Association of clinical characteristics, antidiabetic and cardiovascular agents with diabetes mellitus and COVID-19: a 7-month follow-up cohort study.

BACKGROUND: The prognostic factors of long-term outcomes in hospitalized patients with diabetes mellitus and COVID-19 are lacking. METHODS: In this retrospective cohort study, we evaluated patients aged ≥ 18-years-old with the COVID-19 diagnosis who were hospitalized between Feb 20 and Oct 29, 2020, in the Sina Hospital, Tehran, Iran. 1323 patients with COVID-19 entered in the final analysis, of whom 393 (29.7%) patients had diabetes. We followed up patients for incurring in-hospital death, severe COVID-19, in-hospital complications, and 7-month all-cause mortality. By doing univariate analysis, variables with unadjusted P-value < 0.1 in univariate analyses were regarded as the confounders to include in the logistic regression models. We made adjustments for possible clinical (model 1) and both clinical and laboratory (model 2) confounders. RESULTS: After multivariable regression, it was revealed that preadmission use of sulfonylureas was associated with a borderline increased risk of severity in both models [model 1, OR (95% CI):1.83 (0.91-3.71), P-value: 0.092; model 2, 2.05 (0.87-4.79), P-value: 0.099] and major adverse events (MAE: each of the severe COVID-19, multi-organ damage, or in-hospital mortality) in model 1 [OR (95% CI): 1.86 (0.90-3.87), P-value: 0.094]. Preadmission use of ACEIs/ARBs was associated with borderline increased risk of MAE in the only model 1 [OR (95% CI):1.83 (0.96-3.48), P-value: 0.066]. CONCLUSIONS: Preadmission use of sulfonylureas and ACEIs/ARBs were associated with borderline increased risk of in-hospital adverse outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00901-4.

Association of inflammatory biomarkers with metabolic syndrome in hemodialysis patients.

The relative importance of inflammatory markers in relation with metabolic syndrome (MeS) in hemodialysis (HD) patients is uncertain. This study investigated the association between MeS and high-sensitive C-reactive protein (hsCRP), hallmark of inflammation, and other inflammatory-related biomarkers. The study included 153 patients who were dialyzed at least for the last 3 months. The serum level of hsCRP was assessed by high-sensitive Enzyme-linked immunosorbent assay (ELISA). MeS was defined using the modified National Cholesterol Education Program Adult Treatment Panel III (ATP-III). Ninety-one HD patients (59.5%) were diagnosed as having MeS. Lower level of high-density lipoprotein-cholesterol (HDL-C) was the most prevalent MeS component (85.6%). The serum level of hsCRP in these patients was significantly higher than that in HD patients without MeS (2.3 ± 1.7 vs. 1.7 ± 1.6 mg/dL, p = 0.03). A significant linear increase in the hsCRP levels was found according to the number of MeS components (ß = 0.09, p = 0.022). The study concluded that increasing inflammatory biomarkers, especially hsCRP, is associated with MeS in HD patients.

The frequency of prediabetes and contributing factors in patients with chronic kidney disease.

AIMS: Uremia is a prediabetic state, but abnormal glucose metabolism and relative risk factors in non-diabetic chronic kidney disease (CKD) patients are not studied extensively. This study aimed to evaluate prediabetes and contributing factors in patients with CKD. METHODS: We studied the frequency of prediabetes (defined as fasting plasma glucose 100-125 mg/dl and 2-h plasma glucose 140-199 mg/dl) and contributing risk factors in 91 (34 women and 57 men) non-diabetic CKD (GFR < 60) patients who were referred to Sina Hospital between November 2010 and November 2011. Impaired fasting glucose and impaired glucose tolerance were regarded as prediabetic state. RESULTS: Thirty-eight patients (41.8%), 28 male and 10 female, with mean age of 57.4 ± 17.1 yr, had prediabetes. Among these, 18.7% had impaired fasting glucose, 7.7% impaired glucose tolerance, and 15.4% combined impaired fasting glucose and impaired glucose tolerance. CKD patients with impaired glucose tolerance had more frequently hypertriglyceridemia (85.7% vs. 42.0%, p = 0.001), hypertension (66.6% vs. 31.4%, p = 0.004), and metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel III (52.3% vs. 25.7%, p = 0.02). Also, mean systolic blood pressure (134.2 ± 13.9 vs. 124.5 ± 20.0, p = 0.004) was higher in CKD patients with impaired glucose tolerance compared to CKD patients with normal glucose. CONCLUSIONS: Prediabetes is a frequent condition in CKD patients. Also, hypertriglyceridemia and hypertension are more prevalent in prediabetic CKD patients than in non-diabetic CKD patients.

The risk factors for diabetes mellitus after kidney transplantation.

Post-transplant diabetes mellitus (PTDM) is an adverse complication of kidney transplantation, associated with decreased graft and patient survival. We investigated the risk factors for PTDM and their relation to graft rejection in our kidney transplant recipients. We prospectively included 109 consecutive first kidney transplant recipients transplanted at the Sina Hospital in Tehran from June 2003 to May 2004. Patients were excluded if they had diabetes at the time of transplantation either as the cause of kidney failure or as a comorbidity. PTDM was defined by fasting blood sugar ≥126 mg/dL or random blood sugar ≥200 mg/dL on two occasions and the need for insulin therapy and/or oral hypoglycemic drugs for at least two weeks. Thirty non-diabetic transplant recipients were diagnosed as having PTDM during the six month follow-up period after transplantation. Sixty non-PTDM controls, matched for age, sex and immuno-suppressive regimen, and transplanted as closely as possible to the PTDM cases, were randomly selected. The risk factors for PTDM were investigated in these 90 transplant recipients. Age older than 50 years (P = 0.04), history of hypertension (P = 0.02), polycystic kidney disease (P = 0.015), duration on dialysis more than one year (P < 0.0001), family history of diabetes mellitus (P < 0.0001), mean daily dose of prednisolone ≥15 mg/day (P < 0.0001) and cyclosporine ≥240 mg/day (P < 0.0001) were all more in the PTDM group. Also, the mean serum triglycerides was higher (P = 0.019) and there was an increased risk of graft rejection (P < 0.0001) in the PTDM group.

Intrafamilial associations of lipid profiles and the role of nutrition: the Tehran lipid and glucose study.

BACKGROUND: The role of gene and environment in the genesis of abnormal lipid profile is still a controversial issue. OBJECTIVE: To clarify the importance of certain parental risk factors associated with lipid profiles of children and adolescents. METHODS: We conducted this cross-sectional population-based study in district 13 in the east of metropolitan Tehran. One hundred and thirteen eligible families comprising 455 subjects (including 229 offspring, aged 5-25 years) were enrolled into the study. Anthropometric data were measured using a standard protocol. To measure lipid profiles, venous blood was obtained in the morning after the subjects had fasted for 12-14 h overnight. Dietary intakes were assessed by means of a 2-day dietary recall questionnaire. RESULTS: The chances of having elevated serum total cholesterol were higher in sons of fathers with high cholesterol intake (OR = 3.1; CI = 1.1-9.2) and mothers with high saturated fatty acid (SFA) intake (3.4; 1.1-10.8). Positive correlations were seen between the energy intake of fathers and serum total cholesterol of their daughters (r = 0.34, p < 0.01); between the SFA intake of fathers and serum triglycerides (TGs) of their sons (0.29, p < 0.01) and between mothers' body mass index and daughters' serum TGs (0.23, p < 0.03). The chances of having low serum high-density lipoprotein cholesterol were lower in sons of mothers with high carbohydrate intake (11.0; 2.8-42.8) and mothers with high serum high-density lipoprotein cholesterol (6.8; 1.7-27.0). There were higher chances of having elevated serum low-density lipoprotein cholesterol in sons with fathers having high SFA intake (4.5; 1.4-14.3), with mothers having high serum TGs (6.1; 1.3-29.0) and with mothers having high cholesterol intake (4.3; 1.2-15.2). CONCLUSION: The results indicate independent associations between diet contents and the lipid profiles of parents and their offspring as well as between lipid profiles and diet contents among spouses.