ABSTRACT
INTRODUCTION: Diabetic retinopathy (DR) remains the leading cause of blindness and visual impairment in diabetic patients worldwide. Lipid indices (LI) such as atherogenic coefficient (AC), atherogenic index of plasma (AIP), non-high-density lipoprotein cholesterol (non-HDL-C), and Castelli risk index (CRI) I and II may be associated with bio-physiological changes of DR even when traditional lipids are within normal limit. Hence, the present study was undertaken to evaluate the LI and examine the LI predictive role in assessing the microvascular risk in diabetes patients with and without retinopathy. METHODOLOGY: This case-control study was conducted for six months at a tertiary care hospital and included 90 subjects divided into three groups. Group I had 30 age and sex-matched healthy controls; group II and group III had 30 type 2 diabetes mellitus (T2DM) cases without DR and with DR, respectively. Plasma glucose and lipid profiles including apolipoprotein A-I (Apo A-I) and apolipoprotein B (Apo B) were measured in all subjects. LI such as AIP, AC, CRI-I, CRI-II, and non-HDL-C were calculated from the lipid profile values. ANOVA test was used to compare the means of three groups. RESULTS: The mean age of the study participants was 51.44 ± 11.72, 53.95 ± 12.43, and 57.16 ± 7.96 years for groups I, II, and III, respectively. Triacylglycerol (TG) showed positive correlation with all LI, AIP (r = 0.768, p < 0.00001), AC (r = 0.363, p = 0.048), non-HDL-C (r = 0.372, p = 0.042), and CRI-I (r = 0.363, p = 0.048), except for CRI-II in group III. Low-density lipoprotein cholesterol (LDL-C) showed a statistically significant positive correlation with non-HDL-C and CRI-II in diabetic subjects with and without retinopathy. CONCLUSION: The study showed that LI were raised in diabetic patients with or without DR, suggesting the significant role of LI in assessing microvascular risk in T2DM, particularly when the lipid profile values seem to be normal or not disturbed markedly.
ABSTRACT
INTRODUCTION: The first cervical vertebra, also referred to as the atlas, forms a vital part of the craniovertebral junction (CVJ). The anatomy of the atlas is essential to understand the basis for CVJ anomalies and their surgical correction. The present study was undertaken to provide accurate morphometry and describe the morphological variations of the superior articular facet (SAF) of the atlas. Methods: In this observational, cross-sectional study, the length and width of the SAF of 150 atlas were measured using a digital caliper. The variations in the morphology of the SAF in the same bones were also recorded. Z-test was applied to find the statistically significant difference between the measurements of the SAF of the atlas on the right and left sides. p-value ≤ 0.05 was considered statistically significant. RESULTS: The width of the SAF of the atlas was found to be significantly (p < 0.001) greater on the left side (8.76 mm to 14.84 mm) compared to the right (7.67 mm to 14.83 mm). The mean length of the SAF was 21.1 mm and 21.9 mm on the left and right sides, respectively. Morphologically, four variations of superior articular facets were noted: oval, bilobed, kidney, and dumbbell shaped. The most common variation was an oval-shaped facet with a prevalence of 66.7% on the left side and 57.3% on the right. The least common variation was the bilobed facet, with a prevalence of 4% on the left side and 8.7% on the right. CONCLUSION: The width of the SAF of the atlas was statistically significant on the left side. Morphologically, four types of variations were observed in the shape of the SAF. Knowledge of the morphological and morphometric variations of the SAF can be of help during surgical approaches at the CVJ.
