Type 2 diabetes mellitus first diagnosed before surgery affects the immediate prognosis for coronary artery bypass grafting

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” Purpose To study the preoperative status and assess the rate of in-hospital complications in patients with newly diagnosed type 2 diabetes mellitus (DM) undergoing coronary artery bypass grafting compared to patients with previously diagnosed DM and normoglycemia. Materials and Methods. 708 consecutive patients who underwent coronary artery bypass grafting (CABG) between 2011 to 2012 at the Research Institute for Complex Issues of Cardiovascular Diseases were included in the study. All patients without positive history of diabetes underwent an oral glucose tolerance test (ОGTT). The lab findings were interpreted in accordance with the recommended diagnostic criteria for diabetes and other glycemic disorders. Results. DM screening before coronary artery bypass grafting allowed to diagnose type 2 diabetes in 8.9% (n = 63) and prediabetes in 10.4% (n = 74) of the study population. The preoperative screening increased the number of patients with DM from 15.2% (n = 108) to 24.1% (n = 171), and with prediabetes from 3.0% (n = 21) to 13.4% (n = 95). The total number of patients with carbohydrate metabolism disorders increased from 18.2% (n = 129) to 37.5% (n = 266). The study groups did not differ in the rate of in-hospital complications due to a relatively low number of occurred events. However, a trend towards higher rate of in-hospital complications after CABG was defined among patients with newly diagnosed and previously diagnosed DM. The regression analysis demonstrated the presence of the relationships between the previously diagnosed DM2 and the total number of significant complications (odds ratio (OR) - 1.350, 95% confidence interval (CI): 1.057-1.723, p = 0.020) and prolonged in-hospital stay (OR 1.609, 95% CI: 1.202-2.1555, p = 0.001). The significance of the mentioned above relationships increased with the addition of newly diagnosed diabetes to the regression model as a probable predictor (for in-hospital complications: OR = 1.731, 95% CI: 1.131-2.626, p = 0.012; for prolonged in-hospital stay: OR 2.229, 95% CI: 1.412-3.519, p &amp;lt;0.001). Moreover, additional associations between DM and the risk of developing multiple organ dysfunction (OR 2.911, 95% CI 1.072-7.901, p = 0.039), urgent lower extremity surgery (OR 1.638, 95% CI 1.009-15.213, p = 0.020) and the need for extracorporeal correction of hemostasis (OR 3.472, 95% CI: 1.042-11.556, p = 0.044) have been defined. Importantly, the presence of these associations would not have been identified without including newly diagnosed DM in the regression model. Conclusion The newly diagnosed diabetes mellitus affects the prognosis of CABG as well as the previously diagnosed DM. The obtained results suggest the importance of active preoperative DM screening. </jats:sec

Assessment of the Chemical Composition of Respiratory and Dermal Protective Equipment Used by the Population during the COVID-19 Pandemic

Introduction: The use of personal protective equipment during the COVID-19 pandemic has affected the majority of the global population. The use of face masks has been proven to reduce the incidence of COVID-19 by 53 % and to be an effective means of prevention, both separately and in combination with other non-pharmaceutical measures. Wearing of face masks and gloves was mandated in different regions of the Russian Federation depending on the epidemiological situation, and it is still required in certain areas and workplaces at high risk of this severe infectious disease. Our literature review has shown that the prolonged mask and gloves use has adverse health effects including headaches, difficulty breathing, and various skin reactions. Objective: To analyze chemicals contained in commercially available face masks and protective gloves as one of the stages of hygienic assessment of personal protective equipment and to assess whether the established chemical composition can pose a risk of adverse health outcomes. Materials and methods: In 2021, four types of commercial face masks and protective gloves were analyzed in an accredited testing laboratory center to establish concentrations of chemicals after modeling their release into the aquatic and air environment. Results: We established that, in all types of masks, the levels of detected chemicals did not exceed their appropriate permissible values. Formaldehyde was found in cotton and latex coated cotton gloves in concentrations exceeding the permissible ones by 1.48 and 1.16 times, respectively. A 1.17-fold excess of the acceptable limit was also registered for zinc in latex coated cotton gloves. Conclusions: Increased levels of formaldehyde and zinc were found in cotton and latex coated cotton gloves. Formaldehyde can induce adverse skin reactions. Stricter control over production of respiratory and dermal protective equipment and a comprehensive hygienic assessment of PPE are required.</jats:p

Adiponectin and its receptors in patients with cardiovascular disease

Abstract Funding Acknowledgements Type of funding sources: None. Aim to determine the features of adiponectin expression, secretion of adiponectin and its receptors in local fat depots in CVD. Materials and methods The study included 90 patients with СAD (Group 1) and 60 patients with heart defects (Group 2). Adipocytes were isolated from samples of subcutaneous (SAT), epicardial (EAT) and perivascular (PVAT) adipose tissue obtained during CABG or heart valve replacement. The expression of adiponectin was determined by qPCR using TaqManTM Gene Expression Assays (Applied Biosystems, USA) in the ViiA 7 Real-Time PCR System (Applied Biosystems, USA), the levels of expression products was determined using enzyme immunoassay (Bender MedSystems GmbH, Vienna, Austria). The data were analyzed using the statistical software Statistica 9.0. Results EAT adipocytes were characterized by the lowest adiponectin expression relative to adipocytes of other localization both in Group 1 and Group 2. In patients Group 1 adiponectin expression in EAT was reduced relative in SAT and PVAT (by 1.2 and 1.5 times). In Group 2, the adiponectin mRNA in the EAT was lower than in the SAT and PVAT (1.4 and 1.5 times). The expression of adiponectin in EAT in Group 2 exceeded the same indicator in Group 1 by 1.2 times. The maximum expression of adiponectin was observed in the PVAT culture in patients of both groups. For Group 2, this indicator exceeded the values of Group 1 by 1.2 times. The content of adiponectin in the culture EAT was lower than in the SAT, both in Group 1 and Group 2 (by 1.3 and 1.13 times). The level of this indicator in Group 2 was 1.4 times higher than in Group 1. PVAT adipocytes of patients with CAD were characterized by the lowest level of adiponectin secretion in comparison with adipocytes of other localization. The adiponectin level in the PVAT of Group 2 exceeded that of fat stores of other localization and in Group 1 patients by 1.8 times. There were no statistically significant differences in the expression and concentration of adiponectin in the culture of adipocytes of the SAT between the groups of patients. In Group 1, the lowest level of AdipoR1 was found in the adipocyte culture of the PVAT. Noteworthy is the decrease in the level of AdipoR1 in Group 1 compared to the level of Group 2, observed in the SAT and PVAT: 1.3 and 1.5 times. There were no significant differences in the concentration of the AdipoR1 in the EAT, as well as AdipoR2 in all types of AT between the groups of patients. Conclusion: in CVD the EAT is characterized by minimal expression and secretion of adiponectin, regardless of nosology. In CAD despite the high level of expression of adiponectin, the adipocytes of the PVAT were found to have the lowest content in comparison with adipocytes of other localization. Dysregulation of the adiponectin/AdipoR axis is observed in PVAT, which may be due to low expression of adiponectin receptors and long-term processes of its post-translational modification and oligomerization in CAD. </jats:sec

Transcriptomic and Proteomic Analysis of the Epicardial Adipose Tissue

The study of epicardial adipose tissue (EAT) has been limited by its accessibility due to its proximity to the heart. Moreover, many common animal models do not have EAT, leaving its functional role underestimated and poorly elucidated. Recent advances in medicine and science have allowed for better studies that provide a more comprehensive understanding of its physiological role. One way to dissect its function is the study of its gene expression. In this chapter, we summarize transcriptomic and proteomic analyses which show that EAT expresses a unique set of genes setting it apart from other adipose tissues in the body. This distinctive set of genes modulates a feedback mechanism that has direct interaction with the myocardium. The EAT shares its blood supply with the coronary arteries and innervation with the cardiac muscle, provides physical protection, and regulates energetic metabolites needed by the myocardium. Transcriptomic and proteomic studies show that it is a local source of adipokines with paracrine influence on the myocardium due to the intimate microcirculation shared by both tissues. These analyses also show that it has a role in the immune and endocrine systems affecting the rest of the body. Furthermore, regulation of EAT gene expression is not monolithic and can be affected by multiple factors such as sex, age, underling disease, medication, etc. Gene expression studies can therefore provide great insight into the function of EAT and its role in health and disease