scholarly journals Surgical Outcomes in the Pheochromocytoma Surgery. Results From the PHEO-RISK STUDY.

2021 ◽  
Author(s):  
Marta Araujo-Castro ◽  
Rogelio García Centero ◽  
María-Carmen López-García ◽  
Cristina Álvarez Escolá ◽  
María Calatayud Gutiérrez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Cerebrovascular Disease ◽  
Plasma Glucose ◽  
Surgical Risk ◽  
Glucose Levels ◽  
Postsurgical Complications ◽  
Patients With Diabetes ◽  
Biochemical Cure ◽  
Prolonged Hypotension

Abstract Purpose: To identify presurgical and surgical risk factors for postsurgical complications in the pheochromocytoma surgery.Methods: A retrospective study of pheochromocytomas submitted to surgery in ten Spanish hospitals between 2011 and 2021. Postoperative complications were classified according to Clavien-Dindo scale.Results: One hundred and sixty-two surgeries (159 patients) were included. Preoperative antihypertensive blockade was performed in 95.1% of the patients, being doxazosin in monotherapy (43.8%) the most frequent regimen. Patients pre-treated with doxazosin required intraoperative hypotensive treatment more frequently (49.4% vs 25.0%, P=0.003) than patients treated with phenoxybenzamine, but no differences in the rate of intraoperative and postsurgical complications were observed. However, patients treated with phenoxybenzamine had a longer hospital stay (12.2±11.16 vs 6.2±6.82, P<0.001) than those treated with doxazosin. Hypertension resolution was observed in 78.7% and biochemical cure in 96.6% of the patients. Thirty-one patients (19.1%) had postsurgical complications. Prolonged hypotension was the most common, in 9.9% (n=16), followed by hypoglycaemia in 6 patients and acute renal failure in 4 patients. 13.0% of complications had a score ≥3 in the Clavien-Dindo scale. Postsurgical complications were more common in in patients with diabetes, cerebrovascular disease, higher plasma glucose levels, higher urinary free metanephrine and norepinephrine, and with pheochromocytomas larger than 5 cm.Conclusion: Preoperative medical treatment and postsurgical monitoring of pheochromocytoma should be especially careful in patients with diabetes, cerebrovascular disease, higher levels of plasma glucose and urine free metanephrine and norepinephrine, and with pheochromocytomas >5 cm, due to the higher risk of postsurgical complications.

scholarly journals Risk Factors for the Requirement of Antenatal Insulin Treatment in Gestational Diabetes Mellitus

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Mayu Watanabe ◽  
Akihiro Katayama ◽  
Hidetoshi Kagawa ◽  
Daisuke Ogawa ◽  
Jun Wada
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Insulin Therapy ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Insulin Treatment ◽  
Diet Group ◽  
Glucose Levels

Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group;n=10) and without insulin therapy (Diet group;n=27). The 1-h and 2-h plasma glucose levels and the number of abnormal values in 75 g OGTT were significantly higher in AIT group compared with Diet group. By logistic regression analysis, plasma glucose level at 1-h was significant predictor for AIT and the odds ratios were 1.115 (1.004–1.239) using forward selection method and 1.192 (1.006–1.413) using backward elimination method. There were no significant differences in obstetrical outcomes and neonatal complications. 1-h plasma glucose levels in 75 g OGTT are useful parameters in predicting the requirement for AIT in GDM. Both maternal and neonatal complications are comparable in GDM patients with and without insulin therapy.

Classical cardiovascular risk factors according to fasting plasma glucose levels

2008 ◽  
Vol 19 (3) ◽  
pp. 209-213 ◽  
Author(s):  
Sergio Martinez-Hervas ◽  
Pedro Romero ◽  
Enrique B. Hevilla ◽  
José T. Real ◽  
Antonia Priego ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Levels ◽  
Fasting Plasma

scholarly journals Admission Blood Glucose Is Associated With the 30-Days Mortality in Septic Patients: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyuan Wei ◽  
Yu Min ◽  
Jiangchuan Yu ◽  
Qianli Wang ◽  
Han Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Sofa Score ◽  
Medical Information ◽  
Cox Regression ◽  
Chi Square ◽  
Glucose Levels ◽  
Qualitative Variables ◽  
Patients With Diabetes ◽  
Independent Risk Factors

Background: Sepsis, as one of the severe diseases, is frequently observed in critically ill patients, especially concurrent with diabetes. Whether admission blood glucose is associated with the prognosis, and outcome of septic patients is still debatable.Methods: We retrospectively reviewed and analyzed the demographic characteristics of septic patients in the Medical Information Mart for Intensive Care III (MIMIC III, version 1.4) between June 2001 and October 2012. The Chi-square and Fisher's exact tests were used for the comparison of qualitative variables among septic patients with different glucose levels and the 30-day mortality in septic patients with diabetes or not. Univariate and stepwise multivariate Cox regression analyses were used to determine the risk factors for 30-day mortality. Kaplan-Meier analysis was conducted to reveal the different 30-day survival probabilities in each subgroup.Results: A total of 2,948 septic patients (910 cases with diabetes, 2,038 cases without diabetes) were ultimately included in the study. The 30-day mortality was 32.4% (956/2,948 cases) in the overall population without any difference among diabetic and non-diabetic septic patients (p = 1.000). Admission blood glucose levels &lt;70 mg/dl were only observed to be significantly associated with the 30-day mortality of septic patients without diabetes (hazard ratio (HR) = 2.48, p &lt; 0.001). After adjusting for confounders, age &gt;65 years (HR = 1.53, p = 0.001), the Sequential Organ Failure Assessment (SOFA) score &gt;5 (HR = 2.26, p &lt; 0.001), lactic acid &gt;2 mmol/L (Lac, HR = 1.35, p = 0.024), and platelet abnormality (&lt;100 k/ul: HR = 1.49; &gt;300 k/ul: HR = 1.36, p &lt; 0.001) were the independent risk factors for 30-day mortality in septic patients with diabetes. In non-diabetes population, age &gt;65 years (HR = 1.53, p &lt; 0.001), non-White or non-Black patients (HR = 1.30, p = 0.004), SOFA score &gt;5 (HR = 1.56, p &lt; 0.001), blood glucose &lt;70 mg/dl (HR = 1.91, p = 0.003), anion gap (AG) &gt;2 mmol/L (HR = 1.60, p &lt; 0.001), Lac (HR = 1.61, p &lt; 0.001), urea nitrogen &gt;21 mg/dl (HR = 1.45, p = 0.001), alanine aminotransferase (ALT, HR = 1.31, p = 0.009), total bilirubin &gt;1.2 mg/dl (HR = 1.20, p = 0.033), and low hemoglobin (HR = 1.34, p = 0.001) were the independent risk factors for 30-day mortality.Conclusions: Our results indicate admission blood glucose, especially in terms of &lt;70 mg/dl, is the key signaling in predicting the worse 30-day survival probability of septic patients without diabetes, which could help clinicians to make a more suitable and precise treatment modality in dealing with septic patients.

scholarly journals Anxiety and depressive disorders in patients with diabetes mellitus type 2 and cerebrovascular disease

2012 ◽  
Vol 15 (4) ◽  
pp. 59-62 ◽  
Author(s):  
Inessa Ivanovna Dubinina ◽  
Vladimir Alexeevich Zhadnov ◽  
Svetlana Vital'evna Yankina ◽  
Alexandra Viktorovna Solov'eva
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cerebrovascular Disease ◽  
Diabetes Mellitus Type 2 ◽  
Depressive Disorders ◽  
Diabetes Mellitus Type ◽  
Atherogenic Dyslipidemia ◽  
Anxiety And Depression ◽  
Patients With Diabetes

Aims. Current study was aimed to identify symptoms and risk factors for depression and anxiety and to estimate quality of life (QoL) in patients with diabetes mellitus type 2 (T2DM) and cerebrovascular disease (CVD). Materials and methods. We examined 73 patients with T2DM. 1st group included 49 patients with T2DM and CVD, 2nd group - 24 patients with T2DM and no cardiovascular pathology. The groups were not significantly different in terms of age, BMI, level of HbAlc, fasting and postprandial glycemia. All patients received antihyperglycemic and antihypertensive therapy. Anxiety and depression were diagnosed with Beck Depression Inventory and Spielberger State and Trait Anxiety Scale (SSTAS). SF-36 questionnaire was used for estimation of QoL. Results. 2nd group showed symptoms of anxiety and depressive disorders in 100% and 75% of cases, respectively. 1st group showed significantly more prominent anxiety and depression symptoms. Risk factors for anxiety and depressive disorders in patients with T2DM and CVD were found to be senior age, obesity and atherogenic dyslipidemia. Conclusion. Cardiovascular comorbidity in T2DM significantly decreases QoL, especially in aspects of physical functioning and vitality. Timely diagnostics of anxiety and depression in patients with T2DM and CVD requires development of screening and rehabilitation programs.

scholarly journals Sex Differences in the Prevalence of and Risk Factors for Abnormal Glucose Regulation in Adults Aged 50 Years or Older With Normal Fasting Plasma Glucose Levels

2021 ◽  
Vol 11 ◽  
Author(s):  
Xinxin Zhang ◽  
Jie Liu ◽  
Shuang Shao ◽  
Yuan Yang ◽  
Dongwang Qi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sex Differences ◽  
Low Income ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Glucose Regulation ◽  
Glucose Levels ◽  
Abnormal Glucose Regulation ◽  
Fasting Plasma ◽  
Independent Risk Factors

AimsAbnormal glucose regulation, which can present as diabetes and prediabetes, has become one of the most common chronic conditions. However, sex differences in the prevalence of and factors associated with abnormal glucose regulation remain unclear. Thus, we aimed to explore sex differences in the prevalence of and factors associated with abnormal glucose regulation in low-income adults in China aged ≥50 years with normal fasting plasma glucose levels.Materials and MethodsA total of 2,175 individuals aged ≥50 years with normal fasting plasma glucose levels were recruited into this study. After an overnight fast of at least 10 h, individuals underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose levels were measured to determine the state of glucose regulation.ResultsWomen were more likely than men to have isolated-impaired glucose tolerance (i-IGT) overall (24.7% vs 20.8%; P= 0.034), among individuals aged &lt;65 years (21.7% vs 15.9%; P= 0.012). Among men, independent risk factors for i-IGT were an age of ≥65 years, hypertension, and high serum uric acid (SUA) and triglyceride levels; independent risk factors for diabetes mellitus (DM) were an age of ≥75 years and alcohol consumption. Among women, independent risk factors for i-IGT were central obesity and high levels of high-sensitivity C-reactive protein and SUA; independent risk factors for DM were low education and an elevated white blood cell count.ConclusionsOur findings suggest that conventional cardiovascular disease risk factors (i.e., age, hypertension, and dyslipidemia) associated with high risk of developing DM in men, but poor life style (i.e., obesity) and low education attainment in women. It is necessary for delay or stopping the development of DM among low-income adults in China to implement the personalized scheme of prevention DM between men and women, especially highlight control the risk factors in young and middle aged women.

scholarly journals Comparing the first trimester and second trimester fifty grams oral glucose tolerance test values in gestational diabetes mellitus

2021 ◽  
pp. 1-9
Author(s):  
Hasan Turan
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Plasma Glucose ◽  
Early Period ◽  
First Trimester ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Second Trimester ◽  
Glucose Levels ◽  
History Of

Objective: The present study aimed to assess the results of pregnant women who have been applied a 50 g oral glucose tolerance test (OGTT) in the first and second trimesters and investigate this method’s role in the diagnosis of gestational diabetes mellitus (GDM) and risk factors associated with this disease. Material and Methods: This retrospective study was performed on 153 pregnant women who were admitted to our hospital’s antenatal clinics between March 2011 and August 2011. Fifty grams OGTT was applied to the same pregnant women both in the 1st trimester (between 8th and 14th weeks) and second trimester (between 24th and 28th weeks); values of the test results were then compared. A 100 g OGTT di- agnostic test was performed on those with a 50 g OGTT value of ≥140 mg/dl in both trimesters. The study patients were divided into two groups as non-GDM and GDM based on venous plasma glucose values measured 1 h after 50 g of oral glucose load given. The non-GDM group consisted of those with plasma glucose levels <140 mg/ dl and plasma glucose levels between 140 mg/dl and 200mg/dl, GDM group plasma glucose levels ≥200 mg/dl. First trimester and second-trimester OGTT values and possible risk factors for GDM (age, gravida, parity, number of abortions, smoking, a previous GDM history, etc.) were compared between non-GDM and GDM groups. Results: GDM, diagnosed in 4.5% (7) in the first trimester (between 8th and 14th weeks) and 6.5% (10) second trimester, was detected in 11% (17) of 153 pregnant women in the present study. GDM, diagnosed in 41.2% (7 patients) in the first trimester and 58.8% (10 patients) second trimester, was found with a higher rate in pregnant women over 30 years (p=0.000 <0.05). The mean fasting blood glucose (FBG) level was 96 mg/dl in the GDM group and 83 mg/dl in the non-GDM group, with a statistically sig- nificant difference, which existed (p<0.05). The mean 50 g OGTT value was 170 mg/ dl in pregnant women diagnosed with GDM in the first trimester, and it was 140 mg/dl in those diagnosed in the second trimester, with this difference was considered statis- tically different (p<0.05). Age, parity, a family history of DM, FBG, a previous GDM his- tory, gravida, a previous macrosomia history, and a previous history of preeclampsia were determined as risk factors that significantly increase the risk of GDM (p<0.05). The half of patients was diagnosed with GDM in the early period of pregnancy. In the present study, 41.2% of cases were diagnosed in the first trimester and 58.8% in the second trimester. In general, the patients diagnosed in the first trimester were those being under risk in terms of GDM. According to the present study, it is recommended that the pregnant women should be scanned for GDM in the early period. Conclusion: With screening tests to be applied to risky groups in early pregnancy, a significant number of cases with GDM recently be detected on time. Thereby, mater- nal and fetal morbidity and mortality rates might be considerably reduced thanks to providing proper treatments and regular monitoring. Furthermore, for obtaining spe- cific data concerning the factors with potential influence on the risk of GDM, further studies on this topic need to be performed.

scholarly journals Risk factors of hyperprolactinemia induced by risperidone and olanzapine and their correlations with plasma glucose and lipids

2020 ◽  
Vol 33 (4) ◽  
pp. e100206
Author(s):  
Sidi He ◽  
Wen Juan Yu ◽  
Xiaoliang Wang ◽  
Lei Zhang ◽  
Nan Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
High Serum ◽  
Glucose Levels ◽  
Fasting Plasma ◽  
Number Of Patients

BackgroundHyperprolactinemia is a common adverse reaction in patients with schizophrenia who take antipsychotic drugs; it often leads to treatment non-compliance in patients and has an adverse effect on their prognosis.AimsThis study aimed to explore the risk factors of elevated prolactin (PRL) caused by risperidone (RIS) and olanzapine (OLZ) and the relationship between PRL and fasting plasma glucose and lipids.MethodsPatients with schizophrenia were divided into two groups: 264 patients who were taking RIS and 175 patients who were taking OLZ. These two groups were further divided according to serum PRL levels: an elevated PRL group (>30 ng/mL) and a normal PRL group (PRL ≤30 ng/mL). The demographics, medication dosage, fasting plasma glucose, total cholesterol and triglycerides were compared in the two groups. Logistic regression analysis was performed to explore the risk factors of elevated PRL levels.ResultsCompared with the OLZ group, the RIS group had a greater number of patients with elevated PRL (155/264 vs 58/175). Either the RIS or the OLZ group, the proportion of elevated PRL was greater in female patients (RIS: χ2=6.76, p=0.009; OLZ: χ2=12.98, p<0.001) and with higher doses of the related drugs (RIS: U=−3.73, p<0.001; OLZ: U=−2.31, p=0.021). In patients taking RIS, the elevated PRL subgroup took the drug for a longer period (U=−2.76, p=0.006) and had lower triglyceride levels (U=2.76, p=0.006). In patients taking OLZ, the elevated PRL subgroup had lower fasting plasma glucose levels (U=2.29, p=0.022). Logistic regression analysis showed that gender, dose and fasting glucose levels were significantly associated with elevated PRL levels (RIS: p=0.001, OLZ: p<0.001; RIS: p<0.001; OLZ: p=0.003; RIS: p=0.020, OLZ: p=0.001, respectively).ConclusionCompared with OLZ, RIS had a greater effect on PRL in patients with schizophrenia, and in patients with schizophrenia taking RIS or OLZ, gender and dose were significantly correlated with the PRL value. Moreover, the plasma glucose level of the group with elevated PRL was lower than that of the group with normal PRL. The results also showed that high serum PRL may be associated with a favourable glucose metabolic profile in patients with schizophrenia taking RIS or OLZ. Further studies are warranted to confirm this association.Trial registration numberNCT02640911

scholarly journals Both high and low pre-infection glucose levels associated with increased risk for severe COVID-19: New insights from a population-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254847
Author(s):  
Michal Shauly-Aharonov ◽  
Asher Shafrir ◽  
Ora Paltiel ◽  
Ronit Calderon-Margalit ◽  
Rifaat Safadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Severe Disease ◽  
Fasting Blood Glucose ◽  
Population Based ◽  
Historical Cohort ◽  
Glucose Levels ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
The Relationship

Importance Patients with diabetes are known to be at increased risk for infections including severe coronavirus disease 2019 (COVID-19) but the relationship between COVID-19 severity and specific pre-infection glucose levels is not known. Objective To assess the differential effects of pre-infection glucose levels on the risk for severe COVID-19 amongst patients with and without diabetes. Design Population based historical cohort study. Setting National state-mandated HMO. Patients All adult patients with a positive SARS-COV2 test between March-October 2020. Exposure Recent fasting blood glucose (FBG) and glycated hemoglobin (HBA1C), age, gender, body mass index (BMI) and diagnoses of diabetes, hypertension, ischemic heart disease. Outcome Risk for severe COVID-19, defined as resulting in ≥10 hospitalization days, ICU admission or death. Results 37,121 patients with a positive SARS-COV2 test were identified; 707 defined as severe (1.9%). Unadjusted risk factors for severe disease were age (OR = 1.1 for every year increase; 95% CI 1.09–1.11, p < 0.001), male gender (OR = 1.34, 95% CI 1.06–1.68, p = 0.012); BMI (OR = 1.02 for 1 kg/m2 increase, 95% CI 1.00–1.04, p = 0.025). Controlling for these factors, we found an association between pre-infection FBG and the risk of severe COVID-19, with a differential effect in patients with and without a diagnosis of diabetes. For patients without diabetes, elevated FBG in the pre-diabetes range (106–125 mg/dl) was associated with severe COVID-19 (OR 1.55 95% CI 1.04–2.26 p = 0.027). For patients with a diagnosis of diabetes, we found a J-shaped association between pre-infection glucose control and the risk for severe COVID-19 where the lowest risk for was for patients with FBG 106–125 mg/dl; the risk increased with higher pre-infection glucose levels but strikingly also for patients with a low pre-infection FBG (<100mg/dl) or HbA1C (<5.7%). Conclusions and relevance Elevated pre-infection blood glucose is a risk factor for severe COVID-19 even in non-diabetics. For patients with a diagnosis of diabetes both high as well as low pre-infection glucose levels are risk factors for severe COVID-19. Further research is required to assess whether these associations are causal, but we believe these findings can already have clinical implications for COVID-19 risk assessment and stratification.

Risk factors for patients with diabetes who have abnormal toe-brachial index and normal ankle-brachial index

2018 ◽  
Vol 127 (05) ◽  
pp. 326-330
Author(s):  
Hidetaka Hamasaki ◽  
Yasuteru Hamasaki
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Plasma Glucose ◽  
Ankle Brachial Index ◽  
Smoking History ◽  
Patients With Diabetes ◽  
History Of ◽  
Toe Brachial Index

Abstract Aim To investigate the association of ankle-brachial index (ABI) and toe-brachial index (TBI) with metabolic parameters and the risk factors causing a divergence between ABI and TBI in patients with diabetes. Methods Outpatients who were simultaneously examined for both ABI and TBI were included. Multiple regression analysis was performed to assess the association of ABI and TBI with metabolic parameters. Furthermore, logistic regression analysis was performed to detect the risk factors causing a divergence between ABI and TBI. Results Of the 307 patients that were enrolled, 77 had normal ABI but decreased TBI. ABI was inversely associated with plasma glucose and triglycerides and positively associated with high-density lipoprotein cholesterol. In contrast, TBI was inversely associated with the duration of diabetes, plasma glucose and haemoglobin A1c. Logistic regression analysis showed that smoking history and a history of cardiovascular disease were associated with an increased risk of the divergence between ABI and TBI. Conclusion Our findings suggest that smoking history and a history of cardiovascular disease are important risk factors in patients with diabetes who had normal ABI but decreased TBI. Patients with multiple vascular complications are at a high risk of coexisting peripheral artery disease, even if their ABI is normal.

Sign in / Sign up

Export Citation Format

Share Document