M. Medical College, Meerut. The study have demonstrated that the combination therapy with Sulfonylurea plus Pioglitazone (SUP) is an effective regimen for patients who are insufficiently treated with Sulfonylurea mono-therapy. This regimen may provide a possible positive effect on other coronary risk factors/ dyslipidemias associated with the type 2 Diabetes.