ABSTRACT
Background: Hypocalcemia is one of the important complications of diabetes mellitus. It occurs when the patient develops renal insufficiency but hypercalcemia occurs in diabetes due to many mechanisms including insulin resistance. Meanwhile, hypercalcemia itself produces insulin resistance and the calcium is the important one for the production of insulin and glucose uptake in the cells. Aim of the study: To assess left ventricular dimension and wall thickness mass in diabetic patients having high serum calcium level. Materials and methods: This study was conducted in Government Royapettah Hospital, Chennai for duration of 6 months from April 2018 to September 2018. 2016 patients were enrolled in the study. After obtaining an informed written consent, demographic details, past medical history and clinical examination was done. Following investigation was done in all patients. Serum calcium, serum creatinine, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose was done. 2D ECHO – echocardiography was done in all patients. In left lateral position ECHO was performed in parasternal long axis, 4 chamber view. M mode was used to assess the septal wall, posterior wall thickness and left ventricular diastolic dimension. By using wall thickness left ventricular mass is calculated. Results: According to our serum calcium was main Determinator of left ventricular remodeling by many mechanisms. Serum calcium was > 10.2 in LVH group people but in non-LVH group people serum calcium level was within the normal limit that was given as < 10.2 mg/dl. 1 patient in non-LVH group was having high serum calcium but does not make statistical changes in that group. The mean serum calcium of LVH group was 10.6mg/dl. D. Venkateswarlu, M. Praveen Kumar. A study of high serum calcium level in diabetes mellitus and its association with left ventricular remodeling. IAIM, 2019; 6(9): 66-71. Page 67 Conclusion: Normal calcium mandatory for excitation-contraction coupling but high calcium adversely affect the ECC and produces ventricular dysfunction and through neurohormonal mechanism it produces cardiac muscle hypertrophy. According to this study increased serum calcium in diabetes has strong correlation with occurrence of cardiac remodeling.
ABSTRACT
BACKGROUND: Surfactant protein-A (SP-A), which is an important constituent of natural surfactant, occurs physiologically in small amounts in blood. Tobacco smoke induces increased alveolo-capillary leakage of surfactant proteins into blood and its level in blood may help in the assessment of lung injury caused by smoke. Little is known on the SP-A levels in patients with chronic obstructive pulmonary disease (COPD). METHODS: Prospective analytical study of 30 patients with clinical diagnosis of chronic bronchitis, which was made on the basis of symptoms, signs and chest radiographic findings. Serum SP-A and serum cotinine levels were measured. RESULTS: Out of 30 patients, 21 were smokers and nine were non-smokers. The serum SP-A level in smokers with chronic bronchitis is significantly higher than the non-smokers. The plasma cotinine levels are also high in smokers. However, there was no correlation between the serum SP-A level and plasma cotinine level (r=0.044). Serum SP-A levels were related to age in smokers (r=0.566, p<0.01) but not in non-smokers with chronic bronchitis (r=0.017, p>0.05). CONCLUSION: The increase in SP-A level in smokers with chronic bronchitis suggests that tobacco smoking causes a chronic increase in permeability of the lung parenchyma. The SP-A, a lung-specific secretory protein, is a potential marker for non-invasive assessment of the integrity of the lung epithelium. Further studies are required to find out whether SP-A can be used as a marker for early identification of smokers who are at risk of COPD.