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Ma WY Li HY Pei D Hsia TL Lu KC Tsai LY Wei JN Su CC 《Journal of diabetes and its complications》2012,26(4):296-300
BackgroundTo evaluate the relationship between hemoglobin A1c variability and all-cause mortality in type 2 diabetic patients.MethodsThis was a retrospective cohort study in type 2 diabetic patients followed for at least 2 years between 2003 and 2009. A1C variability was determined from the standard deviation or coefficient of variation of serial A1C values (A1CSD or A1CCV). Subjects were categorized into either the high or low A1C variability group according to their A1CCV median. Hazard ratios (HRs) of various factors for all-cause mortality were determined from Cox's proportional hazard models.ResultsA total of 881 subjects (422 men, 459 women) were included and 73 (8.3%) died during follow-up. The follow-up period was 4.7 ± 2.3 years. All-cause mortality was higher in subjects with high A1CCV (11.0% vs. 5.4%, p = 0.002). In the Kaplan–Meier failure curve, subjects with higher A1CCV demonstrated a trend of higher mortality (p = 0.1). In multivariate Cox's proportional hazards models, A1CSD and A1CCV significantly predicted all-cause mortality with an HR of 1.987 (p = 0.02) and 1.062 (p = 0.013), respectively, after adjusting for age, gender, body mass index, duration of diabetes, mean systolic blood pressure, use of antihypertensives and statins, mean LDL-cholesterol, smoking status, chronic kidney disease, and mean A1C values (A1CMEAN). The ability of A1CSD and A1CCV to predict all-cause mortality was more evident in subjects with relatively low A1CMEAN.ConclusionsA1C variability is an important risk factor for all-cause mortality in type 2 diabetic patients. 相似文献
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Meng-Ying Hsieh Oi-Wa Chan Jainn-Jim Lin Kuang-Lin Lin Shao-Hsuan Hsia Huei-Shyong Wang Cheng-Hsun Chiu 《Brain & development》2013
Background: Guillain–Barré syndrome and myasthenia gravis both lead to muscle weakness but the two combined is uncommon. Detection of these entities can help identify forms of autoimmune neuromuscular diseases that may respond to immunotherapy. This report sought to characterize the clinical features of these two entities when combined. Methods: This report is of a case of combined Guillain–Barré syndrome and myasthenia gravis. The clinical features were analyzed and correlated to those published in English literature from 1960 to 2012. Ten reports and 12 cases, including the present case, were reviewed. Results: There were 12 patients (4 women and 8 men), aged 17 to 84 years, with combined Guillain–Barré syndrome and myasthenia gravis. Four had post-infectious Guillain–Barré syndrome followed by the development of myasthenia gravis concurrently or concomitantly within one month. All cases had symptoms of ptosis and areflexia. The other common presentations were limb weakness, oculobulbar weakness, and respiratory involvement. Functional outcome was mentioned in 10 patients and seven had good outcome (Hughes scale ?2). Conclusion: Detection of ptosis with or without ophthalmoplegia, distribution of limb weakness, and reflex can help in recognizing combined Guillain–Barré syndrome and myasthenia gravis. The early recognition of this combination of peripheral nervous and neuro-muscular junction inflammation is important for initial treatment and prognosis. 相似文献
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