Differences In Glycosylated Hemoglobin To Conventional Cardiovascular Risk Factors In Obesity

Background: Glycosylated hemoglobin (HbA1c) has been used as an index for clinical diagnosis of diabetes which is closely related to the complications of cardiovascular. The purpose of the study was to assess the differences in HbA1c against conventional cardiovascular risk in obese patients. Method: This cross-sectional study was conducted on obese patients (BMI > 25). This study included 40 obese patients, whereas those with a history of CVD, thyroid disorders, or currently on lipid-lowering agents were excluded. HbA1c is divided over HbA1c < 5.6  and HbA1c > 5.6 (prediabetes), body mass index (BMI) were measured using standard methods. Laboratory assessment included venous blood samples in a fasted state for the determination of components of the lipid profile [total cholesterol (TC), HDL-C, and TG], HbA1c, homeostatic model assessment for insulin resistant (HOMA-IR) using the formula: insulin x fasting glucose / 405, C-reactive protein (CRP), and adiponectin. Result: 40 obese patients participated in the study with an age of 41.7±6.0 years and a BMI of 33.1±5.0 kg/m2, and a significant correlation between HbA1c and age and HOMA-IR. All cardiovascular risk factors tend to increase but increased significantly at age, and TG (p<0.5). Conclusion: In this study, the average HbA1c was significantly correlated with age and HOMA-IR, and all lipid parameters of HbA1c > 5.6 (prediabetes) tended to be higher than normal obesity

Predicting the Risk of Mortality for Patients Diabetic with Coronavirus Disease (COVID-19): A Retrospective study

Background. One of the biggest causes of mortality of patients diabetic with COVID-19 in the globe is diabetes mellitus. The study's goal was to examine the predicting the risk of mortality for patients diabetic with coronavirus disease (COVID-19). Methods. This is a retrospective study of patients diabetic with COVID-19 on 22 June 2020 to 21 July 2021 in H. Adam Malik Hospital Medan from 22 June 2020 to 21 July 2021. We collected all the data from electronic medical records on diabetics with SARS-CoV-2 infection, including demographic, clinical, laboratory, and radiological characteristics, treatments, complications, and clinical outcomes. All patients had throat swabs taken from their upper respiratory tracts to determine whether they had SARS-CoV-2 infection. Diagnosis of diabetes mellitus used ADA criteria. Results: There were 163 diabetic patients with COVID-19, consisting of mild (0%), moderate (39.8%), severe (44.2%), and critical (16.5%), and the most comorbid disease is hypertension. There was a significant age difference, length of stay, blood routine, and certain inflammatory markers between patients Diabetic with COVID-19 discharged from the hospital and died (all, p<0.05). The predicted death of patients diabetic with COVID-19 was D-dimer (OR: 4.069; p=0.008*;95% C.I: 1.43-11.55) and dexamethasone use (OR:4.769; p=0.007*; C.I: 1.54-14.71). Conclusion. The use of dexamethasone and the increase of D-dimer values increase mortality predictions in treating diabetic patients with COVID-19 in hospitals. To prevent these harms, the management of inpatients diabetic with COVID-19 must be with good glucose consideration and monitoring

Correlation between Neutrophil to Lymphocyte Ratio (NLR) and D-Dimer In Patients Covid-19 with Diabetes

Abstract: Background: The neutrophil to lymphocyte ratio (NLR) has been proposed as an infammatory biomarker. Tujuan penelitian adalah menilai hubungan antara NLR dan D-dimer pada pasien Covid-19 dengan diabetes. Method: This is a retrospective descriptive and analytical study carried out at NLR, blood rutin and D-dimer, FPG, and PPG levels of COVID-19 patients with comorbid in H. Adam Malik Medan, Indonesia, from May 19, 2020, to Juny 08, 2021. The data were collected by cheek list, using electronic medical records. The data included age, gender, medical history, comorbidity with diabetics, and ward and ICU admission. All these cases of COVID-19 have been confirmed in the laboratory by Real-Time Reverse Transcription Polymerase Chain Reaction (RTPCR). Results: There were 163 COVID-19 patients with diabetes consisting FPG 241.65±122.23 mg/dl, PPG 286.01±123.92 mg/dl, and HbA1c 9.49±2.41%. There is a significant correlation between NRL and hemoglobin, white blood cells, platelets, neutrophils, and D-dimers (all, p<0.001*). Conclusion: Diabetes is the commonest comorbidity in COVID-19 patients, and NLR and the others inflammatory assessment have reliable parameters for assessing and evaluating the prognosis of the COVID-19 patients as well as an accurate and practical coagulation parameter for predicting mortality. &nbsp

D-Dimer Levels of COVID-19 patients with Diabetes Mellitus: a Retrospective study

Background: Diabetes is the commonest comorbidity in Coronavirus disease 2019 (COVID-19) patients, and D-dimer level assessment has reliable parameters for assessing and evaluating the prognosis of COVID-19 patients with comorbid. This study aims to compare D-dimer,  FPG, and PPG levels between COVID-19 patients with comorbid. Method: We conducted a retrospective descriptive and analytical study carried out at D-dimer, FPG, and PPG levels of COVID-19 patients with comorbid in a tertiary Hospital in Medan, Indonesia, from April 04, 2020, to November 22, 2020. The data were collected by cheek list, using electronic medical records. The data included age, gender, medical history, comorbidity disease inward, and ICU admission. All these cases of COVID-19 have been confirmed in the laboratory by Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR). Result: From 323 COVID-19 patients with comorbidities, there are significant differences in D-dimer, FPG, and PPG levels between all groups of COVID-19 patients with the comorbid disease (p<0.05),  and there is a significant difference in D-dimer, FPG, and PPG level between severity of COVID-19 with comorbidities (p<0.005).     Conclusion: There is a significant difference between D-dimer, FPG, and PPG levels in COVID-19 patients with comorbidities in comorbid type and severity of COVID-19

Effect of Lifestyle Modification and Metformin on Fetuin-A and Transforming Growth Factor-ß (TGF- ß) in Metabolic Syndrome

Fetuin-A is a liver-synthesized protein that is secreted into serum. Transforming growth factor-β (TGF-β) is a polypeptide member of the TGF-β superfamily of cytokines. The purpose of this study is to evaluate the effects of lifestyle modification and metformin on fetuin-A and Transforming Growth Factor-ß (TGF- ß) in metabolic syndrome (MetS). Forty MetS subjects were randomly assigned to treatment with placebo (n=20) or metformin (n=20) in addition to lifestyle modification for 12 weeks. All 40 participants completed the study. After 12 weeks, both groups had significant reductions in weight, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) (all p<0.001). The placebo group also had significant improvement in fasting plasma glucose (FPG) and C-reactive protein (CRP) (p<0,001 ; p<0.05 respectively). Weight, BMI, WC, FPG, 2-hour postprandial glucose (2h-PPG), high density lipoprotein cholesterol (HDL-C), triglycerides (TG), fetuin-A and TGF- ß in the metformin group decreased significantly compared to the placebo group. Reduction of plasma fetuin-A was significantly associated with TG in the metformin group. Lifestyle modification and treatment with metformin for 12 weeks improved cardio-metabolic risk factors in MetS and reduced fetuin-A levels

The Relationship Between Adma and Anthropometric, Glucose, Lipid, and Inflammatory Parameters in Obese

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxideproduction and involved in various pathological processes, especially processes involvingcardiovascular risk. The purpose of this study was to analyze the correlation betweenADMA and anthropometric, glucose, lipid, and inflammatory parameters. The study wasanalyzed by a cross-sectional study of 45 obese subjects at H. Adam Malik Hospital. Bloodtests were carried out after 8-10 hours of fasting against cardiovascular risk: anthropometry(body weight, BMI, and WC), glucose (FPS, PPS, HbA1C, Fasting Insulin, and HOMA-IR), lipid (LDL-C, HDL-C, TG, and sd-LDL), and inflammation (ApoB and hs-CRP)parameters. The results showed of the 45 subjects, the average age was 41.69 ± 5.69 yearsold, and the average BMI was 33.09 ± 5.05 (Obesity I). ADMA was also found to becorrelated significantly with FPG, HBA1c, and TG parameters [r=-0.506, p=0.001; r=-0.334, p=0.013, dan r = -0.315. p=0.017, respectively]. In obesity, ADMA correlatedsignificantly with cardiovascular risk parameters: FPG, HbA1C, and TG

Effect of Lifestyle Modification with Metformin on Serum Chemerin Concentration of Metabolic Syndrome Subjects

Chemerin is adipokine that plays an important role in macrophage infiltration into adipose tissue and may contribute to inflammation development and insulin resistance. This study aimed to determine the effect of lifestyle modification with and without metformin on chemerin in metabolic syndrome. Forty-five metabolic syndrome subjects (IDF-2005) were randomly assigned to one of the two groups: placebo group (n=22) and metformin group (n=23). Both groups underwent a 12-week lifestyle modification (diet and moderate aerobic-exercise). Only 40 participants (placebo group n=20 and metformin group n=20) completed the survey whereas 5 participants dropped out of the study. After their lifestyle was modified, body weight, BMI, WC, and chemerin decreased significantly (p<0.001) in both groups. Moreover, there was a significant difference between both groups in body weight, BMI, and WC (p<0.05) but not for chemerin. Thus, lifestyle modification with metformin improved BW, BMI, WC on metabolic syndrome, and there was no decrease significantly of chemerin between placebo and metformin groups. Further investigations should be done to confirm the effect of lifestyle modification and metformin on chemerin after an extended follow-up period

The Correlation between Apolipoprotein B Level and Inflammatory Markers in Obese

Apolipoprotein B (ApoB) levels reflect the total number potentially atherogenic particles that can predict cardiovascular risk. The purpose of this study was to assess if the ApoB in obese subjects is associated with inflammatory markers. This cross-sectional study was conducted on 80 obese patients at H. Adam Malik Hospital, Medan, Indonesia. Results: Of the 80 patients studied, the average age was 38.95 + 8.13 years old. There was a strong positive correlation between ApoB and triglycerides (r=0.44, p<0.001), low-density lipoprotein cholesterol (r=0.74, p<0.001), and HOMA-IR (r=0.31, p=0.005), however not with the inflammatory markers; adiponectin (r=-0.23, p=0.41) and Chemerin (r=0.021, p=0.851). In obesity, ApoB significantly associated with lipid and insulin resistance, as a risk factor for cardiovascular disease

The Expression of Liver Metabolic Enzymes AMPKα1, AMPKα2, and PGC-1α due to Exercise in Type-2 Diabetes Mellitus Rat Model

BACKGROUND: AMP-activated protein kinase (AMPK) and PGC-1α were crucial metabolism enzymes not only in the skeletal muscles but also in the liver. Exercise can modify metabolic enzymes to improve insulin resistance. AIM: The aim of this study was to analyze the expression of mRNA liver metabolic enzymes gene, that is, AMPKα1, AMPKα2, and PGC-1α in different types and intensities of exercise. METHODS: Healthy male Wistar rats aged 8 weeks in 150–180 g body weight were given a combination of high fat diet for five weeks and low doses of streptozotocin (30 mg/kgbw and 45 mg/kgbw in 0.1 citrate buffer pH 4,5) to develop type 2 diabetes mellitus (T2DM) rat model. Animals then were divided into five groups: One group was sedentary, and four groups were forced to run on the treadmill 3 times/week, 30 min each season, for 8 weeks. mRNA gene expression of AMPKα1, AMPKα2, and PGC-1α was determined with real-time PCR. RESULTS: The results showed that expression of mRNA AMPKα1 in treatment groups was elevated than control and the much expression was showed in continuous types. The expression of mRNA AMPKα2 and PGC-1 α was declined in treatment group which little expression was showed in high intensity for AMPKα2 and moderate intensity for PGC-1 α. Base on type and exercise intensity, mRNA AMPKα1 gene expression much in moderate continuous, mRNA AMPKα2 gene expression higher in high intensity, both continuous and interval training, whereas mRNA PGC-1α gene expression higher in interval groups. CONCLUSION: Various types of aerobic exercises with moderate-vigorous intensities gave different impact to mRNA liver metabolic enzyme genes

The Effect of Bay Leaf Extract (Syzygium polyanthum) on Reducing Overexpression of Matrix Metalloproteinases-13 in Acute Coronary Syndrome

AIM: The objective of the study was to determine the inhibitory effect of bay leaf (Syzygium polyanthum) on matrix metalloproteinases (MMPs) (MMP-9 and MMP-13) inhibitory effect in surgery-induced acute coronary syndrome (ACS) rat model. METHODS: This study was experimental animal study. Thirty-two surgery-induced ACS Wistar rats (Rattus norvegicus) divided into 16 bay leaf extract (treatment) group and 16 control groups were sacrificed on days 1, 3, 7, and 14 after induction. Expressions of MMP-9 and MMP-13 were determined by immunohistochemistry and its scoring was assessed by two-blinded experienced pathologists. The immunohistochemical scoring of MMP-9 and MMP-13 between groups was analyzed using independent sample t-test and within groups by using one-way ANOVA test. RESULTS: The expression of MMP-13 in treatment group was decreased compared to control group on days 7 and 14 (p = 0.001 and p = 0.015, respectively). Compared to day 1, the reduction expression of MMP-13 was significant in both control group and treatment group (p = 0.009 and p = 0.003, respectively). There were no significant changes in expression of MMP-9 between groups, and within control group and treatment group. CONCLUSION: Bay leaf can reduce the overexpression of MMP-13 in surgery-induced ACS rat model. Bay leaf extract can be considered to be given as an adjuvant to prevent cardiovascular adverse event and adverse cardiac remodeling post-ACS