Quality of Life and Nutritional Status in diabetic patients on hemodialysis

AimsThe quality of life (QoL) of patients with diabetes and in hemodialysis is affected by their nutritional status. We aimed to determine the correlation between QoL and nutritional status of patients in hemodialysis.MethodsWe conducted a study with people with diabetes and in hemodialysis. We used Kidney Disease and Quality of Life-Short form (KDQOL-SFTM) scale to evaluate QoL and the Subjective Global Assessment (SGA) questionnaire for nutritional evaluation.ResultsThe studied patients, 71.43% were over 55 years old and 81% of participants were male. The domain of QoL must impaired were cognitive function ($\overline{x}=$26.35, SD = 20.81) and interaction of social quality ($\overline{x}=$19.32, SD = 17.24). The characteristics that most favorably impacted QoL were dialysis equipment support ($\overline{x}=$83.93, SD = 20.59) and patient satisfaction ($\overline{x}=$86.51, SD = 17.17). The undernourished patients were 56.6% (n = 14). There was a strong lineal relationship between the Physical and Mental Health Composite and nutritional status, Spearman rank (rho = 0.935, p = <0.001), (rho=0.926, p = <0.001) respectively.ConclusionThere is a strong relationship between QoL and nutritional status, ensuring that a good nutritional status could positively influence QoL.     

Exercise Capacity and Ventilatory Efficiency in Patients With Pulmonary Embolism After Short Duration of Anticoagulation Therapy

BackgroundAlthough anticoagulation therapy can reduce the risk for pulmonary embolism (PE) recurrence, symptoms such as exertional dyspnea or pain can persist for several months to years. Therefore, we aimed to assess the improvement of ventilatory efficiency and exercise capacity during cardiopulmonary exercise test in PE patients after short duration of anticoagulant therapy.Materials and MethodsPulmonary function testing, arterial blood gas analysis and cardiopulmonary exercise test were performed in 30 PE patients after anticoagulant therapy of 4 weeks (early phase) and after 6 months (late phase). In addition, another 30 healthy volunteers underwent the same tests.ResultsPercentage of forced vital capacity (FVC %pred) improvement was evident in the PE group (P < 0.01) after 6 months of treatment. Peak Load, peak Load %pred, peak oxygen uptake ($\stackrel{\circ }{\mathrm{V}}{\mathrm{O}}_2$), peak $\stackrel{\circ }{\mathrm{V}}{\mathrm{O}}_2$%pred increased significantly after treatment for 6 months (P < 0.01), while lowest minute ventilation in relation to carbon dioxide production ($\stackrel{\circ }{\mathrm{V}}\mathrm{E}$ / $\stackrel{\circ }{\mathrm{V}}\mathrm{C}{\mathrm{O}}_2$) and lowest $\stackrel{\circ }{\mathrm{V}}\mathrm{E}$ / $\stackrel{\circ }{\mathrm{V}}\mathrm{C}{\mathrm{O}}_2$ %pred decreased significantly (P = 0.001). In PE group, the increment of peak $\stackrel{\circ }{\mathrm{V}}{\mathrm{O}}_2$ %pred from 4 weeks to 6 months correlated with the decrease of lowest $\stackrel{\circ }{\mathrm{V}}\mathrm{E}$ / $\stackrel{\circ }{\mathrm{V}}\mathrm{C}{\mathrm{O}}_2$ %pred (r = 0.639, P < 0.001) but not the increment of FVC %pred (r = 0.058, P = 0.769).ConclusionsExercise capacity improved significantly and there was a gradual improvement in ventilatory efficiency after 6 months of anticoagulation therapy.     

Association between epicardial adipose tissue and left ventricular function in type 2 diabetes mellitus: Assessment using two-dimensional speckle tracking echocardiography

Background and aimsEpicardial adipose tissue (EAT) is the visceral fat between the myocardium and the visceral pericardium. Dysfunctional EAT can cause cardiovascular diseases. The aim of this study was to investigate the association between EAT and left ventricular function in type 2 diabetes mellitus (T2DM) patients by two-dimensional speckle tracking echocardiography (2D-STE).MethodsWe prospectively enrolled 116 T2DM patients who were divided into two groups according to their left ventricular global longitudinal strain (GLS): 53 with GLS <18% and 63 with GLS ≥18%. The thickness of EAT was measured as the echo-free space between the free wall of the right ventricle and the visceral layer of pericardium at end-systole. LV systolic function was evaluated by GLS measured by 2D-STE. LV diastolic function was defined as the ratio of the early diastolic transmitral flow velocity (E) to average mitral annular velocity ($\overline{e}$).ResultsCompared with patients with GLS ≥18% group, the age, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), glycosylated hemoglobinA1c (HbA1c), E/$\overline{e}$, and thickness of EAT were higher in patients with GLS <18% group (all P < 0.05). Multivariate linear regression analysis revealed that the thickness of EAT was independently associated with left ventricular GLS and E/$\overline{e}$.ConclusionsThickened EAT is associated with impaired left ventricular function in T2DM patients. To investigate the association between EAT and left ventricular function can help us gain a deeper understanding of the pathogenesis of impaired cardiac function in T2DM patients.