Hamidreza Zakeri, Jamshid Izadi,
Volume 5, Issue 4 (17 2006)
Abstract
Background: Atherosclerosis manifests earlier and more extensive in severity among diabetic patients. It seems Homocystein is one of the accelerating factors in development of atherosclerosis and serum levels Homocystein increase in patients with coronary artery involvement. The aim of this investigation was to compare Homocystein levels between diabetic and non-diabetic patients with coronary artery disease (CAD).
Methods: As a case-control study via non-randomized sampling method we collected 33 diabetic CAD patient and 34 CAD patient with normal GTT test. All participants were matched in age, sex, family history of atherosclerosis, blood pressure, smoking, the level of triglyceride, total cholesterol, LDL-C and Body Mass Index (BMI). Fasting serum Homocystein was measured via ELISA technique and other selected variables also were assessed via conventional laboratory methods. The quantitative variables between two groups analyzed by student t-test, while the qualitative variables examined by X2. We used Pearson –spearman test for correlation analysis between two groups.
Results: 33 diabetic and non-diabetic CAD/MI cases were participated. Among diabetic and non-diabetic subjects, mean age were 59.5±10.5 and 62.5±9.5 respectively. The mean duration of diabetes was 5.4 ± 4.1years. Comparison of the mean Homocystein levels between two groups revealed a significant differences,16.2 ± 4.8 mmol/L in diabetics vs. 10.6 ± 4.8 mmol/L in non-diabetics (P<0.5). Correlation between Homocystein levels and blood glucose, uric acid, triglyceride were r≤0.69, r=0.46 and r=0.51, respectively.
Conclusion: Fasting serum Homocystein in diabetic CAD subjects were higher than non-diabetic CAD cases .Our findings may suggest that the increased level of Homocystein is correlated to high prevalence and severity of atherosclerosis among diabetic individuals.
Zahra Kashi, Shiva Borzouei, Ozra Akhi, Narges Moslemi Zadeh, Hamidreza Zakeri, Reza Mohammadpour Tahmtan, Rafat Bonafti, Leila Shahbazadeh,
Volume 6, Issue 1 (19 2006)
Abstract
Background: Detecting mothers with gestational diabetes mellitus (GDM) is not only important in prevention of prenatal morbidities but also has significant effect on neonatal and maternal long term outcomes. Today, there are screening tests for GDM but they are time-consuming and expensive, therefore it seems necessary to perform testes that are uses expensive but with higher sensitivity and specificity. The aim of this study was to determine a cut - off point of fasting plasma glucose (FPG) for screening of GDM.
Methods: 200 pregnant women referring to the perinatal clinic of Imam Khomeini hospital, (Sari – Iran) were studied. All cases with age ≥25 years old, history of recurrent abortion, GDM, preeclampsia, macrosomia, still birth, diabetes mellitus(DM) in first degree family or pre gestational body mass index ≥25kg/m2 were selected. Those with pre gestational diabetes mellitus were excluded. All of participants underwent a 50 g glucose challenge test (GCT) between the 24th and 28th gestational week. If 1- hour plasma glucose was more than 130 mg/dl, a 3- hour 100g oral glucose tolerance test (OGTT) was performed. The diagnosis of GDM was made by ADA 2006 recommendation (Carpenter and Coustan diagnostic criteria). Referring to the Receiver Operative Characteristic Curve, level of FPG having highest sensitivity and specificity in diagnosis of GDM was determined.
Results: From 200 participants, 65 women had positive GCT, of them 58 (response rate 89%) referred for 100g OGTT and 20(10%) were diagnosed GDM. Using ROC curve and under curve area of 0.853 the FBG level of 91.5 mg/dl, showed the highest sensitivity and specificity, 80% and 92% respectively in diagnosis of GDM.
Conclusion: FBG ≥ 91.5 mg/dl has good sensitivity and specificity in screening of GDM. Since this is simpler and cheaper than 50g GCT, is recommended as a screening method in diagnosis of GDM.
