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Objective To investigate the correlation between homocysteine(Hcy) and atheroscIerosis (AS) in type 2 diabetic patients.Methods A total of 98 type 2 diabetic patients in Donghua Hospital Affiliated to Sun Yet-Sen University were enrolled in this study and served as diabetic group.Meanwhile diabetic patients were divided into aged group(aged ＞65 years old) and young and middle aged group(＜65 years old).Fortynine healthy volunteers were used as control group.Intima-media thickness(IMT) and atherosclerotic plaqlles of the extracranial common carotid artery were detected by high-resolution B-mode ultrasoograph.Fasting plasma glucose (FPG),postprandial 2 h glucose (2 hPG),glycosylated hemoglobin (HbA1 c),total cholesterol (TC),total triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),creactive protein(CRP) and Hcy were measured.Correlation analysis of Hcy and IMT with other parameters was performed.Results Hcy level in patients with type 2 diabetes were (34.15 ± 10.25) μmol/L,significantly higher than those in healthy control group((8.46 ± 3.62) μmol/L,P =0.014).Hcy level in age group((40.63 ± 11.78) μmol/L) was significantly higher than that of young and middle aged group((26.54 ±9.38) μmol/L,P =0.028).IMT value and plaque detection rate in elderly patients were (1.28 ±0.26) mm and 66.1％ (20/41),significantly higher than that in the young and middle aged group((1.02 ±0.20) mm and 38.9％,P =0.041,0.027).Multiple stepwise regression analysis showed that age (OR =1.46,95％ CI:1.18-6.36,P =0.029),duration of diabetes (OR =2.62,95％ CI:1.78-7.43,P ＜ 0.001),LDL-C (OR =1.54,95％CI 1.19-6.27,P =0.028),CRP(OR =1.38,95％ CI 1.11-4.84,P =0.032),Hcy(OR =2.45,95％ CI 1.34-6.61,P =0.018)) were independent risk factors for carotid AS.Conclusion The Hcy level significantly increase in type 2 diabetic patients.Hcy,age,duration of diabetes,LDL-C,CRP are independently risk factors of neck AS.
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Objective To study the relationship between cardiovascular diseases (CVD) and ischemia modified albumin (IMA) in patients with type 2 diabetes mellitus (T2DM).Methods Ninety-six patients with T2DM were selected as T2DM group retrospectively,and 60 cases of healthy physical examination were selected as control group,the patient' s medical history data were collected,the IMA was detected and Doppler ultrasound examination was performed.The relationship between serum IMA level and some laboratory parameters were analyzed.Results Twenty-eight cases (29.2％,28/96) occurred CVD among 96 cases of T2DM patients.The level of IMA in T2DM group was higher than that in control group [(58.25 ± 11.84) kU/L vs.(23.38 ± 6.41) kU/L],there was significant difference (P ＜ 0.05).The levels of IMA in T2DM combined with CVD group (28 cases) and T2DM not combined with CVD group (68 cases) were(91.46 ± 13.63),(47.91 ± 9.38) kU/L; the level of IMA in T2DM combined with CVD group was higher than that in T2DM not combined with CVD group and control group,there was significant difference (P ＜ 0.05).All patients completed echocardiography,Spearman correlation analysis between IMA and echocardiography indicators showed that the level of IMA was positively correlated with left ventricular end-diastolic diameter (r =0.546,P =0.031),interventricular septal thickness (r =0.427,P =0.039),posterior wall diameter of left ventricle at end-diastolic (r =0.582,P =0.026) and left venifieular mass index (r =0.339,P =0.042),and IMA was negatively correlated with ejection fraction of left ventricle (r =-0.561,P =0.024).Multivariable Logistic regression analysis showed that IMA,high-sensitivity C reactive protein,diabetes duration,fasting blood glucose levels were independent risk factors for CVD.Conclusions Serum IMA level is significantly higher in T2DM patients.IMA level is a related risk factor for CVD.
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Objective To explore the risk factors of Pseudomonas aeruginosa infection in diabetic foot .Methods 136 patients with diabetic foot were divided into infection group (n=12) and control group(n=124) according to whether Pseudomonas aerugi-nosa infection existed .Their age ,gender ,body mass index (BMI) and complications were recorded ,and their hemoglobin ,fasting plasma glucose (FPG ) ,two hours postprandial blood glucose (2hPBG ) ,glycosylated hemoglobin A1c (GHbA1c) ,cholesterol , triglycerides ,low density lipid(LDL) ,high density lipid(HDL) ,serum albumin(SALB) were detected .Logistic regression analysis was employed to analyze the risk factors of Pseudomonas aeruginosa infection .Results Incidence of Pseudomonas aeruginosa infec-tion in diabetic foot was 8 .8% .Among them ,the infection incidences of elderly patients and patients with diabetic nephropathy were 11 .6% and 12 .7% ,respectively .Univariate analysis showed that male ,advanced age ,BMI ,duration of diabetes ,history of heart disease ,diabetic nephropathy ,FPG ,2hPBG ,GHbA1c ,low hemoglobin and low SALB were associated risk factors of Pseudomonas aeruginosa infection(P<0 .05) .After correction of confounding factors such as male ,BMI ,history of heart disease ,2hPBG and low hemoglobin ,advanced age ,duration of diabetes ,diabetic nephropathy ,GHbA1c and low SALB were independent risk factors for Pseudomonas aeruginosa infection(P<0 .05) .Conclusion Advanced age ,duration of diabetes ,diabetic nephropathy ,GHbA1c and low SALB are independent risk factors for Pseudomonas aeruginosa infection .
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Objective To determine the levels of vitamin D in the peripheral blood of patients with systemic lupus erythematosus(SLE).Methods Seventy-eight cases of SLE were selected as SLE group,42 cases of chronic nephritis (CN) were as CN group,and 40 cases of healthy persons were as control group.Vitamin D levels were detected by enzyme-linked immunosorbant assay.The correlation of vitamin D levels in patients with SLE and 24 h urinary protein excretion,SLE disease activity (SLEDAI) score,anti-ds-DNA antibodies,complement C3 were analyzed,and the relationships between vitamin D levels and kidney damage were estimated.Results The vitamin D levels in SLE group were (13.3 ± 6.2) μ g/L,significantly lower than those in CN group [(21.4 ± 9.7) μ g/L] and control group [(20.8 ± 9.5) μ g/L] (P ＜ 0.05),and the difference was not statistically significant between CN group and control group (P ＞ 0.05).The vitamin D levels in SLE and lupus nephritis (LN) patients were significantly lower than those in SLE and non-LN patients [(9.8 ±6.1) μg/L vs.(15.9 ±7.8) μg/L,P ＜0.05].Vitamin D levels in SLE patients were negatively correlated with SLEDAI score,anti-ds-DNA antibodies and 24 h urinary protein excretion (r =-0.712,-0.682,-0.769,P ＜ 0.05),and were positively correlated with complement C3(r =0.608,P ＜ 0.05).Conclusions The vitamin D levels in SLE patients decrease significantly and have close relationship with disease activity.It can not only reflect disease activity,but also act as a useful marker to predict visceral involvement.
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Objective To study prevalence and risk factors of anemia in adult patients with antineutrophil cytoplasmic antibody (ANCA) associated vasculitis.Methods The clinical data of 72 adult patients with ANCA associated vasculitis were studied retrospectively.According the age,the patients were divided into youth group (age ＜ 65 years,43 cases) and old group (age ≥ 65 years,29 cases).Baseline characteristics and lab measurements were recorded and analyzed.Risk factors of anemia were evaluated using Logistic analysis.Results In 72 adult patients with ANCA associated vasculitis,47 cases (65.3％)developed anemia.The prevalence of anemia in the youth group was 55.8％ (24/43),and that in the old group was 79.3％ (23/29).The prevalence of anemia in the old group was significantly higher than that in the youth group (P ＜ 0.01).When adjusted for confounders,age (increased 10 age,OR =1.23,95％ CI 1.12-1.95,P=0.001),diabetes (OR =1.34,95％ CI 1.14-1.89,P=0.013) and massive proteinuria (OR =1.11,95％ CI 1.05-1.76,P =0.011) were independently associated with increased risk of anemia in all patients.Conclusions The prevalence of anemia in the older patients is higher than that in the younger patients with ANCA associated vasculitis.Age(increased 10 age),diabetes and massive proteinuria are independently risk factor of anemia in adult patients with ANCA associated vasculitis.
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Objective To analyze the correlation between serum antinucleosome antibody (AnuA) and renal pathological characteristic,disease activity as well as some laboratory tests in patients with lupus nephritis (LN).Methods Serum AnuA levels were detected by enzyme-linked immunosorbant assay in 40 patients with LN (observation group) and 40 healthy people (control group).Renal biopsy was examined in all LN patients.The relationships between serum AnuA level and systemic lupus erythematosus disease activity index (SLEDAI),renal pathohistology,laboratory parameters were analyzed.Results The serum AnuA level in observation group before treatment was significantly higher than that in control group [ ( 110.23 ± 80.48) kU/L vs. ( 10.45 ± 8.20) kU/L,P ＜ 0.05 ].Four cases of renal biopsies were class Ⅱ,8 cases were class m,23 cases were class Ⅳ,and 5 cases were class V.Serum AnuA level had significant difference between each class by Kruskal-Wallis rank sum test (P ＜ 0.05),and serum AnuA level of class Ⅳ was the highest (P ＜ 0.05).Serum AnuA level had positive correlation with SLEDAI,urine protein quantitation and anti-double strands DNA antibody (r =0.462,0.521,0.394,P ＜0.05),negative correlation with complement C3 and C4 levels (r =-0.403,-0.489,P ＜ 0.05 ).Serum AnuA level after treatment [ (32.45 ± 18.31) kU/L] was significantly decreased than that before treatment [(110.23 ± 80.48) kU/L](P＜0.05).Conclusions Serum AnuA level is not only a good index of LN activity,but also reflect renal involvement.That serial measurement of serum AnuA level may provide better clinical strategies for the therapy.