Background: Patients with type 2 diabetes (T2DM) have an increased prevalence of dyslipidemia, which contributes to their high risk of cardiovascular diseases (CVDs). This study is an attempt to determine the correlation between hemoglobin A1c (HbA1c) and serum lipid profile and to evaluate the importance of HbA1c as an indicator of dyslipidemia in Afghani patients with T2DM. Methods: A total of 401 Afghani patients with T2DM (men, 175; women, 226; mean age, 51.29 years) were included in this study. The whole blood and sera were analyzed for fasting blood sugar (FBS), HbA1c, total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines. Diabetes was defined as per American Diabetes Association criteria. The correlation of FBS, HbA1c with lipid ratios and individual lipid indexes were analyzed. The statistical analysis was done by SPSS statistical package version 16.0. Results:The mean age ± standard deviation of male and female patients were 51.71 ± 11.70 and 50.97 ± 10.23 years respectively. There was a significant positive correlation between HbA1c, TC, TG, LDL-C and LDL-C/HDL-C ratio. The correlation between HbA1c and HDL-C was negative and was statistically nonsignificant. Furthermore, HbA1c was found to be a predictor of hypercholesterolemia, LDL-C and TG via a linear regression analysis. Patients with HbA1c value greater than 7.0% had significantly higher value of cholesterol, LDL-C, and LDL-C/HDL-C ratio compared with patients with an HbA1c value up to 7.0%. Conclusions: Apart from a reliable glycemic index, HbA1c can also be used as a predictor of dyslipidemia and thus early diagnosis of dyslipidemia can be used as a preventive measure for the development of CVD in patients with T2DM.

Reducing acquisition time may improve patient throughput, increase camera efficiency, and reduce costs; reducing acquisition time also increases image noise. Newly available software controls the effects of noise by maximum a posteriori reconstruction while maintaining resolution with resolution-recovery methods. This study compares half-time (HT) gated myocardial SPECT images processed with ordered-subset expectation maximization with resolution recovery (OSEM-RR) (with and without CT-based attenuation correction [AC]) with full-time (FT) images obtained with a standard clinical protocol and reconstructed with filtered backprojection (FBP) and OSEM (with and without AC). Methods: A total of 212 patients (mean age, 57 y; age range, 27-86 y) underwent 1-d rest/stress 99m Tc-tetrofosmin gated SPECT. FT (12.5 min, both rest and stress) and HT (rest, 7.5 min; stress, 6.0 min) images were acquired with low-dose CT for AC in 112 patients. HT acquisitions were processed with OSEM-RR (with and without AC) using software, and FT acquisitions were processed with FBP and OSEM (with and without AC). In another 100 patients, test-retest repeatability was assessed using 2 sets of FT images (FBP reconstruction) that were acquired one immediately after the other. Radiologists unaware of the acquisition and reconstruction protocols visually assessed all reconstructed images for summed stress, summed rest, and summed difference scores and regional wall motion using a 17-segment model. Automated analysis on gated SPECT was used to determine left ventricular volumes, ejection fraction, and dilation (end-diastolic volume, end-systolic volume, left ventricular ejection fraction, and transient ischemic dilation [TID]). A clinical diagnosis was also determined. Results: All measurements resulted in significant correlations (P , 0.01) between the HT and FT images. The only significant difference in mean values was for OSEM-RR plus AC; this method led to an increase in TID by 4% over FT imaging. The concordance in the clinical diagnosis for HT versus FT was 106 to 112 (k 5 0.88) for no AC and 102 to 106 (k 5 0.91) for AC, similar to the repeatability of FT versus FT (98/100, k 5 0.95). Conclusion: HT images processed with the new algorithm provided a clinical diagnosis in concordance with that from FT images in 95% (no AC) to 96% (AC) of cases. This concordance is similar to the test-retest repeatability of FT imaging.

BackgroundWe define the repeatability coefficients (RC) of key quantitative and visual perfusion and function parameters that can be derived by the QGS/QPS automated software and by expert visual observer from gated myocardial perfusion SPECT (MPS) scans.MethodsStandard QGS/QPS algorithms have been applied to derive quantitative perfusion and function parameters in 200 99mTc-tetrofosmin rest/stress MPS scans, obtained in 100 consecutive patients who underwent 2 separate gated rest/stress scans on the same camera. Variables included stress, rest, and ischemic total perfusion deficit (TPD), ejection fraction, motion, and thickening. Visual perfusion/motion scores were derived by an expert reader using randomized scan order and normalized to % myocardium.ResultsQuantitative and visual parameters were highly reproducible with smaller RC for some quantitative measures as compared to visual measures (P < .0001). RC for quantitative measures were 3.3% for stress TPD, 1.8% for rest TPD, and 3.2% for ischemic TPD and for visual scoring 4.8% for stress, 3.8% for rest, and 4.3% for ischemic (P ≤ .002). The results in each vessel territory showed that in the right coronary artery (RCA) territory the quantitative approach had improved reproducibility as compared to visual reading. Visual thickening scoring was more reproducible than motion scoring (P < .0001).ConclusionsThis study demonstrates that standard perfusion and function parameters derived from MPS by visual or quantitative analysis are highly reproducible with some advantages to the quantitative approach.

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