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Diabetic retinopathy (DR) is a major microvascular complication of diabetes. It is the most common cause of blindness in the working-age population in developed countries. We wanted to analyse the correlation between risk factors of blindness like duration of diabetes, dyslipidaemia, hypertension, HbA1c with severity of diabetic retinopathy in order to design appropriate strategies for prevention and treatment of diabetic retinopathy.METHODSThis was a retrospective study of all diabetic patients with diabetic retinopathy who presented to the eye OPD at KS Hegde Medical Academy from April 1st 2018 to March 31st 2019 that fulfilled the inclusion criteria. A dilated fundus examination was done to note the grade of diabetic retinopathy. The demographic data along with the duration of diabetes, HbA1c values, Cholesterol levels and Blood pressure were documented and correlated with the severity of diabetic retinopathy.RESULTSThe study included 92 patients, of which 63 were males and 29 were females with a mean age of 54.5±2.8 years. We found that there was statistically significant association between the duration of diabetes and HbA1c levels with severity of diabetic retinopathy (p= 0.022 and 0.034 association), whereas there was no statistically significant correlation between blood pressure and cholesterol levels with severity of diabetic retinopathy (p= 0.52 and 0.456 respectively)CONCLUSIONSDiabetic retinopathy showed a male preponderance, with risk factors like duration of diabetes and HbA1c levels having a significant association with the severity of diabetic retinopathy. Therefore, it is essential to have a good systemic control of diabetes with diet and suitable medications. Diabetic retinopathy is a preventable cause of blindness when diagnosed early and screening of diabetic retinopathy must be done in all diabetics to prevent the progression of the disease.
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Objective: To Study the association of cerebrovascular disease with metabolic syndrome. Methods: A Total 104 patients were included in this study & investigated for cerebrovascular disease associated with metabolic syndrome or not. A study of presence or absence of metabolic syndrome in cerebrovascular disease was done. P value was calculated by using analysis of variance test (ANOVA) & P value <0.05 was considered as statistically significant. Results: Total 104 patients were included in this study in 72 patients (69.23%) were suffering from metabolic syndrome and 32 patient (30.77%) were not suffering from metabolic syndrome. Most of the patients suffering from cerebrovascular disease associated with metabolic syndrome were of older age groups (61.11%)>61 years. Second most common group was (22.22%) 51-60 years. Other patients of cerebrovascular disease not suffering from metabolic syndrome (56.25%) in 51-60 years followed by (31.25%) in 41-50 years. Amongst the patients suffering from cerebrovascular accident and metabolic syndrome males outnumbered females, although this data is not statistically significant p=0.4. Among the Cerebrovascular accident patient group prevalence was highest therefore raised fasting blood sugar (n=58) (80.55%) and low HDL values (75.2%), whereas it was highest for Hypertension (88.89%). In the cerebrovascular accident group out of total 104 patients 72%(n=72) were suffering from metabolic syndrome and 30.77%(n=32) were not suffering from metabolic syndrome there is positive correlation between metabolic syndrome and cerebrovascular accident .Using Test for equality for proportion (zscore) this data is found to be statistically significant. Conclusion: In cerebrovascular accident group (total patients =104) 67.5%(n=108) were having 3 risk factors, 50%(n=80) were having 4 risk factors and 11.25%(n=18) were having 5 risk factors of metabolic syndrome among the cases .Among the patients suffering from cerebrovascular accident (total patients =104) the prevalence of hypertension was 88.89%(n=64),of low HDL was 75.2%(n=54),of high TGs was 80.55%(n=58),of raised waist circumference was 58.32%(n=42) and of increased fasting blood sugar was 80.55%(n=58) in the case group.
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Background: Evidence shows that high density lipoproteins (HDLs) may exert multiple anti-atherogenic and anti-thrombotic effects that together decrease the risk of cardiovascular morbidity in hyperlipidaemic state. Experimental studies showed that fresh wheatgrass (Triticum aestivum Linn.) juice exerts lipid lowering effect as well as increases HDL-cholesterol level in rats. Objective: The present study was done to observe the effect of wheatgrass juice on serum HDL-cholesterol on experimentally induced dyslipidaemic rats evident by reduced HDL-cholesterol level. Materials and method: This experimental study was carried out in the Department of Pharmacology & Therapeutics, Dhaka Medical College, Dhaka, from July 2009 to June 2010. A total number of 48 healthy adult male Long Evans rats, age ranging from 2-3 months, and weighing from 140-200 grams were used for the present study. Six rats were taken in each group of total 8 groups treated differently with 1 control group. Rats of the first 5 groups were sacrificed at 29th day and their lipid profile was measured. Rests of the rats were sacrificed at 57th day and their lipid profile was measured. Results: Mean HDL-cholesterol of the group of rats treated with 10 mL/kg grass juice and 1% cholesterol diet, with 10 mL/kg grass juice and with 20 mL/kg grass juice were significantly increased (P<0.05, P<0.05, P<0.01 respectively). The mean HDL-cholesterol of the group treated with Atorvastatin for 28 days were also significantly increased (P<0.001). Conclusion: The present experiment showed that HDL-cholesterol level is increased by ingestion of wheat grass juice in experimental animals. Therefore, it provides the initial step for demonstrating cardio-protective effect of wheatgrass juice by increasing HDL-cholesterol level in blood in dyslipidaemic state.
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Today, there are 382 million people living with diabetes. A further 316 million with impaired glucose tolerance are at high risk from the disease – an alarming number that is set to reach 471 million by 2035. One of the most overlooked of all serious complications of diabetes is cardiovascular autonomic neuropathy (CAN) which encompasses damage to the autonomic nerve fibers that innervate the heart and blood vessels, resulting in abnormalities in heart rate control and vascular dynamics. The present report discusses the clinical manifestations (eg, resting tachycardia, orthostatic hypotension exercise intolerance, intra operative cardiovascular liability, silent myocardial infarction (MI), and increased risk of mortality) in the presence of CAN. The reported prevalence of CAN varies greatly depending on the criteria used to identify CAN and the population studied. CAN prevalence ranges from as low as 2.5% of the primary prevention cohort in the Diabetes Control and Complications Trial (DCCT) to as high as 90% of patients with long-standing type 1 diabetes who were potential candidates for a pancreas transplantation. Objective: The aim of this study was to evaluate the Cardiac Autonomic Neuropathy (CAN) among diabetic patients.This study included patients with T1 DM and 20 patients with T2 DM total (97 male, 86 female) diabetic patients. The CAN diagnosed by 6 clinical tests: Resting Heart Rate (RHR), Expiration : Inspiration (E:I) ratio, Heart rate response to standing (30:15 ratio), Orthostatic hypotension (OH) and Sustained Hand Grip (SHG) using Cardiac Autonomic Neuropathy System Analyzer CAN-504. CAN was indicated at least two of five tests are abnormal.Diabetic patients’ mean age was 48.74±12.74, diabetes duration 7.55±5.72, systolic blood pressure 136.25±22.76mm Hg, diastolic blood pressure 84.82±11.90 mmHg, cholesterol 5.04±1.04mmol/l, triglyceride 2.20±1.24mmol/l, LDL2.64±0.85mmol/l, HDL 1.12±0.41mmol/l, non-HDL 3.71±1.06, cholesterol/HDL ratio 4.70±1.29, HBA1c 10.08±2.39%. Result of RHR resting heart rate test was normal 92%, borderline 0.5% and abnormal 7.1%,Expiration:inspiration(E:I) ratio was normal 72.7%,borderline 13.7% and abnormal 14%, Heart rate response to standing (30:15ratio) was normal 47%,borderline 13.714% and abnormal 39.3%, Valsalva was normal 97.8%,borderline 2.2% and abnormal 0%, Orthostatic hypotension (OH) was normal 66%,borderline 29% abnormal 6% and Sustained hand grip(SHG) test was normal 4.9%,borderline 9%, and abnormal 87.8%.Number of abnormal cardiac autonomic neuropathy test results 2 (with cardiac autonomic neuropathy) was in 97(53%) among diabetic patients. Among diabetic patients cardiac autonomic neuropathy (CAN) was 53%.
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Risk of coronary heart disease and other forms of atherosclerotic vascular diseases, rises with plasma cholesterol concentration and in particular with the rise of ratio of total cholesterol to high density lipoprotein (HDL-C) cholesterol. A much weaker correlation also exists with plasma triglyceride concentration. Extensive large-scale randomized trials have shown that lowering total cholesterol and LDL-C concentrations reduces the risk of cardiovascular events including death, myocardial infarction and stroke and reduces the need for revascularisation.This cross-sectional analytical study was designed to observe association between lipid profile level with chronic ischaemic heart disease and the study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from July 2010 to June 2011. A total of 50 cases were selected purposively according to the selection criteria from the patients admitted in the Department of Cardiology, Dhaka Medical College Hospital with chronic ischaemic heart disease (IHD). Diagnosed IHD patients were taken as cases and 50 age- & sex- matched healthy subjects were taken as controls. Serum TC, TG, LDL-C & HDL-C were measured in all study subjects.The mean±SD of serum TC, TG, HDL-C and LDL-C concentration in cases were 314.54±73.72 mg/dl, 288.04±60.45 mg/dl, 36.02±4.12 mg/dl, and 178.62±22.7 mg/dl respectively and in controls were 174.64±18.97 mg/dl, 119.42±12.47 mg/dl, 43.04±2.58 mg/dl & 126.28±11.45 mg/dl respectively. Serum Total Cholesterol, TG & LDL-C were found to be significantly higher in cases than that of controls. Serum HDL-C was found to be significantly lower in cases than that of controls. The present study reveals that the patients with chronic ischemic heart disease is accociated with significantly higher levels of serum TC, TG and LDL-C whereas HDL-C was found to be lower in IHD patients.
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Objective To evaluate the association between serum HDL-C and the risk of cardiovascular diseases(CHD) in subjects aged 35-64 years. Methods A prospective study was carried out in 11 provinces from 1992 to 2002. The association of baseline HDL-C level and cardiovascular disease occurrence was analyzed in 30384 subjects aged 35-64 years using Cox multivariate proportional hazards regression. Results (1) Compared with the group of HDL-C≥1.56 mmol/L, multivariate-adjusted relative risk of ischemic cardiovascular disease(ICVD), including CHD and ischemic stroke increased continuously with decreased HDL-C level. (2)HDL-C level had different impact on different types of CVD.Positive association was observed between HDL-C level and the risk of ischemic stroke,but the relationship between HDL-C level and the risk of hemorrhagic stroke was indefinite. Compared with the group with HDL-C≥1.56 mmol/L,the risk of CHD of the group with HDL-C≤1.03 mmol/L increased by 45%(RR=1.45,P＜0.05)and that of ischemic stroke increased by 53%(RR=1.53,P＜0.01).(3)6.4% of ICVD,7.2% of the acute CHD and 7.3% of the acute stroke was attributable to low serum high density lipoprotein cholesterol. Conclusions Starting from HDL-C≥1.56 mmol/L, the risk of ICVD increasescontinuously with decreased HDL-C level. Comprehensive intervention for multiple risk factor clustering should be strengthened to reduce theoverall risk of CVD.
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Atherosclerosis (AS) is pathologically important basis of many kinds of coronary atherosclerosis disease (CAD). It can be substantially protected by raising high-density lipoprotein (HDL).In view of mechanism, drugs for raising HDL include: cholesterol ester transfer protein inhibitors, peroxisomal proliferator-activated receptor agonists, liver X-activated receptor agonists, farnesoid X receptor antagonists or agonists, lipoprotein lipase activators, niacin, and phenytoin and lecin : cholesterol acyltransferase activators, etc. This review aimed to the progress of drugs for regulating high-density lipoprotein and their mechanism, in view of clinical and preclinical aspects.
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BACKGROUND AND OBJECTIVES: The aims of this study were to compare the lipid distributions and risk factors in an angiographically normal coronary artery group to those of microvascular and coronary artery diseased groups of Koreans, and to find the effects of the variable risk factors on the serum lipid levels according to the coronary atherosclerosis status. SUBJECTS AND METHODS: A total of 1,198 patients (563 males and 635 females), having undergone a coronary angiography (CAG) using Judkins method, were included. According to their coronary angiographic findings, they were divided into normal CAG (n=568), microvascular disease (n=230) and coronary atherosclerosis (n=400) groups. RESULTS: The mean value of the total cholesterol in the patients with normal coronary artery was 175 mg/dl, which progressively increased to 182 mg/dl and 198 mg/dl in the patients with microvascular disease and coronary atherosclerosis, respectively. The frequencies of the risk factors for coronary atherosclerosis also progressively increased in the patients with microvascular disease and coronary atherosclerosis. The mean values of the serum total cholesterol, LDL-cholesterol and lipoprotein(a), progressively increased from the patients with normal angiographic findings to those with microvascular disease and coronary atherosclerosis, and the results were statistically significant. The results for the patients with microvascular disease were in between those of the patients with normal angiographic findings and those with coronary atherosclerosis. CONCLUSION: The correlation between coronary atherosclerosis and the serum cholesterol levels has, until now, been studied epidemiologically, and this is the first study to angiographically elucidate the positive relationship between coronary artery disease and the serum cholesterol levels. Our data showed lower ranges of lipid distributions compared to those of the ATP III guideline.
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Humans , Male , Adenosine Triphosphate , Cholesterol , Coronary Angiography , Coronary Artery Disease , Coronary Vessels , Lipoprotein(a) , Risk Factors , TriglyceridesABSTRACT
Objective To explore the protective effect of high density lipoprotein on the liver function of rats with severe burns. Methods 135 Wistar rats employed in present study were randomly divided into control group (n=15, without treatment), burn group (n=60, with 30%TBSA full-thickness burn on the back) and experimental group (n=60, with the injection of 80mg/kg HDL via the caudal vein immediately after burns). The rats in the groups with burns injury were resuscitated with intraperitoneal isotonic saline (50ml/kg) 30 minutes after burn. The serum content of AST, ALT, ICAM-1 and TNF-? of the rats were determined with corresponding methods. The histological changes in the liver tissue of the rats in all groups were observed under light microscope and electronic microscope. Results The serum content of AST, ALT, ICAM-1 and TNF-? in the rats of control group were significantly lower than those in burn group (P
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0.05). CONCLUSION:HDL of human plasma could attenuate or inhibit the decrease in BP induced by endotoxin and prolong the survival time.These results indicated that HDL has therapeutic and protective effect on rat with endotoxemia.Inhibition of TNF release might be one of mechanisms.