coronary heart disease is the Framinghamriskscore (FRS). According to the National Institutes of Health, the patients having chronic kidney disease are considered as having a coronary heart disease risk equivalent, meaning that they are primarily patients with a 10-year risk for myocardial infarction or coronary death >20%, despite without known coronary heart disease. [ 8 ]
Metabolic acidosis, a common condition and an important manifestation of the late stage of chronic kidney disease, leads to clinically significant consequences, including bone disease disorders
Alin Albai, Mirela Frandeș, Ramona Luminița Sandu, Gabriel Spoială, Flavia Hristodorescu, Bogdan Timar and Romulus Timar
Background and aims: Diabetes mellitus is the disease-challenge of our century, characterized by an increase in serum glycemia, which may lead to the occurrence of micro- and macro-vascular complications with serious consequences on both patient and public health. The Framingham risk score was obtained from a complex study and it estimates the individual risk of each patient to develop a cardiovascular event over the next 10 years depending on certain parameters (age, smoking, total cholesterol, HDL-cholesterol, systolic blood pressure). Our study main aim was to evaluate the cross-associations between the components of the metabolic syndrome, cardiovascular risk, diabetes-related biological parameters and chronic kidney disease in patients hospitalized due to poor metabolic control.
Material and methods: In this cross-sectional study, we enrolled 218 patients with type 2 diabetes, admitted in the Diabetes Clinic of the “Pius Brinzeu” Emergency Hospital Timisoara according to a consecutive-case population-based principle.
Results: We observed that the quality of the glycemic control is impaired in patients with higher age; the body mass index was positively correlated with HbA1c and hypertension accompanies diabetes in more than half of the cases. Moreover, we observed that high levels of LDL cholesterol are significantly correlated with high levels of HbA1c.
Conclusions: There was poor metabolic control in patients with associated complications such as hyperlipidemia, cardiovascular disease or chronic kidney diseases. Also, in most of the cases hypertension was associated with type 2 diabetes mellitus.
Matjaz Vrtovec, Ajda Anzic, Irena Preloznik Zupan, Katja Zaletel and Ales Blinc
Patients with myeloproliferative neoplasms (MPNs) are at increased risk for atherothrombotic events. Our aim was to determine if patients with essential thrombocytosis (ET), a subtype of MPNs, free of symptomatic atherosclerosis, have greater carotid artery stiffness, worse endothelial function, greater coronary calcium and carotid plaque burden than control subjects.
Patients and methods
40 ET patients without overt vascular disease, and 42 apparently healthy, age and sex-matched control subjects with comparable classical risk factors for atherosclerosis and Framingham risk of coronary disease were enrolled. All subjects were examined by physical and laboratory testing, carotid echo-tracking ultrasound, digital EndoPat pletysmography and CT coronary calcium scoring.
No significant differences were found between ET patients and controls in carotid plaque score [1 (0-1.25) vs. 0 (0-2), p=0.30], β- index of carotid stiffness [7.75 (2.33) vs. 8.44 (2,81), p=0.23], pulse wave velocity [6,21 (1,00) vs. 6.45 (1.04) m/s; p=0.46], digital reactive hyperemia index [2.10 (0.57) vs. 2.35 (0.62), p=0.07], or augmentation index [19 (3-30) vs. 13 (5-22) %, p=0.38]. Overall coronary calcium burden did not differ between groups [Agatston score 0.1 (0-16.85) vs. 0 (0-8.55), p=0.26]. However, significantly more ET patients had an elevated coronary calcium score of >160 [6/40 vs. 0/42, p < 0.01].
No significant differences between groups were found in carotid artery morphology and function, digital endothelial function or overall coronary calcium score. Significantly more ET patients had an elevated coronary calcium score of >160, indicating high cardiovascular risk, not predicted by the Framingham equation.
The aim of this cross-sectional study was to see whether genetic polymorphisms of the enzymes CYP1A1, GSTM1, and GSTT1 are associated with higher risk of coronary artery disease (CAD) and whether they affect lipid profile in 252 subjects living near a natural gas plant, who are likely to be exposed to polycyclic aromatic hydrocarbons (PAHs). Fasting serum concentrations of biochemical parameters were determined with standard methods. Genetic polymorphisms of CYP 1A1 rs4646903, rs1048943, rs4986883, and rs1799814 were genotyped with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFPL), while GSTM1 and GSTT1 deletions were detected with multiplex PCR. Cardiovascular risk was assessed with Framingham risk score, and the subjects divided in two groups: >10% risk and ≤10% risk. The two groups did not differ in the genotype frequencies. MANCOVA analysis, which included lipid parameters, glucose, and BMI with sex, age, hypertension and smoking status as covariates, showed a significant difference between the GSTT1*0 and GSTT1*1 allele carriers (p=0.001). UNIANCOVA with same covariates showed that total cholesterol and triglyceride levels were significantly higher in GSTT1*1 allele carriers than in GSTT1*0 carriers (p<0.001 and p=0.006, respectively). Our findings suggest that CYP1A1, GSTM1, and GSTT1 polymorphisms are not associated with the higher risk of CAD, but that GSTT1 affects lipid profile.
Polona Selič, Zalika Klemenc-Ketiš, Erika Zelko, Andrej Kravos, Janez Rifel, Irena Makivić, Antonija Poplas Susič, Špela Tevžič, Metka Cerovič, Borut Peterlin and Nena Kopčavar Guček
alcohol, perception of stress, signs of depression, social health determinants, body mass index, blood pressure values, laboratory test values (blood sugar, lipidogram) and cardiovascular risk, based on Framinghamriskscores ( 24 ).
For assessing the HRQOL, we will use the EQ-5D scale. This consists of four parts ( 25 ). The first part is intended to familiarize the respondents with the descriptions of health states. Each health state has five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). In the first part of the
R. Gancheva, A. Kundurdjiev, T. Kundurdjiev and Zl. Kolarov
Aim: To study the differences in cardiovascular risk between type 2 diabetic and non-diabetic patients with asymptomatic hyperuricemia and gout using the Framingham Risk Score (FRS) and complex multimodal ultrasonography.
Patients and methods: A total of 201 patients participated, divided into two groups: 1/ patients with asymptomatic hyperuricemia (n = 52), and 2/ patients with gout (n = 149). FRS was determined as well as ultrasound parameters, independent predictors of cardiovascular risk: left atrial size (LA), intima-media thickness (IMT) and common carotid artery resistive index (CCARI).
Results: The patients in the two groups were age-matched and conventional cardiovascular risk factors were equally distributed. In the asymptomatic hyperuricemia group, 12 patients (23.1%) had diabetes. In this group, there was no difference in FRS between diabetic and non-diabetic individuals. However, diabetic patients had larger LA, thicker intima-media and higher CCARI. In the gout group 18 subjects (12%) had diabetes, but the FRS, LA, IMT and CCARI values were similar among diabetic and non-diabetic patients. Furthermore, when gout subjects were subdivided according to the presence of tophi, we found that the subgroup having gouty tophi and diabetes had larger LA (p = 0.014) compared to those with gouty tophi without diabetes.
Conclusion: In diabetic patients with asymptomatic hyperuricemia and gouty tophi, a more complex approach for estimation of cardiovascular risk is needed. Our work suggests that diabetes and tophi might potentiate their action on the cardiovascular system.
Davorina Petek, Marija Petek-Ster and Ksenija Tusek-Bunc
the Framinghamriskscore and patients were selected randomly from the register of high-risk patients for CVD, mandatorily kept by each practice. The patients with already established CVD and patients with diabetes mellitus type 2 were not eligible for participation. The patients were contacted by the practice nurse by phone, in person or in writing, and received the questionnaire after giving the informed consent for cooperation.
The data for this analysis were gathered by a questionnaire filled out by the
Manta Andrei, Maștaleru Alexandra, Oancea Andra, Anghel Razvan Constantin, Roca Mihai, Leon-Constantin Maria Magdalena and Mitu Florin
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6. Vanavanan S, Srisawasdi P, Rochanawutanon M, Kumproa N
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European Group for the Study of Insulin Resistance: Relationship between Insulin Sensitivity and Risk of Cardiovascular Disease): I. Methodology and objectives. Diabetologia 47: 566-570, 2004.
Wannamethee SG, Shaper AG, Lennon L, Morris RW. Metabolic syndrome vs FraminghamRiskScore for prediction of coronary heart disease, stroke, and type 2 diabetes mellitus. Arch Intern Med 165: 2644-2650, 2005.
DECODE Study Group, European Diabetes Epidemiology Group. Is the current definition for diabetes relevant to