Hasil untuk "Diseases of the endocrine glands. Clinical endocrinology"

Kebao Zhang, Lidan Chen, Zhe Deng et al.

BackgroundStudies have shown that the aspartate aminotransferase (AST)/alanine transaminase (ALT) ratio is related to prediabetes, diabetes, and diabetes complications. However, there is limited evidence proving that the AST/ALT ratio is correlated with blood glucose reversal in patients with impaired fasting glucose (IFG). In this study, we analyzed the relationship between the AST/ALT ratio and blood glucose reversal in a large group of Chinese individuals with impaired fasting blood glucose.MethodsParticipants were recruited from the Rich Healthcare Group’s physical examinations from 2010 to 2016. Among them, 11,121 Chinese adults were selected for enrollment in this study. Cox proportional hazards regression was used to identify the association between the AST/ALT ratio and blood glucose reversal to normoglycemia in individuals with IFG. A generalized additive model (GAM) and smooth curve fitting were used to identify a nonlinear relationship between the AST/ALT ratio and blood glucose reversal. In addition, sensitivity analyses and subgroup analyses were used to test the reliability of our study.ResultsThe AST/ALT ratio was found to be independently related to blood glucose reversal in pre-diabetic populations of Chinese adults (HR = 1.20, 95%CI = 1.11–1.30, p < 0.00001). A nonlinear relationship was found between the AST/ALT ratio and reversion to normoglycemia. On the right side of the inflection point, the AST/ALT ratio was actively related to blood glucose reversal in populations with IFG (HR = 1.37, 95%CI = 1.23–1.52, p < 0.0001). However, on the left side of the inflection point, the relationship was not closely related. Sensitivity analyses, competing risk multivariate Cox regression, and subgroup analyses also confirmed the study results.ConclusionOur study revealed that the AST/ALT ratio is independently related to reversion to normoglycemia in pre-diabetic Chinese people. The relationship between the AST/ALT ratio and reversion to normoglycemia from IFG is nonlinear. There is a significant positive relationship between the AST/ALT ratio and reversion to normoglycemia when the AST/ALT ratio is >1.13.

Yuki Gen, Kyuho Kim, Joonyub Lee et al.

Background Most studies focus solely on the relationship between parity and type 2 diabetes mellitus (T2DM) risk, providing limited insights into other contributing or protective factors. This study aims to explore the complex relationship between parity and T2DM risk, considering additional factors such as obesity, race, and body composition. Methods This prospective cohort study used data from 242,159 women aged 40 to 69 from the UK Biobank, none of whom had T2DM at baseline. Multivariable Cox proportional hazard models were applied to assess the association between parity and T2DM. Subgroup analyses were performed based on body mass index (BMI), waist circumference (WC), and race. Results The hazard ratio for T2DM per additional child was 1.16 (95% confidence interval, 1.13 to 1.16). Subgroup analysis revealed that Asian women and those with obesity or abdominal obesity had a higher risk of T2DM associated with multiparity. No increased risk was observed in women with normal BMI or WC. Mediation analysis showed that WC and BMI significantly mediated the parity-T2DM relationship, accounting for 49% and 38% of the effect, respectively. Conclusion There is a clear positive association between multiparity and T2DM risk, particularly in Asian women and those with obesity. Maintaining normal BMI and WC appears to mitigate this risk, highlighting the importance of weight management for women at higher parity levels. These findings offer crucial insights for public health interventions aimed at reducing T2DM risk among women.

Kathryn Flynn, Jennifer Hatfield, Kevin Brown et al.

Diabetes insipidus (DI) is a rare endocrine disease involving antidiuretic hormone (ADH), encompassing both central and nephrogenic causes. Inability to respond to or produce ADH leads to inability of the kidneys to reabsorb water, resulting in hypotonic polyuria and, if lack of hydration, hypernatremia. DI cannot be cured and is an unfamiliar disease process to many clinicians. This diagnosis must be distinguished from primary polydipsia and other causes of hypotonic polyuria. The main branchpoints in pathophysiology depend on the level of ADH pathology: the brain or the kidneys. Prompt diagnosis and treatment are critical as DI can cause substantial morbidity and mortality. The gold standard for diagnosis is a water deprivation test followed by desmopressin administration. There is promising research regarding a new surrogate marker of ADH called copeptin, which may simplify and improve the accuracy in diagnosing DI in the future. Patients with DI require adequate access to water, and there are nuances on treatment approaches depending on whether a patient is diagnosed with central or nephrogenic DI. This article describes a stepwise approach to recognition, diagnosis, and treatment of DI.

Wataru Tanikawa, Hirotomo Saitsu, Yasuhiko Nakamura et al.

Abstract Background FIGLA is a transcription factor gene which plays a critical role in folliculogenesis. Consistent with this, FIGLA variants have been identified in females with non‐syndromic primary ovarian insufficiency (POI) in both autosomal‐dominant and autosomal‐recessive forms. Case Description We encountered two Japanese sisters who had secondary or primary amenorrhea at 15 years of age. They were diagnosed as having non‐syndromic primary ovarian insufficiency (POI) with hypergonadotropic hypoestrogenism and markedly low serum anti‐Müllerian hormone values. Outcome Whole genome sequencing revealed a novel homozygous missense variant, NM_001004311.3:c.338A>G:p.(Tyr113Cys), in FIGLA essential for folliculogenesis in the two sisters. The parents were heterozygous for this variant, and the heterozygous mother had regular menses at 51 years of age. This variant was extremely rare in public databases, and was invariably assessed as deleterious by six prediction tools. Furthermore, the p.(Tyr113Cys)‐FIGLA protein was assessed as “pathogenic” or “likely pathogenic” by protein structural predictions, and was evaluated as “destabilizing” or “decrease stability” by protein stability predictions Conclusion The results, in conjunction with the data reported in the literature, imply that FIGLA variants account for a small but certain fraction of non‐syndromic POI, and pose a question as to the relevance of FIGLA variants to an autosomal dominant form of POI, although FIGLA variants have been identified in both autosomal dominant and autosomal recessive forms of non‐syndromic POI.

Yingmei Cen, Wei Wei, Yinchun Huang et al.

BackgroundAutoimmune thyroid disease (AITD) is the most common autoimmune disease in patients with Turner Syndrome (TS). There is a high prevalence of AITD in TS patients, it has an early age of onset and can present as severe thyroid dysfunction. The specific etiology of AITD in TS is not clear and may be associated with sex chromosome-related genetic defects, immune dysfunction, or sex hormone imbalance due to ovarian insufficiency. The aim of this study was to investigate the prevalence and related influencing factors of AITD in Chinese patients with TS.MethodsIn total 63 female patients aged 14–32 diagnosed with TS received titer of thyroid autoantibodies and thyroid function examinations, including thyroid stimulating hormone (TSH), free tetraiodothyronine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), total triiodothyronine (TT3), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). The effects of age, body mass index (BMI), karyotype, fasting insulin, blood lipids and other factors that may affect thyroid function were analyzed, and the possible risk factors associated with AITD in TS patients explored.ResultsOf the 63 TS patients, 24 (38.10%) had normal thyroid function and 39 (61.90%) patients had TgAb and/or TPOAb. Among the 39 women with positive thyroid autoantibodies, 10 had abnormal thyroid function, including 3 with hyperthyroidism and 7 with hypothyroidism. Patients with isochromosome X had an increased risk of developing AITD.ConclusionsThe risk of AITD with TS correlates with the chromosomal karyotype, patients with isochromosome X have an increased risk of AITD. Patients with positive thyroid autoantibodies have a higher risk of thyroid dysfunction.

Ye Li, Ye Li, Ling Zeng et al.

PurposeThis study aims to compare the association of hypertension plus hyperuricemia (HTN-HUA) with seven anthropometric indexes. These include the atherogenic index of plasma (AIP), lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose index (TyG), body roundness index (BRI), a body shape index (ABSI), and the cardiometabolic index (CMI).MethodsData was procured from the National Health and Nutrition Examination Survey (NHANES), which recruited a representative population aged 18 years and above to calculate these seven indexes. Logistic regression analysis was employed to delineate their correlation and to compute the odds ratios (OR). Concurrently, receiver operating characteristic (ROC) curves were utilized to evaluate the predictive power of the seven indexes.ResultsA total of 23,478 subjects were included in the study. Among these, 6,537 (27.84%) were patients with HUA alone, 2,015 (8.58%) had HTN alone, and 2,836 (12.08%) had HTN-HUA. The multivariate logistic regression analysis showed that the AIP, LAP, VAI, TyG, BRI, ABSI, and CMI were all significantly associated with concurrent HTN-HUA. The OR for the highest quartile of the seven indexes for HTN-HUA were as follows: AIP was 4.45 (95% CI 3.82-5.18), LAP was 9.52 (95% CI 7.82-11.59), VAI was 4.53 (95% CI 38.9-5.28), TyG was 4.91 (95% CI 4.15-5.80), BRI was 9.08 (95% CI 7.45-11.07), ABSI was 1.71 (95% CI 1.45 -2.02), and CMI was 6.57 (95% CI 5.56-7.76). Notably, LAP and BRI demonstrated significant discriminatory abilities for HTN-HUA, with area under the curve (AUC) values of 0.72 (95% CI 0.71 - 0.73) and 0.73 (95% CI 0.72 - 0.74) respectively.ConclusionThe AIP, LAP, VAI, TyG, BRI, ABSI, and CMI all show significant correlation with HTN-HUA. Notably, both LAP and BRI demonstrate the capability to differentiate cases of HTN-HUA. Among these, BRI is underscored for its effective, non-invasive nature in predicting HTN-HUA, making it a superior choice for early detection and management strategies.

Connie B. Newman

Imrich Richard, Zatkova Andrea, Lukacova Olga et al.

Alkaptonuria (AKU, OMIM, No. 203500) is a rare, slow-progressing, irreversible, multisystemic disease resulting from a deficiency of the homogentisate 1,2-dioxygenase enzyme, which leads to the accumulation of homogentisic acid (HGA) and subsequent deposition as pigment in connective tissues called ochronosis. As a result, severe arthropathy of large joints and spondyloarthropathy with frequent fractures, ligament ruptures, and osteoporosis develops in AKU patients. Since 2020, the first-time treatment with nitisinone has become available in the European Union. Nitisinone significantly reduces HGA production and arrests ochronosis in AKU patients. However, blocking of the tyrosine metabolic pathway by the drug leads to tyrosine plasma and tissue concentrations increase. The nitisinone-induced hypertyrosinemia can lead to the development of corneal keratopathy, and once it develops, the treatment needs to be interrupted. A decrease in overall protein intake reduces the risk of the keratopathy during nitisinone-induced hypertyrosinemia in AKU patients. The low-protein diet is not only poorly tolerated by patients, but over longer periods, leads to a severe muscle loss and weight gain due to increased energy intake from carbohydrates and fats. Therefore, the development of novel nutritional approaches is required to prevent the adverse events due to nitisinone-induced hypertyrosinemia and the negative impact on skeletal muscle metabolism in AKU patients.

Meiqi Yin, Liang Zhou, Yanan Ji et al.

Type 2 diabetes (T2D) is a major global public health burden, with β-cell dysfunction a key component in its pathogenesis. However, the exact pathogenesis of β-cell dysfunction in T2D is yet to be fully elucidated. Ferroptosis, a recently discovered regulated form of non-apoptotic cell death, plays a vital role in the development of diabetes and its complications. The current study aimed to identify the key molecules involved in β-cell ferroptosis3 in patients with T2D using the mRNA expression profile data of GSE25724 by bioinformatic approaches. The differentially expressed mRNAs (DE-mRNAs) in human islets of patients with T2D were screened using the islet mRNA expression profiling data from the Gene Expression Omnibus and their intersection with ferroptosis genes was then obtained. Ferroptosis-related DE-mRNA functional and pathway enrichment analysis in T2D islet were performed. Using a protein-protein interaction (PPI) network constructed from the STRING database, Cytoscape software identified ferroptosis-related hub genes in the T2D islet with a Degree algorithm. We constructed a miRNA-hub gene network using the miRWalk database. We generated a rat model of T2D to assess the expression of hub genes. A total of 1,316 DE-mRNAs were identified in the islet of patients between T2D and non-T2D (NT2D), including 221 and 1,095 up- and down-regulated genes. Gene set enrichment analysis revealed that the ferroptosis-related gene set was significantly different in islets between T2D and NT2D at an overall level. A total of 33 ferroptosis-related DE-mRNAs were identified, most of which were significantly enriched in pathways including ferroptosis. The established PPI network with ferroptosis-related DE-mRNAs identified five hub genes (JUN, NFE2L2, ATG5, KRAS, and HSPA5), and the area under the ROC curve of these five hub genes was 0.929 in the Logistic regression model. We constructed a regulatory network of hub genes and miRNAs, and the results showed that suggesting that hsa-miR-6855-5p, hsa-miR-9985, and hsa-miR-584-5p could regulate most hub genes. In rat model of T2D, the protein expression levels of JUN and NFE2L2 in pancreatic tissues were upregulated and downregulated, respectively. These results contribute to further elucidation of ferroptosis-related molecular mechanisms in the pathogenesis of β-cell dysfunction of T2D.

Dmitry A. Nikulin, Anna A. Chernova, Svetlana J. Nikulina et al.

Acute cerebrovascular accident (ACC) is a formidable complication of a number of cardiovascular diseases, in a significant percentage of cases leading to disability and mortality. The literature available to us provides information on the role of type 3 matrix metalloproteinase gene (MMP-3) polymorphism in the development of stroke. It is believed that MMP-3 plays an important role in the natural processes of tissue remodeling and pathological processes. The mechanism of regulation of tissue remodeling MMP-3 is based on the activation of procollagenase-1. The associations of the single-nucleotide variant rs3025058 (5A/6A) with the development of ONMK in patients with cardiovascular pathology and risk factors of its development for the implementation of measures of primary prevention of this disease are considered. The article discusses issues related to the role and identification of associations of the single nucleotide variant rs3025058 (5А/6А) with the development of stroke in patients with cardiovascular pathology. When preparing the review, publications were searched in the MEDLINE/PubMed, Scopus, Cochrane Library, PEDro, eLIBRARY databases and Google Scholar. In preparing the literature review, the analysis of publications for the last 15 years is carried out. Represented evidence suggests the need for further study and effective use of the results of the study of the rs3025058 MMP-3 polymorphism for the implementation of primary prevention measures in the development of acute cerebrovascular accident, especially in the families of these patients.

Jin-xiang Wu, Shu Lin, Shu Lin et al.

The human endometrium plays a vital role in providing the site for embryo implantation and maintaining the normal development and survival of the embryo. Recent studies have shown that stress is a common factor for the development of unexplained reproductive disorders. The nonreceptive endometrium and disturbed early maternal-fetal interaction might lead to infertility including the repeated embryo implantation failure and recurrent spontaneous abortion, or late pregnancy complications, thereby affecting the quality of life as well as the psychological status of the affected individuals. Additionally, psychological stress might also adversely affect female reproductive health. In recent years, several basic and clinical studies have tried to investigate the harm caused by psychological stress to reproductive health, however, the mechanism is still unclear. Here, we review the relationship between psychological stress and endometrial dysfunction, and its consequent effects on female infertility to provide new insights for clinical therapeutic interventions in the future.

Daisuke Yabe, Katsumi Iizuka, Mike Baxter et al.

Abstract Introduction Treatments for type 2 diabetes targeting baseline glucose levels but not postprandial glucose can result in normalized fasting blood glucose but suboptimal overall glycemic control (high glycated hemoglobin): residual hyperglycemia. In Japanese patients with type 2 diabetes the predominant pathophysiology is a lower insulin secretory capacity, and residual hyperglycemia is common with basal insulin treatment. Single‐injection, fixed‐ratio combinations of glucagon‐like peptide‐1 receptor agonists and basal insulin have been developed. iGlarLixi (insulin glargine 100 units/mL [iGlar]: lixisenatide ratio of 1 unit:1 µg) is for specific use in Japan. Post‐hoc analysis of the LixiLan JP‐L trial (NCT02752412) compared the effect of iGlarLixi with iGlar on this specific subpopulation with residual hyperglycemia. Materials and Methods Outcomes at week 26 (based on the last observation carried forward) were assessed in patients in the modified intent‐to‐treat population with baseline residual hyperglycemia. Results Overall, 83 (32.5%) patients in the iGlarLixi group and 79 (30.7%) patients in the iGlar group had baseline residual hyperglycemia. The proportion of patients with residual hyperglycemia at week 26 decreased to 15.7% in the iGlarLixi group, and increased to 36.9% in the iGlar group. Patients in the iGlarLixi group had significantly greater reductions in glycated hemoglobin compared with the iGlar group (−0.72% difference between groups; P < 0.0001). Conclusions New data from this post‐hoc analysis of the JP‐L trial show that treatment with the fixed‐ratio combination iGlarLixi reduced the proportion of Japanese patients with residual hyperglycemia from baseline to week 26 and significantly reduced glycated hemoglobin vs similar doses of iGlar alone.

Konstantina Dipla, Andreas Zafeiridis, Gesthimani Mintziori et al.

Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Regular exercise is important for a healthy pregnancy and can lower the risk of developing GDM. For women with GDM, exercise is safe and can affect the pregnancy outcomes beneficially. A single exercise bout increases skeletal muscle glucose uptake, minimizing hyperglycemia. Regular exercise training promotes mitochondrial biogenesis, improves oxidative capacity, enhances insulin sensitivity and vascular function, and reduces systemic inflammation. Exercise may also aid in lowering the insulin dose in insulin-treated pregnant women. Despite these benefits, women with GDM are usually inactive or have poor participation in exercise training. Attractive individualized exercise programs that will increase adherence and result in optimal maternal and offspring benefits are needed. However, as women with GDM have a unique physiology, more attention is required during exercise prescription. This review (i) summarizes the cardiovascular and metabolic adaptations due to pregnancy and outlines the mechanisms through which exercise can improve glycemic control and overall health in insulin resistance states, (ii) presents the pathophysiological alterations induced by GDM that affect exercise responses, and (iii) highlights cardinal points of an exercise program for women with GDM.

Wei Li, Wei Li, Chunxia Ban et al.

Background: Depressive symptoms are common comorbidities in schizophrenia. However, the effect of APOE E3 on depressive symptoms has never been investigated in an aging Chinese population with schizophrenia. This cross-sectional study aimed to investigate the effects of APOE E3 on blood lipid metabolism and depressive symptoms in elderly schizophrenics in China.Methods: Three Hundred and one elderly schizophrenics (161 males, age ranges from 60 to 92 years, with an average age of 67.31 ± 6.667) were included in the study. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). APOE gene polymorphism was determined by polymerase chain reaction (PCR). We assessed the correlations of GDS and serum low-density lipoprotein (LDL) with APOE genotypes.Results: The concentration of LDL in the Homozygous APOE E3 group was significantly higher than that in the non-homozygous APOE E3 group, while the scores of GDS of the Homozygous APOE E3 group were lower than that in the non-homozygous APOE E3 group. Using partial correlation analysis and controlling age, gender, duration of disease, and hyperlipidemia, we found that the scores of GDS were significantly correlated with LDL (r = −0.194, p = 0.016).Conclusions: APOE E3 is associated with less depressive symptoms and higher serum LDL in Chinese elderly patients with schizophrenia, and there is a negative correlation between depressive symptoms and LDL.

Renata S. Auriemma, Dario De Alcubierre, Rosa Pirchio et al.

The pathogenesis of obesity and alterations in glucose profile have been linked to PRL excess, as it is reportedly associated with metabolic syndrome in thereabout one third of patients. In vitro exposure of pancreatic islet to PRL is known to stimulate insulin secretion and β-cell proliferation, and in turn overexpression of PRL in β-cells increases insulin release and β-cell replication. PRL excess has been found to worsen glucose profile because it reduces glucose tolerance and induces insulin resistance either in obese and non-obese patients. To note, pancreatic β-cells and adipocytes widely express dopamine receptors type 2, and dopamine has been hypothesized to play a key role as modulator of insulin and adipose functions. The dopamine agonists bromocriptine and cabergoline significantly improve abnormalities in glucose profile and reduce the prevalence of metabolic syndrome in a remarkable proportion of patients, regardless of whether body weight and PRL status may change. However, in men with hyperprolactinemia complicated by hypogonadism, testosterone replacement can ameliorate insulin resistance and abnormalities in glucose metabolism. Therefore, in patients with PRL-secreting pituitary adenomas control of PRL excess by dopamine agonists is mandatory to improve glucose and insulin abnormalities.

Christina Tugendsam, Veronika Petz, Wolfgang Buchinger et al.

Abstract Background We aimed to study the validity of six published ultrasound criteria for risk stratification of thyroid nodules in the former severely iodine deficient population of Austria. Methods Retrospective, single centre, observer blinded study design. All patients with a history of thyroidectomy due to nodules seen in the centre between 2004 and 2014 with preoperative in-house sonography and documented postoperative histology were analyzed (n = 195). A board of five experienced thyroidologists evaluated the images of 45 papillary carcinomas, 8 follicular carcinomas, and 142 benign nodules regarding the following criteria: mild hypoechogenicity, marked hypoechogenicity, microlobulated or irregular margins, microcalcifications, taller than wide shape, missing thin halo. Results All criteria but mild hypoechogenicity were significantly more frequent in thyroid cancer than in benign nodules. The number of positive criteria was significantly higher in cancer (2.79 ± 1.35) than in benign nodules (1.73 ± 1.18; p < 0.001). Thus, with a cut-off of two or more positive criteria, a sensitivity of 85% and a specificity of 45% were reached to predict malignancy in this sample of thyroid nodules. As expected, the findings were even more pronounced in papillary cancer only (2.98 ± 1.32 vs. 1.73 ± 1.18, p < 0.001). The six ultrasound criteria could not identify follicular cancer. Conclusion Our findings support the recently published EU-TIRADS score. Apart from mild hypoechogenicity, the analyzed ultrasound criteria can be applied for risk stratification of thyroid nodules in the previously severely iodine deficient population of Austria.

Chenyue Qian, Heming Guo, Xiaohong Chen et al.

Aims. The programmed death- (PD-) 1/PD-1 ligand (PD-L) pathway plays an important role in regulating T cell activation and maintaining peripheral tolerance. Accumulated studies showed that PD-1/PD-L1 pathway was involved in the development of type 1 diabetes (T1DM). Since the genetic background of type 1 diabetes differs greatly among the different population, we aim to investigate the association of genetic polymorphisms in PD-1 and PD-L1 with T1DM susceptibility in Chinese population. Methods. In total, 166 T1DM patients and 100 healthy controls were enrolled into the study. Genomic DNA was extracted from 4 mL peripheral blood samples collected from each subject. Genotyping of 8 selected SNPs of PD-1 and PD-L1 was carried out by the pyrosequencing PSQ 24 System using PyroMark Gold reagents (QIAGEN). Results. SNP rs4143815 in PD-L1 was significantly associated with T1DM. People carrying the C allele of rs4143815 suffering less risk of T1DM and T1DM patients with G/G genotype showed higher levels of autoantibody (AAB) positive incidence compared with C allele carriers. No significant associations were found in other SNPs. Conclusions. Our results indicate that rs4143815 of PD-L1 is significantly associated with T1DM and may serve as a new biomarker to predict the T1DM susceptibility.

M.L. Kyryliuk, Ya.O. Atanova, O.E. Tretiak

The article deals with the impact of diabetes mellitus (DM) on the phosphorus and calcium metabolism in postmenopausal women, depending on the type and duration of the disease, duration of menopause, body mass and type of hypoglycemic therapy. The state of phosphorus and calcium metabolism in 86 women with type 1 DM (13 patients) and type 2 DM (73 patients) was studied. In all patients, the concentration of calcium and phosphorus in the blood was within normal limits. It was found that the concentration of ionized calcium, total calcium and inorganic phosphorus in the blood can not be the main criterion for the state of bone mineral density in postmenopausal women with DM. Sulfonylureas and insulin in combination with biguanides have no effect on the status of phosphorus and calcium metabolism in postmenopausal women with type 2 DM.

J. Fortunato, V. Bláha, J. Bis et al.

Objective. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is extensively expressed by advanced atherosclerotic lesions and may play a role in plaque instability. We selected a group of elderly subjects that underwent transcatheter aortic valve implantation (TAVI) or balloon angioplasty (BA) and separated them into two groups, diabetic and nondiabetic, to compare the level of Lp-PLA2 mass between them. Methods. 44 patients aged 79.6±5.6 years with symptomatic severe aortic valve stenosis underwent TAVI (n=35) or BA (n=9). 21 subjects had confirmed type 2 diabetes mellitus. Lp-PLA2 mass was measured using an enzyme-linked immunosorbent assay kit (USCN Life Science, China) before and 3 days after the procedure. Results. Lp-PLA2 mass was significantly elevated in this population (1296±358 ng/mL before TAVI; 1413±268 ng/mL before BA) and further increased after TAVI (1604±437 ng/mL, P<0.01) or BA (1808±303 ng/mL, P<0.01). Lp-PLA2 mass was significantly increased on the diabetic group before these interventions. Conclusion. Lp-PLA2 may be a novel biomarker for the presence of rupture-prone atherosclerotic lesions in elderly patients. Levels of Lp-PLA2 in diabetic patients may accompany the higher amount of small dense LDL particles seen in these subjects.

Sarita Bajaj, Susheel Kumar Tyagi, Anudita Bhargava

Aims and Objectives : To assess the prevalence of metabolic syndrome (MetS) in human immunodeficiency virus (HIV) positive patients. Prevalence of MetS was compared in patients who were not on highly active antiretroviral therapy (HAART) to patients who were on HAART. Materials and Methods: Seventy HIV positive cases were studied. Pregnant and lactating women, patients on drugs other than HAART known to cause metabolic abnormalities and those having diabetes or hypertension were excluded. Cases were evaluated for MetS by using National Cholesterol Education Program Adult Treatment Panel-III. Results: 47 cases were on HAART and 23 cases were not on HAART. Fasting Blood Glucose ≥100 mg/dl was present in 28.6% cases, out of whom 27.7% were on HAART and 30.4% were not on HAART (P = 0.8089). 12.9% cases had BP ≥130/≥85 mm Hg, out of whom 14.9% were on HAART and 8.7% were not on HAART (P = 0.4666). 42.9% cases had TG ≥150 mg/dl, out of whom 44.7% were on HAART and 39.1% were not on HAART (P = 0.6894). HDL cholesterol was low (males <40 mg/dl, females <50 mg/dl) in 50% cases, out of whom 55.3% were on HAART and 39.1% were not on HAART (P = 0.2035). Conclusions: Prevalence of MetS was 20%. Majority of patients had only one component of MetS (32.9%). Low HDL was present in 50%, followed by raised triglycerides in 42.9%. Waist circumference was not increased in any of the patients. There was no statistically significant difference between those on HAART and those not on HAART in distribution of risk factors and individual components of MetS.