Ten-year incidence of diabetic retinopathy and macular edema. Risk factors in a sample of people with type 1 diabetes

Aims

To determine the 10-year incidence of diabetic retinopathy (DR) and macular edema (DME), and its relationship with its risk factors in a sample of type 1 diabetes mellitus.

Methods

A total of 334 patients without diabetic retinopathy at baseline underwent a 10-year prospective study, the risk factors included: age, gender, diabetes duration, HbA1c, LDL-C, HDl-C, TC/HDL-C ratio, ApoA1, ApoB, ApoB/ApoA1 ratio, and triglycerides were recorded. Risk factors for diabetic macular edema (DME) were also recorded.

Results

The 10-year incidence of any DR was 35.90%, and 11.07% developed DME. The risk factors for DR and DME were: diabetes duration, high glycosylated level, and arterial hypertension, and overt nephropathy was well correlated with DME. The lipid study demonstrated that ApoB/ApoA1 ratio was significant for any DR [HRR: 0.594 (0.416-0.848), p = 0.01], and DME [HRR: 0.601 (0.433-0.894), p = 0.009]. The TC/HDL ratio was only significant for DME [HRR: 0.624 (0.440-0.886), p = 0.008]; other lipids values were not significant for any groups studied.

Conclusions

In the present study, the ApoB/ApoA1 ratio was significant to the 10-year incidence of diabetic retinopathy and to macular edema; and the TC/HDL ratio was significant to a 10-year incidence of macular edema.     

Type 2 diabetes risk in persons with dysglycemia: the Framingham Offspring Study

Aims

Detection of risk of type 2 diabetes mellitus (T2DM) among adults with dysglycemia.

Methods

We used a nested case-cohort prospective design to estimate risk of new diabetes (diabetes treatment or FPG ≥7.0 mmol/L) among 1004 Framingham Heart Study Offspring with baseline dysglycemia [fasting plasma glucose (FPG) 5.4-6.9 mmol/L and/or 2-h post glucose load level 7.8-11.0 mmol/L]. Using clinical characteristics previously shown to predict incident T2DM, we used logistic regression to estimate odds ratios (OR), p-values for predictors, and assessment of model discrimination.

Results

At the end of 7 years follow-up there were 118 incident T2DM cases. In a model that included age, sex, elevated blood pressure or blood pressure treatment, lipid-lowering treatment and elevated triglycerides, we found the following additional characteristics to be independently associated with new T2DM: parental history of diabetes (OR 2.28, p = 0.004); excess adiposity (BMI ≥ 30 kg/m² or waist circumference ≥101.6 cm) (OR 2.04, p = 0.0005), and low HDL-C [<1.0 (men) or <1.3 mmol/L (women)] (OR 2.77, p < 0.0001). The multivariable C-statistic for this model was 0.701, and with glycemic category information included, c = 0.751.

Conclusions

The key non-glycemic traits that predicted later T2DM in adults with dysglycemia were parental history of diabetes, excess adiposity and low HDL-C.     

心房颤动患者血浆高密度脂蛋白胆固醇水平变化的临床研究

目的 探讨血浆高密度脂蛋白胆固醇(HDL-C)水平与心房颤动之间的关系.方法 研究对象为135例房颤患者,按能否自行复律分为阵发性房颤组及非阵发性房颤组,并选择同期健康人群30例作为对照组.非阵发性房颤组又分别按左心房内径(LAD＞35 mm,LAD≤35mm)分成亚组,测量所有房颤及正常对照组患者的血浆HDL-C的水...     

运动和限食对肥胖大鼠体脂及血清HDL-C和HL活性的影响

目的：探讨运动和限食干预对食源性肥胖大鼠体脂及血清高密度脂蛋白胆固醇（HDL-C）和肝脂酶（HL）活性的影响。方法：肥胖模型建立后将32只肥胖大鼠随机分为对照组、限食组、运动组、运动＋限食组。各组继续喂食高脂饲料,限食组喂食量为对照组的80%。游泳运动,5周,6 d/周,90 min/d。最后一次运动结束后60 h宰杀大鼠,测量体重、肾脏周围脂肪重量、附睾周围脂肪重量,血清HDL-C浓度和HL活性。结果：（1）对体重降低的影响：限食（P〈0.01）、运动（P〈0.001）有显著作用;运动与限食之间无协同作用（P〉0.05）。（2）对内脏脂肪重量降低的影响：限食无显著影响（P〉0.05）;运动影响作用显著,大鼠肾脏周围脂肪（P〈0.05）和附睾周围脂肪重量（P〈0.01）降低;运动与限食之间无协同作用（P〉0.05）。（3）对于血清HDL-C浓度升高的影响：限食（P〈0.05）、运动（P〈0.01）有显著作用;且运动与限食在大鼠血清HDL-C浓度升高的变化中产生了协同作用（P〈0.01）。（4）对于血清HL活性降低的影响：限食作用不显著（P〉0.05）;运动影响作用显著（P〈0.05）;运动与限食之间无协同作用（P〉0.05）。结论：在不改变膳食结构的前提下,运动和限食能够显著降低肥胖大鼠体重,对内脏脂肪的堆积产生抑制作用,提高肥胖大鼠血清HDL-C浓度同时降低HL活性,降低发生动脉硬化病变的风险。     

One hundred percent orange juice consumption is associated with better diet quality, improved nutrient adequacy, and no increased risk for overweight/obesity in children

The purpose of this study was to examine the association of 100% orange juice (OJ) consumption by children 2 to 18 years of age (n = 7250) participating in the 2003 to 2006 National Health and Nutrition Examination Survey with intakes of select nutrients, MyPyramid food groups, diet quality—measured by the Healthy Eating Index-2005, weight status, and associated risk factors. The National Cancer Institute method was used to estimate the usual intake of 100% OJ consumption, selected nutrients, and MyPyramid food groups. Percentages of the population below the Estimated Average Requirement were determined. Covariate adjusted logistic regression was used to determine if consumers had a lower odds ratio of being overweight or obese. Usual per capita intake of 100% OJ was 1.7 oz/d. Among consumers, the usual intake of 100% OJ for children (n = 2183; 26.2% of population) was 10.2 oz/d. Consumers had higher (P < .05) energy intakes than nonconsumers (9148 ± 113 vs 8625 ± 473 kJ). However, there were no differences in weight or body mass index in consumers and nonconsumers, and there was no significant difference in the risk of being overweight or obese between consumers and nonconsumers (odds ratio, 0.86; 95% confidence interval, 0.70-1.05). Compared with nonconsumers, consumers had a higher (P < .01) percentage (% ± SE) of the population meeting the Estimated Average Requirement for vitamin A (19.6 ± 2.0 vs 30.2 ± 1.4), vitamin C (0.0 ± 0.0 vs 29.2 ± 1.2), folate (1.3 ± 0.3 vs 5.1 ± 0.6), and magnesium (25.5 ± 2.0 vs 39.0 ± 11). The Healthy Eating Index-2005 was significantly (P < .01) higher in consumers (52.4 ± 0.4 vs 48.5 ± 0.3). Consumers also had higher intakes of total fruit, fruit juice, and whole fruit. Moderate consumption of 100% OJ should be encouraged in children as a component of a healthy diet.     

Association of an HDL Apolipoproteomic Score With Coronary Atherosclerosis and Cardiovascular Death

Background

Concentrations of circulating apolipoproteins are strongly linked to risk for coronary artery disease (CAD). The relative importance of the additional knowledge of apolipoprotein concentrations within specific lipoprotein species for CAD risk prediction is limited.

甘油三酯与高密度脂蛋白胆固醇比值和H型高血压的相关性研究

目的 探讨在原发性高血压患者中甘油三酯与高密度脂蛋白胆固醇比值与H型高血压的关系。方法 采取多阶段整群随机抽样的方法,以湖南省6个城市的社区人群作为研究对象。采取问卷调查、体格检查、实验室检查的方式来收集研究对象的资料。采用回归分析的统计学方法分析甘油三酯与高密度脂蛋白胆固醇比值与H型高血压的效应值大小。结果 本研究共纳入1 538名高血压患者,其中H型高血压患者共有1 311人（85.24%）,男性766人（49.80%）。TG/HDL - C与H型高血压的关系呈现倒U型的曲线关系。通过阈值效应分析得出:模型1与模型2的对数似然比检验结果具有统计学意义（P = 0.003）,进一步证实了TG/HDL - C与H型高血压之间是曲线关系。在模型2中可知:在拐点2.22之前,TG/HDL - C每增加一个单位发生H型高血压的风险增加52%（OR = 1.52, 95% CI = 1.16, 2.00, P = 0.002）;在拐点2.22之后,TG/HDL - C每增加一个单位发生H型高血压的风险降低3%（OR = 0.97, 95% CI = 0.90, 1.04, P = 0.401）。结论 在原发性高血压的患者中TG/HDL - C与H型高血压呈现倒U型的曲线关系,并存在饱和阈值效应。