Combined past preeclampsia and gestational diabetes is associated with a very high frequency of coronary microvascular dysfunction

Kul, Şeref; Güvenç, Tolga Sinan; Baycan, Ömer Faruk; Çelik, Fatma; Çalışkan, Zuhal; Güvenç, Rengin Çetin; Çiftçi, Faika Ceylan; Çalışkan, Mustafa

doi:10.1016/j.mvr.2020.104104

Cited by 18 publications

(19 citation statements)

References 26 publications

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“…Consistent with the previous studies [ 27 , 28 ], the present study demonstrated that hypertension was strongly associated with both incidence and severity of PD following TJA, and this condition was especially in patients with moderate to severe hypertension. According to the previous studies [ 29 , 30 ], hypertension is significantly associated with increased endothelial dysfunction and atherosclerosis, thus leading to an increased risk of cerebral embolization. As a result, the inhibited cerebral blood flow caused by cerebral atherosclerosis and postsurgical inflammatory changes results in postoperative PD [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Preoperative prognostic nutritional index is useful factor for predicting postoperative delirium after primary total joint arthroplasty

Chen

Zheng

Zhong³

et al. 2021

BMC Musculoskelet Disord

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Background Postoperative delirium (PD), as an acute brain failure, is widely reported as a very common postoperative complication, and it is closely associated with increased morbidity and mortality. Recently, malnutrition is reported as one of the risk factors for PD. The prognostic nutritional index (PNI) is a simple method for nutritional evaluation. However, few studies have discussed the effectiveness of PNI as a nutritional assessment in predicting PD after primary total joint arthroplasty (TJA). The aim of this study is to investigate potential risk factors including PNI for PD following primary TJA. Methods A retrospective analysis of 994 patients was performed to identify risk factors associated with PD after primary TJA by using univariate and multivariate analyses. A receiver operating characteristic curve and the area under the curve were applied to evaluate the significant results of the multivariate analysis and the optimal cutoff value (CV). Results Postoperatively, sixty-seven patients (67/994, 6.7 %) experienced PD. Univariate analysis demonstrated that operative time, duration of anesthesia, age, hypertension, serum albumin, and PNI differed between the PD and non-PD groups (P < 0.05). Multivariate logistic regression analysis showed that the preoperative PNI (odds ratio [OR]: 0.908; 95 % confidence interval [CI]: 0.840–0.983; CV: 47.05), age of patients (OR: 1.055; 95 % CI: 1.024–1.087; CV: 73.5 years), and hypertension (OR: 1.798; 95 % CI: 1.047–3.086), were independently associated with PD (P < 0.05). Conclusions A low preoperative PNI associated with malnutrition was demonstrated to be an independent risk factor for PD following primary TJA. Patients with preoperative low PNI should be cautioned and provided with adequate nutritional intervention to reduce postoperative PD.

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Section: Discussionmentioning

confidence: 99%

Preoperative prognostic nutritional index is useful factor for predicting postoperative delirium after primary total joint arthroplasty

Chen

Zheng

Zhong³

et al. 2021

BMC Musculoskelet Disord

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show abstract

“…Consistent with the previous studies [27,28], the present study demonstrated that hypertension was especially associated with PD following TJA. According to the previous studies [29,30], hypertension is signi cantly associated with increased endothelial dysfunction and atherosclerosis, thus leading to an increased risk of cerebral embolization. As a result, the inhibited cerebral blood ow caused by cerebral atherosclerosis and postsurgical in ammatory changes results in postoperative PD [23].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Prognostic Nutritional Index Is Useful Factor for Predicting Postoperative Delirium After Primary Total Joint Arthroplasty

CHEN

Zheng

et al. 2020

Preprint

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Background:Postoperative delirium (PD), as an acute brain failure, is widely reported as a very common postoperative complication, and it is closely associated with increased morbidity and mortality. Recently, malnutrition is reported as one of the risk factors for PD. The prognostic nutritional index (PNI) is a simple method for nutritional evaluation. However, few studies have discussed the effectiveness of PNI as a nutritional assessment in predicting PD after primary total joint arthroplasty (TJA). The aim of this study is to investigate potential risk factors including PNI for PD following primary TJA. Methods:A retrospective analysis of 994 patients was performed to identify risk factors associated with PD after primary TJA by using univariate and multivariate analyses. A receiver operating characteristic curve and the area under the curve were applied to evaluate the significant results of the multivariate analysis and the optimal cutoff value (CV). Results:Postoperatively, sixty-seven patients (67/994, 6.7%) experienced PD. Univariate analysis demonstrated that operative time, duration of anesthesia, age, hypertension, serum albumin, and PNI differed between the PD and non-PD groups (P<0.05). Multivariate logistic regression analysis showed that the preoperative PNI (odds ratio [OR]: 0.908; 95% confidence interval [CI]: 0.840-0.983; B: -0.096; CV: 47.05), age of patients (OR: 1.055; 95% CI: 1.024-1.087; B: 0.053; CV: 73.5 years), and hypertension (OR: 1.798; 95% CI: 1.047-3.086; B: 0.586), were independently associated with PD (P<0.05). Conclusions: A low preoperative PNI associated with malnutrition was demonstrated to be an independent risk factor for PD following primary TJA. Patients with preoperative low PNI should be cautioned and provided with adequate nutritional intervention to reduce postoperative PD.

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“…One study in Canada reported that having both APOs was associated with more than an additive effect on diabetes mellitus, hypertension, and CVD when compared with having neither GDM nor preeclampsia after six months of delivery [ 30 ]. Furthermore, a recent study with a small population that was conducted in Turkey also proved that patients with a combination of GDM and preeclampsia had a higher prevalence of CHD than patients with only GDM [ 31 ]. Unlike these previous studies, the present study failed to prove the additive effect of the combination of GDM and preeclampsia on chronic diseases.…”

Section: Discussionmentioning

confidence: 99%

“…This may be due to differences in the study population and the duration of the follow-up period. One of these previous studies [ 30 ] had a limitation in that it was comprised of women with various ethnocultural backgrounds, and the other study [ 31 ] had the limitation of a small sample size. Moreover, these studies had a shorter follow-up period of CVD evaluation after delivery than that in the present study.…”

Section: Discussionmentioning

confidence: 99%

Adverse Pregnancy Outcomes and Maternal Chronic Diseases in the Future: A Cross-Sectional Study Using KoGES-HEXA Data

Cho

Kim

et al. 2022

JCM

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Adverse pregnancy outcomes (APOs) are associated with an increased risk of chronic diseases, including cardiovascular disease (CVD) and metabolic syndrome (MS), in the future. We designed a large-scale cohort study to evaluate the influence of APOs (preeclampsia, gestational diabetes mellitus (GDM), stillbirth, macrosomia, and low birth weight) on the incidence of chronic diseases, body measurements, and serum biochemistry in the future and investigate whether combinations of APOs had additive effects on chronic diseases. We used health examinee data from the Korean Genome and Epidemiology Study (KoGES-HEXA) and extracted data of parous women (n = 30,174; mean age, 53.02 years) for the analysis. Women with APOs were more frequently diagnosed with chronic diseases and had a family history of chronic diseases compared with women without APOs. Composite APOs were associated with an increased risk of hypertension, diabetes mellitus, hyperlipidemia, angina pectoris, stroke, and MS (adjusted odds ratio: 1.093, 1.379, 1.269, 1.351, 1.414, and 1.104, respectively) after adjustment for family history and social behaviors. Preeclampsia and GDM were associated with an increased risk of some chronic diseases; however, the combination of preeclampsia and GDM did not have an additive effect on the risk. APOs moderately influenced the future development of maternal CVD and metabolic derangements, independent of family history and social behaviors.

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Combined past preeclampsia and gestational diabetes is associated with a very high frequency of coronary microvascular dysfunction

Cited by 18 publications

References 26 publications

Preoperative prognostic nutritional index is useful factor for predicting postoperative delirium after primary total joint arthroplasty

Preoperative prognostic nutritional index is useful factor for predicting postoperative delirium after primary total joint arthroplasty

Preoperative Prognostic Nutritional Index Is Useful Factor for Predicting Postoperative Delirium After Primary Total Joint Arthroplasty

Adverse Pregnancy Outcomes and Maternal Chronic Diseases in the Future: A Cross-Sectional Study Using KoGES-HEXA Data

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