The Cut-off Values of Triglycerides - Glucose Index for Metabolic Syndrome Associated with Type 2 Diabetes Mellitus

يؤدي حدوث متلازمة الأيض مع داء السكري من النوع 2 الى زيادة شدة المرض والوفيات المرتبطة بكل منهما. يوصى باستخدام مؤشر الجلوكوز الصائم للدهون الثلاثية (مؤشر TyG) كعلامة مفيدة للتنبؤ بمتلازمة التمثيل الغذائي. كان الهدف من هذه الدراسة هو تحديد القيم الحدية لنوع Triglyceride-Glucose لتشخيص متلازمة الأيض في داء السكري من النوع الثاني. تم جمع البيانات من مستشفيات بغداد في الفترة ما بين مايو وديسمبر 2019. وكان عدد المشاركين المؤهلين 424 حيث تم قياس الجلوكوز في الدم في وضع الصيام ، مستوى الدهون ، مستوى HbA1c. فضلا عن قياس ضغط الدم وتم حساب مؤشر Triglyceride-Glucose . تم الحصول على الموافقة الأخلاقية والموافقة المستنيرة .استخدم برنامج SPSS لمعالجة البيانات. أظهر مرضى السكري الذين يعانون من متلازمة الأيض زيادة مستوى مؤشر TyG. ازداد انتشار متلازمة الأيض مع زيادة مؤشر TyG. أظهر مؤشر TyG ارتباطًا كبيرًا مع جميع مكونات متلازمة الأيض. حيث ارتبط طرديا مع مستوى الكاوكوز في الدم ومحيط الخصر ,مستوى الدهون وضغط الدم الانبساطي بينما تناسب عكسيا مع مستوى الكولسترول النافع .مقدار قيمة القطع الأمثل للمؤشر كانت 9.14 ، 9.28 للذكور والإناث على التوالي.نستنج من الدراسة ان مؤشر TyG ملائم للكشف عن متلازمة الأيض في داء السكري من النوع الثاني       The co-occurrence of metabolic syndrome with type 2 diabetes mellitus (T2DM) will potentiate the morbidity and mortality that may be associated with each case. Fasting triglycerides-glucose index (TyG index) has been recommended as a useful marker to predict metabolic syndrome. Our study aimed to introduce gender-specific cut-off values of triglycerides- glucose index   for diagnosing metabolic syndrome associated with type 2 diabetes mellitus. The data were collected from Baghdad hospitals between May - December 2019. The number of eligible participants was 424. National cholesterol education program, Adult Treatment Panel III criteria were used to define metabolic syndrome. Measurement of fasting blood glucose, lipid profile, HbA1c level, blood pressure, and anthropometric were done and the triglyceride-glucose index was calculated. Ethical approval and informed consent were obtained .SPSS was used to analyze the data. Diabetic patients with metabolic syndrome showed an increased level of TyG Index. The prevalence of metabolic syndrome increased with increased TyG index quartiles. The TyG-Index showed significant correlations with all components of metabolic syndrome. The optimal cut-off value revealed 9.14, 9.28 for males and females respectively. In conclusion, TyG index is a good predictor of the presence of MetS in T2DM the TyG index, just measured in one laboratory test, is simple, informative and more suitable for the detection of metabolic syndrome in Iraqi type 2 diabetes mellitus

International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)

Background Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment. Methods and results Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines). Conclusions The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world