Biochemical and clinical markers of endothelial dysfunction do not outweigh traditional risk factors for the presence of diabetic retinopathy in patients with type 1 diabetes

Matheus, Alessandra Saldanha de Mattos; Matta, Maria de Fátima Bevilacqua da; Clemente, Eliete L.S.; Rodrigues, Maria de Lourdes Guimarães; Valença, D.; Drummond, Karla Rezende Guerra; Gomes, Marília Brito

doi:10.1186/s13098-022-00912-y

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…When the cuff deflates, the blood flow shocks cause reactive congestion, which can be captured by RHI-PAT in time, and the signal amplitude ratio before and after blocking can be calculated by software to obtain the evaluation index of endothelial function RHI. RHI < 1.67 was considered to indicate ED 17 .…”

Section: Methodsmentioning

confidence: 99%

Lower glomerular filtration rate after mild stroke induces cognitive impairment by causing endothelial dysfunction

Shang,

Yan,

Chen

2024

Sci Rep

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The incidence of post stroke cognitive impairment (PSCI) is high in patients with mild stroke (MIS), and the risk factors and mechanism are uncertain. Increased cystatin C (CysC) levels after stroke may reflect lower glomerular filtration rate (GFR) and renal impairment. Previous studies have suggested endothelial dysfunction (ED) is closely related to renal impairment and cognitive impairment, respectively. We aimed to observe whether lower GFR estimated by CysC after MIS leaded to a high incidence of PSCI, and the role of ED in this process. 256 patients were enrolled in this prospective observational study. Renal function was assessed using GFR estimated by serum CysC. Endothelial function was evaluated by reactive hyperemia index (RHI) which calculated automatically by peripheral arterial tonometry (PAT). The cognitive function at baseline and 3 months was evaluated by MoCA score, and MoCA score ≤ 26 indicates the presence of PSCI. Spearman correlation analysis and linear regression were conducted to explore the factors affecting ED. Univariate and multivariate analysis was used to identify the independent risk factors of PSCI. The receiver operating characteristic (ROC) curve was applied to explore the optimal cutoff value of the independent risk factors levels for predicting PSCI. A total of 141 patients (55.1%) suffered from ED. Multiple linear regression analysis showed that there was a strong linear correlation between eGFRcys and RHI (p < 0.001). At the three-month follow-up, a total of 150 (58.6%) patients had been diagnosed with PSCI. Multivariate logistic regression analysis showed that RHI was an independent factor affecting the occurrence of PSCI (p < 0.05). ROC curve showed that the area under the curve was 0.724, and the optimal cut-off value of RHI was 1.655, with the sensitivity and specificity for PSCI were 72.7% and 73.6%, respectively. The lower eGFRcys level after MIS was significantly associated with ED, and ED may mediate the higher incidence of PSCI at 3 months after MIS.

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Section: Methodsmentioning

confidence: 99%

Lower glomerular filtration rate after mild stroke induces cognitive impairment by causing endothelial dysfunction

Shang,

Yan,

Chen

2024

Sci Rep

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“…In a comparative study examining the significance of adhesion molecules (sVCAM-1 and sICAM) as risk factors for the development of DR, it was found that their role does not exceed the significance of the traditional DR risk factors, such as age, high HbA1c, arterial blood pressure, and use of drugs that could interfere with endothelial function. 14 In another study, it was acquired that the level of sICAM-1 in the vitreous in PDR was higher compared to nondiabetic control samples. 27 …”

Section: Discussionmentioning

confidence: 98%

“…However, publications on the role of adhesive molecules in the pathogenesis of DR are contradictory, which requires further study of this problem. 14 – 16 …”

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confidence: 99%

Evaluation of Hypoxia and Microcirculation Factors in the Progression of Diabetic Retinopathy

Majidova

2024

Invest. Ophthalmol. Vis. Sci.

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Purpose The purpose of this study was to evaluate comparatively the changes in HIF-1ɑ, EPO, sICAM-1, hemodynamic, and electrophysiological parameters during the progression of non-proliferative diabetic retinopathy (NPDR). Methods This retrospective longitudinal study included 82 patients with NPDR, who were divided into 2 groups: group I ( n = 40) consisted of patients without progression of NPDR after 1 year and group II ( n = 42) included patients with the transition of NPDR to proliferative diabetic retinopathy (PDR). The hemodynamics of the eye was assessed by Doppler ultrasonography. The glial hypoxia index Cg was calculated using ERG. The serum levels of hypoxia-inducible factor 1-a (HIF1-α), soluble intercellular adhesion molecule-1 (sICAM-1), and erythropoietin (EPO) were determined by ELISA method. Results In group II, resistive index (RI), short posterior ciliary arteries (SPCAs) increased significantly from 0.62 ± 0.005 to 0.65 ± 0.007 ( P = 0.003), being higher than the corresponding parameter in group I ( P = 0.013). In group II, there was an increase in the hypoxia index Cg (5.56 ± 0.05) relative to the primary indicators and in group I ( P < 0.001). In group II, HIF1-ɑ, EPO, and sICAM-1 levels after a year significantly increased (0.213 ± 0.02 ng/mL, 37.7 ± 2.4 mIU/mL, and 576.3 ± 11.9 ng/mL, respectively) both relative to the main indicators and the values in group I ( P < 0.001). When EPO exceeds 27.5 mIU/mL, a high risk of progression of NPDR to the initial stages of PDR is predicted. Conclusions The glial Cg index and the level of HIF1-a, EPO in the serum of patients with progression of NPDR were initially higher than in patients without progression of NPDR and have increased during the year, indicating the development of PDR due to more severe hypoxia.

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“…provided the first evidence that HbA1c <6.1% in late pregnancy reduced the risk of pre-eclampsia in type 1 diabetic women ( 39 ). Although the mechanism of this association is not fully clear, some evidence showed that elevated HbA1c may induce endothelial dysfunction by generating superoxide anions that interfere with nitric oxide mediated response ( 40 ). Endothelial dysfunction may perturb vascular biomarkers including P-selectin, E-selectin, intercellular adhesion molecules and vascular cell adhesion molecules further impairing the vasculature ( 41 ), and thus HbA1c may be associated with hypertension.…”

Section: Discussionmentioning

confidence: 99%

Pre-pregnancy body mass index and glycated-hemoglobin with the risk of metabolic diseases in gestational diabetes: a prospective cohort study

Wang,

Zhang,

et al. 2023

Front. Endocrinol.

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BackgroundMetabolic diseases during pregnancy result in negative consequences for mothers. Pre-pregnancy body mass index (BMI) and late-pregnancy glycated-hemoglobin (HbA1c) are most important factors independently affecting the risk of gestational diabetes mellitus (GDM). However how both affect the combined risk of other metabolic diseases in women with GDM is unclear. The study aims to investigate the influence of pre-pregnancy BMI and pregnancy glycemic levels on other gestational metabolic diseases in women with GDM.MethodsPregnancies with GDM from January 2015 to December 2018 in the Xi’an longitudinal mother-child cohort study (XAMC) were retrospectively enrolled. Those without other metabolic diseases by the time of oral glucose tolerance test (OGTT) detection were finally recruited and divided into four groups by pre-pregnancy BMI (Underweight <18.5kg/m2; Normal weight 18.5-23.9 kg/m2; Overweight 24.0-27.9 kg/m2; Obesity ≥28.0 kg/m2, respectively) or two groups by HbA1c in late pregnancy (normal HbA1c<5.7%; high HbA1c≥5.7%). Multivariate logistic regression analysis was used to identify risk factors. Interaction between pre-pregnancy BMI (reference group 18.5-23.9 kg/m2) and HbA1c (reference group <5.7%) was determined using strata-specific analysis.ResultsA total of 8928 subjects with GDM were included, 16.2% of which had a composite of metabolic diseases. The pre-pregnancy overweight and obesity, compared with normal BMI, were linked to the elevated risk of the composite of metabolic diseases, particularly pre-eclampsia (both P <0.001) and gestational hypertension (both P <0.001). Meanwhile, patients with high HbA1c had an obvious higher risk of pre-eclampsia (P< 0.001) and gestational hypertension (P= 0.005) compared to those with normal HbA1c. In addition, there were significant interactions between pre-pregnancy BMI and HbA1c (P< 0.001). The OR of pre-pregnancy BMI≥ 28 kg/m2 and HbA1c≥ 5.7% was 4.46 (95% CI: 2.85, 6.99; P< 0.001). The risk of other metabolic diseases, except for pre-eclampsia (P= 0.003), was comparable between the two groups of patients with different HbA1c levels at normal pre-pregnancy BMI group. However, that was remarkably elevated in obese patients (P= 0.004), particularly the risk of gestational hypertension (P= 0.004).ConclusionPre-pregnancy overweight/obesity and late-pregnancy high HbA1c increased the risk of other gestational metabolic diseases of women with GDM. Monitoring and controlling late-pregnancy HbA1c was effective in reducing metabolic diseases, particularly in those who were overweight/obese before conception.

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Biochemical and clinical markers of endothelial dysfunction do not outweigh traditional risk factors for the presence of diabetic retinopathy in patients with type 1 diabetes

Cited by 5 publications

References 33 publications

Lower glomerular filtration rate after mild stroke induces cognitive impairment by causing endothelial dysfunction

Lower glomerular filtration rate after mild stroke induces cognitive impairment by causing endothelial dysfunction

Evaluation of Hypoxia and Microcirculation Factors in the Progression of Diabetic Retinopathy

Pre-pregnancy body mass index and glycated-hemoglobin with the risk of metabolic diseases in gestational diabetes: a prospective cohort study

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