Patients with metabolic syndrome, with or without AGA, were significantly more insulin resistant compared with patients with AGA with no metabolic syndrome and with healthy subjects and, therefore, no true association exists between AGA and insulin resistance.
The development of vasculopathies in diabetes involves multifactorial processes. Increased levels of platelets-derived microparticles (PMPs) have been reported in diseases associated with thrombotic risk, but few data are available in diabetes. We explored the level of PMPs in young patients with type 1 diabetes in relation to inflammation, glycemic control, micro-vascular complications and carotid intima media thickness (CIMT). Eighty children and adolescents with type 1 diabetes were divided into two groups according to the presence of micro-vascular complications and compared with 40 healthy controls. Patients were subjected to medical history, clinical examination and assessment of high-sensitivity C-reactive protein (hs-CRP), HbA1c, urinary albumin creatinine ratio (UACR), flow cytometric analysis for PMPs using anti-CD41b and CIMT. PMP levels were significantly increased in all patients with type 1 diabetes (2.92 ± 1.3%) whether with micro-vascular complications (3.46 ± 1.11%) or those without complications (2.37 ± 1.28%) compared with healthy controls (1.28 ± 0.64%; p < 0.001). CIMT was significantly elevated in all patients, and the highest levels were among those with micro-vascular complications (p < 0.001). Significant positive correlations were found between PMPs and body mass index, HbA1c, serum creatinine, total cholesterol, UACR, hs-CRP and CIMT (p < 0.05). Multiple linear regression analysis showed that HbA1c, UACR, hs-CRP and CIMT were independently related to PMPs levels in type 1 diabetes. According to Receiver operating characteristic curve analysis, the cutoff value of PMPs at 2.48% could differentiate patients with and without micro-vascular complications with a sensitivity of 80% and specificity of 73.3%. PMPs are elevated in patients with type 1 diabetes and can be considered as an early marker of micro-vascular complications and subclinical atherosclerosis.
Propionibacterium acnes in vitro susceptibility patterns differed among Egyptian patients to the commonly prescribed antibiotics with the highest to lowest resistance to clindamycin, erythromycin, oxytetracycline, doxycycline and azithromycin.
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