1.
The importance of measurement of plasma fibrinogen level among patients with type- 2 diabetes mellitus.
Abdul Razak, MK, Sultan, AA
Diabetes & metabolic syndrome. 2019;(2):1151-1158
Abstract
BACKGROUND & AIM: Fibrinogen has been implicated as a cause of atherosclerosis and its complications in patients with type 2 DM. We aimed to measure the plasma fibrinogen level in type 2 diabetics and to correlate it with the duration, type of treatment, HbA1c, smoking, lipid profile, diabetic retinopathy, hypertension and ischemic heart disease in comparison to control. METHODS A case control single center study included 50 patients with type 2 DM between the ages of 35-85 y who were randomly selected from the medical units of Baghdad Teaching Hospital compared to 30 non-diabetics as a control. After taking verbal consents; plasma fibrinogen levels were estimated and correlated with aimed variables. Odds ratios with 95% CI were calculated and regression analysis was performed for correlations. P ≤ 0.05 was considered statistically significant. RESULTS There were statistically significant differences regarding total cholesterol, TG, and LDL between cases and control. Mean HbA1c of diabetics was 8.31 ± 1.75% (P < 0.001). Cases showed plasma fibrinogen of (4.01 ± 1.89 g/dL) compared to (2.79 ± 0.55 g/dL) of control (P < 0.001). ROC curve revealed that the AUC was (0.679 ± 0.06, 95%CI = 0.561-0.797, P < 0.008). The sensitivity and specificity of the test at cut off value of 3.05 g/dL were 0.62 and 0.567 respectively. There was a significant correlation between fibrinogen level and each of HbA1c (r = 0.497, P < 0.001) and TG (r = 0.359, P = 0.01). CONCLUSIONS HbA1c has a significant positive effect on plasma fibrinogen and it is important to measure plasma fibrinogen level in patients with type 2 DM.
2.
Clinical correlation between N-terminal pro-B-type natriuretic peptide and angiographic coronary atherosclerosis.
Ribeiro, DG, Silva, RP, Barboza, DR, Lima-Júnior, RC, Ribeiro, RA
Clinics (Sao Paulo, Brazil). 2014;(6):405-12
Abstract
OBJECTIVES This study aimed to investigate the clinical correlation between angiographic coronary atherosclerosis and N-terminal pro-B-type natriuretic peptide along with other known correlated factors. METHODS In total, 153 patients with a diagnostic hypothesis of stable angina, unstable angina or acute myocardial infarction were classified as group A (patients with angiographically normal coronary arteries) or group B (patients with angiographic coronary atherosclerosis). The two groups were analyzed with respect to the following factors: gender, age, body mass index, abdominal circumference, smoking, diabetes mellitus, arterial hypertension, early family history of atherosclerosis, statin use, the presence of metabolic syndrome, clinical presentation and biochemical factors, including cholesterol, creatinine and fibrinogen plasma concentrations, monocyte counts and N-terminal pro-B-type natriuretic peptide. RESULTS Univariate analyses comparing the two groups revealed that group B patients more frequently had diabetes, used statins and had systolic dysfunction, N-terminal pro-B-type natriuretic peptide levels ≥ 250 pg/mL, fibrinogen levels >500 mg/dL and ≥ 501 monocytes/mm3 compared with group A patients (p<0.05). Nevertheless, multivariate logistic regression analysis demonstrated that the independent predictors of angiographic coronary atherosclerosis were an N-terminal pro-B-type natriuretic peptide level ≥ 250 pg/mL, diabetes mellitus and increased monocyte numbers and fibrinogen plasma concentration, regardless of the creatinine level or the presence of systolic dysfunction. CONCLUSIONS An N-terminal pro-B-type natriuretic peptide plasma concentration of ≥ 250 pg/mL is an independent predictor of angiographic coronary atherosclerosis.
3.
Effects of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: a controlled clinical trial.
López, NJ, Quintero, A, Casanova, PA, Ibieta, CI, Baelum, V, López, R
Journal of periodontology. 2012;(3):267-78
Abstract
BACKGROUND The systemic inflammation in both metabolic syndrome (MetS) and periodontitis is a common denominator of the association of these conditions with higher risk of atherosclerosis. The current study investigates whether periodontal therapy may reduce systemic inflammation in patients with MetS and reduce cardiovascular risk. METHODS A parallel-arm, double-blind, randomized clinical trial of 1-year duration in patients with MetS and periodontitis was conducted. Participants were randomized to an experimental treatment group (ETG) (n = 82) that received plaque control and root planing plus amoxicillin and metronidazole or to a control treatment group (CTG) (n = 83) that received plaque control instructions, supragingival scaling, and two placebos. Risk factors for cardiovascular disease were recorded; serum lipoprotein cholesterol, glucose, body mass index (BMI), C-reactive protein (CRP) and fibrinogen concentrations, and clinical periodontal parameters were assessed at baseline and every 3 months until 12 months after therapy. The primary and secondary outcomes were changes in CRP and fibrinogen levels, respectively. RESULTS The baseline patients' characteristics of both groups were similar. No significant changes in lifestyle factors, frequency of hypertension, BMI, serum lipoprotein cholesterol, and glucose levels were observed during the study period. The periodontal parameters significantly improved in both groups 3 months after therapy (P = 0.0001) and remained lower than baseline up to 12 months. The improvement of periodontal status was significantly greater in the ETG (P = 0.0001). A multiple linear regression analysis, controlled for sex, smoking, hypertension, and extent of periodontitis, demonstrated that CRP levels decreased with time and that this reduction was significant at 9 (P = 0.024) and 12 (P = 0.001) months in both groups, without difference between the groups. Fibrinogen levels significantly decreased in the ETG at 6 and 12 months but not in the CTG. CONCLUSION Reduction of periodontal inflammation either with root planing and systemic antibiotics or with plaque control and subgingival scaling significantly reduces CRP levels after 9 months in patients with MetS.
4.
Changes of protein kinetics in nephrotic patients.
Castellino, P, Cataliotti, A
Current opinion in clinical nutrition and metabolic care. 2002;(1):51-4
Abstract
Nephrotic patients show various abnormalities in protein kinetics. Plasma albumin levels and the total plasma albumin pool are reduced. The rate of hepatic absolute and fractional albumin synthesis are increased. Transferrin synthesis is also increased. Fibrinogen levels are elevated in nephrotic syndrome because of an increase in the hepatic synthesis. Regulation of albumin and fibrinogen synthesis seems to be coordinated. A low protein diet has been proposed as a therapeutic tool in nephrotic patients--clinical studies have shown that such a diet reduces proteinuria and increases renal survival. Nephrotic patients can adapt to moderate protein restriction with no sign of malnutrition and maintenance of a neutral nitrogen balance. Albumin and fibrinogen synthesis are ameliorated by dietary protein restriction and these changes are correlated with the beneficial effect of the diet on proteinuria.
5.
Liver protein synthesis in physiology and in disease states.
De Feo, P, Lucidi, P
Current opinion in clinical nutrition and metabolic care. 2002;(1):47-50
Abstract
Liver protein synthesis is usually estimated in humans by measuring the synthesis rates of major exported liver proteins. Among these, the synthesis rates of albumin and fibrinogen have been more commonly studied. Recently, it was reported that several physiological stimuli such as physical exercise followed by recovery in the upright position, active and passive ascent to high altitude or life-style habits like vegetarian diet or smoking affect the synthesis rates of albumin and fibrinogen. Among disease states, the most recent literature addresses the effects of kidney diseases (hemodialysis, nephrotic syndrome), type 2 diabetes mellitus and growth hormone administration to critically ill patients and to patients undergoing laparoscopic colecystectomy. The results of these studies have clarified several aspects of the regulation of liver protein synthesis in humans and raise open questions that will stimulate the future research in the area.