Lipids in association with serum magnesium in diabetes mellitus patients

Background. The aim of the study was to investigate if and how, in diabetes mellitus (DM) patients, serum Magnesium (Mg) concentration influences serum lipids. A cross-sectional study was conducted on diabetic mellitus (DM) patients with various kidney functions, not yet on dialysis. Material and methods. Serum lipoprotein (a), glycosylated haemoglobin (HbA1c), serum magnesium (Mg), serum creatinine (creat) and serum lipids, consisting of triglycerides (Tg), cholesterol (Chol) and high density lipoprotein (HDL) were measured. Results. Study patients included 122 patients (82 F, 40 M). The mean patient's age was 63 (± 10) years. The mean length of time they were diabetic was 7.4 (± 5.8) years (median: 6 years). The mean serum Mg was 2 (± 0.4) mg/dl (median: 1.99 mg/dl). The mean creatinine clearance was 64 (± 24) cc/min (median: 64 cc/min). In this study significant inverse correlations of serum Mg with serum cholesterol and LDL, and also non significant correlations of serum Mg with serum Lp (a), HDL, Tg and with serum HbA1c were seen. Moreover, a significant inverse correlation of serum Mg with the patients' ages and a significant positive correlation of serum Mg with serum creatinine were also seen. Conclusions. It seems that in diabetic patients, kidney function is a key role in the regulation of serum Lp(a) levels instead of other factors like serum Mg level. Our findings further support the importance of Mg supplementation in diabetes mellitus patients. In our study no significant correlation between serum Mg with serum HDL and Tg were found, which needs further investigation.Background. The aim of the study was to investigate if and how, in diabetes mellitus (DM) patients, serum Magnesium (Mg) concentration influences serum lipids. A cross-sectional study was conducted on diabetic mellitus (DM) patients with various kidney functions, not yet on dialysis. Material and methods. Serum lipoprotein (a), glycosylated haemoglobin (HbA1c), serum magnesium (Mg), serum creatinine (creat) and serum lipids, consisting of triglycerides (Tg), cholesterol (Chol) and high density lipoprotein (HDL) were measured. Results. Study patients included 122 patients (82 F, 40 M). The mean patient's age was 63 (± 10) years. The mean length of time they were diabetic was 7.4 (± 5.8) years (median: 6 years). The mean serum Mg was 2 (± 0.4) mg/dl (median: 1.99 mg/dl). The mean creatinine clearance was 64 (± 24) cc/min (median: 64 cc/min). In this study significant inverse correlations of serum Mg with serum cholesterol and LDL, and also non significant correlations of serum Mg with serum Lp (a), HDL, Tg and with serum HbA1c were seen. Moreover, a significant inverse correlation of serum Mg with the patients' ages and a significant positive correlation of serum Mg with serum creatinine were also seen. Conclusions. It seems that in diabetic patients, kidney function is a key role in the regulation of serum Lp(a) levels instead of other factors like serum Mg level. Our findings further support the importance of Mg supplementation in diabetes mellitus patients. In our study no significant correlation between serum Mg with serum HDL and Tg were found, which needs further investigation

Adiponectin and chronic kidney disease; a review on recent findings.

Adiponectin is a multifunctional cytokine that has a role in regulating inflammation. In patients without chronic renal failure (CRF) and type 2 diabetics, decreased adiponectin levels are associated with insulin resistance. Lower serum plasma adiponectin values are link to larger tumor size and metastasis in clear-cell carcinoma of the kidney too. However, in patients with established chronic kidney disease (CKD), adiponectin levels are elevated and positively predict progression of disease. In addition, increased levels of serum adiponectin of hemodialysis patients were associated with decrease in bone mineral density in hemodialysis patients. Thus, depending on type of renal failure should be adjusted the adiponectin levels in patients. In CKD patients without diabetic, decreasing adiponectin levels by ARB drugs may be appropriate for inhibition of disease progression

Association of serum vitamin D level with age in individuals with normal renal function.

There is no sufficient data on the relation between vitamin D status and age in subjects with normal renal function. The aim of this study was to investigate the association of serum 25-hydroxy vitamin D (25[OH]D) concentrations with age of Iranian healthy individuals. The data were collected from 259 ambulant healthy medical staffs who had the inclusion criteria of the study. Fasting 25-hydroxy vitamin D level was measured. Vitamin D deficiency was defined as having a 25(OH)D concentration <25 nmol/L. The average of persons ages were 20-65 years with mean age of 34±9 years, and about 57.5% of the participants were female. The mean±SD vitamin D level of the subjects was 29±16 nmol/L (median=26 nmol/L). Also 48% of the individuals had vitamin D deficiency. In this study, there was no association between vitamin D level and gender of the participants. A significant positive correlation of age with vitamin D level was found (r =0.002). It seems that for evaluation of 25-OH-vit D status, age should be noticed

Catastrophic antiphospholipid syndrome presented with sudden renal failure and history of long-lasting psychosis and hypertension in a 42 years old women

Implication for health policy/practice/research/medical education: The catastrophic variant of the antiphospholipid syndrome (CASP) is defined as a potential life-threatening variant of antiphospholipid syndrome (APS), which is characterized by multiple small-vessel thrombosis that can lead to organ failure especially renal deterioration. This vaso-occlusive nephropathy mainly affects arterioles, interlobular arteries and glomerular tufts. However, interstitial area and tubules maybe subsequently involved. © 2013, Society of Diabetic Nephropathy Prevention. All rights reserved

Silymarin and diabetic nephropathy.

Nephropathy is one of the most important complications of diabetes mellitus and drug induced toxicity. Nephrotoxicity is mostly related to oxidative stress and nowadays much attention has been made towards the possible kidney protective properties of medicinal plants. Studies revealed, silymarin is useful for diabetic nephropathy. The combination of metformin, silymarin and renin-angiotensin system inhibitors or angiotensin receptor blockers may have additive kidney protective property to prevent or slowing the progression of diabetic nephropathy

Serum anti-hepatitis B surface antigen in hemodialysis patients.

To evaluate the immune response to hepatitis B vaccination in stable hemodialysis (HD) patients, a retro-prospective investigation was conducted on 68 HD patients. Participants were vaccinated against hepatitis B virus with an intramuscular hepatitis B vaccination schedule, 40 micrograms at 0, 1, and 6 months. The serum antibody level against hepatitis B surface antigen (HBs) in HD patients was 35±55. In this study, no significant differences of Anti-HBs antibody between diabetic and non-diabetics or male and female subjects were observed. There were not any significant correlation between antibody against HBs-Ag and serum albumin. There was not significant correlation between anti-HBs antibody and age, proportion of HD, duration of HD or dialysis efficacy. In this study, there was not significant correlation between serum antibody level against hepatitis B surface antigen and some demographic indices of HD patients, however, these findings need to re-test in other centers with more participants

Platelet counts and mean platelet volume in association with serum magnesium in maintenance hemodialysis patients.

INTRODUCTION Platelet dysfunction is responsible for increased bleeding tendency of chronic renal failure patients. Magnesium (Mg) retention can occur in patients on maintenance hemodialysis. OBJECTIVES Studies concerning the impact of magnesium disturbances on platelet counts and mean volume in hemodialysis are quiet scarce. PATIENTS AND METHODS A total of 36 (f= 15, m= 21), HD patients were included. The mean patients' age was 46 (±16) years. The mean length of time patients had received hemodialysis was 32 (±36) (median: 19) months. RESULTS The mean platelet count was 165 (±70) (median: 163) [x10(3)μ/L]. The mean platelet volume was 9 (±1) (median: 9.2) fl. The mean Mg was 9.2 ±1.4 (median: 2.4) mg/dl. In this study a significant inverse correlation of platelet count with mean platelet volume (r= -0.39, p= 0.017) was seen. A significant inverse correlation of serum Magnesium with mean platelet volume (r= -0.37, p= 0.025) was seen. There was not significant association of serum Mg and PLT count was found too (p> 0.05). CONCLUSION A significant inverse correlation of serum Magnesium with mean platelet volume needs further investigations to clarify the clinical significance of this finding

CLOSE RELATIONSHIP OF CAROTID INTIMA-MEDIA THICKNESS WITH LEFT VENTRICULAR HYPERTROPHY AND EJECTION FRACTION IN END-STAGE RENAL DISEASE PATIENTS UNDERGOING HEMODIALYSIS TREATMENT

Background- Two principal findings of cardiovascular disease in end-stage renal disease patients undergoing regular hemodialysis are left ventricular hypertrophy (LVH) and arterial disease due to rapidly progressive atherosclerotic vascular disease that can be characterized by an enlargement and hypertrophy of arteries (intima-media complex thickening, IMT). In this study, we sought to study the relationship between left ventricular hypertrophy with intima-media complex thickening in end-stage renal disease patients undergoing regular hemodialysis. Methods- Sixty-one unselected patients with end-stage renal disease (ESRD) who were undergoing regular and maintenance hemodialysis treatment (F=23, M=38) were studied. The subjects consisted of 50 non-diabetic hemodialysis patients (F=20, M=30) and 11 diabetic hemodialysis patients (F=3, M=8). For all the subjects, echocardiography and carotid intima-media thickness measuring by B-mode ultrasonography were performed. Results- In this study, there was a positive correlation between stages of LVH with duration of hemodialysis treatment, stages of hypertension (HTN), and with carotid-IMT. A positive correlation was also seen between stages of LVH and presence of chest pain, and more thickening of the intima-media complex was seen in the diabetic group. Diabetes mellitus was associated with the presence of chest pain, as was positive correlation between stages of HTN with IMT, and a reverse correlation was observed between IMT with the percent of cardiac ejection fraction. Conclusion- Prevalence of thickening in intima-media complex is more evident in hemodialysis subjects with LVH. When there is LVH, IMT is similar in severity to the LVH (Iranian Heart Journal 2006; 7 (1): 40-46)