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- Meziani, Sara, et al.
(författare)
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Mannose-binding lectin does not explain the dismal prognosis after an acute coronary event in dysglycaemic patients : A report from the GAMI cohort
- 2022
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Ingår i: Cardiovascular Diabetology. - : Springer Nature. - 1475-2840. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Mannose binding lectin (MBL) has been suggested to be associated with an impaired cardiovascular prognosis in dysglycaemic conditions, but results are still contrasting. Our aims are (i) to examine whether MBL levels differ between patients with an acute myocardial infarction (MI) and healthy controls and between subgroups with different glucose tolerance status, and (ii) to investigate the relation between MBL and future cardiovascular events. Methods MBL levels were assessed at discharge and after 3 months in 161 AMI patients without any previously known glucose perturbations and in 183 age- and gender-matched controls from the Glucose metabolism in patients with Acute Myocardial Infarction (GAMI) study. Participants were classified as having dysglycaemia, i.e. type 2 diabetes or impaired glucose tolerance, or not by an oral glucose tolerance test. The primary outcome was a composite of cardiovascular events comprising cardiovascular death, AMI, stroke or severe heart failure during 11 years of follow-up. Total and cardiovascular mortality served as secondary outcomes. Results At hospital discharge patients had higher MBL levels (median 1246 mu g/L) than three months later (median 575 mu g/L; p < 0.01), the latter did not significantly differ from those in the controls (801 mu g/L; p = 0.47). MBL levels were not affected by dysglycaemia either in patients or controls. Independent of glycaemic state, increasing MBL levels did not predict any of the studied outcomes in patients. In unadjusted analyses increasing MBL levels predicted cardiovascular events (hazard ratio HR: 1.67, 95% confidence interval CI 1.06-2.64) and total mortality (HR 1.53, 95% CI 1.12-2.10) in the control group. However, this did not remain in adjusted analyses. Conclusions Patients had higher MBL levels than controls during the hospital phase of AMI, supporting the assumption that elevated MBL reflects acute stress. MBL was not found to be independently associated with cardiovascular prognosis in patients with AMI regardless of glucose state.
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| 2. |
- Wang, Anne, et al.
(författare)
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Dynamics of testosterone levels in patients with newly detected glucose abnormalities and acute myocardial infarction
- 2018
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Ingår i: Diabetes & Vascular Disease Research. - : Sage Publications. - 1479-1641 .- 1752-8984. ; 15:6, s. 511-518
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Low testosterone has been associated with increased cardiovascular risk and glucose abnormalities. This study explored the prevalence of low testosterone, dynamics over time and prognostic implications in acute myocardial infarction patients with or without glucose abnormalities. Methods: Male acute myocardial infarction patients (n = 123) and healthy controls (n = 124) were categorised as having normal or abnormal glucose tolerance (impaired glucose tolerance or diabetes) by oral glucose tolerance testing. Testosterone was measured at hospital admission, discharge, 3 and 12 months thereafter in patients. Patients and controls were followed for 11 years for major cardiovascular events (cardiovascular death/acute myocardial infarction/stroke/severe heart failure). Results: At hospital admission, more patients had low testosterone (<= 300 ng/dl) and lower median levels than controls (64 vs 28%; p < 0.001 and 243 vs 380 ng/dl; p < 0.01). At the subsequent time points, testosterone had increased to 311, 345 and 357 ng/dl. Patients with abnormal glucose tolerance had the highest prevalence (75%) of low levels. In adjusted Cox regression models, neither total nor free testosterone predicted major cardiovascular events. Conclusion: Low testosterone levels were common in male acute myocardial infarction patients in the acute phase, especially in the presence of abnormal glucose tolerance, but increased over time indicating that testosterone measured in close proximity to acute myocardial infarction should be interpreted with caution.
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| 3. |
- Gyberg, Viveca, et al.
(författare)
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Measuring risk online-Feasibility of using FINDRISC in an online workplace survey
- 2012
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 6:2, s. 103-107
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: With the globally increasing prevalence of diabetes and the knowledge on how to prevent the disease there is a high demand for an effective way of identifying people at risk. The hypothesis behind this investigation was that incorporation of the FINnish Diabetes Risk SCore (FINDRISC) questionnaire in a regular workplace survey would be a feasible way to identify individuals and groups at risk for diabetes that could benefit from preventive interventions.METHOD: The eight FINDRISC questions were slightly modified and incorporated to Webb-QPS, an online work place survey, and distributed by e-mail to 5166 employees at Karolinska University Hospital (KUH).RESULTS: The total number of responders to Webb-QPS was 3581 (69%). Of those responding 3029 (84%) replied to the FINDRISC section which comprises 59% of the original population. A group of 1082 high risk individuals could be considered for intervention whereof 298 (9.8%) are expected to develop diabetes the upcoming 10 years if left without intervention.CONCLUSION: It is feasible to incorporate a diabetes risk score such as the FINDRISC in a workplace survey. A group that could be subject to preventive intervention programs was identified.
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| 4. |
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| 5. |
- Gyberg, Viveca
(författare)
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Prevention of cardiovascular disease and diabetes on a population level
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Cardiovascular disease and diabetes are responsible for just over half of the global mortality, and these diseases are expected to increase. The upsurge is due to increased longevity and a westernisation of the global lifestyle. Preventive efforts have proven effective and are believed to be the only way to curb the rapid increase of these diseases. Still the implementations of preventive measures are reported as underused. Aims: to study prevention by: 1. Investigating the perception of key policymakers on cardiovascular disease; 2. Examining if screening for diabetes online is feasible using FINDRISC; 3. Assessing management of patients with coronary artery disease and diabetes; andd 4. Determining the best screening test for dysglycaemia in patients with coronary artery disease. Policymakers’ perception of cardiovascular disease: Policymakers in Europe agreed that national patterns of cardiovascular disease and its prevention are far from satisfactory. A similar rating of the perceived proximity to a specific target in two countries did not necessarily reflect a similar national situation when compared to available statistics on the actual situation. Policymakers had diverging opinions on what actions to take and what obstacles to overcome to improve population health.Feasibility of using FINDRISC as an online questionnaire It was feasible to incorporate a diabetes risk score such as FINDRISC in an online survey. A reasonable response rate was achieved and a group that could benefit from preventive intervention programs was identified. Management of patients with coronary artery disease and diabetes: A large proportion of the patients are far from guideline recommended evidence based treatment targets for blood pressure, LDL-cholesterol and HbA1c. A potential reason is a consistent, relatively low combined use of four selected cardioprotective drug therapies and/or lack of dose titration. There was, however, some improvement over time. Screening for dysglycaemia in patients with coronary artery disease: Screening by means of an oral glucose tolerance test (OGTT) identified the largest number of patients with undetected diabetes. The overlap in case-detection between fasting plasma glucose (FPG), 2-hour plasma glucose (2hPG) and HbA1c was small. Screening with HbA1c alone would have left 83% of those with diabetes undetected. The total proportion of patients identified with diabetes and other forms of dysglycaemia varied from 90% using the American Diabetes Association’s criteria for FPG + HbA1c, which may be an overestimate, to 73% using WHO criteria for OGTT = FPG + 2hPG, which may be more realistic. Conclusion: Creating a coherent knowledge base and action agenda regarding prevention among key policy-makers should be given high priority in future population based prevention programmes. The online questionnaire FINDRISC is a feasible way to identify high-risk individuals as well as risk typing populations. Despite some improvement, patients with coronary artery disease and diabetes are not managed according to best available knowledge. Efforts to improve this are needed to improve their still dismal prognosis. An oral glucose tolerance test has the best capacity to screen-detect dysglycaemia in patients with coronary artery disease.
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| 7. |
- Segerhag, Ellen, et al.
(författare)
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Accuracy of a Simplified Glucose Measurement Device-The HemoCue Glucose 201RT.
- 2015
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Ingår i: Diabetes Technology & Therapeutics. - : Mary Ann Liebert Inc. - 1520-9156 .- 1557-8593. ; 17:10, s. 755-758
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Tidskriftsartikel (refereegranskat)abstract
- Easily available, accurate glucose recordings are important when screening for and managing people with diabetes. The photometric HemoCue(®) (Ängelholm, Sweden) Glucose 201+ system, which delivers lab-comparable glucose recordings, has the drawback that its microcuvettes must be delivered and stored at 4-8°C. A newly developed system, HemoCue Glucose 201RT, has microcuvettes that can be stored at room temperature.
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