Introduction: In Low and Middle Income Countries (LMIC) like India, either Fasting Plasma Glucose or Postprandial Plasma Glucose (FPG/PPG) estimations were adopted as surrogate alternative to Glycated Haemoglobin (HbA1c) in Type 2 Diabetes Mellitus (T2DM). However, the reliability of this correlation remains ambiguous due to lack of consensus among the previous studies. Aim: To determine the correlation of FPG and PPG as well as their calculated mean with HbA1c in T2DM subjects for monitoring glycaemic status. Materials and Methods: A single centre, retrospective, cross- sectional data survey was carried out for a sampling frame of 13 months (August 2017 to August 2018) encompassing 1268 T2DM subjects. The data was collected during September 2018 to March 2019 and subsequently analysed during April 2019 to August 2019. The analysis was carried out in two approaches. In the first approach: the data was segregated into two major groups and six subgroups to understand relative concordance and discordance percentage; sensitivity, specificity and accuracy; and absolute and percentage difference recruiting relevant statistical tools. In the second approach, Area Under Curve (AUC) of Receiver Operating Characteristic (ROC) curves were employed to understand changes in FPG/PPG/calculated mean with increasing severity of T2DM. Results: With increasing severity of T2DM (HbA1c), not only gradual exacerbation of underestimation in FPG and overestimation in PPG but also declination of sensitivity in either of them was apparent. Though calculated mean of FPG and PPG measurements appended with intermittent features yet mimics PPG. AUC of ROC analysis revealed relatively high PPG levels at lower HbA1c levels and its replacement with FPG with increasing HbA1c levels. Conclusion: An integrated utility of both FPG and PPG as tuning tools of treatment modalities to achieve desired HbA1c levels in T2DM could be a promising approach.

Introduction: Recent exploratory proteomics study reported increased blood levels of Fetuin B (FETUB) in Chronic Obstructive Pulmonary Disease (COPD). Growing body of evidence demonstrates fibrinogen not only as acute phase reactant but also possesses features advocating as biomarker of COPD. Aim: To determine the blood levels of FETUB and fibrinogen independently as well as in combination COPD and among severity of COPD. Materials and Methods: A single-centred cross-sectional study of eight months duration was conducted during May to December 2017. A total of 76 blood samples (38 COPD patients and 38 controls) were recruited. Based on distribution, parametric and non parametric statistical tools were used. Analysis of co-variance and multiple multivariate linear regression models were utilised to assess the influence of clinical data on FETUB. Steel-Dwass-Critchlow- Fligner method was employed for multiple pairwise comparisons. Receiver Operating Characteristic (ROC) curve were generated to compute cut-off of FETUB, fibrinogen and their combination. Results: The median age of subjects were 57 years with an IQR of 50-66 years for controls whereas 58 years (IQR 50-65 years) for COPD subjects. In comparison to controls, a significant increase in blood levels of both FETUB and fibrinogen in COPD and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages of COPD was prominent. Among COPD grades, differences of FETUB levels were significant in GOLD I vs II and GOLD IV vs I, II and III whereas fibrinogen levels in GOLD III from GOLD IV. FETUB showed independent correlation with Forced Expiratory Volume (FEV) 1% pred and severity of COPD. A moderate improvement in combined (FETUB+fibrinogen) analysis of control vs COPD was noticed. Conclusion: The present study demonstrates significant increase in blood levels of FETUB in COPD and among the severity of COPD in comparison to fibrinogen. Hence, FETUB can be a more promising probable inflammatory biomarker in COPD.

Background The most popular Friedewald formula (FF) was tailored with a fixed factor of 5 for triglyceride-very low-density lipoprotein cholesterol (TGL:VLDL-C) ratio. Some of the subsequent studies on diverse population demonstrated modified FF with only altered TGL:VLDL-C ratio, comprising either a fixed or an adjustable factor. Hata and Nakajima as well as Puavilai et al proposed fixed factors of 4 and 6, respectively. Recently, Martin et al recommended an adjustable factor derived as N-strata-specific median TGL:VLDL-C ratio based on TGL and non-high-density lipoprotein cholesterol (non-HDL-C). Aim This comparative retrospective study evaluates the efficacy of LDL-C formulae, varying only in TGL-VLDL-C ratio, using direct LDL-C assay as a reference method in a tertiary care hospital. Materials and Methods A total of 1,747 patient records with lipid profile data were procured. Concordance analysis, absolute difference, and post hoc test were employed as analytical tools. The impact of total cholesterol (TChol), TGL, and HDL-C on formulae was also evaluated. Results Overall, Martin equation had relatively the highest concordance, narrowest absolute difference, and minimal influence of TChol, TGL, and HDL-C. On the contrary, the Hata method revealed comparatively the lowest concordance, widest absolute difference, and high influence of TChol, TGL, and HDL-C. The remaining formula-based approaches, that is, FF and Puavilai calculation, executed mostly inconsistent intermittent features between Martin equation and Hata method. Conclusions Relatively dominant and competitive analytical attributes of the Martin equation with an adjustable TGL:VLDL-C factor outweigh the remaining three formulae-based methods with fixed TGL:VLDL-C factor in Indian adults.